zondag 11 mei 2014

Dealing with pain without drugs

A soldier's war on pain relates how doctors are less relying on drugs nowadays for chronic patients. The Veteran Administration is running in front in this area because it is not dependent on insurers and for that reason more free to experiment and innovate. Problem is that some patients get ever increasing doses of those pills and also increasing numbers of pills to deal with side effects. This turns them into a kind of zombies. Recommendation is a combination of alternative therapies (like acupuncture, baths and non-opioid medicine) and accepting that experiencing the pain may be better than the alternative of being drugged. Some quotes: A 2008 study by the Mayo Clinic found that patients who were weaned off opioids and put through a non-drug-based program experienced less pain than while on opioids and also significantly improved in function. Other studies have had similar findings. Programs like his are initially more expensive than opioids, and insurers are loath to invest in patients when they do not know if they will be their customers next year. The drugs do not seem to help many with chronic pain. “I think that the more appropriate use of opioids is in the acute pain setting and the surgical setting,” said Dr. Seal, the expert in San Francisco. “I am not convinced that opioids are any better than non-opioids” for chronic pain, she said.

donderdag 8 mei 2014

The Phineas Gage story

Slate has a story (Phineas Gage, Neuroscience’s Most Famous Patient) that is inspired by a book (An Odd Kind of Fame: Stories of Phineas Gage about this man who got a metal rod through his brain and became a fixture in every psychology textbook to illustrate the effects of the loss of the frontal lobes. According to the article very little is actually known about Gage. There are many claims, but they are often contradicting each other and without proof. Gage's story is often told as that much of his frontal brain was destroyed and that afterwards he started behaving badly, cursing a lot and losing his job. But the pictures that have been found from him after the accident show a well dressed man and it is now known that he later found another steady job. So the harmful effect of damage to the frontal brain may be exaggerated. Also the stories of Gage and others may actually be illustrations that even after major injury the brain holds a lot of capability to repair itself.