#ive taken my pharmacology i know

[rocals]

seems like SOMEONE is experiencing the expected side effects of rifampin

[srlkiller]

ive realised that my self esteem & just general ‘sense of self’/love for myself is so awful & low.. horribly dependant & reliant on something or someONE else these days & i absolutely fucking loathe myself for ittttttt bc im beyond self aware.. yet ive jus never been loved my entire life by even my own parents to be shown that im worth a singular fuck so the bar is so low for humans… i seemingly will jus allow the fucking worst bc i guess subconsciously that’s what ive always been taught/shown/drilled into me by my parents to believe that i deserve? wen i know it’s not at all bc literally NO ONE deserves to be treated like shit by another human being. i have trouble saying the words no to other people. i have a lot of trouble just standing up for myself these days.. especially the lonelier i get, the more isolated i have become & older ive gotten. i found comfort in being alone & definitely got to know myself sm better.. then i went thru horrible shit all over again & lost myself completely.. all over again.. & haven’t been able to rebuild myself back up since then.. ive only gone downhill.. over & over & over. i know that I AM the only one that inevitably can help myself & save myself.. i have to do the work & put in the effort etc etc but it’s so hard with absolutely ZERRROOO support system of any kind & feeling like you have nothing & no one.. not one family member.. not one pet.. nothing at all anymore. everything has been ripped from me, taken by force or by death itself. I’ve been broken sm times but now that ive finally been able to let someone in again on some kind of romantic level.. im terrified.. so im letting them jus walk all over me which is the total opposite of who I am & everything i stand for, emulate as a woman & my whole fucking energy as a being. i don’t recognise myself at all so ive totally seperated myself from whoever this is.. the body, the mind.. the soul. i numb every feeling n thought i can.. whenever i can. but wow just having this huge surgery & putting my body under such duress & jeopardy was lowkey such a wake up call bc wtf?! IVE NEVER DONE NO SHIT LIKE FHIS BEFORE FOR ANYONE ELSE?!?! AND FOR WHAATTTT?!?! HE HAD THE PERF OPPORTUNITY TO DO EVERYTHING FHE RIGHT WAY N STILL FUXKED IT UP TO SATISFY HIS OWN SELFISH NEEDS.. so wtf am i doing? what am i doing risking myself for someone like that… i look stupid, feel stupid.. & could get left at any minute which would send me spiraling for someone who is quite frankly… not even close to what i need in a man or what ive ever wanted. im simply cheating myself out of a great self help story.. as i turn 29.. i reach my last year if my 20’s & I’ll b damned if i waste that shit on some young dumb n full of cum mf who doesn’t even give a fuck ab my health in any capacity who is probably lying n doing god knows what behind my back anyway… I seriously just need to put myself first.. just try.. I need to try. bc remember when I did? how proud I was? how it worked? it’s always worked. time to start writing goals n writing shit down again.. as we start approaching this date n it gets closer n closer.. on the 25/11/23 I’ll be 29 yall. it’s the 13/11/23 today. 11 days to get things in order. my goals don’t even need to be big I jus need to get things ‘in order’… ‘ready for 29’ sounds like a cool lil title.. as my bday is pretty much leading into the New Year anyway it’d b cool to get a lil head start on others too. like the needles into my head for alopecia which I have an appt for jus before my bday.. lashes n brows I have that appt for.. i needa get my actual hair done somehow.. before nye!! change my piercings to cold & possibly get another?! more tattoos!! coverup of the Drake matching one for sure. Look into studying pharmacology or some other career pathway course.. possibly something with units I’ve completed already at uni?? i need to write a list.. basically is what I’m saying as some things are more easy fix small goals that are appearance self care based, some are medium level, some are mental, some are spiritual, some are academic, some will take

[juuheizou]

i can’t understand how people orphan their fics on ao3. even the ones i wrote in high school and would change so many details of and cringe when i reread certain parts, i wrote those. i wrote them and they’re mine and for some reason i still really want people to know they’re mine no matter how much my writing has changed

[ambulanceperson]

Long but worth the read. From SARmed on Facebook:

The Trauma Blanket.

The More Things Change, The More They Stay The Same.

It's an old saying that holds a lot of weight in every aspect of life. It holds particular weight when it comes to trauma management.

A lot of things have changed since I first took a first aid course. A lot of things. But when you boil it all down to what works, a lot of things have also stayed the same, except for us. How many of us have taken the best of what we learned back then and incorporated it in our every day practice?

Be honest with yourself.

I remember one of the most important things in every first aid kit used to be a blanket to keep the patient warm. Eventually as I got more education and increased my scope of practice, those blankets became something very different in most of our eyes.

In fact with many of us, those blankets became a little bit of a joke. A sign of the limitations of those with a more limited scope of practice.

But the irony is, those trauma blankets should actually signify many of the things you should be doing in your practice to manage the critically injured patients. Every patient really.

These days we can use vacuum spine boards, pelvic binders, IV's, TXA, chest decompression, intubation, surgical airways, meds... the list goes on.

But if we're not managing hypothermia well.....well, there's a reason they call it the Trauma Triad of Death(every time I say that I hear "DUN DUN DUN").

Coagulopathy, acidosis, and hypothermia. Intertwined and each potentially deadly on their own. But combined together in a case of trauma, they're lethal.

The Trauma Triad of Death is a leading cause of death in trauma. And we're terrible at treating it.

I'll take you back a bunch of years to a shooting.

25 year old male, multiple GSW's to the chest from a long rifle. If I remember correctly he had 7 entry wounds and 6 exits. He was alive and panicked. He knew what was coming but we gave him everything we could. For better or for worse.

It was dark, raining, and barely above freezing. We cut his clothes off to assess his injuries, applied dressings to the entry and exit wounds, slid a board under him and moved. In transport, we kept him supine and kept him stripped to reassess the wounds, decompressed both sides of his chest, started a couple of 14g IV's and ran normal saline wide open. Then we followed up with morphine to control his obvious pain.

When he arrested, we rushed to start CPR and intubate him. But he didn't survive the trip to the hospital. His wounds were too severe.

But did we really give him everything we could? In hindsight, maybe not. We gave him the best of what we thought we knew at the time, but if I were to do that call again today, man, I would sure do things differently.

Let's take a look at everything we did for him back then and think about what we know now.

We stripped him down in a cold, wet environment to assess his injuries. Put him on a cold board, decompressed both sides of his chest and then started big IV's and bolused him with saline. Then we followed it up with good old Morphine.

The classic trauma strip is a double edged sword. Let's face it, we've discovered a huge amount of injuries that would have been missed without a trauma strip. But is it best practise to leave the patient stripped, uninsulated and cold? Radiation and convection (lets be honest we probably turned the air conditioning on in the ambulance because we were working hard) are both at play now, further cooling this patient and making sure the trauma triad has a better chance to work.

Your interventions these days should include updated hemorrhage control techniques, especially for extremity hemorrhage. If direct pressure doesn’t control the hemorrhage, go straight to tourniquets. The sooner the better. Early tourniquet application saves lives. Late application is a missed opportunity to intervene and perhaps save a life. High and tight are the general rules, but lets just make it “high, tight and early”.

Wound packing and hemostatic agents absolutely have earned their place too. Don’t be afraid to control hemorrhage aggressively. If you’re loading into a helicopter, or any transport modality that causes vibration, you need to step up your hemorrhage control to the next level or you’ll find your patient bleeding out. Vibration further inhibits the clotting cascade and will increase hemorrhage.

That cold board falls into the triad also. The spine board or clamshell has been stored in an unheated compartment and now it's pretty much a superconductor, stealing heat away from the patients core to ensure that the board warms up instead of the patient.

Next is our aggressive IV therapy. Two large bore IV's and crack em wide open! Well, I still like the large bore IV's (thanks to Freddy Siegers), but now, I'm sure careful with my "fluid resuscitation".

If you look at the IV fluid warmer in a hospital, you'll notice that the temp is between 38-42c. It's that temp for a reason. Bluntly put, if your IV fluid temps aren't maintained at those temps, you are making your patient hypothermic. Let me say that again. You are making the patient hypothermic.

Average IV fluid temps in an ambulance sit between 17-20c... Let that sink in for a bit. Less than half the correct temperature for safe fluid administration.

And don't get me started about failing clotting factors secondary to hypothermia, interruption of clotting factors secondary to fluid boluses, and hemodilution.

Then morphine comes up. Morphine does a few things. One good, a couple bad.

Pain control is actually extremely important to my practice. The saying "nobody ever died from pain" is a brutal, terrible phrase.

Shred the mountain doctor sure drilled it into me that treating pain should be part of our practice and it's stuck with me. Thanks Shred. You made me a better practitioner, and a better person.

I'd want some pain control if it were me. I can tough it up with the best of them, but please treat my pain. There's enough literature out there showing that pain control reduces PTSD that it's prudent to still treat a patients pain.

But know your pharmacology inside and out. One of the quirks about morphine is the effect it has on the patients ability to shiver. Adminster morphine for pain control and you will inhibit the patients ability to increase their body temperature with shivering. And if you're administering entonox.... cold gas....cold gas=cold patient....

It will also blunt sympathetic tone, thereby reducing the ability to maintain blood pressure through an increased heart rate. This will exacerbate hypotension and further complicate the course of treatment.

If you have other pharmacological choices, maybe morphine isn’t the best option anymore....

Let's fast forward to today. What would I do differently?

First off the trauma strip is now focused. Get the critical interventions done as fast as possible, get into a microclimate (bothy bag)or the back of the ambulance and then finish the trauma strip in a warm environment, then cover them back up as soon as possible.

If you have a heating device, or ReadyHeat blankets or vests, using them can mean the difference between life and death. Warm the core, front AND back. Forget the groin and focus on the fastest path to the core organs. Warming the back is absolutely the fastest approach to warming the core.

If you're using a board, clamshell or scoop still, get them off it as soon as possible and get them on a stretcher mattress (depending on your treatment guidelines). I'm a big vacuum spine board guy and it's clear that the proper use of a blanket and VSB will increase patient temps, but if I'm working for an employer that doesn't use VSB, I'll store the board or clamshell in as warm a place as possible to limit conductive heat loss.

If you're in an austere setting and don't have a VSB, board or stretcher, get the patient off the ground and onto an insulating layer like a foam pad or thermarest.

Bind pelvises prophylactically if there is mechanism to suggest a pelvic injury. Don't make your decision based on palpation. You could iatrogenically worsen pelvic hemorrhage. Bind the pelvis based on mechanism.

I'll still start large bore IV's but I'll definitely limit fluid resuscitation. Especially in freezing environments. The risks far outweigh the benefits. Far outweigh. Titrate fluid resuscitation to achieve a palpable radial pulse as per permissive hypotension guidelines.

And be early and aggressive with TXA . For every 15 minutes you delay TXA administration, efficacy drops by 10%. We all know you need to administer it within 3 hours of injury, but how many of us are aware of that time related drop in efficacy? Get on it and get on it early.

Pain meds? Oh I'll still give them. Without a doubt I'll still treat a patients pain. We're supposed to be in the business of treating patients and making them feel better. But I'll be mindful of not blunting sympathetic tone, and I'll up my hypothermia management game.

At the end of the day, aside from transport to a surgeon (a diesel or Jet A bolus), perhaps the most important thing we can give a patient is the very thing we've joked about and looked down on all these years.

That Trauma Blanket....

[withgoodintcntions]

Moving on up.

It’s been over a year since I last wrote a post for this blog, and a lot has happened in the interim. Where to begin? In reading over the posts of M1-past, I am struck by how vivid a picture I painted of my first month of medical school--and how much has changed between that point and now. 

For starters, I’ve now seen so many SPs that touching a stranger or asking them questions otherwise unsuitable for civilized conversation is no longer a foreign feeling. Once I made the (what should have been obvious) connection that white coat equals a certain set of privileges and responsibilities with respect to personal space, I fairly quickly adjusted. I still remember the first time I did an exam other than HEENT. At that point, looking in people’s ears, eyes, and noses was now normal. Having them undress so I could take a look at their abdomen was certainly not. Again, with time, shock and uncertainty was replaced with confidence and self-assurance. Since then, I’ve learned a full lymph node exam, abdominal exam, chest exam, vision testing, cognition, neurological function and muscle strength/range of motion exams. I survived the dreaded evolution of taking a full patient history. I’ve now done it in the context of not only the well-looking patient, but one clutching their head in agony. I’ve counseled patients on diseases like diabetes, high blood pressure, weight loss methods, and how to properly use an inhaler. I’ve learned basic suture techniques, IV placement, injections, and intubation. 

In short: I look back at who I was then, and only through reading my reflections can I remember what it was like before I had the mantra of ‘CC, HPI, PMSHx, FHx, social, ROS’. The entirety of M1 year, we had checklists to help guide our histories of various present illnesses and to make sure we hit all of the most important physical exam techniques. Now, we’re tossed in the deep end and asked to swim--and it’s not that difficult to stay afloat. 

Classwork is still the same as it ever was, but I’ve streamlined my entire approach. I am very selective about which lectures I attend. I spend the majority of my time using outside resources to make sure I’m learning the material for each block in the order I need and with the right amount of emphasis on every component. I have tricks for learning pharmacology and microbiology. I’ve cultivated a small but effective library of textbooks that now live on a bookshelf by my (recently acquired) desk. I’ve got a comfortable work space set up with candles, task lighting, and a view to keep me from never seeing the sun, because I’m always here, working on something. 

My insights on life beyond studies still hold true. As predicted, times did get tough periodically. Running, volleyball, studying at a local Starbucks, and finding good groups of friends to study with really helped. Self care really can’t be emphasized enough in medical school. I’ve seen first-hand over the last year or so the toll it can take when you don’t take care of yourself. It’s a struggle to find a balance that keeps things tolerable, and at times you hate everyone and everything. To be frank, it sucks, but the good part is that if you take the time to look around and open up to your colleagues, you’ll find you’re not alone. Sometimes, that’s all you need to tip things back in your favor. 

I wish I’d taken the time to write about my first experience with our cadaver. I couldn’t even try to re-capture that moment. However, when we returned from our summer break, we found we had fresh cadavers to continue our dissections with. I couldn’t have been more awestruck by the delicate beauty of the fine nerve fibers piercing through muscle tissue as they coursed to their destinations. As I examined the tiny blood vessel running alongside each white strand, I realized how much my eye had developed for those sorts of details. Over the course of the last year, we examined the musculoskeletal system, sliced brains into cross-sections to study the structures therein, and removed hearts and lungs to study their lobes and valves. Now, we’ve come to the GI tract. Even though our cadaver honestly reeks to high heaven due to an inadvertent gallbladder decompression maneuver and an unusual amount of standing fluid, I have enjoyed every moment of lab. Searching through mesentery for vasculature and separating layers of muscles brings peace to an otherwise chaotic block--a feeling that has slowly developed since the very first time I laid scalpel to skin to expose what was underneath.

Other things have changed in my life. As I’d hoped, I found a better living situation with a roommate who is largely a joy to be around. We spend what little free time we have playing volleyball, cooking, and getting (very sporadic) pedicures. Though I enjoyed the change of pace that came with living alone, I have equally enjoyed having her here to distract and commiserate with. Though it seems like just yesterday I was assigned a ‘big sibling’ in the M2 class, I now have a ‘little sibling’ of my own to keep an eye on. It has been nothing short of extraordinary getting to know the new M1 class, and truly eye-opening. I recall looking at the M2 class above me with awe as they confidently strutted onto campus for their OSCE days. They seemed so calm and collected, like they had their lives together. Now, a year later, I find I am that M2, and it’s my job to assure the M1s below me that this time next year, they will be just as confident to don the white coat and enter an exam room. 

As we move toward the end of this block, I am cognizant of the fact that it has not been my favorite one. A chaotic final week of exam prep is about to commence, and with it comes responsibilities that seem to have tripled since my first days here. The biggest change I can cite in this moment is how relatively unperturbed I am. Eventually, you begin to roll with the punches; and not a moment too soon. That flexibility I spoke of when I was moving across the country is still invaluable. The week ahead brings thousands of flash cards, practice clinical vignettes, the weekly case assignment, and likely a few unforeseen obstacles. Thankfully, I’ve got friends, a free yoga class, and two pairs of sneakers ready for a jog to carry me through. This not-so-freshly-minted M2 is ready to say so long to GI, and hello to Renal!

[enzaime-blog]

Cancer and Pain Management

New Story has been published on http://enzaime.com/cancer-pain-management/

Cancer and Pain Management

What is pain? Pain is an unpleasant sensory or emotional experience. It may be acute or chronic. Acute pain can be mild to severe and last a relatively short time (usually less than three months). It is usually a signal that body tissue is being injured in some way, and it generally disappears when the injury heals. Chronic pain may range from mild to severe, and is present to some degree for longer periods of time (generally lasting longer than three months).

With cancer, will I have pain? Many people believe individuals with cancer must be in pain. This is not necessarily the case. Further, even if pain cannot be prevented, it can often be reduced or alleviated. Pain management is an important topic to discuss with your doctor as soon as a diagnosis of cancer is made or suspected.

Pain may occur as a result of cancer, cancer treatment, or both. Pain may also occur for other reasons. It is normal to have occasional general discomfort, headaches, pains, and muscle strains in daily life, even without cancer. But, even after a cancer diagnosis, not every pain is related to or caused by cancer. Cancer pain may depend on the type of cancer, the stage (extent) of the disease, and an individual’s threshold (tolerance) for pain.

What should I do if I am in pain? A test cannot be performed to measure different levels of pain. So that any pain you may be experiencing can be reduced or eliminated, you will need to talk to your doctor about the pain and provide specific details about your level of discomfort.

According to the National Cancer Institute, the answers you give to the following questions can help your doctor locate the cause of the pain and develop a plan to provide you with as much relief as possible.

The following questions may be asked of you to more accurately evaluate your condition:

Can you describe the pain and what it feels like? What do you think could be the cause?

How strong is the pain? To accurately answer this, your doctor may ask you to rate your pain using a scale from 0 to 10; 0 is no pain and 10 is extreme pain.

When did the pain start and how long does it last?

Is the pain worse during certain times of the day or night?

Can you show exactly where on your body you are experiencing pain?

Does the pain move or travel? If yes, can you show how and where?

Have you taken any medications to relieve the pain, or tried any other approaches to reduce the pain? Have you experienced any relief?

Have you noticed particular activities or positions that make the pain better or worse?

You may want to make some notes so that when your doctor asks specific questions about your pain, you will be able to provide accurate answers. Write down the details of any discomfort you might have been having so you will not forget to report them. Consider keeping a diary of your pain, or ask a friend or family member to help track your symptoms. The types of information that you may want to note in your diary include:

Date

Time

Pain scale rating

Type and dose of medication

Time pain medication was taken

How well pain responded to medication taken

Any other pain relief methods attempted

Your doctor may need to refer to your diary when making a plan to relieve your pain and make you more comfortable, therefore, be sure to bring it with you to your doctor visits.

How can I describe my pain? When your doctor or nurse asks about your pain, you will need to communicate how your pain feels in as specific terms as possible. When you are asked how it feels, using the following terminology may be helpful:

Dull pain. A slow or weak pain, not very sudden or strong.

Throbbing pain. A pain that surges, beats, or pounds.

Steady pain. A pain that does not change in its intensity.

Sharp pain. Pain that causes intense mental or physical distress, that may feel “knife-like.”

Acute pain. Severe pain that lasts a relatively short period of time.

Chronic or persistent pain. Mild to severe pain that is present to some degree for long periods of time.

Breakthrough pain. When you are taking medication for chronic pain, moderate to severe pain that occurs between doses (pain that “breaks through”).

What causes pain with cancer? Cancer pain that lasts several days or longer may result from one or more of the following and should be evaluated right away:

Pain from a tumor that is pressing on body organs, nerves, or bones

Poor blood circulation

Blockage of an organ or canal in the body

Metastasis (cancer cells that have spread to other sites in the body)

Infection or inflammation

Side effects from chemotherapy, radiation therapy, or surgery

Stiffness from inactivity

Psychological responses to tension, depression, or anxiety

Treatment for pain Specific treatment for pain will be determined by your doctor based on the following:

Your age, overall health, and medical history

Type of cancer

Extent of disease

Your tolerance for specific medications, procedures, or therapies

Expectations for the course of the condition

Your opinion or preference

Cancer pain may be treated directly with chemotherapy or radiation therapy. Sometimes a surgical procedure may even be recommended specifically to reduce pain. Multiple approaches may be used to treat pain including both pharmacological and nonpharmacological.

What is pharmacological pain management? Pharmacological pain management for cancer refers to the use of medications. Oncology clinics usually offer several pain management options for any procedure that may be painful, such as a bone marrow aspiration or lumbar puncture. There are many types of medications and several methods used for administration, from very temporary (10 minute) mild sedation, to full general anesthesia (where you are in a deep sleep) in the operating room.

Pain medication may be given in one or more of the following methods:

By mouth (orally in pill form, liquid, or as a lozenge placed inside the cheek or under the tongue)

With an injection under the skin (subcutaneous injection)

Through a needle in a vein (IV)

With a special catheter in a space around the spinal column (epidural)

By blocking a specific nerve that is causing pain

Through a patch on the skin

Through implanted methods (such as a pump that is implanted in the body)

By inserting rectal suppositories

Examples of pharmacological pain relief include the following:

Analgesics (for mild to severe pain relief)

Sedation (usually given for relief of pain during a procedure)

Anesthesia (usually given for relief of pain during a procedure)

Topical anesthetics (cream, gel, or liquid applied to the skin to numb the area)

Other pain relievers

Some people can build up a tolerance to pain relievers. Over time, doses or types of medication used for pain relief may need to be increased or changed. Fear of addiction to opioids is common, although, in most cases, it is rarely a problem. It is important to understand that the ultimate goal is comfort, which means taking appropriate measures to alleviate your pain.

Questions to ask about your pain medication Each time a pain medication is prescribed by your doctor, consider seeking answers to the following questions:

What dose of pain medication is being prescribed and how many times a day will I be taking medication?

What should I do if my pain is not relieved with the recommended dose?

What would warrant a dosage increase?

Should I call you before increasing the dose?

What if a dose is missed or not taken on time?

Should this medication be taken with food or on an empty stomach?

Should I be taking this medication (if tablet or capsule) with a particular type of liquid?

How long does it take the medication to start working?

Is it safe to drink alcoholic beverages, drive, or operate machinery while taking this pain medicine? Are there any other activity restrictions?

Are there prescription or over-the-counter medications that are dangerous to take with this medication?

Are there any side effects associated with this medication? If yes, is there any way to prevent or reduce them?

What if I need to change my pain medicine? If you are dissatisfied with the medication you have been prescribed, consult your doctor or cancer treatment team. There may be other ways to alleviate the pain, including switching to a different pain medication. Changes may also be recommended regarding the way you are taking the medication.

Be sure to talk with your doctor if you are uncomfortable, as a different pain medicine, different dose, or different combination of pain medications may be required if:

Your pain continues.

Your pain medication does not start working within the time frame specified by your doctor.

Your pain medication does not work for the length of time specified by your doctor.

You are experiencing breakthrough pain (moderate to severe pain that “breaks through” between doses).

The dosage schedule or method is inconvenient and you are having trouble adapting your schedule.

Pain becomes disruptive to your daily activities, such as eating, sleeping, working, and sexual activity.

You experience serious side effects such as difficulty breathing, dizziness, and rashes. If serious side effects occur, call your doctor immediately. Side effects such as sleepiness, nausea, and itching usually resolve after your body adjusts to the medication. However, call your doctor if you are experiencing any side effects from your pain medication.

What is nonpharmacological pain management? Nonpharmacological pain management is the management of pain without medications. This method utilizes ways to alter thoughts and focus concentration to better manage and reduce pain. Methods of nonpharmacological pain include:

Education and psychological conditioning. Not knowing what to expect with cancer treatment is very stressful. However, if you are prepared and can anticipate what will happen, your stress level will be much lower. To decrease your anxiety about cancer treatment, consider the following:

Ask for an explanation of each step of a procedure in detail, utilizing simple pictures or diagrams when available.

Meet with the person who will be performing the procedure and write down answers to questions.

Tour the room where the procedure will take place.

Ask what you can expect as an outcome of the treatment.

Hypnosis. With hypnosis, a psychologist or trained clinician guides you into an altered state of consciousness. This helps you to focus or narrow your attention to reduce discomfort.

Imagery. Using mental images of sights, sounds, tastes, smells, and feelings can help shift attention away from the pain.

Distraction. Distraction is usually used to help children, especially babies. Using colorful, moving objects or singing songs, telling stories, or looking at books or videos can distract preschoolers. Older children and adults may find watching TV or listening to music helpful. Use distraction appropriately, and not in place of an explanation of what to expect.

Relaxation. Relaxation exercises include deep breathing and stretching and can often reduce discomfort.

Other nonpharmacological pain management may utilize alternative therapies, such as comfort therapy, physical and occupational therapy, psychosocial therapy/counseling, and neurostimulation to better manage and reduce pain. Examples of these nonpharmacological pain management techniques include the following:

Comfort therapy. Comfort therapy may involve the following:

Companionship

Exercise

Heat or cold application

Lotions or massage therapy

Meditation

Music, art, or drama therapy

Pastoral counseling

Positioning

Physical and occupational therapy. Physical and occupational therapy may involve the following:

Aquatherapy

Tone and strengthening

Desensitization

Psychosocial therapy or counseling. Psychosocial therapy or counseling may involve the following:

Individual counseling

Family counseling

Group counseling

Neurostimulation. Neurostimulation may involve the following:

Transcutaneous electrical nerve stimulation

Acupuncture

Acupressure

[jaxonchaffey94-blog]

How Can Drugs Affect Our Body?

Has Sirna Been Applied Onto Humans To Cure Any Diseases And Are There Any Side Effects?

How do the drugs given through an IV work?

Look at the GI diet which explains how some of the foods affect your blood glucose levels try and stick to gi low or medium foods and limit the amount of high ones. For example, in 2000 the US Food and Drug Administration (FDA) announced their intention to rescind approval for fluoroquinolone use in poultry production because of substantial evidence linking it to the emergence of fluoroquinolone resistant Campylobacter infections in humans. And I believe in all the bipolar and schizophrenia thing, because those people need help because they are insane.

Does having excessive food reduce the effect of a drug taken?

Oxy and methadone are both opiates, both painkillers and both effect that "pleasure sense" in your head so they will have similar withdraws. CPS workers are lazy, so they'll want you to prove their case for them. If he tries to get you to disrespect your parents, get out. People who get caught should not have their lives ruined and placed in with rapist and murders over a moral issue. And the second song they have is called LAUREN, about loss, death of a loved one and touches on suicide. For instance an TNN was a Two Neuron Nutcase and that lead to the even worse NNN which is easily deciphered as a No Neuron Nutcase.

Pharma companies' research shows that when a patient asks for a drug by name, their doctor will prescribe that brand 9 out of 10 times. Drug companies believe this is an effective way to drive market share.

Another practice which I mentioned once on yahoo answers and I got like fifty thumbs down and all sorts of hate mail calling me a liar. When grocery shopping, break your addiction to brand names. What you need to do is record all of this, and have it ready for someone to read. Looks like he has hypothyroidism, high blood pressure, anxiety, enlarged prostate, acid reflux, poor nutrition, osteoarthritis (perhaps in the knees?) and possibly atrial fibrillation (?) and mild congestive heart failure (?). Saliva can't transmit AIDS unless the person with the HIV/AIDS is unlucky enough to also be suffering from rabies, and you literally dunked a fresh wound into a giant pail of their spit or something like that. You need to educate yourself on how they go through FDA approval and how they directly affect the brain. It is not known whether the pleasure-induced pupil dilation is a side-effect, a social signal, or an adaptation for receiving as much sensory input as possible. It's a little less strong and supposed to have fewer side effects. I will take a look to see if there are any restrictions on the use of the coupon. All 3 meds are indicated for acute pain episodes lasting up to two weeks. I have a beautiful grandson because of St John's Wort making birth control pills a lot less effective. Click here to know the Effects of Tramadol in our body. Make sure that mixed drinks are accurately measured, and be sure to account for added calories and carbohydrates in fruit juices, sodas, and other mixers. Be warned, though, that when taken in excess, Benzoyl Peroxide can cause peeling and drying. Sedatives can be abused to produce an overly-calming effect (alcohol being the classic and most common sedating drug). Factors that have been implicated in precipitating an addiction include: genetic, biological/pharmacological and social factors. As for the withdrawal symptoms, everyones different. For many individuals, certain medication could cause them to develop a pattern of nightmares. Healing plants are being used by more people today than ever before. Prescribed What blood tests did the doctor prescribe? I am posting the images of the doctor- prescription and lab-receipt below. can provide you with that. On the way home from my appointment I stopped and filled the prescription. This allows observation throughout the testing procedure and virtually eliminates switching, diluting or tampering with the sample. You can get it at a pharmacy without a prescription. The girl will still look white and her skin tone will appear more sun kissed (though I see a lot with hideous leather face skin and orange glow..yuck) A person who bleaches their skin is seen as self hating because they are trying to make them self closer to the beauty ideal. There are no hard and fast rules on that, but generally if you're intending to live in the UK you can bring a one month supply and if you're on holiday here you may bring enough to cover the period of your stay plus a few days more. It can treat my frozen shoulder without cortisone and not long ago i read about a plant that is in the chinese materica medica and it looks very promising for the treatment of malaria. Your doctor can usually diagnose measles based on the disease's characteristic rash as well as the small, bright red spots with bluish-white centers on the inside lining of the cheek, called Koplik's spots. I've been taking that for over two years, and it's working very well for me. This was more crass, less fun and filmed in the "Found Footage" style.