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This blog has now been retired. We appreciate the wisdom and support Indie Cooper-Guzman, RN has brought to the WebMD community throughout the years. Talk with others about chronic pain management at the WebMD Chronic Pain Exchange.

Tuesday, December 9, 2008

Surviving the Holidays This Year

Well it’s that time of year again when folks are out in full force, pounding the pavement searching for that special gift for the holidays. With the economic crises being felt by many this year, the stress of maintaining the level of festivities one is accustomed to may be unrealistic.

With the colder weather and damp chills that come with the changing seasons, arthritis and other muscular-skeletal conditions can wreck havoc with normal everyday functioning. So how can folks get through the holidays this year?

Prioritize. Sit down and map out the important and necessary issues that need to be addressed. And spend money wisely. Paying on a bill is more important than buying holiday gifts. Consider cutting back and spending less. Shorten your gift-giving list if necessary. And limit the number of gifts purchased per person. Remember it is the thought that counts.

Some of the best gifts are those that were crafted or made by hand. The thoughtfulness and time that go into creations is a priceless gift. You can’t put a price tag on the amount of kindness and love that is shown by the efforts put into making a special gift for that special loved one.

Another idea might be to offer your services to someone. Create your own gift certificates such as 4 hours of baby sitting to provide relief for a new mom. Run errands, assist with light house cleaning for a busy friend or loved one. Helping others in spite of personal pain and limitations can feel rewarding in itself so you benefit in more than one way by sharing yourself with others. And most important of all, remember the reason for the season. That should help you put things in proper perspective.

When you prepare to go shopping, plan your trips carefully. Don’t overdo. If whatever you plan to purchase is big and heavy, bring someone along who can help manage the item. Make sure to have assistance from the store employees when necessary.

If walking is a problem for you and the trip will require a good deal of it, consider taking some medication before leaving the house. This will help keep you comfortable while you are out and about. Be careful however if you plan to take a medication that could cause drowsiness. Be sure to have someone else do the driving. And plan to take a little time when you get back home to rest for a short while with some ice or maybe some heat so that you can get a jump on any possible inflammation that might have occurred with the activities of the day. For acute conditions, one common course of treatment is to start with ice and then introduce heat after at least 24 hours. And perhaps one of your family members can provide a short massage to help relax tired and achy muscles.

These are some coping strategies that might help folks get through the stress of the holiday season. I encourage folks to share some of their survival tricks with us. Post them on either my Pain Management or Migraine board. Refer to “Surviving the Holiday Season” in the subject field so I will know your post is linked to this blog. Happy Holidays!

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Posted by: Indie Cooper-Guzman at 2:00 pm

Tuesday, October 28, 2008

Use of Placebos: Is It Ever Appropriate?

I just read an article that said that nearly half of the doctors in a survey prescribe and give their patients placebos. “About half of the 679 US internists and rheumatologists questioned reported prescribing placebo treatments to their patients on a regular basis.”[Tilburt, J.C. BMJ, online first edition, Oct. 24, 2008] And many do not tell heir patients they are doing so. I figured it happens, but I was shocked at the number of doctors who admitted to doing it.

I feel it is unethical for professionals to do this. There is a great focus on pain patients being labeled as seekers when they take meds that provide no relief and continue – in desperation – to try to find someone to help them. Now I am curious – how many of those instances can be tied to a patient being given a placebo? No wonder it wouldn’t work! And yet the first to be scrutinized is the patient, not the prescriber. This would make for a very interesting and important research study.

Now these are my own personal comments and opinions on the issues around placebos. If you would like to share your comments, please visit either my pain management and/or migraine message boards and share your thoughts. Put the word “Placebo” in your subject line. Let’s hear what people have to say about this controversial topic. Look forward to hearing from you!

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Posted by: Indie Cooper-Guzman at 12:00 pm

Monday, October 27, 2008

Changing Seasons – Comforting Images

Well the summer is gone and fall has arrived. Some areas are experiencing that all too unsettled feeling when the seasons change and winter is around the corner. For some the temperature fluctuations can bring on cluster headaches. And the cold can often be felt right straight to the bones of folks who suffer arthritis.

During this time of added stress for many who have experienced financial upheaval and other stressful times, it is especially important to take care of yourself. Be sure to eat right and get rest. And if you begin to notice symptoms of a cluster, see your doctor and get on your meds promptly. It is easier to break a cluster if it hasn’t lasted too long. Be kind to yourself. Take one day at a time. Seek out the help and support of others if you need to.

During this time of year many folks are preparing for winter – plastic on the windows, furnaces checked and fireplaces stoked. Thinking of images that bring comfort and warmth can be soothing during cold or stressful times. Maybe you can create some comfort images to add to your pain management tool box. Let’s see how many we can gather. Post your comfort images on either my pain management or migraine message boards here on WebMD and let’s see how many we can collect!

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Posted by: Indie Cooper-Guzman at 8:30 am

Tuesday, October 21, 2008

Stressed and Worried? Build a Tool Box to Cope

Whether it’s reading the news or listening to frequent discussions around us, we can’t ignore the state of our current economy. People reviewing investments feel the urgency and panic that go with the realization of hard-earned money being lost. People who live on those financial resources realize they are quickly reaching a point of “no available funds.”

Retirement plans dwindle and Social Security funds are being eaten up quickly, leaving those who have yet to reach retirement age wondering if we will have anything to count on when we do. The most strategic retirement plans continue to leave people ill-prepared for retirement during the financial crisis. People all around are filing bankruptcy, losing their homes to foreclosure, and wondering where they will go and what they will do.

Coping with the stress and worry of life is hard enough for people in relatively good health. For those with chronic pain and physical limitations, it can lead to increased pain symptoms and decreased ability to cope with them.

I strongly encourage you to reach out to someone to discuss concerns. Find a close friend or join an online chat group of people experiencing similar situations and support each other. Start writing a journal, either online or in a notebook. Sometimes it helps to get your thoughts and concerns out on paper so you can visualize them. It helps to keep them from swimming around in your head all night long.

If you find yourself in a crisis situation, find a counselor to speak with. In the meantime, list your situation in your notebook. Ask yourself if there is anything you can do to help the situation. If so, start writing down the steps you can take. If not, then the issue becomes locating someone who might be able to help or some how realizing the situation for what it is and work with it. Call on family and friends for support and brainstorm with people about things. Sometimes people can suggest options we might not consider on our own. Try not to be hard on yourself. The economy is not your fault. It is what it is. The important thing is to do the best with what you have.

Photo Credit: German Meyer

To help with the physical pain and symptoms, try to be kind to yourself. Take a bubble bath. If the doctor says using Epsom salts is ok, add some to your bath water to help with inflammation. Pace yourself. Try not to overdo. Don’t be afraid to ask for help when you need it. This is not a time for being proud and ego-centered.

Are there anythings you have found helpful in coping with the issues of life? If so, please share them on either my Pain Management or Migraine message board here on WebMD. Start your post with “Coping Tool Box” so we can find your post and respond. Let’s see how we can add to our pain and stress management tool boxes together.

Most respectfully,

Indie

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Posted by: Indie Cooper-Guzman at 3:07 pm

Monday, September 29, 2008

The Value of Change…Getting Outside

For folks who suffer chronic pain and limitations, the tendency to stay home and remain sedentary can be more harmful than good. The fear of making pain increase or symptoms intensify is very real and the fear in itself can be crippling if we are not careful. On those days when it is nice outside and you can manage, consider stepping outside into the sunshine. Sit on your porch, walk about your yard or grounds, take a short ride. The change of scenery, the feeling of fresh air, and the change of pace can change the way you think and how you feel.

beach-sunsetToday I took my first trip to the ocean. My husband drove me down to Seaside to take a short walk. Just to be sure, I took a couple NSAIDS before we left and by the time I reached there I was doing fine. We took it easy, walked a little, sampled the boardwalk fare by having some ice cream and a slice of pizza, watched some sunbathers and took in the sounds and smells of of the surf and then headed back. We weren’t gone more than about 3-4 hours tops, but it felt like I had taken a little mini escape and boy, did I need that!

The walk did me good. I recently had neck surgery so I focused on my posture, which not only helped that but also helped keep my low back in check as well. I used a fanny pack and carried little in it. So my shoulders and arms were free of any weight. I made sure to enjoy the ocean air and focused on relaxing as I sat briefly on a bench and I enjoyed the present. I didn’t think about the stress or the worries that have occupied my mind. My husband and I shared nice light conversation about the ship traveling down the coast and the kids we watched building sand projects. And we saw some daredevils riding on a skyride and knew that would not be either of us…lol. It was an important time of sharing and relaxing – just living in the moment.

It is important to allow ourselves these times. They are important – they lift our spirits and help us through trying times. Fresh air and sunshine can help us feel better and cope easier. When was the last time you went outside, took a short trip, or enjoyed a change of scene? There is still some time… think about it. And when you get back, write and tell me about it on either the pain management or migraine boards. Label it “My Day Trip” or “Change of Scene” or something like that and I will know you are responding to this blog. I look forward to hearing from you.

~Indie

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Posted by: Indie Cooper-Guzman at 4:00 pm

Thursday, September 18, 2008

Fear of Taking Meds

While looking at posts on my Migraine and Pain Management message boards, I have noticed the fear of taking meds as a theme. The fear of med side effects is legitimate, and when people read all of the possible side effects and interactions, it can lead to significant concern and hesitation to try a new medication. Sometimes it comes down to weighing the risks against the benefits and remembering a few things.

  • Meds react differently with different people. What some folks experience while taking a drug does not mean everyone will experience the same negative or positive effects.
  • Every medication is a foreign substance taken into the body. Therefore there is a chance of reaction with any medication. However, if a patient takes a drug as prescribed and is monitored by a physician, any problems should be recognized and reported promptly. This enables drug doses to be regulated and side effects minimized if the drug is not stopped and another prescribed.
  • Medication is but one approach to chronic pain. To gain the best results, it often takes a multi-faceted approach to treat pain. In this case, having an open mind to various alternatives can be very helpful.
  • Some folks take herbs feeling they are harmless. Be very careful. Herbs if taken without proper research and supervision can be harmful and even deadly if taken in combination with other herbs or prescribed medications.
  • Some meds have temporary side effects that resolve as the body gets used to the drug. At the same time, it often takes time for the body to build a blood level that will result in benefits. Quite often people will start a med only to stop it too soon, thus losing the chance of realizing the full benefit the drug might have for them. Therefore, it is important to give meds a fair chance to work before writing them off as being ineffective.

These are some things to ponder if you find your doctor prescribing new medications for your condition. I hope they help you as you work with your doctor as a team to find the best combination of treatments and modalities for your individual condition. May you find the relief you need and so greatly deserve.

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Posted by: Indie Cooper-Guzman at 7:15 am

Tuesday, September 16, 2008

Anterior Cervical Discectomy and Fusion: Healing One Day at a Time

Recently I underwent an ACDF (anterior cervical discectomy and fusion) with hardware at C5-6. It was a last resort following conservative treatment with failed outcomes, deterioration in fine motor skills, and neuropathy in both shoulders and arms including hands.

The decision to undergo surgery was difficult at first. However, I realized the time had come. It needed to be done to save my livelihood – the ability to use my hands. Functionality is as important – if not more important – as pain at some points.

I am roughly two weeks post op and continue to have stiffness and pain when I turn my head to the right. And although my arms still feel very heavy, the tingling and pins and needles are less. I am thankful for that. I am trying to stay optimistic that with healing will come a decrease in pain and stiffness. I am currently using heat and also have meds for pain and spasms if I need to take them. They can be sedating, so I try to hold off and take them at night. I find myself up a lot at night and am looking at the possibility my pillow may be an aggravating factor. I am going to try a different one tonight to see if it helps.

My doctor said the problems with my neck didn’t start yesterday and it would take time for the nerves to calm down following the surgery, so I know that being just two weeks it is not reasonable to be symptom free. The good thing is my surgeon performs a lot of these surgeries and everyone I talked to said I was in the best hands possible. So I feel good about that.

What I need to do now is focus on getting better. I am thinking as positively as I can that my chances for a positive outcome are good. Tincture of time can sometimes be hard to take. I am looking to reduce stress wherever possible because I know that this can drain my coping skills and waste my energy. Sometimes it is easier said than done. I must eat and rest and take it easy. Although it is hard for me, I am asking for help when I need it. I am fortunate to have a supportive husband and family to help me through this trying time.

I am hoping for a speedy recovery so I can get back to full time work with as few limitations as possible. And for now, I will work on it one day at a time.

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Posted by: Indie Cooper-Guzman at 4:56 pm

Friday, August 1, 2008

Gaining on Pain: New Treatment Breakthroughs

Have you ever read WebMD the Magazine? If you have been in doctor’s offices, you may have seen copies in the waiting area. In the July/August 2008 edition, there is a great article, Gaining on Pain: New Treatment Breakthroughs, by WebMD’s own Michael W. Smith, MD and Scott M Fishman, MD, president of the American Pain Foundation.

This article, written in question/answer format, shares some exciting things about latest discoveries, new drugs,and experimental treatments for chronic pain. It brings out the point that chronic pain is a disease that requires a multi-faceted and holistic approach to treatment that includes focusing on the patient’s physical, psychological, social and cultural issues effected by their pain and limitations.

In the article there is a very accurate description of the downward spiral often experienced by chronic pain sufferers. The impact can be devastating to victims and their families – especially if the person in pain is also the main breadwinner in the family. As a chronic pain sufferer myself, I read it with all too much understanding of the price that can be paid by victims of this condition.

But the article is not about gloom and doom. It is about accomplishment and hope. Research has revealed exciting discoveries and increasingly effective alternatives. New drugs are being developed and tested and combinations of known alternatives are showing promise toward combating the debilitation caused by some chronic pain syndromes.

WebMD takes the issues of chronic pain and education very seriously. They make sure all of their content is accurate by calling upon the expertise of recognized leaders like Michael W. Smith, MD and Scott M. Fishman, MD. When you read WebMD the Magazine, you know you are reading reliable information. So if you haven’t yet seen this valuable resource, consider picking up a complimentary copy on your next doctor visit.

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Technorati Tags: chronic pain, treatment, WebMD the Magazine

Posted by: Indie Cooper-Guzman at 10:00 am

Wednesday, July 30, 2008

Complimentary and Alternative Medicine for Pain Relief

While recently reading the Spring 2008 edition of The Pain Community Newsletter of the American Pain Foundation, I was pleased to see the focus on complimentary and alternative medicine (CAM) for relieving pain. I am glad that people are beginning to consider the benefits of various alternatives. I remember years ago when I would talk about certain alternatives, people would laugh and call them bogus and fake. It is good to see that they are now being explored and tested more seriously.

The article, The Evolving Role of Complementary and Alternative Medicine for Pain Relief, includes a scale that shows back pain as the main condition being treated by CAM. The use of these alternatives for other conditions such as headache, recurring pain, and insomnia remains low. This is a very good article and I encourage folks to check it out. Share your responses with me on my Pain Management and Migraine message boards. What complimentary and alternative medicine approaches have you tried? What conditions were causing your painful symptoms? Did you find them helpful? I look forward to hearing from you!

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Technorati Tags: pain, alternative medicine, CAM, complimentary medicine

Posted by: Indie Cooper-Guzman at 8:34 am

Tuesday, July 15, 2008

Reconnecting: The Importance of Friendships & Faith

An opportunity to see a dear friend of mine presented itself this weekend. I hadn’t seen her in over four years since she moved from New Jersey to Georgia. To see her, I needed to drive to Delaware where she was visiting family. I am so glad I had the chance to take that trip.

At first I was reluctant to travel due to a variety of issues, including physical limitations, but in the end I decided seeing my friend would be worth the effort.

My friend and I both suffer physical difficulties so we planned our time together with a lot of flexibility. We managed to travel into Baltimore Harbor and see some sights and enjoy some great food. We didn’t push it. In fact, I was pro-active and put in an extra set of clothes right below my heating pad in my suitcase. I was determined to be prepared in case I needed to stay an extra night…and it turned out to be a good thing because I did indeed need to take the extra time and use it to relax with meds and pad after the events of the busy day. But it was worth it.

We had a wonderful time. Over the couple days, we talked like teenagers for hours about all the different things we had encountered over the past four years. We also enjoyed laughing at some of the crazy things we remembered as colleagues and coworkers. It was all good.

Our faith is very important to us and we found a place to worship Sunday morning before I headed home. While driving back, I had time to contemplate the importance of reconnecting with friendships and faith. All relationships take work. And it is important to make the effort to nurture them. I came home feeling refreshed. Although I may have physical discomforts, this past weekend was needed and deserved and I am thankful I made the right decision and went. It raised my spirits and added energy to my coping reserves which have been tested.

If you have a close friend or family you haven’t seen in a while, find some way to reconnect. A phone call, a visit, an email, whatever way you can, reach out and make that connection. Perhaps your faith has been challenged. Seek to reconnect with that part of your life. Find positive people to be around and among. It will help you build strength and coping energy to deal with the painful areas and conditions you may have in your life.

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Technorati Tags: pain management, family, friends, faith, connections

Posted by: Indie Cooper-Guzman at 3:54 pm

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