Archive

Posts Tagged ‘Painkillers’

Feb
17

This is one of the “mystery” diseases or disorders. Those that have it report exhaustion and a constant dull ache but, no matter how many tests are performed, your doctor says there’s nothing wrong with you. The tests come back “normal”. This is frustrating and annoying because the traditional view is then to class you as a psych case. Like that’s a constructive response. So let’s start with what we know. No-one knows what triggers it. People say it comes on after both physical injuries and emotional traumas. Some researchers speculate that people can be genetically predisposed to develop it. Others believe it is a viral disease. No matter what its cause, the result is greatly increased sensitivity to pain. It’s as if the brain is overreacting to pain signals.

Once it appears, it’s a chronic condition with long-lasting pain in the muscles, ligaments and tendons. It particularly affects the back of the head, the neck, shoulders and upper chest, and the major joints in the arms, hips and legs. Your body is also likely to develop tender spots where even the slightest of touches causes pain. You lose stamina, feeling exhausted after any form of activity, no matter how trivial. Sleep is disrupted and people wake not feeling properly rested, There seems to be a gender difference with women more likely than men to develop the disorder. Estimates of the number of people who have this set of symptoms varies but the best guess is that it affects about 2% of the adult population in the US.

Because this disorder is associated with depressive conditions, it’s quite common for doctors to prescribe antidepressants. Not only does this sometimes improve the mental attitude to the continuing pain, it can also help people to get more sleep. But the main medication strategies resolve around the use of painkillers and anti-seizure drugs. Depending on the level of pain you experience, the doctor will either start you off with a relatively low-powered NSAID or pick an opioid. With a reduction in the sensitivity to pain, sleep is improved and, as side effect, this relieves the general exhaustion and improves the mood. One or two of the anti-seizure drugs initially approved and used for epilepsy have now been granted FDA approval for use in the treatment of fibromyalgia.

The best hope, however, lies in a combination of physical therapy, counseling and skelaxin. This drug is most useful because it both relaxes the musculature and acts as a sedative. This both relieves the symptoms of ache in the major muscle groups and supports better sleep. But the use of a drug on its own is not enough. A physical therapist should teach basic sets of exercises to stretch the muscles and restore tone. More importantly, a cognitive behavioral therapist should teach you coping strategies. You must learn how to get the most out of your life within the new physical limits. Positive thinking is required to strengthen the belief in your ability to improve and to avoid situations in which there might be stress. Overall, the aim should be to exercise regularly, pace yourself through the day, get enough sleep and reduce the sources of stress in your life. This combination of skelaxin and counseling is now the preferred treatment regime.

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Jan
29

If you ask any cat or dog owner, they will tell the animals are one of the family. Talk to them for a while and they will strike you as happy and well-adjusted. This might not seem significant but continuing medical research has detected a significant trend. This is not just your neighbor. It’s the majority of people who keep a pet. The most recent piece of research was presented to the International Society of Anthrozoology conference held in Kansas City this October by a team from Loyola University of Chicago.

They were testing the hypothesis that the use of dogs in a hospital environment would represent a beneficial therapy, promoting faster healing and a better rehabilitation following joint replacement surgery. Some of you will be convinced that dogs are the equivalent of disease carriers and believe they should never be allowed into a hopefully relatively sterile hospital. After all, dogs are barred from most eating places. Allowing animals into public spaces is a balancing of risks and benefits. Hospitals are not as clean as we might believe and dogs do not make what is often a bad situation any worse. In fact, their presence is proving to be great therapy and the benefits of admission now significantly outweigh keeping them out.

The team was using a number of dogs specially trained to respond positively to patients. Each animal has been taught some 40 different commands and will respond with behavior likely to soothe a patient or to motive his or her to resume movement. The exploits a fairly common reaction in humans to stroke dogs. Many of them found the feeling of fingers running on and through fur to be relaxing. When the dogs also appear to show appreciation, bonding takes place quickly and patients feel happier. Pets are stress busters. Even more significantly, this research confirms that patients going through rehabilitation with dogs healed more quickly and used 50% less painkillers than a control group who relied on human therapists for counseling and support. Regular monitoring found the pets lowered the heart rate and blood pressure of their human companions.

It’s easy to sneer at research like this, feeling people who get sappy over dogs are strange in all kinds of ways. Yet this research is not unique. There have been many studies with similar findings. The real point of interest in the latest trial is the finding that patients who are not pet owners benefit after only one period of interaction with a dog. The more regular the contact, the better the human’s physical and emotional response. This research does not, of course, suggest people should recover from serious surgery without the use of some painkillers. Tramadol will remain the standard drug for pain management. But the finding that people recover more quickly using less medication is encouraging. No matter how good tramadol, it’s better to use it only over the short term. Having a pet is clearly a good move.

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Jan
27

There is a wonderful idiom, several times used as the title to a movie and offering the comparative warning, “It shouldn’t happen to a dog.” It refers to some proposed act or omission that is so unpleasant to humans, it should not even be wished on a dog (being a mere animal, it might be expected to bear most things, but not this). Human culture has grown up with animals a part of our lives. Whether as pets, living as one of the family in our own homes, or as working beasts, we value them for “who” they are and what they can do for us. This means treating them in much the same way as humans. If they get sick, we give them our medications. Sometimes, they retaliate by acting as incubators to encourage viruses to mutate and, as with “swine” or “bird” flu, return the favor by passing us infections to which we have no resistance. But, in general, we worry about them. Even the animals we propose to eat are stuffed full of antibiotics to keep them fit and healthy. So, keeping this real, there are many protections we have put in place for our animals. The most carefully monitored rules affect horses. These powerful animals have become a key part of the gambling industry, running in races for our excitement and jumping fences for our admiration.

As with most sports, the fear is that horses dosed with stimulants and other drugs might run faster and/or jump higher. Think Barry Bonds and the debate about the use of steroids in Major League Baseball for an understanding of the passion in the world of racing and equestrian sports. At the top of the sport, the International Equestrian Federation (FEI) carried out detailed research in the early part of this century and concluded it was unsafe to allow horses to compete if they were relying on painkillers. In 2004, the Federation moved toward a zero-tolerance policy. This was approved by the Veterinary Committee and representatives of the different national bodies. The risk of seriously injuring the horses was too great and this protective care was strongly endorsed by horse-lovers around the world. Horses should only be used when they are completely fit. It’s therefore somewhat surprising to see the FEI change the policy to allow the use of a range of painkillers. Indeed, the decision has provoked outrage.

Yet, when it comes to humans, we routinely buy tramadol, dose ourselves and then carry on with sometimes energetic activities. The problem is the same as with horses. With pain suppressed, we can attempt to move normally and aggravate the existing injuries. As with everything, a balance has to be struck. Pain is inconvenient most of the time but nevertheless a useful warning when we might be overexerting ourselves. When we are recovering from injuries or learning to live within new physical limits, using tramadol is reasonable in the first stages of regaining mobility. But, in the long term, it’s better to recover muscle tone and build stamina without the help of drugs. That way, we learn coping strategies and need only use a painkiller when the pain flares up again. We are entitled to the same protection as horses.

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