Tuesday, November 15, 2016

Is Chronic Pain a Disease? My Interview with Pain Specialist, Dr. Karl Hurst-Wicker, MD


To kick off this interview, I asked Dr. Hurst-Wicker this predominant question among the scientific community,

Is Chronic Pain a Disease?

Here is what Dr. Hurst-Wicker had to say.

Pain is a symptom of some other underlying problem, much like a runny nose is a symptom of a cold or allergies. The key to solving a problem is identifying the problem and figuring out how to fix it. If we invest all our time and energies in treating only the symptom, pain, without diagnosing the cause, we risk missing the chance to fix the problem and remove the symptom. We miss the opportunity to get the patient the right treatment, right away.

People experience chronic pain for many reasons, and many patients can be treated with injections, medication, surgery, or other modalities. The tough thing for both patients and physicians is realizing that human bodies are complex organisms. We are in the process of learning and understanding this intricate machine, but we don’t have all the answers to the problems we face readily available. This means that for some patients pain could be caused by something we don’t fully understand and therefore don’t have great treatments. Eventually we will get there. But if we started saying, “Oh, the problem is just chronic pain and we need to treat only the pain,” we’d miss the opportunity to find real causes, and we would miss opportunities to develop treatments that could truly help people, instead of only masking the symptoms.

Q. How important is a history and physical?

Take chronic myofascial pain as an example. Myofascial pain syndrome (MPS) is a common cause of chronic pain. It can be the primary peripheral pain generator and at the same time, it may flare up as an indicator of other pain generator in the same area. That’s why a big part of evaluating a patient with pain is getting a good history and physical exam. 


Q. Why does pain become chronic in some people and not others?

The transition from acute to chronic pain has a variety of contributing factors. Sometimes the problem is that the underlying problem can’t be fixed, like a bad joint that can’t be replaced because the patient is too sick for surgery. In other cases, people can develop the changes to central sensitization thus perpetuating pain even after the initial problem is fixed.

Some studies indicate genetic factors play a role and may explain why some people experience chronic pain and others don’t, and other studies indicate certain pain medications could initiate the process of central sensitization.

I’m not sure we will ever develop a quick or simple way to figure out what patient will develop or experience chronic pain. There are many factors at play and I think it is too complex to determine right away. But, we continue to learn more year after year.

Q. Are there other factors that contribute to chronic pain?

MRI of amygdala and hippocampus
Stress and sleep can certainly have an effect on pain. Stress alone can change the levels of neurological hormones in our central nervous system and thus, amplify chronic pain. We discussed a study in a separate interview on centralization in fibromyalgia. In this study, they used the MRI to evaluate the size of the hippocampus in fibromyalgia patients [the region of the brain responsible for with memory and spatial navigation]. One of the things they discussed was whether the hippocampus was small due to the stress of chronic pain in fibromyalgia, or if patients maybe had higher stress levels that shrunk their hippocampus and thus got fibromyalgia. Sleep, more specifically the lack of sleep, is known to worsen pain. The restorative process of sleep allows our bodies to refresh, regenerate, and heal. So when we don’t sleep, we not only miss out on restoration, we also have a concomitant increase in both the physical and mental stress that our bodies must endure.

Patients can help themselves by being more aware of stress in their life, take time to eliminate those that they can, and find better ways to deal with the ones they must. It may mean setting aside time to take a nap in the middle of the day, or other things to care for themselves. Regular exercise has shown it reduces stress and promote better sleep habits.

Stay tuned for more answers from Dr. Hurst-Wicker about what happens when our brain perceives chronic pain as a threat.

In healing,,Celeste
"Adversity is only an obstacle if we fail to see opportunity."  


Karl S. Hurst-Wicker, MD, is a board certified anesthesiologist practicing pain management at the Desert Pain Institute. He graduated from Columbia University College of Physicians and Surgeons and completed his residency in anesthesiology at the University of Utah.


Other contributing articles written for you:

Q&A on Chronic Pain - Health Central
The Centralization of Pain - Health Central
Myofascial Pain Syndrome - Celeste's website


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Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Monday, November 14, 2016

Coming Clean on Personal Hygiene: The Luxe Bidet – Chronic Illness Blogger


"I have been given this product as part of a product review through the Chronic Illness Bloggers network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company. "


Little did I know when I wrote the blog on irritable bowel syndrome (IBS), Coming Clean on A Dirty Little Secret, that I would be writing a blog from a different perspective, one of “coming clean” on personal hygiene.  

Personal hygiene means a great deal to those of us with irritable bladder, irritable bowel or other chronic illness disorders, such as immune deficiency or inflammatory bowel disease. Those of us with bowel problems, particularly those causing bowel hypermobility or other disorders, such as vulvodynia or interstitial cystitis know how important rituals of cleanliness are to our health. Accelerated bowel movement also interferes with nutrient absorption, again putting us at risk for infection.

For me, an irritable bowel attack leaves my bottom side raw and sore, breaking down my first line of defense, skin. The attack itself is very painful and the consequences are uncomfortable to say the least. Having interstitial cystitis and having IBS increases the risk of bacterial going where it should not causing frequent urinary tract infections. Personal hygiene is a priority to minimizing a great deal of collateral damage and pain from IBS.

Why is a bidet a good choice?

The Luxe Bidet (Neo 185) negates excessive wiping of watery stools that have high concentrations of digestive chemicals from the small bowel. Every boxcar of this runaway train is packed with juices that when moved into other portions of the bowel cause cramping, contracting, and spastic bowel function during an irritable bowel or inflammatory bowel attack. They are rapidly delivered to areas they should not be. While these important digestive chemicals are integral to digestion in their own portion of the digestive track, they can wreak havoc when they are rapidly moved from the small bowel into the large bowel during a painful episode. The damage doesn't end with the attack, these chemicals also irritate and breakdown sensitive tissue around the rectum and other surrounding structures. We know that stinging pain and we know this opens us up to skin infection from bacteria and candida.

Having the Luxe Bidet Neo 185 not only makes things more comfortable and clean, it gives me peace of mind when everything else is out of control.

How does the bidet work?

The Luxe Bidet Neo 185 is a dual nozzle, fresh water, non-electric mechanical bidet attachment for the commode with one-touch pressure control. It has a guard gate,  a regular nozzle and feminine wash nozzle for rear wash and a more gentle frontal wash. The nozzles drop down and retract when it’s not being used. And, it cleans itself!

The stream of water is adjustable. I feel clean without having to take a shower. I don’t have to worry about getting a yeast infection from using too many wipes, and I no longer have to worry about lurking contaminants staying behind to wreak havoc later. And it’s affordable.  

Installation

Adding the bidet to your commode doesn’t require plumbing skills. It comes with everything you need for a do-it-yourself installation. The only extra things you need is a screwdriver and a wrench. And, there are installation Instructions you can download.  Generally, it should only take about 20 minutes. It took my husband a bit longer, but we are older and it took a bit to get the connection loose at the water supply.

You can learn more about the Neo 185 at Luxebidet.com.

In healing,,Celeste


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"Adversity is only an obstacle if we fail to see opportunity."  

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Celeste's Website

Celeste's Website
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