Chronic Pain Today

There are times when everyone wants to have fun. Especially fun that is particularly silly or not really a “good idea”. I happened to come across hubby in one of these moments, and the video of the pocket bike on a wet garage floor was made. Now remember this little bike wasn’t going fast, but if you have a pre-existing back injury or some joint and muscle condition this is why its not a good idea to try to  impress friends



Please comment as much as you like, and no hubby didn’t “hurt” himself but he was a little sore. Everyone else may have audibly laughed at the end of it, but remember Chronic Pain is never anything to laugh about.

Antidepressants in general are well absorbed in the majority of people, and most doctors use them in chronic pain management. They are prescribed at a lower dosage than if they were for mental health use, but patients on them get better sleep, eased depression, and mild pain relief.

Tricyclic Antidepressants
Tricyclic antidepressants gives a deep restorative sleep and has special sedating qualities that will help most chronic pain sufferers. They are the most frequently prescribed of all antidepressants for chronic pain use. They have been shown to improve mood and regulate pain signals. Tricyclics are the older of the antidepressants.

Side Effects:

• Dizziness
• Drowsiness
• Constipation
• Dry Mouth
• Fatigue
• Headache
• Sedating effects
• Weight gain

Examples of Brands:
Nortriptyline (Pamelor)
Amitriptyline (Elavil, Endep)
Imipramine (Tofranil)
Doxepin (Sinequan)

MAOI Antidepressants
MAOI Inhibitors are also known as monoamine oxidase inhibitors. Monoamine oxidase is an enzyme readily found in the body that will destroy norepinephrine or serotonin in the brain. Inhibiting this will limit that destruction and will stimulate rather than sedate the body. These work faster than tricyclic antidepressants but requires a change in the diet and has worse side effects.

Side Effects:

• Dizziness
• Loss of libido
• Interacts with food and other drugs
• Faster heartbeat

Diet Change Examples:

• No aged cheeses
• No fish or soy products
• No MSG foods (i.e. Chinese foods)
• No red wines
• No processed meats

Examples of MAOIs:
Phenelzine (Nardil)
Tranylcypromine (Parnate)
Isocarboxazid (Marplan)

SSRI Antidepressants
SSRI, or selective serotonin reuptake inhibitors, are alternatives to the tricyclic antidepressants. They will boost energy, and are sometimes better tolerated than tricyclics. They block the reuptake of serotonin and this can have an effect on the pain response.

Side Effects:

• Anxiety
• Rash
• Headache
• Diarrhea and Nausea
• Sexual problems

Examples of SSRIs:
Sertraline (Zoloft)
Paroxetine (Paxil)
Fluoxetine (Prozac)
Venlafazine (Effexor)

FDA Approves Relistor for Opioid-Induced Constipation
Drug will help reduce effects of drugs like morphine on bowel function

The U.S. Food and Drug Administration today approved Relistor (methylnaltrexone bromide) to help restore bowel function in patients with late-stage, advanced illness who are receiving opioids on a continuous basis to help alleviate their pain.

Opioids are often prescribed on a continuous basis for patients with late-stage, advanced illness to help alleviate pain. This includes patients with a diagnosis of incurable cancer, end-stage Chronic Obstructive Pulmonary Disease (COPD) from emphysema, heart failure, Alzheimer’s disease with dementia, HIV/AIDS or other advanced illnesses.

Opioids can interfere with normal bowel elimination function by relaxing the intestinal smooth muscles and preventing them from contracting and pushing out waste products. Relistor acts by blocking opioid entrance into the cells thus allowing the bowels to continue to function normally.

“This new drug will be helpful to patients who experience severe constipation associated with the continuous use of morphine or other opioids, which are an important part of care for patients with late-stage, advanced illness.” said Joyce Korvick, M.D., deputy director of the Division of Gastroenterology Products, FDA.

Relistor is an injectable medication. It can be administered as needed, but not to exceed one dose in a 24 hour period. The recommended starting schedule is one dose every other day as needed for patients with late-stage advanced illness. Relistor is not recommended for patients with known or suspected intestinal obstructions.

Common side effects include abdominal pain, gas, nausea, dizziness and diarrhea. If severe diarrhea, vomiting, nausea or abdominal pain occurs while taking Relistor, patients should discontinue use of the medication in consultation with their health care professional.

The safety and effectiveness of the drug was demonstrated in clinical studies conducted by the sponsors. The two randomized, double-blind placebo-controlled studies involving a total of 287 participants were conducted over a four month period. The median age of the study participants was 68 years, and 51 percent of the participants were women. In both studies, all patients had advanced late-stage illnesses with a life expectancy of less than 6 months. Prior to treatment with Relistor, participants had either less than three bowel movements in the week prior to treatment or no bowel movement for more than 2 days. Patients who were treated with Relistor had a significantly higher rate of elimination than those receiving placebo. The safety and effectiveness of Relistor have not been studied in pediatric populations.

Relistor is manufactured by Wyeth Pharmaceuticals Inc., Philadelphia, PA., and Progenics Pharmaceuticals, Tarrytown, NY.

Those that are disabled from any condition can now get a national park pass for free.  According to the National Park Service: “The pass admits the pass holder and passengers in a non-commercial vehicle at per vehicle fee areas and pass holder + 3 adults, not to exceed 4 adults, at per person fee areas (children under 16 are admitted free). The pass can only be obtained in person at the park. The Access Pass provides a 50 percent discount on some Expanded Amenity Fees charged for facilities and services such as camping, swimming, boat launching, and specialized interpretive services. In some cases where Expanded Amenity Fees are charged, only the pass holder will be given the 50 percent price reduction.”

There are some rules and details on how to get this, and you do need to pick it up in person they will not mail them or send them as a download. If you are a U.S. Citizen or a permenant resident, look into getting your free National Park Access Pass for free. Details for the entire program can be found here: http://www.nps.gov/fees_passes.htm .

Please Scroll down to the America The Beautiful National Parks and Federal Recreational Lands Pass Access Pass- Free section to get details.