While opioids (narcotics) can be helpful with chronic pain, they can also have significant side effects. Constipation is one of the main negative effects.
And we’re not talking a minor “slow down.” Indeed, opioid-induced constipation can persist despite strong medication to relieve it. In rare cases, it can progress to obstruction - “nothing going through.”
The first FDA-approved medication to counteract this side effect is Relistor (methylnaltrexone bromide). It’s an injectable medication, approved for patients with later-stage advanced illness who use a continual regimen of opioids. Because it doesn’t cross into the brain, it shouldn’t decrease pain relief.
A clinical trial is reported in JAMA 2000, Vol 283, pg 367-372.
An interesting side-story of this medication is that it was originally developed by pharmacologist Leon Goldberg, MD, PhD, to help a friend with a terminal illness who was on morphine and had severe constipation. A true humanitarian.
Want to take a 5-minute online survey about blogs? Dr. Jeong-Nam Kim of Purdue University needs 100 more people for a health communication study of people with chronic conditions. Click here to go to the survey.
Grand Rounds, a medical blog carnival, is up at MDOD. Funny guys over there… I think they might be the judges for the Darwin awards.
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I’m biking for charity and I’d love your support!!!
I’ve organized a 27-mile charity bike ride on Saturday, October 25, and invite you to participate by sponsoring me. The ride will raise money for the Reflex Sympathetic Dystrophy Syndrome Association, RSDSA. RSDSA is a national organization working to end RSD (also called CRPS), a neurological pain condition.
A donation of any amount will be helpful. I’d especially appreciate a donation representing the miles I’ll ride, for example, $27 or $2.70. Even 27 cents lets me know you’re rooting for me.
Or you can donate directly at the RSDSA website and let me know in the comments how much you’ve donated, so I can add it to the ride total. (For my own patients who read this blog, you’re welcome to donate directly to RSDSA or any other pain organization on your own, but I ask that you not donate at the First Giving link above. It could be seen as a possible conflict of interest (:
So make a donation…
to end RSD
to support a great national pain organization
to say thanks if you’ve been helped by How to Cope with Pain
in honor of a family member, friend or doctor who’s supported you
for many other great reasons
Thanks for your support!
Want to take a 5-minute online survey about blogs? Dr. Jeong-Nam Kim of Purdue University needs 100 more people for a health communication study of people with chronic conditions. Click here to go to the survey.
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We’re now into the swing of Fall (in the northern hemisphere, at least). For kids, September means back to school and learning new things, making new friends… expanding horizons. How about for those of us with pain? New Beginnings is the theme for September’s Pain-Blog Carnival. Snuggle up in a comfy sweatshirt, warm up a mug of cider, and enjoy!
Somebody Heal Me will be trying a new treatment, Botox, for migraine prevention. Despite reservations and low expectations, she’ll be giving it a (ha, ha) shot.
A new contributor, Fibromyalgia Advice, takes the plunge of trying a new doctor and method. Read about a chiropractic approach called NUCCA and how it’s working.
New Beginnings = New Outlooks
Arthritis Friend, shares a story about a man’s acceptance of his invisible illness, and how he decided to make it more visible.
How do we make each day a new beginning? Spiritual Healing Journey looks at letting go of the old to make room for healing.
A Chronic Doseexplores how our expectations can hinder our keeping an open mind.
New Beginnings = Doing Things Differently
Can’t do what you once did? Then can you re-invent yourself? Working with Chronic Illness creatively explores how the new world of virtual jobs can open up many possibilities.
Thanks to G.M.B.at Flickr for the photo. This week’s Grand Rounds, a medical carnival, is up at Monash Medical Student.
Want to take a 5-minute online survey about blogs? Dr. Jeong-Nam Kim of Purdue University needs 100 more people for a health communication study of people with chronic conditions. Click here to go to the survey.
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Last week, I wrote about the inspiring movie The Diving Bell and the Butterfly. For today’s Monday Chat, you’re invited to share what your own favorite inspiring movie is.
Want to take a 5-minute online survey about blogs? Dr. Jeong-Nam Kim of Purdue University needs 100 more people for a health communication study of people with chronic conditions. Click here to go to the survey.
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I’m always on the lookout for good relaxation or guided imagery products. I recently tried a CD by Dr. Alfred Frost, Director of the Focused Neural Fields Institute, and think it’s excellent. Dr. Frost’s clinical focus is hypnosis for pain management and other medical conditions.
The CD is called Focused Fields Training for Deep Relaxation and Stress Reduction. It has 4 sections, including introductions to relaxation and stress, as well as what exactly hypnosis is and isn’t. These sections are clear, helpful overviews. I particularly liked the explanation of the mind-body connection, and how relaxation and hypnosis can help both your body and mind.
The last 2 sections cover first a practice relaxation/guided imagery exercise, with each step explained. This is followed by a regular exercise.
I think this is a very good product, and is worthwhile for relaxation and stress management. It doesn’t include any particular suggestions for pain management, but the exercises found on the CD are a good start to understand this type of treatment. There are slight differences in how I teach these techniques. For example, Dr. Frost uses a count of 10 to relax, then a count of 5 to re-alert, while I like to keep the number or method the same. I think these differences are minor, and you can vary things like this to suit your own preferences.
Whether you use this product, another one, or just your own imagination, relaxation and guided imagery are wonderful to do and they help in pain management. Thanks, Dr. Frost, for sharing your exercises.
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Here’s a challenge… you have a stroke and go into a coma, but luckily enough, you wake up. However, you come to realize you’re completely unable to move - except for your eyes!
You can look around and blink , but that’s it. This real neurological condition is aptly called “locked-in syndrome.” Can you imagine what that would be like?
That’s the real-life story on which the movie The Diving Bell and the Butterflyis based. After struggling to try to come to terms with his condition, Jean-Dominique Bauby, a journalist, decides to write a book on his unusual experience. It’s an amazing feat - dictating his book a letter at a time - describing his amazing journey.
It’s a movie I’d recommend for its inspiration, as well as artistry. How would you handle such an extreme challenge?
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A boy is in a car accident and is rushed to the emergency room, where emergency surgery is needed. The surgeon comes into the operating room, but says, “I can’t operate on this child. He’s my son.” The surgeon is not the boy’s father. Who is the surgeon? (Think about it before you scroll down.)
Did you have any trouble figuring out that the surgeon is the boy’s mother? If that answer didn’t come to you, does that surprise you?
Don’t think that we’re beyond that sort of bias… a few years ago, I got an announcement from a psychiatry organization that a dinner was for “doctors and their wives.” (Yes, I sent a letter to the editor about that!)
September is Women in Medicine month. So for today’s Monday Chat, I thought I’d ask a few questions…
Do you have a preference for a female or male doctor?
Do you think there are, in general, differences between male and female doctors?
Do you think women doctors are more empathic?
Would you let a female neurosurgeon operate on you?
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The National Institutes of Health (NIH) is one of the premier research centers in the US. Here’s a podcast from them about Irritable Bowel Syndrome (IBS).
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The National Institutes of Health (NIH) is one of the premier research centers in the US. Here’s a podcast from them about Vulvadynia, a painful pelvic disorder in women.
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National Invisible Chronic Illness Awareness Week is officially over, but I hope its positive effect goes on and on. What did you learn from the week? What was your favorite part of this event that raises awareness of invisible illnesses like pain?
You’re invited to share your thoughts in the comments!
Posts this week at How to Cope with Pain in honor of the week:
You’re also invited to read a guest post I wrote over at The Daily Headache about positive strengths that can flourish when we’re faced with illness.
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And we’re not talking a minor “slow down.” Indeed, opioid-induced constipation can persist despite strong medication to relieve it. In rare cases, it can progress to obstruction - “nothing going through.”
The CD is called Focused Fields Training for Deep Relaxation and Stress Reduction. It has 4 sections, including introductions to relaxation and stress, as well as what exactly hypnosis is and isn’t. These sections are clear, helpful overviews. I particularly liked the explanation of the mind-body connection, and how relaxation and hypnosis can help both your body and mind.
