Dr. Cady's Blog

…It is Inappropriate Treatment

There is no doubt that more opioids are being used than necessary with associated unintentional  deaths—almost 45 Americans per day in 2010! (1) Yet, voices rise after hearing condemnation of opioids or when having difficulty in obtaining them. They are the people who already found opioids helpful or believe that they are helpful. Then, there are those who do not have access to any adequate treatment and proclaim “undertreatment” of pain? Fewer opioids, more opioids, or undertreatment of pain seem to be the prominent arguments in the pain community.

True, some people can function well on intermittent use of opioids. However, if numerous patients are so mentally clouded by the opioids that they use and/or do not do anything for themselves in the form of enhancing their own function or mental/physical health (aka self-care), then those drugs’ benefits are...

It should not come as a huge surprise that a larger percentage of our American newborns are suffering the consequences of a rising trend in opioid use and abuse related to the American PAINDEMIC. More and more babies are suffering withdrawal effects after birth due to their mothers using licit or illicit drugs during pregnancy, such as hydrocodone, oxycodone, and heroin. Some of the withdrawal effects include:

• Poor feeding
• Irritability
• Hyperactive reflexes
• Excessive crying
• Tremors
• Seizures
• Sweating
• Vomiting
• Fever
• Diarrhea

These effects make up what is called the neonatal abstinence syndrome (NAS). Depending on the drug used by the mother during pregnancy, the withdrawal effects can begin up to three days after birth. The abrupt discontinuation of the drug from the mother’s blood supply can be incredibly uncomfortable for the newborn and may require re-administering a similar drug to the newborn and weaning slowly to avoid severe withdrawal effects.

The rise...

Our PAINDEMIC (Pain-epidemic)

With over 100 million Americans with chronic pain per the Institute of Medicine, it is no wonder we have a PAINDEMIC® on our hands! (1) Despite the barrage of technological advances, drugs, injections , and surgeries, more people continue to suffer with pain than those with diabetes, heart disease, and cancer combined. And as more strong painkillers are being used to suppress the painful symptoms, there has been a directly proportional rise in unintentional drug overdoses. (Graph 1)  Many of these strong painkillers are called opioids, which are medications such as morphine, oxycodone, and hydrocodone. Unfortunately, these medications have the potential to cause significant respiratory depression and hence, death. The reality is that these medications cannot be received without a prescription; yet, there are over 250 million opioids still being prescribed every year in the United States with almost 50 people dying every day as a...

If you have not experienced back pain, then you likely know someone who has endured a short bout of low back pain or perhaps is still suffering from the affliction. The most common assumption by many patients is that they have “slipped a disc.” Worst of all, there is a tendency for limited histories and physical exams to be done and MRI studies ordered hastily. Unfortunately, this can lead to an overutilization of unnecessary imaging technology, which leads to many dreadful-sounding descriptions of the patient’s back. The patient’s concerns that a single event happened, such as a slipped disc, may be reaffirmed. This could lead to a patient becoming diagnocentric (see my blog, Diagnocentricity).

But let me just blow some assumptions out of the water here. Does the presence of bulging discs really mean PAIN? Take a look at the graph below to see where your age fits among the various groups:

ALL of these individuals are people who DO have...

PAIN is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” But when pain is chronic and not related to cancer, there is a tendency for many people to have difficulty empathizing with the pain patient’s plight. There are a few reasons for this, in my opinion:

THE INVISIBLE: When pain means suffering, many people want others to know the challenges that they are undergoing due to that pain. However, there is rarely obvious information to prove that the pain truly exists. There is a struggle for patients to have friends, family, or medical professionals believe their pain exists. Unfortunately, not being believed can have a negative impact on that patient’s experience of pain. The suffering is real whether we see it or not.

THE INSIDIOUS: The reality is that chronic pain started out as acute pain since chronic pain is typically defined as a duration of 3...

Have you heard someone say: "I am diabetic", "I have fibromyalgia", "I have complex regional pain syndrome" or "I have a herniated disk"?  It is not uncommon to label ourselves. If we visit a doctor, then we are likely to be assigned a diagnosis. It is usually required as part of the documentation for the provider to receive reimbursement from insurance providers. However, there is also a general tendency to accept the diagnosis as correct, irreversible, or our identity. I have coined the terms, diagnocentric™ and diagnocentricity®, to reference the state of our society with respect to a diagnosis.

Although there are diagnoses that are out of the patient's control, many times a diagnosis is merely a symptom or a constellation of symptoms that reflects an unknown cause or a result of a poor lifestyle. If the diagnosis is accurate, then there is still a reliance on someone else, such as a physician, to FIX the problem. Unfortunately, the diagnosis is NOT always...

Suppose you were in the middle of your typical, busy day, rustling papers, and you cut your finger. What do you grab? A Band–Aid? What about an adhesive bandage? What if your injury was more than just a paper cut? Who would you call? A D.O.? What about a physician? Just as a Band–Aid is a brand name for an adhesive bandage, a D.O. is one of two titles representing a physician. Most of society is familiar with M.D., which also implies a physician, but many patients may not even realize that their family doctor is a D.O. How important is it to know?

First of all, what is a D.O.? D.O. are the initials for a doctor of osteopathic medicine (formerly known as osteopathy in the United States). An osteopathic physician is the only other legal and professional equivalent of an M.D. and practices medicine based upon osteopathic philosophy. The philosophy emphasizes the inter–relationship between structure and function and has an appreciation of the body’s ability...