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News to Noodle

I’m tired of complaining, so here’s some news and information.

Children May Outgrow Migraines

A majority of adolescents with migraines either stop having headaches or develop less-severe ones as they reach adulthood, new research shows.

Of the 55 children studied, 40% had remission by their early 20s, while 20% shifted to less troubling tension-type headaches, according to the report, published in the Oct. 24 issue of Neurology.

Migraine Study Brings Men New Headaches

. . . [M]en who experience migraine attacks have a 24 percent increased risk of suffering from major cardiovascular problems and a 42 percent increased risk of suffering a heart attack.

Web Health Info Seekers Tend Not to Check Sources

Only one-fourth of Americans who search the Internet for health advice regularly check the source and date of the information they find to assess its quality. . . .

Just 15 percent of those surveyed said they always checked the source and date of the health information found online, while another 10 percent said they did so most of the time. Three-quarters of those surveyed said they checked the source and date sometimes, hardly ever or never, Pew said.

I’m appalled by these numbers. There’s too much bad information online to accept it at face value. I never use a source that I’m even slightly skeptical of.

[via Kevin, MD]

Oh, the pain of it all! Oh, the pain!

An ER doc’s take on distinguishing real pain patients from drug seekers:

I occasionally wish my job demanded something more than a valid DEA license, and decision-making skills beyond “yes narcs” and “no narcs.” It just drains the carpe right out of your diem to start the day off in a series of ugly little dogfights over drugs with people whom, to put it charitably, you have concerns about the validity of their reported pain.

Now please don’t jump to conclusions here. Pain sucks, and in the common event that I know to a reasonable certainty that someone is suffering, I am quite free with the narcotics. That’s a big part of my raison d’etre. The problem is that increasingly, it seems that the chronic pain complaints far outnumber the acute pain complaints, and treating chronic (or recurrent) pain in the ED is fraught with difficulty to say the least. You don’t know the patient, they come to the ED over and over for the same thing, they are demanding (both in terms of time expended and emotional energy), some are dishonest, there always seems to be some barrier to treatment which requires ED therapy (“Doctor out of town,” “Lost prescription,” “Only a shot works,” “Threw up my pills,” etc), and there is never objective evidence of physical disease.

[via Kevin, MD]

Sensitivity to Pain Explained

Stabbing back pain or the aches of arthritis send some people to bed in misery while the same distress seems easily tolerated by others. Why does pain hurt some people more than others? Scientists finally have an answer.

It involves a single molecule under control of a gene that acts like a dimmer switch. A “bright” or high setting excites sensory nerves to produce more of a chemical called BH4. For scientists, BH4 has one meaning, but for sufferers, it might as well mean “Big Hurt.” Lower settings block BH4, protecting people from the wrench and bite of chronic pain.

New Report Finds Pain Affects Millions of Americans

One in four U.S. adults say they suffered a day-long bout of pain in the past month, and one in 10 say the pain lasted a year or more, according to the government’s annual, comprehensive report of Americans’ health. . . .

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Chronic Pain, Opioids & the War on Drugs: Everyone Suffers

People with chronic pain often don’t have access to painkillers because their doctors won’t prescribe opioids. Doctors see plenty of patients who want drugs, not pain relief, and have to decide in a short time which category the patient fits into. The DEA is cracking down on docs who it believes over-prescribe opioids.

There are many, many sides to every story. When it comes to access to opiates, not a single side is happy. Except for numerous recreational drug users, who are still getting the drugs they want.

If you’re reading this, you’re probably familiar with a patient’s perspective, but doctors have their own struggles. Dr. Charles, a literary medical blogger, recently chronicled his frustrations with determining whether patients are drug-seekers or just need pain relief. Some doctors don’t even apply for a license to prescribe schedule II drugs* because the risk and hassle are too great.

How long will we as a society continue punishing people who face each day in agony?

*The brand names of some Schedule II drugs include: Actiq, Duragesic, Sublimaze (fentanyl); Alfenta (alfentanyl); Demerol (meperidine); DHC Plus (dihydrocodeine); Dolophine (methadone); Leritine (anileridine); Lomotil, Panlor, Synalgos  (diphenoxylate); Orlaam (levomethadyl); Sufenta (Sufentanil)