Health

Pain Management Techniques After Surgery

Palliative Care Methods for Controlling Pain

palliative care is used to manage a disease or medical condition that is serious or life threatening by easing pain and other associated physical, emotional, or psychosocial symptoms

Palliative care also eases other distressing symptoms, like depression, anxiety, fatigue, insomnia, and shortness of breath. Palliative care provides advanced care planning and a support system to help you live a life that is as active, fulfilling, and as pain-free as possible.

Principles of palliative care and pain medicine

The first step in managing pain is to do a total pain assessment. You may be asked to choose a number from 0 to 10 to rank your pain, with 0 being very mild pain and 10 being the worst possible pain you could have.

Understanding opioid drugs

Opioid drugs are the most effective and commonly used drugs for moderate to severe pain. A wide range of opioid drugs is available, and they can be taken in a variety of ways. One drawback of these medicines is that, over time, you will almost certainly develop a tolerance to the one you’re taking and need higher doses to get the same effect. One way your healthcare provider may get around this problem is by switching the type, dose, or the way the drug is given.

Understanding helper drugs

These medicines, called adjuvant analgesics, can help control pain in certain situations.

How to properly manage patients’ pain

One recent evening in Denver, a man known to EMS to have a history of drug abuse was brought by ambulance to Denver General Hospital after being hit by a car. A bone in his arm was poking through his skin, but paramedics didn’t give him pain medication. “We’re familiar with him. He likes his drugs,” Christopher Colwell, M.D., an emergency physician and medical director for the Denver Fire Department and Denver Health Paramedic Division, recalls medics telling him

Colwell was appalled. The man was obviously in severe pain, yet he was being denied relief because of his drug dependency status. “It was astounding. Here was someone with a bone sticking out of his arm, whose pain should have been treated,” he says. “Yet medics were not able to step out of that and treat the patient based on his current situation rather than his history.”

Relieving pain becomes a priority

For a condition as uncomfortable and as universal as pain, it took until the mid-’90s for pain management to become a priority in hospitals. “At the time, we were really coming to full recognition of how poorly we were doing in managing patients’ pain,” says Bob Twillman, Ph.D., director of policy and advocacy for the American Academy of Pain Management in Sonora, Calif.

Research papers showed that patients with poorly treated pain were more likely to end up with chronic pain conditions, post-traumatic stress, depression, and other physical and psychological problems, while other research showed that proper pain management could help with wound healing and get people home from the hospital sooner, Twillman says. At the same time, new pharmaceuticals came on the market, providing alternative pain-relief options. “Prior to the mid-’90s, we had oxycodone (Percocet) and hydrocodone (Vicodin, Lortab) and only one long-acting opioid—morphine,” Twillman says. “But then fentanyl patches and Oxycontin became available. We had a lot more options for treating people not just with acute pain, but with longstanding pain related to cancer or other pain conditions.”

Responders reluctant to give drugs

Even as hospitals worked to better manage pain, awareness of the importance of pain management in the prehospital setting lagged. EMS has no pain-management standards as part of accreditation. (The Commission on Accreditation of Ambulance Services, or CAAS, doesn’t include a pain-management standard as part of its clinical assessment.) Nor is pain management a major part of EMS education, Taigman says. Sure, pain medications are touched on. But there are no long discussions about the role of the prehospital care provider in treating pain. “There’s a long module on reading EKGs, a super long module on trauma assessment and management, but there’s no module on pain management,” he says.

 

How to Choose the Best Over-the-Counter Pain Medicine

Pain is one of the most challenging symptoms to treat. It can be caused by many different things such as heat, cold, pressure, traction, inflammation, and nerve damage. Over-the-counter (OTC) pain medicines offer a wide variety of treatment options for the various types of pain. It’s important to understand the cause of your pain in order to choose the best medicine(s) to treat it. I’ll review some of the most common types of pain, and explain which active ingredients are best suited to provide relief.

Headaches & Migraines

Believe it or not, doctors are still not completely sure what causes headaches. The Mayo Clinic notes, “Chemical activity in your brain, the nerves or blood vessels of your head outside your skull, or muscles of your head and neck — or some combination of these factors — may play a role in primary headaches.”

The most common kind of headache is known as a “tension headache” and as the name suggests, it often feels like a tight band around your head. Asprin, ibuprofen, naproxen, and acetaminophen all are effective to treat tension headaches, but it’s important not to overuse OTC headache medicines or else you may experience headaches from the medicines themselves. According to physician resource Up to Date, “over-use headaches” can occur if you use these medicines for more than nine days over the course of a month.

Arthritis Pain

Arthritis literally means “joint inflammation” and it is one of the most common causes of pain experienced by adults. Most arthritis is due to normal “wear-and-tear” on joints and is known as osteoarthritis. There are less common types of arthritis that are caused by an autoimmune reaction to joint tissues (such as rheumatoid and psoriatic arthritis).

Muscle Pain

Muscle pain is usually caused by micro-tears in muscle fibers that stimulate nerve endings in the surrounding tissues. Nerve endings that sense inflammation, stretch and pressure exist near muscle tissue and their messages are usually perceived by the brain as dull, aching pain sensations. People experience muscle pain most commonly after exertion or exercise. In addition to oral anti-inflammatory medicines, acetaminophen, and NSAIDs, many OTC muscle pain treatments involve the application of heat, or superficial cooling and anti-inflammatory creams. The active ingredients in topical consumer products that have been found to be helpful in easing muscle pain and soreness are: menthol, camphor, methyl salicylate, capsaicin, heat wraps, and cold packs.

 

Pain Management During End-of-life

Understanding Pain During End-of-life

Unfortunately, what should be a time to spend with loved ones is all too often accompanied by severe pain. To give just one example, a report published in the American Journal of Hospice and Palliative Care revealed that for over 50% of patients with terminal cancer, their pain is managed insufficiently. Especially at the end of life, serious pain is an unnecessary distraction which can rob terminal patients of precious time with the people who they value the most

Understanding Pain Management

Pain management and palliative care has advanced greatly over the past few decades and this no longer needs to be the case. June Dahl, PhD, a professor of pharmacology at the University of Wisconsin-Madison and a founder of the American Alliance of Cancer Pain Initiatives says that over 90% and perhaps as many as 95% of terminal patients should be able to be given a significant amount of relief from their pain. While Dahl says that eliminating pain completely isn’t realistic, it is realistic for patients to expect that their pain can be minimized to the point that it could be described as 2 or 3 on a scale of 0 to 10.

Managing Pain

Pain relief should always be one of the top priorities in the treatment of terminal patients. Too much emphasis on treating other symptoms or the underlying disease in the face of a poor prognosis can mean that terminal patients will have to wait needlessly to receive hospice care and to benefit from a more aggressive pain management strategy

Where Support Is Provided

Terminally ill patients may receive hospice care in a dedicated hospice facility or, as is increasingly the case, in their own home, where patients may feel more at ease. Hospice care is provided by a team which includes doctors, nurses, physician assistants, therapists and chaplains make regular visits to the patient in their home and give instruction to family members and other caregivers on administering pain medications and comforting the patient. These hospice care specialists have also been trained on assisting patients and their loved ones to handle the emotional and mental toll of dealing with a terminal illness and end of life

Complications of Pain Management

Even with regular administration of pain medication, terminal patients may still need higher dosages at times or a change in their medication routine in order to manage their pain. Caregivers need to monitor the pain of their loved ones by asking the patient regularly about their pain and react appropriately. Pain can quickly become acute at the end of life and patients may not always volunteer this information, so it becomes especially important for caregivers to ask this important question regularly.

 

All You Need to Know About Pain Management in Hospice

When faced with a serious illness, patients are accustomed to seeking out the support of a specialist. Facing heart disease, patients want a well-trained cardiologist by their side. When diagnosing a particular type of cancer, a primary care physician will refer their patient to an oncologist with expertise in that area. For terminally ill patients, Crossroads Hospice & Palliative Care is the comfort care specialist patients need to control pain and other end-of-life symptoms.

Hospice Pain Management

Pain management is one of the primary goals of hospice care – keeping the patient comfortable and managing symptoms to ensure they have the highest quality of life for as long as they live.

Signs and Symptoms of Pain

While many patients can assess and communicate their pain levels, other patients can sometimes believe that admitting pain makes them appear weak – which is not true. In other cases, Alzheimer’s disease and other dementia make it difficult for individuals to communicate their needs. In any case, caregivers should keep an eye out for signs and symptoms that indicate their loved one is in pain.

Hospice Pain Medication Protocol

Medication is an essential tool in hospice pain management. This includes the use of opioids to control pain. Opioids work by attaching themselves to “opioid receptors” in the brain, blocking the feeling of pain. They are used to treat moderate to severe pain

Managing Emotional and Spiritual Pain

In addition to managing physical pain, the hospice pain management plan will assess the patient’s emotional and spiritual pain.

The Cheapest Dentist Or Best Dentist In Your Area

How to Find a Good Dentist: The Ultimate Guide

Moving to a new area? Not happy with your current provider but you need to schedule a dentist today? Don’t settle for the first dentist you come across. You’re putting your finances and your health on the line. The only problem is that it’s easy to get lost when you see a myriad of dentists readily available to you

How to Find a Good Dentist: Start with the Basics

Learning how to pick a dentist starts by checking the ones closest to you. Choose one that’s near your home or your office, making it easy to visit if you use public transportation. Think of how you can get to it in case of emergency as well.

What Type of Dentist Do You Need?

Next, you also have to consider the type of dentist you want. Although a general dentist might refer to themselves as a cosmetic or family dentist, these are not official specialisations.

Ask for Recommendations from Friends and Family

Chances are, friends and family will happily suggest a good dentist that they are comfortable and satisfied with. Ask them specifics of what they like about their dentists to give you a better idea of their work

Look for a Member of an Organisation

If you are relocating to a new city, your current dentist may have a recommendation too. Dentists working within an association could know someone in the city you’re moving to.

 

TIPS FOR FINDING A DOCTOR OR DENTIST

When you have a rare disorder like ectodermal dysplasia, it’s not easy to find a doctor or dentist who has a lot of experience in treating the condition. Some may go their whole career and never see a patient with ectodermal dysplasia. The process can be frustrating and time-consuming for you. Consider working with a care provider who is willing to study and  learn about ectodermal dysplasia because they are interested in you and how to best care for you.

Check out one of our Dental Treatment Centers led by dental teams with experience in treating the ectodermal dysplasias.

Contact the closest University School of Dentistry or Medical Center for specialty care.

Contact us at the NFED office for a listing of care providers for your state. We can also assist you in locating a physician or dentist. We don’t recommend or endorse medical specialists, but we can assist you in finding medical and dental professionals in the U.S. recommended by NFED families or by other clinicians

Check out Gene Reviews, the National Organization for Rare Disorders, and Medscape Reference. Experts are often called upon to contribute to online publications such as these. Many of these resources list the author’s name and institution and may provide an e-mail address or phone number.

 

THINGS YOU MUST CONSIDER BEFORE CHOOSING YOUR DENTIST

Oral health plays a key role in your whole body health. And you know that to keep your teeth clean, fresh and strong, you need to visit a local dentist at least twice a year. These are no brainers. Yet, if you feel an office visit is a real burden, chances are you won’t make it to your local dentist as often as you should. That’s why finding the right local dentist is the first step to achieve a healthy and beautiful smile

Location (a.k.a find a local dentist)

It’s better to choose a dental office which is close to your home, or one that is on your way to or back from work. Traffic can be quite annoying and you may be late for your appointment due to distance or traffic issues. Also, before scheduling an appointment it is better to check the office hours. Choosing a dentist who is conveniently located becomes very important for dental emergencies or when you finally commit to going for check ups and cleanings on a regular basis.

Professional Experience

The most recommendable choice is to find the most friendly and experienced professionals in your area. You’re going to see them for a good number of years so you should choose a dentist (and a dental team) whom you get along with.

Insurance

One of the most dreaded questions we hear is: “Do you take my insurance?” Truth is dental insurance is not what it used to be. Its coverage and benefits have not kept up with healthcare inflation

Holistic Dentistry

First things first, holistic dentistry does not equal “wacky dentistry”. A holistic dentist is trained in both conventional and alternative approaches to dental care

 

tips for finding the perfect dentist

People sometimes underestimate the importance of good oral health in their lives and for their loved ones. Proper oral health improves quality of life, so it is important to choose the best dentist for your family.

Hold a job interview

Before you visit the dental office, angieslist.com recommends you interview potential dentists or dental practices: “Find out where the dentist graduated, how long they have been practicing and what type of dentistry they do, how many staff members work there and how long have they been with that dentist.”

Consider your wants and needs

If you have a busy job where it is difficult to schedule time away, you might want to consider a high-volume dental practice that can get you in and out quickly. Families have crazy schedules. If the dentist schedules evening and weekend appointments, that is a good indication the office understands and respects the importance of patients’ time. Ask about emergency visits. If you have a dental emergency on a Sunday, there should be an accommodation for that.

Ask for referrals

The American Dental Association suggests you seek recommendations from a trusted friend or relative. If your mom or neighbors raves about a dentist, find out what things they like. You can also ask your family doctor. You can even ask other dentists if there is someone they might recommend. Most are understanding if you want a dentist close to your home or one that works with your insurance network.

Check insurance and pricing

You want a dental practice that charges reasonable fees and also works with most dental insurers. The Consumer Guide to Dentistry says the office should be able to tell you the complete cost of procedures in advance, including what will be covered by insurance and what portion you must pay out of pocket. In some cases, dentists will also offer a discount if you pay in full at the time of your appointment.

 

Vital Tips On How To Find A Good Dentist

For those who want to get a dental exam after a few years with no check-up or people who have just moved into a new city, finding dentists may seem a bit difficult at first, but it’s not as hard as it sounds. However, choosing a good dentist can make the difference between rotting teeth and healthy gums and that is why people need to be very careful when choosing one. With that in mind, below this article will offer some tips on the things people need to keep in mind when choosing a dentist

Insurance company

One of the first things people should do when they want to find a new dentist is to call their insurance company. As for the number, it’s usually on the back of the insurance card. The advantage of choosing to go with a dentist within a certain network that is affiliated with one’s insurance company is that the individual is covered and at the same time he is also certain that the dentist is experienced and will do a great job. On the other hand, those who want to select a dentist outside their network should know that they’ll incur extra costs, because their policy may not cover them

Professional Qualifications

There is a lot to find out about the dentist’s training and qualifications when visiting his office. A good dental cabinet needs to have policies on infection control, while at the same time the staff should also be friendly. If the staff is reluctant when it comes to answering certain questions or if the individual is uncomfortable being around them, then it’s better to look for another dentist

Emergency care

Some people, depending on the dental problems they have, may require emergency care and that is why they need to see if the dentists Guelph offer such services. One thing to keep in mind is that a dentist should never refer his clients to a hospital emergency room, but give him his number to the client can call him directly

Office hours

Before choosing a dentist, people should also learn more about their office hours and if they have room for new appointments. In some cases, when clients cannot make it on time to the cabinet, the dentists Guelph may be willing to take them in the weekends, but that may involve an extra fee. Nevertheless, going with a dentist that works in the weekend is very much recommended for people who are too busy to honor their appointment during weekdays.

Tips To Find The Best Dentist

How Dental Fears Work

How dental anxiety or phobia can affect your oral health

Avoiding the dentist can result in the worsening of dental disease, a greater need for emergency care or more complex treatment. It can also feeding the underlying problem of dental anxiety. This is known as the ‘vicious cycle of dental anxiety’.
Regular dental check-ups, cleans and screening X-rays can prevent dental disease and help the dentist find any problems early, so that simpler and less invasive treatments are needed.
Most dental disease is lifestyle-related and preventable. By avoiding going to the dentist, not only are you more likely to need more complex treatments when you do finally attend, but you are also missing out on learning how to better care for your oral health.
The lifestyle factors that lead to dental disease are very similar to those that lead to diabetes, obesity, heart disease, stroke and some cancers, so taking care of your oral and general health is very important.

 

What Causes Dental Phobia and Anxiety?

There are many reasons why some people have dental phobia and anxiety. Some of the common reasons include:

  • Fear of pain. Fear of pain is a very common reason for avoiding the dentist. This fear usually stems from an early dental experience that was unpleasant or painful or from dental “pain and horror” stories told by others. Thanks to the many advances in dentistry made over the years, most of today’s dental procedures are considerably less painful or even pain-free.
  • Fear of injections or fear the injection won’t work. Many people are terrified of needles, especially when inserted into their mouth. Beyond this fear, others fear that the anesthesia hasn’t yet taken effect or wasn’t a large enough dose to eliminate any pain before the dental procedure begins.
  • Fear of anesthetic side effects. Some people fear the potential side effects of anesthesia such as dizziness, feeling faint, or nausea. Others don’t like the numbness or “fat lip” associated with local anesthetics.
  • Feelings of helplessness and loss of control. It’s common for people to feel these emotions considering the situation — sitting in a dental chair with your mouth wide open, unable to see what’s going on.
  • Embarrassment and loss of personal space. Many people feel uncomfortable about the physical closeness of the dentist or hygienist to their face. Others may feel self-conscious about the appearance of their teeth or possible mouth odors.

 

Dental Anxiety: 3 Ways to Stop Fearing the Dentist

If you ever get nervous just thinking about going to the dentist, you’re not alone. Perhaps you’re scared the visit might hurt or you haven’t been in a while and not sure what the dentist will find.

Whatever your reason, the right dental team will make sure your dental and your emotional health are taken care of. The more you delay – or just don’t go – to the dentist, the higher your risk of developing dental problems that will make gearing up for future dental visits more difficult. In fact, seeing your dentist regularly can actually make the entire process – from making an appointment to sailing through it – much easier on many levels.
Use these strategies at your next appointment to help ease your anxiety and strengthen your smile.

  1. Speak up 

Anyone with anxiety knows sharing your feelings makes a world of difference. If you’re tense or anxious, do yourself a favor and get your concerns off your chest. Your dentist and dental team are better able to treat you if they know your needs.

  • Tell your dentist about your anxiety. When you book your appointment, tell the receptionist you’re nervous about dental visits. Remind the dentist and dental staff about your anxiety when you arrive. Share any bad experiences you may have had in the past, and ask for suggestions on coping strategies.
  • Don’t be afraid to ask questions. Sometimes knowing what is going to happen alleviates any fears of the unknown.
  • Agree on a signal. Let your dentist know by raising your hand if you need to take a break during an exam.
  • If you experience pain even with a local anesthetic, tell your dentist. Some patients get embarrassed about their pain tolerance or don’t want to interrupt a dentist during a procedure. Talk with your dentist about pain before it starts so your dentist knows how to communicate with you and make it more comfortable.
  1. Distract yourself 

Taking your mind off the exam may seem impossible when you’re nervous, but there are some things that that can help distract your thoughts.

  • Wear headphones. If the sound of the drill bothers you, bring headphones so you can listen to your favorite music or audiobook. Some dental offices even have televisions or show DVDs.
  • Occupy your hands by squeezing a stress ball or playing with a small handheld object, like a fidget spinner.
  • Imagine your happy place and visualize yourself at a relaxing beach or garden.
  1. Use mindfulness techniques 

Relaxation starts in the mind. Try deep breathing exercises to help relax tension in your muscles.

  • Count your breaths. Inhale slowly and then exhale for the same number of counts. Do this five times while you’re waiting for your appointment, or during breaks while you’re sitting in the dental chair.
  • Do a body scan. Concentrate on relaxing your muscles, one body part at a time. Start with your head and work your way down to your toes. For example, you can focus on releasing tension starting in your forehead, then your cheeks, your neck and down the rest of your body.

 

4 Reasons why you shouldn’t be afraid of the dentist

  1. There is such a thing as ‘Pain-Free’ Dentistry

Most people are afraid of the dentist because they think it will hurt.  Modern materials and improved techniques means that dentists are able to virtually eliminate pain from dentistry. And by visiting the dentist regularly problems can be spotted early and resolved before any pain or infection occurs.  A toothache is definitely more painful than seeing your dentist!

  1. Smilefocus provides a relaxed and comfortable environment

Many people are concerned about the noise of dentistry.  If you ask someone want they associate most with dentists they will say the drill. These days you barely hear the mechanics.  Noise-cancelling headphones and the TV, movies or music contribute to a more relaxed and diversionary environment.

  1. A healthy mouth is a healthy heart

Your dentist is concerned about your general health, too, not just your teeth, gums and mouth.  Some conditions such as heart disease are linked to the bacteria in your mouth so your dentist is as important as your GP.

  1. Dentists want to help you

Dentists actually like people; thet study dentistry because it is a helping profession.  We asked our dentists to tell us why they chose dentistry, and their answers are on our website, included in their profile.  Almost without exception it is because dentistry enables them to make a positive difference to peoples’ lives, either because their own dentist was a great role model, or because childhood experiences were terrifying, and they resolved to prevent similar experiences to others.

 

Here are some common worries—and strategies to subdue them:

  • “It’s going to hurt” — If you’re nervous about pain, let your dentist know; she can administer anesthesia comfortably so you don’t have to suffer. Afraid of needles? Nitrous oxide (laughing gas) works well to help you relax first. If nitrous oxide isn’t enough to dull your senses, sedation dentistry is common, and all you need is a designated driver to shuttle you to and from your appointment. For patients who can’t get past an unrelenting fear of the dentist, this is usually the best option.
  • Bad experience in the past — This seems to be the second most common complaint of apprehensive patients. Sometimes the overall experience of the appointment leaves you feeling unsettled — or worse, repulsed. Perhaps the office over-billed you, the hygienist wasn’t thorough, the assistant was annoying, or the dentist was insensitive. It happens, and it’s unfortunate. But it shouldn’t prejudice you against future visits either (whether with the same dentist or a new one). It’s almost always helpful to tell dental staff about your past experience, so they can understand exactly what offended you. It may require some patience, but you should be able to find a team that will be a good fit for you. And that can make all the difference.
  • Feelings of helplessness or loss of control — Not being able to talk or being confined to a chair with a “noose” around your neck (not to mention being drill-shy) can evoke feelings similar to claustrophobia. If this is you, let the assistant know at the beginning of the appointment how you’re feeling. During the appointment, raise a hand to take a break (and they can stretch their backs at the same time).
  • Embarrassment about your oral health — You may have gone years without a cleaning. Maybe you put off treatment, and you’re embarrassed or ashamed by the compromised state of your mouth, or what the dentist might say to you. But consider: dental professionals have seen it all. It won’t phase them, so it shouldn’t phase you either.
  • Anxiety About Cost — Dental work can be expensive, especially if your insurance doesn’t cover it. Still, regular appointments with your hygienist help reduce the need for more costly treatments later. When a filling or crown is necessary, however, talk to the office manager about payment options. Most offices will work with you to create a comfortable financial arrangement. Plus, check your area for free or low-cost clinics. If you’re near a dental school, students are always looking for patients. And they work under close supervision, so no need to worry. (Sometimes they even pay you to be their patient.)