WebMD Blogs
Icon

Pain Management and Migraine Relief

Chronic pain affects an estimated 86 million American adults to some degree. Approximately 45 million Americans suffer from chronic headaches. Indie Cooper-Guzman RN shares information and advice about migraines and headaches, their causes, triggers, and treatments.

background

WebMD Health News

Wednesday, April 30, 2008

The Pain of Obesity...Bariatric Considerations
AddThis Social Bookmark Button

Recently I attended a seminar with my daughter regarding obesity, weight loss, and surgical alternatives. My daughter has struggled all her life with weight issues and has tried many things to lose weight. At the age of 25 she has several co-morbidities that are most often seen in the older adult population, i.e.: high blood pressure, asthma, GI problems, arthritis, low back pain, and fertility issues. Three of her doctors have recommended surgery and will be providing statements of medical necessity for her.

The biggest challenge has been insurance coverage which has kept her from even considering this option in the past. Then she found an organization at one of the local hospitals that gives hope to the obese and support to the many that pass through their doors to get surgical assistance that might not only improve the quality of their lives, but may even save them.

I was glad to see this program requires all of the necessary pre-assessments prior to acceptance into the program. We don't foresee my daughter having a problem and pray that the insurance coverage will be sufficient. She emphasizes this is not a cosmetic move. She has a loving husband now at her current weight and she feels blessed. This is for her health and quality of life. She feels that once she gets the weight off, she will be able to pursue a different line of work and become more financially stable. She sees this as a new lease on life - the beginning of a new one in terms of eating and nutrition and other behavioral considerations that are so often linked to unhealthy eating patterns.

I am thrilled to see my daughter pursuing this alternative since she has tried diet after diet, prescription meds, and exercise (which usually leads her to a back spasm and PT). She needs to get some of the weight off so she can start to exercise regularly and continue a more active lifestyle. Right now she is exercising at home using a TV stretching and aerobic video because she is embarrassed to walk outside. She has lost over 50 pounds. However she has issues with an inability to keep the weight off once she loses it. And when it comes back, it comes with a few extra pounds besides.

My daughter is diligently researching the surgical procedure. She is talking to people who have had it done to hear their experiences and outcomes. She is linking up to networks to build her support group. She has looked into the dietary supplements she would need to take and also the protein supplements. Being lactose intolerant, we were concerned about her finding products to work with but she has at a local supplement store. The store manager has been supportive and willing to help her learn about the different products that are used for nutritional supplementation after bariatric surgery. She wants to have a comprehensive understanding about what it will take to make this a positive experience and a new lease on life. She is not looking for miracles. But like many of the close to 100 other people attending the seminar, one would be welcomed I think.

These past few days I have seen some positive changes in my daughter. She is brighter and more energetic. She is becoming quite educated on the subject of bariatric surgery and weight loss. She feels she may have found her only hope after exhausting all of the other less invasive approaches. I am proud of her for pursuing this. I am going to be her biggest fan as she finally begins to feel better about herself and her pain begins to decrease and resolve.

I told my daughter she is a beautiful young lady and she is...regardless of her weight. Being healthier and beautiful at the same time...It can't get much better than that.

I'll keep you posted.

Related Topics: Technorati Tags: , , ,

Posted by: Indie Cooper-Guzman, RN at 1:07 PM

Wednesday, April 16, 2008

Part V: Total Knee Replacement - And the Beat Goes On
AddThis Social Bookmark Button

Up until about a month ago, my husband continued working hard to recover from his total knee replacement rehabilitation at home. He spent a total of 6 hours a day on the CPM (continuous passive motion) machine in addition to other exercises his therapist prescribed. Then one day we hit a major road block that put a halt to the formal rehabilitation and threatened my husband's positive recovery experience.

Feeling proud of his accomplishments, my husband met with his surgeon for a follow-up. Expecting my husband to be using a walker and ambulating at a slow pace, the surgeon was surprised and very pleased to see him ambulate with one crutch at a regular pace. Watching him maneuver the exam table and sit with his knee dangling close to 90 degrees brought a big smile to his face. Significant swelling remained and pain continued to rise to a moderate level by the end of the day when there had been a lot of activity. But my husband remained very motivated to recover so he could get back to work. So the surgeon discontinued the home therapy and ordered an outpatient PT evaluation and treatment plan.

The next day my husband contacted a couple of outpatient centers in the area and gave them the disability/insurance information so they could set up the reimbursement process. Then the phone call came telling us that it was now over 6 months since my husband worked and both his disability and his insurance benefits had been exhausted! With mouths agape, we just stood looking at each other. Here we were with a need to finish therapy in order to get back to work - but without insurance and with no income, my husband had nothing to cover the therapy. He even asked about performing therapy at home and then going to the surgeon for a follow-up, but that was unacceptable. He was in a catch-22.

The first reaction was to panic; then we stopped. We needed to focus our energy on finding a solution. I had recently accepted a position myself and was therefore in the midst of benefits transfers. Now I needed to get my husband onto my insurance as soon as possible. Then he would need to find a therapy center and get going with the therapy. So I went to work on getting this switch to my insurance accomplished.

Two and a half weeks later, my husband was covered. Today he had his evaluation for outpatient therapy. The key to his ability to continue progressing forward in the interim was his unceasing desire to heal and get back to work. Every day - several times a day - my husband performed exercises to keep his range of motion. He practiced stretches using stairs and a chair; he walked up and down the flight of stairs a couple times or more every day without fail. Following each session, he iced his knee and when the going got tough, he took some meds and elevated his leg until he was back up and about. What could have been a set back in terms of regaining function did not because of the consistent and persistent exercise my husband did on his own.

This has been a learning experience for us, to say the least. Now my husband is prepared to work on continued therapy and strengthening. He is hoping to get back to work soon. Based on our experience, we encourage anyone who must undergo a surgery or problem that may lead to more than 6 months off the job, to file for social security temporary disability insurance benefits early. Don't get caught off-guard like we did.

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!
Part IV: Healing Continues

Related Topics: Technorati Tags: , , ,

Posted by: Indie Cooper-Guzman, RN at 4:20 PM

Thursday, March 20, 2008

Cool Idea for Your Pain Management Toolbox
AddThis Social Bookmark Button

One of the things my husband has needed to do is ice his knee before and after using the CPM (continuous passive motion) machine or having the physical therapist work with his post op knee. This is what we were told to do:

Take paper cups and fill with water. Place in freezer. When needed, take a totally frozen paper cup and peel around the cup edge exposing the ice surface. While holding the paper cup, rub the ice around the knee area. You can either put the rest of the frozen ice back in the freezer to use later or toss away.

This tool can be used on many parts of the body that need icing. Use any size paper cup you want. The larger sizes are great for low back and large areas. For headaches, perhaps a smaller cup would be fine. It is an easy tool to create and inexpensive as well. Give it a try!

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!
Part IV: Healing Continues

Related Topics: Technorati Tags: , , ,

Posted by: Indie Cooper-Guzman, RN at 10:23 AM

Monday, March 17, 2008

Part IV: Healing Continues
AddThis Social Bookmark Button

It has been roughly 4 weeks since my husband's total knee replacement. He remains on crutches and finds challenges getting into and out of vehicles and managing stairs, but he has improved significantly. He is tired at times, yet his attitude remains positive. There are times when he feels extreme pain, but he sees the value in the continuous passive motion (CPM) machine and he continues his exercise regimen faithfully.

I am thrilled when he is blessed by his efforts. He finally walked around the house with his crutches feeling no pain which is something he has not experienced in years. And he is bending his knee further and further each day. Outpatient rehab comes next for further strengthening we are told. I bet it will be a short course.

My husband will be going for his post-op visit to see the surgeon soon. I hope he is as pleased at my husband's progress as we are. I will keep you posted!

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!

Related Topics: Technorati Tags: , ,

Posted by: Indie Cooper-Guzman, RN at 10:13 PM

Wednesday, March 12, 2008

Part III: Coming Home!
AddThis Social Bookmark Button

After three days in the hospital, we learned insurance wouldn't cover the level of care my husband needed following his knee replacement surgery. They decided to send him home and set him up for home care and home PT (physical therapy). At first I panicked because I knew he was going to be home alone about 12 hours a day and they seemed a little too eager to discharge him. So I went with him to PT and watched him walk with walker and crutches and manage stairs, etc.

I was literally trembling as I got into the truck to swing by the front of the hospital where they were bringing him. His pain levels were through the roof and getting him into the truck with the knee immobilizer on and the crutches was an ordeal. With sheets of exercise regimens in hand we headed home.

We got home and made it up the steps. He was a little off balance when the dog ran to greet him and I was glad to be there to support him and help him regain his balance. Just the ordeal of getting home tired him, so he settled into bed to rest. It is very difficult to sleep in a hospital and he was exhausted period.

From the start my husband had a very determined and motivated attitude. He was warned it was going to be painful, but he was not going to let it keep him from doing what he needed to do so he could get back to the business of living a "normal" life.

The first few days he slept a lot partly due to the pain meds and also because of the exercises he was doing throughout the day. He used the crutches and walked short distances around the house. He didn't push himself, but he exercised regularly.

Many nights my husband wakens with stabbing jabbing pains down his leg; and yet with so little restful sleep, he doesn't complain. He accepts it as part of the healing process. His visiting nurse and therapist feel he is really doing above the average in speed of healing in spite of the mess the surgeon found when he started his work. He did a wonderful job on the inside and out. We feel very thankful and blessed.

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event

Related Topics: Technorati Tags: , ,

Posted by: Indie Cooper-Guzman, RN at 7:31 PM

background