I have always promoted a good nights sleep for my patients to promote healing and pain relief. Now there is an addition reason to avoid sleep deprivation. It turns out a bad night can make you crabby. Two recent studies in the Journal of Psychosomatic Research assessed a group of college students on emotional responses to positive and negative images. The students were divided into two groups and were asked to completed a simulated work-shift. One group had five hours sleep beforehand and the other group was kept awake for 24 hours. Both groups showed diminished emotional response to positive imagery. As the night wore on the response be even less. Basically, they were less and less likely to be uplifted by positive images. “The human brain is naturally more attentive to negative events,” says June J. Pilcher, study co-author and psychologist at Clemson University. This gives us a tendency to over react to minor negative events, such as a traffic jam, especially when we are overly tired.
Month: May 2016 (Page 1 of 2)
I am often asked this question by my patients whenever they have a change in their pain condition. An MRI is an invaluable tool for clinicians but it is unfortuneately overused by many practitioners. New onset spinal pain associated with weakness or incontinence certainly may need re-imaging, but for most cases of back and neck pain a repeat MRI may actually be harmful.
How could it be harmful? I thought it just used high powered magnets and was completely safe. The harm is not in obtaining the image, it is what else might be found on the image. Often, new “problems” are found which lead to more workups and procedures, any of which could possibly harm you. A vast majority of these new problems are benign (harmless) and are considered incidental findings. So next time when your doctor says you don’t actually need a repeat scan, you will know the rationale behind their thinking.
Even though Prince will be only one of over 100,000 to die this year from prescription drug abuse this year he has brought public attention to the opioid epidemic facing America. Additional physician training requirements have been proposed in the past by the FDA but were essentially made voluntary at the behest of the pharmaceutical companies. However, the new FDA commissioner stated in a speech earlier this year he specifically addressed the opioid problem and the role of the FDA in combating the epidemic. He also spoke at length about opioid specific physician education programs developed through the Risk Evaluation Mitigation Strategies (REMS) programs promoted by the FDA. So far, 100,000 physicians have “voluntarily” participated in these programs. Many of which were required by the states licensing them. I too have completed some of these programs and I can attest to their length. Sure enough, shortly after it was revealed Prince died of an opioid overdose, an FDA panel recommended mandatory REMS training for all physicians with DEA registrations.
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As a Minnesota native I was devastated to learn of Prince’s death. It turns out he suffered from a percocet addiction. His addiction started innocently as a prescription from his doctor to treat his chronic hip pain. In fact, he was scheduled to see an addictionologist the day he was discovered dead.
America is in the midst of an opioid epidemic. According to the CDC, 40 Americans die every day from prescription opioid overdoses. The number of opioids prescribed in this country has quadrupled in the past decade. This problem is now out of control with both doctors and patients to blame. Years ago, the Joint Commision made pain the “fifth vital sign” and many physicians blame them for starting the epidemic. However, it is much more complicated. Many factors including marketing by pharmaceutical companies, increased access to care, patient empowerment, and legal issues have contributed to the increased use of opioids in this country. I used to prescribe large amounts of opioids a decade ago and personally contributed to this problem. Although thousands have already died, we can still save thousands by reducing the number of opioid prescriptions and treating patient on opioids and those addicted to pain killers.