We admit that we are guilty of not taking time away from our busy days to be intentionally quiet, what many would call “meditating”. Call it what you will; approach it religiously or secularly. The data is in and it is irrefutable: regular quiet meditation is beneficial to your physical and mental well being. We love this infographic, courtesy of Huffington Post:
Test Anxiety: What are all these Scans?
There are so many medical procedures to help evaluate all kinds of acute and chronic conditions. What exactly are these scans and how do they differ? We help break it down for you:
X-Ray: The x-ray has been around for a long time. Other than exposing you to a bit of radiation, the x-ray procedure is non-invasive and should not produce much pain, other than perhaps having to get into a certain position and hold still. X-rays are typically used to show bones and therefore fractures. Chest x-rays, however, also can show diseases of the lungs.
CT Scan (also known as CAT Scan) which stands for computed tomography works very much like an x-ray in terms of emitting beams of energy at the body. However the CT scan takes these “slices” of images while moving around the body. Then, using computer technology, these slices are assembled, creating a more detailed 3D image on a computer monitor. CT scans should be relatively painless, other than having to remain still. CT scans are quite effective in diagnosing serious injuries to the head, chest, spine and abdomen as well as discovering tumors. CT scans are also useful in diagnosing kidney stones.
CT Scan with Contrast: There are times when a physician needs to examine a particular organ or tissue area and will order a CT scan with contrast. This test requires the patient to either ingest by mouth or be injected intravenously with a dye. As the dye moves through the tissue or organ, the radiologist can often see blockages and other issues. Sometimes these scans require that the patient fast ahead of time. Some patients have an allergy to the contrast dye. CT scans with contrast are also not suitable for patients with kidney disease. In addition, diabetics who take metformin or Glucophage have to stop taking the medication after the dye has been introduced for a few days. Some patients experience unpleasant side effects after taking in the contrast dye, including nausea, a metallic taste, headache and flushing.
MRI: Magnetic Resonance Imaging, unlike X-rays and CT scans, utilizes radio waves and powerful magnets to create a three dimensional image. MRI scans take a little longer than CT scans. MRI’s are quite effective in diagnosing issues in soft tissue, joints, tendons, muscles and ligaments. MRI’s are often utilized to evaluate the spine, neck, brain, breast and abdomen. MRI’s are more enclosed than CT machines and may induce a type of claustrophobia. There are open MRI’s which can be utilized if your insurance covers that. In addition, sedatives or anti-anxiety medications may lessen the closed-in feeling. Patients should avoid eating or drinking prior to the exam, particularly any food or drink that contains caffeine.
PET Scan: Positron Emission Tomography utilizes a radioactive substance that has been administered to the patient. The PET scan then looks for the particles emitted from the substance within the body. PET scans are used to look for the location of cancerous areas as well as to track any spread of cancer. A PET scan is also useful in cardiac care as well as in neurologic diagnoses. Patients need to drink water prior to a PET scan, but cannot eat for four hours prior to the scan. The radioactive substance will be administered through an intravenous line. PET scans take longer than both CT and MRI scans as you will have to remain relatively quiet and still after the IV starts, but before the scan can begin. The major discomforts of the PET scan include the administration of the IV, having to stay still and being in a closed machine.
Don’t Sweat It: Heat, Humidity and Pain
Heat and humidity, while a welcome change from the freezing Michigan winters, often bring with them challenges for our pain patients.
Arthritis sufferers often say they prefer heat as they find it easier on their joints. However, headache patients vary: some prefer heat; others experience more pain during the summer.
The effects of humidity are not clear. Migraine sufferers report less pain in both low humidity and high humidity, while many report increased migraine headaches during changes in both humidity and pressure.
Sweating and Humidity: Sweat is a natural phenomenon. It helps the body to cool down. However, perspiration only works if the sweat evaporates off your body. In highly humid days, if the sweat just lingers on your body, it is not working well. Be aware that if you are feeling constantly dewy or moist, that your body’s perspiration functions aren’t working optimally. You can actually become dehydrated in this situation, increasing your chances for headaches and spine pain. Increase your hydration accordingly, drinking as much as 1-2 cups per hour of water while actively sweating.
Take a Dip: The warm weather makes swimming an ideal pastime and exercise, all in one. Take advantage of the sunny skies and swim, either leisurely or with some gusto. Enroll in a water aerobics or hydrotherapy class. All of these are beneficial for all pain sufferers. Check out these articles about swimming for pain relief:
Water Workouts Swimming Away From Back Pain
Other summer issues that may bother pain sufferers:
- Different summer schedules which could mean school age children underfoot who need attention and activities. Often, vacations can be stressful, as adults’ and children’s activities outside (waterparks, theme parks, sports events) are not always easy on pain patients.
- Long days and short nights. If you are very sensitive to the amount of light outside, then it may be hard for you to settle down until much later in the evening than usual. In addition, the morning light may wake you up earlier than you had hoped. Pain sufferers need consistent, restorative sleep. Buy the plushest pair of eyeshades possible (think 1940’s films!) and try to avoid the light.
- Traveling while exciting can be tough on pain sufferers. You might want to check out these tips for traveling and pain management:
Travel Tips to Stay Pain Free Driving Trips for Pain Sufferers
Pregnancy and Pelvic Girdle Pain: No Need to Suffer
Pregnant women may not have heard of the term pelvic girdle pain, but many women have experienced this condition.
The pelvic girdle refers to a ring of bones at the base of the spine. Pelvic girdle pain is felt in the front or back of the pelvis. Other symptoms include pain in the lower back, hips, groin, pubic region, pain in the thighs and knees and clicking or grinding sounds made in the pelvis area, which can be exacerbated with certain movements of the legs and hips. Pain can range from mild pain to severe pain.
Pregnancy can put a great deal of stress on the pelvic girdle, which can cause weakness and instability; as a result 20% of pregnant women experience pelvic girdle pain.
The good news: pelvic girdle pain during pregnancy is treatable throughout the pregnancy. Even better news: the treatment is safe for the growing baby. Women do not need to suffer needlessly when they experience pelvic girdle pain.
If you experience pelvic girdle pain, contact your health care provider. In the meantime, you should be aware of some typical treatments:
- Avoiding movements that seem to contribute to the pain. For instance if moving your legs apart laterally tends to produce clicking or pain, avoid that position. Adapting to this temporary condition may require consultation with a physical therapist with whom you can discuss your regular activities, including exercise. You may also need to discuss sex and sex positions with your physical therapist.
- Exercises can also be prescribed which reduce pain, increase flexibility and strength. Swimming is a great exercise, which is easy on all of your joints. In addition, the water temperature and the feeling of weightlessness can be quite therapeutic.
- Chiropractic manual therapy is often quite successful in addressing pelvic girdle pain issues.
- Acupuncture is another complementary therapy that can bring immediate as well as long term relief.
Looking ahead: most women with pelvic girdle pain are able to have a vaginal birth. In addition, 90% of pregnant women who experience pelvic girdle pain are “cured” once the baby has been delivered. One caveat: future pregnancies have a higher chance of also including pelvic girdle pain.
Fitting in Fitness on Vacation
Taking a vacation is great for your body and your soul. It is a time to connect with family and friends, to change up your routine and hopefully to escape from the chores and responsibilities that await you at home.
Vacations can come in a variety of shapes and sizes: a quick camping trip that is easy on the budget and forces you to uplug from the wired world and plug into nature and family, a trip to a resort that takes care of all of your needs and has entertainment and luxury all within reach, a trip to a favorite beach or mountain to enjoy a different vista and revisit familiar restaurants and fun activities, a busy sight-seeing trip, taking in cities and famed sites, and enriching youself through culture and art.
Wherever you vacation, you do not need to take a vacation from healthy behaviors, especially if your healthy habits also contribute to experiencing less pain.
One of the easiest healthy habits to continue on vacation is movement and exercise. If your vacation gives you a bit more time, than you can utilize the time to pamper yourself with enjoyable fitness activities. Here are some ideas as to how to stay fit on vacation:
- Bring walking/exercise shoes, even if you have to take something else out of the luggage and leave it at home. Even if you don’t plan on exercising every day, not having the right shoes will surely eliminate even the possibility of exercise.
- Sign up for walking tours. The possibilities are endless. There are dozens of walking tours in New York, Chicago, and cities everywhere as well as regularly scheduled easy to difficult guided hikes in national and state parks. Cruise ships often have city walks and rainforest/nature walks as one of their many offerings.
- Swim every day! Access to a pool, beach or lake allows easy opportunities for relaxing movement that can also burn calories. Even floating is better than watching TV, but try to amp it up and at least tread water or better yet, swim more vigorously.
- Check out the exercise room, but exercise caution. The state of cleanliness and repair can vary tremendously in workout rooms in hotels, cruise ships and resorts. Cruise ship exercise rooms are our favorites. They tend to be immaculate, and they often have machines looking out over the water. Hotel exercise rooms sometimes are just “meh”. If the equipment looks even the slightest bit dirty or worn out, take a hike and exercise outside.
- Stretch out or do a little movement in your room. If you have access to Wifi, you have the ability to look at thousands of videos on Youtube on a phone or tablet. Fitness Blender has hundreds of free videos that range in length and intensity, so you can just stretch after a long drive or flight, or even carve out time for a 1000-calorie epic exercise session.
Vacations can give you the time to rejuvenate. Fitting in fitness ultimately will result in a more energizing vacation.
It’s a Matter of Trust: Responsible Use of Pain Relief Medication
One of the tools in our arsenal for combating pain issues is a large variety of pain medications.
We prescribe medication to our patients as part of a comprehensive pain management approach, along with other therapeutic treatment, like physical therapy, chiropractic treatment, massage therapy, social and psychological services and acupuncture.
Many times our patients’ pain level is reduced significantly with over-the-counter pain relievers. Over-the-counter drugs are a great option, as they tend to be inexpensive and widely available. However, even over-the-counter pain relief needs management as they are not without side effects.
When over-the-counter analgesics are not effective, we often turn to different classes of prescription pain medications. Unfortunately, certain pain medications can become addictive. Addiction to pain medication ultimately negates the positive aspects of pain relief.
At Michigan Spine & Pain, we are committed to responsible medication use. The way to accomplish this is through honest partnership with our patients as well as the pharmacists in our community.
Our goals are simple:
- We want our patients to have access to effective medication which relieves acute and chronic pain.
- We want to be responsible members of the health care community, ensuring that our patients utilize the medications in the manner they are prescribed and only in the prescribed amounts.
We are conservative in prescribing pain relief medication, working first to make sure other modalities aren’t effective on their own. We also rely on our patients’ truthful input, telling us how much pain they are in, how effective various pain relief treatments are as well as what side effects, if any, they are experiencing.
There is no one size-fits all solution for pain. All pain relief requires a team approach. An integral component of that team approach is the relationship between the patients and the members of the health care providers.
Returning to the Greens: Getting Back on Course
If you haven’t played golf in a while due to injury or weather or your schedule, summer is a great time to fit in a few rounds or even 9 holes here and there. Golf is great exercise and can be a fun way to pass the time with friends and family. Golf is lower impact than many other activities.
Returning to golf in general is a good idea. However, as with all potentially intense periods of exercise, you can’t just jump right into the deep end. Here are some ideas to help you get right bank on the links safely:
- Strengthen any weakened muscles. Squeeze a tennis ball and do wrist curls to strengthen your wrists. Do core exercises, including sit-ups, planks and other stretches to fortify your abdominal muscles, thereby protecting your lower back.
- Start with working on your short game. These shots are the least taxing on your low back, hips and shoulders. Getting out to a practice green and putting as well as practicing your chipping are important preliminary exercises to undertake prior to your first real outing with friends and family.
- Super-slo-mo your swing for the longer shots. Practice swinging with the club but really, really slow it down, so that it takes even as long as 10 seconds from back swing to follow through. Focus on your body: your hands, wrists, shoulders, hips and back. If anything hurts during these practice swings, address that body part before continuing.
- Place some tees around your yard and just make contact with the tees.
- Go to the driving range to get a feel for how effective your swing is. Perhaps you need to change your club choices or be much more deliberate about your posture. Don’t berate yourself, just find ways to compensate. Hire a golf instructor if you get frustrated for some fine-tuning.
- Before your first round of golf, give yourself at least 15 minutes of good warm-up prior to teeing off at the first hole. Stretch your arms above your head with the clubs in your hand. Swing your clubs. Stretch out your legs and your hips. Pay attention to your hands, too, clenching and unclenching them slowly.
- Change your goals for the day and maybe for a while to come: it’s not about a score; it’s about trying to golf without pain and with some sense of joy.
- You’re not in the PGA or LPGA. You are not required to finish every round that you start, nor even play every ball (depending on the rules that you follow within your playing group and the rules of the course). Take a break on a particularly challenging hole. Walk a little more if you can, a little less if it hurts.
Golf is a great source of exercise and camaraderie. With some careful planning, it’s a sport that can be enjoyed for many years by lots of Michiganders.
Pregnancy Headaches: What Can You Do?
Pregnancy brings with it the promise of a new baby and all of the attendant excitement.
But pregnancy can also bring new health issues or exacerbate old ones. One of the most bothersome side effects of pregnancy can be headaches.
Why do you get pregnancy headaches?
A number of things are happening in your body and your life that could be causing your pregnancy headache.
If you are already prone to tension headaches or migraines, your state of being pregnant will not improve on that. For many women, pregnancy (particularly an unplanned one), may trigger more concerns or anxiety, which is perfectly understandable. If your family or economic situation is stressful, this could also be leading to pregnancy headaches.
But the major cause of pregnancy headaches is hormonal changes in your body. These hormones are the same things that cause nausea. There is nothing you can do about hormonal changes.
Know your personal headache triggers. If you already know what caused you to get headaches pre-pregnancy, avoid those triggers now that you are pregnant. Some women respond poorly to low blood sugar and need to eat small meals more often; other women are suddenly sideswiped with overwhelming fatigue that brings on headaches and need to curtail their activities and take time for occasional naps or else catch up on the weekends. Other women find that certain foods are headache-inducing.
If you are not sure what could be contributing to your headaches, keep a headache diary and note the time and date of your headache as well as what you ate and did during the 6-12 hours prior to the headache. Bring the diary with you to your doctor and try to find the patterns of pain.
Caffeine withdrawal can also cause headaches. If you are giving up caffeine, do so slowly over two weeks’ time, as an immediate cold turkey can bring on headaches.
Treating your pregnancy headache:
Just popping a pill for headache is not so simple during pregnancy. On the list of drugs to avoid are aspirin, naproxen, ibuprofen as well as Imitrex.
Doctors used to regularly recommend acetaminophen (Tylenol) to their pregnant patients You should be aware of two recent studies that implicate acetaminophen in developmental delays and increased incidence of ADHD among children whose mothers took it.
Other remedies can be effective. Some of these include:
- Meditation and relaxation
- Slow stretching
- Warm baths with the lights off (for migraine sufferers)
- Cold compresses behind the neck
- Warm compresses over the nose and eyes (for sinus headache sufferers)
- Increasing water consumption
- Massage, acupuncture and acupressure
- Including physical activity, especially outside walks
- Getting adequate rest
- Monitor your posture to be sure it is not contributing to headaches.
Pregnancy is a complicated time for your body. Please consult with your health care provider regarding all aspects of your pregnancy.
Why is Fibromyalgia So Hard to Diagnose?
Fibromyalgia is a complex, chronic health problem. Its chief symptoms are pain or tenderness, especially a tenderness or soreness that is made worse when touched. Fibromyalgia is also indicated when fatigue, poor sleep, memory and cognition issues (often called “Fibro-Fog”) and severe moods are present.
Other symptoms can include headaches (tension and migraine), digestive issues, pelvic pain, jaw or face pain as well as depression and anxiety.
Fibromyalgia can be tricky to diagnose.
Typically, patients who experience fibromyalgia have symptoms that can have multiple causes. To make things even trickier, there is no fibromyalgia test. Frequently, diagnostic tests will be ordered to ensure that other diseases or injuries are not the cause of the symptoms. These could include x-rays and scans such as MRI and CT scans.
In addition, there is not even a single “cause” of fibromyalgia. It has not been found in gene studies, but it may run in families. For many patients, there are triggers to fibromyalgia. These can include injuries or other diseases, or even stress. For other patients, there appear to be no significant triggers.
Doctors will ask you where you are feeling pain, will ask you to describe the pain’s intensity and will often touch or palpate parts of your body to see how your body responds to slight pressure and touching. Doctors will also want to know how long you have been experiencing the major symptoms (pain, fatigue, mood disorders and cognitive issues); typically a 3 months’ duration is necessary before a fibromyalgia diagnosis can be reached.
Fibromyalgia pain needs to occur on both the left side and the right side of the body and should also not be isolated to one small area.
Physicians have to rule out a whole host of other diseases before definitively diagnosing fibromyalgia. As a result, many physicians are still hesitant to diagnose fibromyalgia.
Your Knees Need You to Lose Weight Now
If you’re trying to get motivated to lose weight, think about your knees.
The sheer numbers of knee replacement surgery have skyrocketed. In fact, the number of knee replacements has doubled in the past decade. More worrisome is that the number of knee replacement surgeries on patients younger than 65 has tripled in the same time frame.
There are some possibilities as to why this is occurring, including aging baby boomers as well as positive word of mouth and advertising regarding the surgeries.
But experts are circling around this theory: the increased obesity rate of middle age adults is driving the deterioration of our knees.
In a database called Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR), information is accumulated regarding total joint replacement surgeries from orthopedic surgeons in 22 states.
The latest data from FORCE-TJR revealed that younger patients were more likely to be obese than patients over age 65 who underwent knee replacement surgery. In fact, the average body mass index (BMI) of the middle age patients in the study was 33. A BMI of 33 falls into the obese range. Furthermore, this is the average BMI which means that roughly half of the participants have an even higher BMI.
Being overweight puts stress on all joints and can exacerbate osteoarthritis. Excess weight can cause an erosion of cartilage surrounding the knee. In addition, fat cells are believed to produce inflammatory cytokines that contribute to arthritis.
Overweight patients are particularly vulnerable to anterior knee pain, which is knee pain at the front of the knee. Anterior knee pain can include pain upon waking up, pain when walking after a sedentary period, difficulty walking up and down stairs, stiffness and soreness around the knee area and a general sensation of instability when standing upright.
Overweight patients may have other disease processes that can make a knee replacement surgery more complicated like diabetes, poor circulation and cardiovascular issues. Perhaps most troubling, some surgeons will not perform knee replacement surgery on morbidly obese patients, whose BMI is over 40.
Losing weight, even a fairly minimal amount can drastically reduce knee pain. An osteoarthritis study (the Framingham Study) showed that a 5% drop in weight among the participants improved joint pain by 18%.
One of the components to effective weight loss, of course, is increased exercise. Unfortunately for many patients with painful knees, some forms of exercise can be impossible. Physicians recommend swimming and water aerobics for these patients, as these exercises put far less stress on aching joints.
Please consult your health care team about any knee pain issues that you have and before you start any exercise regimen to alleviate them.
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