pain

pain mgmt intro …

Pain is what the patient says it is … but not all pain is mu-opioid responsive … Bio-Psycho-Social-Spiritual assume most acute pain is predominantly “bio” assume most chronic pain has elements of “psycho-social-spiritual” + neuropathy   pain mgmt case #1 78 female severe lower extremity ulcerations – circumferential on right diabetes, morbid obesity, s/p multiple …

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chronic pain management …

… as we have noted before, there is mounting evidence that we need to move away from just “throwing more opioids” at patients with chronic non-malignant pain syndromes … as well as those with multidimensional pain. Some resources … Alberta Hospice Palliative Care Manual (see esp. pp. 12 ff. multidimensional pain) … McBeth’s recent article …

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breaking up is painful …

… Kross et. al. in “Social rejection shares somatosensory representations with physical pain” use functional MRI to show that “rejection [recent break-up of a relationship] and physical pain are similar not only in that they are both distressing—they share a common somatosensory representation as well.” Pain is what the patient says it is … but …

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