Friday, December 28, 2012


I wanted to share these with you! Thank you so much for the nominations!!! Please vote by Dec 31 at: http://info.wegohealth.com/health-activist-awards-2012

#HAAwards - Trailblazer Nominee - Tireless work in support of chronic pain patients, with a site that encourages social connectivity and support. Many informational links, as well as room to ask questions from members and staff. Dr. Patty's CIPAY is a one in a million program that advocates for the patient in the best ways possible.

#HAAwards - Best in Show: Facebook Nominee - She has been very kind to me,and helpfull.She has never given up on me,and very sweet.I care for her very much,she is a very good Doctor and very compaaionate.

#HAAwards - Health Activist Hero Nominee - Dr. Patty is remarkable in her undying efforts to get the word out about sufferers of chronic pain. She is fantastic in her work on Facebook, her website, email, and showing an upbeat manner in everything she does.

#HAAwards - Advocating for Another Nominee - DR.Patty,Is such a caring lady,even though she has her own illness to deal with she always is trying to do something to help someone else.She is such a caring lady.

I wanted to share these with you! Thank you so much for the nominations!!! Please vote by Dec 31 at: http://info.wegohealth.com/health-activist-awards-2012

#HAAwards - Trailblazer Nominee - Tireless work in support of chronic pain patients, with a site that encourages social connectivity and support. Many informational links, as well as room to ask questions from members and staff. Dr. Patty's CIPAY is a one in a million program that advocates for the patient in the best ways possible.

#HAAwards - Best in Show: Facebook Nominee - She has been very kind to me,and helpfull.She has never given up on me,and very sweet.I care for her very much,she is a very good Doctor and very compaaionate.

#HAAwards - Health Activist Hero Nominee - Dr. Patty is remarkable in her undying efforts to get the word out about sufferers of chronic pain. She is fantastic in her work on Facebook, her website, email, and showing an upbeat manner in everything she does.

#HAAwards - Advocating for Another Nominee - DR.Patty,Is such a caring lady,even though she has her own illness to deal with she always is trying to do something to help someone else.She is such a caring lady.

Tuesday, December 25, 2012

100 Tips for Coping with Fibromyalgia & Insomnia by Dominie's Fibromyalgia and Chronic Fatigue Syndrome Homepage - Chronic-Intractable Pain And You, Inc. (Main Site)

100 Tips for Coping with Fibromyalgia & Insomnia by Dominie's Fibromyalgia and Chronic Fatigue Syndrome Homepage - Chronic-Intractable Pain And You, Inc. (Main Site)


When Your Caregiver Is Your Significant Other - Chronic-Intractable Pain And You, Inc. (Main Site)

When Your Caregiver Is Your Significant Other - Chronic-Intractable Pain And You, Inc. (Main Site)


Sick Humor: The top ten worst suggestions commonly given to someone with a chronic illness - Chronic-Intractable Pain And You, Inc. (Main Site)

Sick Humor: The top ten worst suggestions commonly given to someone with a chronic illness - Chronic-Intractable Pain And You, Inc. (Main Site)


Safety Alerts for Human Medical Products Hydrocodone Bitartrate and Acetaminophen Tablets 10 mg/500 mg: Recall - Potential for Oversized Tablets

Safety Alerts for Human Medical Products Hydrocodone Bitartrate and Acetaminophen Tablets 10 mg/500 mg: Recall - Potential for Oversized Tablets


Friday, December 21, 2012

Please Nominate Dr Patty - Chronic-Intractable Pain And You, Inc. (Main Site)

Please Nominate Dr Patty - Chronic-Intractable Pain And You, Inc. (Main Site)

It's that time of year! Please nominate your favorite health activist(s) for this years WEGO Awards. http://www.chronicintractablepainandyou.org/page/please-nominate-dr-patty#/ To Nominate someone please click here: http://info.wegohealth.com/health-activist-awards-2012

Monday, November 12, 2012

Do you feel that you have too many medical test done? - Chronic-Intractable Pain And You, Inc. (Main Site)

Do you feel that you have too many medical test done? - Chronic-Intractable Pain And You, Inc. (Main Site)


Do You Want To Become A Staff Member On CIPAY? Updated 10/7/12 - Chronic-Intractable Pain And You, Inc. (Main Site)

Do You Want To Become A Staff Member On CIPAY? Updated 10/7/12 - Chronic-Intractable Pain And You, Inc. (Main Site)

Do You Want To Become A Staff Member On CIPAY? http://www.chronicintractablepainandyou.org/page/help-wanted#.UKGTbYbYQtE

The Eye of the Storm (Chronic Pain Art) - Chronic-Intractable Pain And You, Inc. (Main Site)

The Eye of the Storm (Chronic Pain Art) - Chronic-Intractable Pain And You, Inc. (Main Site)


Chronic Pain Art

Chronic Pain Art


PonyGirl (Chronic Pain Art) - Chronic-Intractable Pain And You, Inc. (Main Site)

PonyGirl (Chronic Pain Art) - Chronic-Intractable Pain And You, Inc. (Main Site)

The Migraine (Chronic Pain Art) - Chronic-Intractable Pain And You, Inc. (Main Site)

The Migraine (Chronic Pain Art) - Chronic-Intractable Pain And You, Inc. (Main Site)

Who Receives Higher-Dose Opioids for Back Pain? - Chronic-Intractable Pain And You, Inc. (Main Site)

Who Receives Higher-Dose Opioids for Back Pain? - Chronic-Intractable Pain And You, Inc. (Main Site)


Opioid Analgesics Less Addictive Than Feared?

Opioid Analgesics Less Addictive Than Feared?

Opioid Analgesics Less Addictive Than Feared? http://www.chronicintractablepainandyou.org/forum/topics/opioid-analgesics-less-addictive-than-feared#.UKFm74bYQtE

Question Of The Week: For Pain Sufferers: Have You Ever Felt High From Your Pain Meds? Describe It If You Can. - Chronic-Intractable Pain And You, Inc. (Main Site)

Question Of The Week: For Pain Sufferers: Have You Ever Felt High From Your Pain Meds? Describe It If You Can. - Chronic-Intractable Pain And You, Inc. (Main Site)

Question Of The Week: For Pain Sufferers: Have You Ever Felt High From Your Pain Meds? Describe It If You Can.
http://www.chronicintractablepainandyou.org/forum/topics/question-of-the-week-for-pain-sufferers-have-you-ever-felt-high-f#.UKEM64bYQtE

Thursday, November 8, 2012

Drug wars: Menace to America - Chronic-Intractable Pain And You, Inc. (Main Site)

Drug wars: Menace to America - Chronic-Intractable Pain And You, Inc. (Main Site)


DEA Abuses and Fear Tactics Impact Pain Management - Chronic-Intractable Pain And You, Inc. (Main Site)

DEA Abuses and Fear Tactics Impact Pain Management - Chronic-Intractable Pain And You, Inc. (Main Site)


Breakthrough pain: Finding the right balance - Chronic-Intractable Pain And You, Inc. (Main Site)

Breakthrough pain: Finding the right balance - Chronic-Intractable Pain And You, Inc. (Main Site)


Describing your pain - Chronic-Intractable Pain And You, Inc. (Main Site)

Describing your pain - Chronic-Intractable Pain And You, Inc. (Main Site)


Does your doctor understand? - Chronic-Intractable Pain And You, Inc. (Main Site)

Does your doctor understand? - Chronic-Intractable Pain And You, Inc. (Main Site)


Dr Patty's Pain Journey (Part 1) - Chronic-Intractable Pain And You, Inc. (Main Site)

Dr Patty's Pain Journey (Part 1) - Chronic-Intractable Pain And You, Inc. (Main Site)


Are they listening? Talking about your pain - Chronic-Intractable Pain And You, Inc. (Main Site)

Are they listening? Talking about your pain - Chronic-Intractable Pain And You, Inc. (Main Site)


Do you know the difference between acute, chronic and intractable pain? - Chronic-Intractable Pain And You, Inc. (Main Site)

Do you know the difference between acute, chronic and intractable pain? - Chronic-Intractable Pain And You, Inc. (Main Site)


Real Medications 4 Real Pain Sufferers

Real Medications 4 Real Pain Sufferers

Please sign our petiton

Embed widget - Opinion Stage





Thursday, November 1, 2012

Researchers Are Finding New Ways To Treat And Rehabilitate Patients With Spinal Cord Injury - Chronic-Intractable Pain And You, Inc. (Main Site)

Researchers Are Finding New Ways To Treat And Rehabilitate Patients With Spinal Cord Injury - Chronic-Intractable Pain And You, Inc. (Main Site)
http://www.chronicintractablepainandyou.org/group/back-neck-spinal-issues-group/forum/topics/researchers-are-finding-new-ways-to-treat-and-rehabilitate-patien#.UJNWHYbYQtE




Advocacy Tips for Family Caregivers - Chronic-Intractable Pain And You, Inc. (Main Site)

Advocacy Tips for Family Caregivers - Chronic-Intractable Pain And You, Inc. (Main Site)

http://www.chronicintractablepainandyou.org/page/advocacy-tips-for-family-caregivers#.UJLZ_oZmMtE

Three Ways Chronic Pain Affects Sex and Intimacy - Chronic-Intractable Pain And You, Inc. (Main Site)

Three Ways Chronic Pain Affects Sex and Intimacy - Chronic-Intractable Pain And You, Inc. (Main Site)


Pain Management: Maintaining Intimacy - Chronic-Intractable Pain And You, Inc. (Main Site)

Pain Management: Maintaining Intimacy - Chronic-Intractable Pain And You, Inc. (Main Site)


Lubricants Are A “Must” For Most Of Us In Pain! ~ The Nitty Gritty - Chronic-Intractable Pain And You, Inc. (Main Site)

Lubricants Are A “Must” For Most Of Us In Pain! ~ The Nitty Gritty - Chronic-Intractable Pain And You, Inc. (Main Site)

What is Raynaud's phenomenon? - Chronic-Intractable Pain And You, Inc. (Main Site)

What is Raynaud's phenomenon? - Chronic-Intractable Pain And You, Inc. (Main Site)


Thursday, October 18, 2012

You and your partner can have a satisfying sexual relationship in spite of your chronic pain. - Chronic-Intractable Pain And You, Inc. (Main Site)

You and your partner can have a satisfying sexual relationship in spite of your chronic pain. - Chronic-Intractable Pain And You, Inc. (Main Site)

You and your partner can have a satisfying sexual relationship in spite of your chronic pain.

By Mayo Clinic staff
People need physical and emotional intimacy almost as much as they need food and shelter. Sexuality helps fulfill the vital need for human connection. It's a natural and healthy part of living, as well as an important aspect of your identity as a person. But when chronic pain invades your life, the pleasures of sexuality often disappear. Here's help on how to reconnect with your sexuality in spite of the chronic pain.

Talk to your doctor

Sometimes pain is the direct cause of sexual problems. You may simply hurt too much for sex. Adjusting your pain medication may be the solution. If your pain is so severe that sex seems out of the question, talk to your doctor. You may need to adjust the timing of your medication or create a different or stronger pain control plan.
On the flip side, certain medications may cause sexual problems. Some medicines diminish sex drive (libido) or inhibit sexual function by causing changes in your nervous system. Drugs may also affect blood flow and hormones — two important factors in sexual response. Tell your doctor about any medication side effects that seem to be affecting your sexuality. Your doctor may be able to recommend an alternative medication or adjust the dose of your current medication.

Examine your emotions

To have good sex, you need to feel good about yourself. So start by examining your own emotions. If pain has left you physically scarred, unemployed or unable to contribute to housework, your self-esteem could be so battered that you feel you are unattractive and undesirable to your partner. Awareness that your physical and emotional distance is hurting your partner may add to your anxiety, fear, guilt and resentment.
Stress can also exacerbate underlying difficulties in your relationship. Even strong relationships can be challenged by medical problems or chronic pain. Being aware of emotional conflict and what's causing it is an important first step in strengthening your relationship with your partner. Counseling may help.

Talk to your partner

The next step in reclaiming your sexuality is to talk with your partner about your feelings. At first, this may be best accomplished by talking to each other fully clothed, at the kitchen table or in another neutral setting. Sex can be difficult to talk about. Begin your sentences with, "I," not with "you." For example, "I feel loved and cared about when you hold me close," is more likely to invite dialogue than, "You never touch me anymore."
This is the time for both of you to talk about your fears and desires. You may think that your partner has stopped touching you because he or she has lost interest, or finds you undesirable. Instead, your partner may be fearful of causing you more physical pain.

Rekindling the spark

Spend time just getting to know each other again. Each of you might do little things that will make the other feel loved. Restoring your emotional intimacy will make it easier to move to the next step — physical intimacy.
Start reconnecting physically with an exploration of each other's bodies that avoids the genitals entirely (sensate focusing). The goal is not orgasm. Instead, you're learning more about what feels good to you and to your partner.

Be creative

Sexual intercourse is just one way to satisfy your need for human closeness. Intimacy can be expressed in many different ways.
  • Touch. Exploring your partner's body through touch is an exciting way to express your sexual feelings. This can include holding hands, cuddling, fondling, stroking, massaging and kissing. Touch in any form increases feelings of intimacy.
  • Self-stimulation. Masturbation is a normal and healthy way to fulfill your sexual needs. One partner may use masturbation during mutual sexual activity if the other partner is unable to be very active.
  • Oral sex. It can be an alternative or supplement to traditional intercourse.
  • Different positions. Lie side by side, kneel or sit. Look in your library or bookstore for a guide that describes and illustrates different ways to have intercourse. If you're embarrassed to get this kind of book locally, try an online book retailer.
  • Vibrators and lubricants. A vibrator can add pleasure without physical exertion. If lack of natural lubrication is a problem, over-the-counter lubricants can prevent pain associated with vaginal dryness.

Plan ahead

Intimacy can be more satisfying if you plan for it in advance. Make a date with your partner, picking a time of day when you have the most energy and the least pain.
Take your pain medication well in advance so that its effectiveness will peak when you need it. Limit the amount of alcohol you drink and avoid using tobacco in any form. Alcohol and tobacco can impair sexual function.
Give yourself plenty of time to try new things. Try to stay relaxed and keep your sense of humor. Focus on the journey, not the destination. If you encounter setbacks, try not to become discouraged or focus on the negative — keep trying.

Worth the effort

Intimacy can actually make you feel better. The body's natural painkillers, called endorphins, are released during touch and sex. And the closeness you feel during lovemaking can help you feel stronger and better able to cope with your chronic pain.
References
  1. Sexuality for the man with cancer. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/002910-pdf.pdf. Accessed Oct. 5, 2010.
  2. Basson R, et al. Sexual sequelae of general medical disorders. Lancet. 2007;369:409.
  3. Gevirtz C. How chronic pain affects sexuality. Nursing. 2008;38:17.
  4. Paice J. Sexuality and chronic pain. American Journal of Nursing. 2003;103:87.
  5. Sex and arthritis. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/sexandarthritis.pdf. Accessed Oct. 5, 2010.
  6. Sexuality and reproductive issues (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/sexuality/healthprofessional/allpages/print. Accessed Oct. 5, 2010.
  7. Wilmoth MC. Sexuality: A critical component of quality of life in chronic disease. Nursing Clinics of North America. 2007;42:507.
http://www.mayoclinic.com/health/chronic-pain/PN00009

Nervous System Animation



Tuesday, October 16, 2012

Urgent Action Requested With Regards To Opiates and Chronic Pain And The Prescribing Of Pain Medications - Chronic-Intractable Pain And You, Inc. (Main Site)

Urgent Action Requested With Regards To Opiates and Chronic Pain And The Prescribing Of Pain Medications - Chronic-Intractable Pain And You, Inc. (Main Site)

Urgent Action Requested With Regards To Opiates and Chronic Pain And The Prescribing Of Pain Medications
Please send this to everyone you know!! The FDA is trying to make and end run around the laws of prescribing for pain sufferers!!

The Chronic-Intractable Pain and You Site(s) is joining with the RSDSA and would like to make you aware of a petition currently before the Food and Drug Administration (FDA) that requests labeling changes for opioid analgesics (narcotic pain medications). Since many individuals with chronic and/or intractable pain rely on opioids as part of their medication regimen, we wanted to bring this petition to your attention.
The petition, submitted by Physicians for Responsible Opioid Prescribing (PROP), requests three specific changes to opioid analgesic labels:
1- That they no longer be prescribed for "moderate" noncancer pain, but only for "severe" noncancer pain
2- That the maximum allowable dosage per day be equivalent to 100 mg of morphine for noncancer pain
3- That this medication can only be used for a maximum duration of 90 DAYS.

What this petition appears to mandate is a "one size fits all" prescribing mentality which DOES NOT benefit the chronic and/or intractable pain patients.

The RSDSA has chosen to oppose the PROP petition on behalf of you, our members. On Wednesday, October 10th, The RSDSA sent this opposition letter to the FDA. Cick Here to read RSDSA letter .

For those of you who would like to send your own individual response regarding PROP to the FDA, we encourage you to stress the specific details that your medication enables you to do that without it you would be unable to do. We suggest you use the following language to keep the message clear:

My name is _______. As a person who suffers with the chronic and yet incurable pain of ______(Your pain disoder), I ask the FDA to deny the PROP petition. I use opioids as prescribed by my physician allowing me to function better and partake in life in ways I would be unable to do without this prescribed care.
To send your comments to the FDA click here. The category to use for your response is Individual Consumer.

Your immediate action to this issue will make a difference. To read the PROP petition,
click here.
Please forward this email along to your friends and loved ones.
Should you have any questions

Please forward this email along to your friends and loved ones.
Should you have any questions or would like to receive further information, please email me.
Dr Patty Hagler-Verdugo, PsyD
Creator/Chair of Chronic-Intractable Pain And You Site(s) drpattyverdugo@chronicintractablepainandyou.org

Monday, October 15, 2012


Urgent Action Requested With Regards To Opiates and Chronic Pain And The Prescribing Of Pain Medications
Please send this to everyone you know!! The FDA is trying to make and end run around the laws of prescribing for pain sufferers!!

The Chronic-Intractable Pain and You Site(s) is joining with the RSDSA and would like to make you aware of a petition currently before the Food and Drug Administration (FDA) that requests labeling changes for opioid analgesics (narcotic pain medications). Since many individuals with chronic and/or intractable pain rely on opioids as part of their medication regimen, we wanted to bring this petition to your attention.
The petition, submitted by Physicians for Responsible Opioid Prescribing (PROP), requests three specific changes to opioid analgesic labels:
1- That they no longer be prescribed for "moderate" noncancer pain, but only for "severe" noncancer pain
2- That the maximum allowable dosage per day be equivalent to 100 mg of morphine for noncancer pain
3- That this medication can only be used for a maximum duration of 90 DAYS.

What this petition appears to mandate is a "one size fits all" prescribing mentality which DOES NOT benefit the chronic and/or intractable pain patients.

The RSDSA has chosen to oppose the PROP petition on behalf of you, our members. On Wednesday, October 10th, The RSDSA sent this opposition letter to the FDA. Cick Here to read RSDSA letter .

For those of you who would like to send your own individual response regarding PROP to the FDA, we encourage you to stress the specific details that your medication enables you to do that without it you would be unable to do. We suggest you use the following language to keep  the message clear:

My name is  _______. As a person  who suffers with the chronic and  yet incurable pain of  ______(Your pain disoder),  I ask the FDA to  deny the PROP petition. I use opioids as prescribed by my physician allowing me to function better and partake  in life in ways I would be unable to do without this prescribed care.
To send your comments to the FDA click here.  The category to use for your response is Individual Consumer.
   
Your immediate action to this issue will make a difference. To read the PROP petition,
click here.
Please forward this email along to your friends and loved ones.
Should you have any questions

Please forward this email along to your friends and loved ones.
Should you have any questions or would like to receive further information, please email me.
Dr Patty Hagler-Verdugo, PsyD
Creator/Chair of Chronic-Intractable Pain And You Site(s) drpattyverdugo@chronicintractablepainandyou.org

Chronic-Intractable Pain And You, Inc. (Main Site) - A Chronic Pain Advocacy Site 501C(3) In Process

Chronic-Intractable Pain And You, Inc. (Main Site) - A Chronic Pain Advocacy Site 501C(3) In Process


Urgent Action Requested With Regards To Opiates and Chronic Pain And The Prescribing Of Pain Medications
Please send this to everyone you know!! The FDA is trying to make and end run around the laws of prescribing for pain sufferers!!

The Chronic-Intractable Pain and You Site(s) is joining with the RSDSA and would like to make you aware of a petition currently before the Food and Drug Administration (FDA) that requests labeling changes for opioid analgesics (narcotic pain medications). Since many individuals with chronic and/or intractable pain rely on opioids as part of their medication regimen, we wanted to bring this petition to your attention.
The petition, submitted by Physicians for Responsible Opioid Prescribing (PROP), requests three specific changes to opioid analgesic labels:
1- That they no longer be prescribed for "moderate" noncancer pain, but only for "severe" noncancer pain
2- That the maximum allowable dosage per day be equivalent to 100 mg of morphine for noncancer pain
3- That this medication can only be used for a maximum duration of 90 DAYS.

What this petition appears to mandate is a "one size fits all" prescribing mentality which DOES NOT benefit the chronic and/or intractable pain patients.

The RSDSA has chosen to oppose the PROP petition on behalf of you, our members. On Wednesday, October 10th, The RSDSA sent this opposition letter to the FDA. Cick Here to read RSDSA letter .

For those of you who would like to send your own individual response regarding PROP to the FDA, we encourage you to stress the specific details that your medication enables you to do that without it you would be unable to do. We suggest you use the following language to keep  the message clear:

My name is  _______. As a person  who suffers with the chronic and  yet incurable pain of  ______(Your pain disoder),  I ask the FDA to  deny the PROP petition. I use opioids as prescribed by my physician allowing me to function better and partake  in life in ways I would be unable to do without this prescribed care.
To send your comments to the FDA click here.  The category to use for your response is Individual Consumer.
   
Your immediate action to this issue will make a difference. To read the PROP petition,
click here.
Please forward this email along to your friends and loved ones.
Should you have any questions

Please forward this email along to your friends and loved ones.
Should you have any questions or would like to receive further information, please email me.
Dr Patty Hagler-Verdugo, PsyD
Creator/Chair of Chronic-Intractable Pain And You Site(s) drpattyverdugo@chronicintractablepainandyou.org

Tuesday, February 21, 2012

Who is responsible for improving health literacy?

Who is at risk?
Populations most likely to experience low health literacy are older adults, racial and ethnic minorities, people with less than a high school degree or GED certificate, people with low income levels, non-native speakers of English, and people with compromised health status.7 Education, language, culture, access to resources, and age are all factors that affect a person's health literacy skills.

Who is responsible for improving health literacy?

The primary responsibility for improving health literacy lies with public health professionals and the healthcare and public health systems. We must work together to ensure that health information and services can be understood and used by all Americans. We must engage in skill building with healthcare consumers and health professionals. Adult educators can be productive partners in reaching adults with limited literacy skills.

Why is health literacy important?


Why is health literacy important?

Only 12 percent of adults have Proficient health literacy, according to the National Assessment of Adult Literacy.  In other words, nearly nine out of ten adults may lack the skills needed to manage their health and prevent disease.  Fourteen percent of adults (30 million people) have Below Basic health literacy.  These adults were more likely to report their health as poor (42 percent) and are more likely to lack health insurance (28 percent) than adults with Proficient health literacy.6
Low literacy has been linked to poor health outcomes such as higher rates of hospitalization and less frequent use of preventive services (see Fact Sheet: Health Literacy and Health Outcomes). Both of these outcomes are associated with higher healthcare costs.

What is cultural and linguistic competency?


What is cultural and linguistic competency?

Culture affects how people communicate, understand, and respond to health information. Cultural and linguistic competency of health professionals can contribute to health literacy. Cultural competence is the ability of health organizations and practitioners to recognize the cultural beliefs, values, attitudes, traditions, language preferences, and health practices of diverse populations, and to apply that knowledge to produce a positive health outcome.4 Competency includes communicating in a manner that is linguistically and culturally appropriate.5
Healthcare professionals have their own culture and language. Many adopt the “culture of medicine” and the language of their specialty as a result of their training and work environment. This can affect how health professionals communicate with the public.
For many individuals with limited English proficiency (LEP), the inability to communicate in English is the primary barrier to accessing health information and services. Health information for people with LEP needs to be communicated plainly in their primary language, using words and examples that make the information understandable.

What is plain language?

What is plain language?

Plain language is a strategy for making written and oral information easier to understand. It is one important tool for improving health literacy.

Plain language is communication that users can understand the first time they read or hear it. With reasonable time and effort, a plain language document is one in which people can find what they need, understand what they find, and act appropriately on that understanding.3

Key elements of plain language include:

Organizing information so that the most important points come first

Breaking complex information into understandable chunks

Using simple language and defining technical terms

Using the active voice

Language that is plain to one set of readers may not be plain to others.3 It is critical to know your audience and have them test your materials before, during, and after they are developed.

Speaking plainly is just as important as writing plainly. Many plain language techniques apply to verbal messages, such as avoiding jargon and explaining technical or medical terms.

http://www.health.gov/communication/literacy/quickguide/factsbasic.htm

What is literacy?

What is literacy?

Literacy can be defined as a person's ability to read, write, speak, and compute and solve problems at levels necessary to:

  • Function on the job and in society
  • Achieve one's goals
  • Develop one's knowledge and potential2
The term “illiteracy” means being unable to read or write. A person who has limited or low literacy skills is not illiterate.

What is health literacy?


What is health literacy?

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.1
Health literacy is dependent on individual and systemic factors:
  • Communication skills of lay persons and professionals
  • Lay and professional knowledge of health topics
  • Culture
  • Demands of the healthcare and public health systems
  • Demands of the situation/context
Health literacy affects people's ability to:
  • Navigate the healthcare system, including filling out complex forms and locating providers and services
  • Share personal information, such as health history, with providers
  • Engage in self-care and chronic-disease management
  • Understand mathematical concepts such as probability and risk
Health literacy includes numeracy skills. For example, calculating cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels all require math skills. Choosing between health plans or comparing prescription drug coverage requires calculating premiums, copays, and deductibles.
In addition to basic literacy skills, health literacy requires knowledge of health topics. People with limited health literacy often lack knowledge or have misinformation about the body as well as the nature and causes of disease. Without this knowledge, they may not understand the relationship between lifestyle factors such as diet and exercise and various health outcomes.
Health information can overwhelm even persons with advanced literacy skills. Medical science progresses rapidly. What people may have learned about health or biology during their school years often becomes outdated or forgotten, or it is incomplete. Moreover, health information provided in a stressful or unfamiliar situation is unlikely to be retained.

Monday, February 20, 2012

California Pain Patients Bill of Rights


California Pain Patients Bill of Rights
California Senate Bill No 402
Passed the Senate September 5, 1997
Passed the Assembly September 2, 1997

An act to add Part 4.5 (commencing with Section 124960) to Division 106 of the Health and Safety Code, relating to health.
LEGISLATIVE COUNSEL’S DIGEST
SB 402, Greene. Health: opiate drugs.
Existing law, the Intractable Pain Treatment Act, authorizes a physician and surgeon to prescribe or administer controlled substances to a person in the course of treating that person for a diagnosed condition called intractable pain, and prohibits the Medical Board of California from disciplining a physician and surgeon for this action.
This bill establishes the Pain Patient’s Bill of Rights and states the legislative findings and declarations regarding the value of opiate drugs to persons suffering from severe chronic intractable pain. It, among other things, authorizes a physician to refuse to prescribe opiate medication for a patient who requests the treatment for severe chronic intractable pain, the physician to inform the patient that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates, and authorizes a physician who prescribes opiates to prescribe a dosage deemed medically necessary.
The people of the State of California do enact as follows:
SECTION 1. Part 4.5 (commencing with Section 124960) is added to Division 106 of the Health and Safety Code, to read:
PART 4.5. PAIN PATIENT’S BILL OF RIGHTS
124960. The Legislature finds and declares all of the following:
(a) The state has a right and duty to control the illegal use of opiate drugs
(b) Inadequate treatment of acute and chronic pain originating from cancer or non-cancerous conditions is a significant health problem.
(c) For some patients, pain management is the single most important treatment a physician can provide.
(d) A patient suffering from severe chronic intractable pain should have access to proper treatment of his or her pain.
(e) Due to the complexity of their problems, many patients suffering from severe chronic intractable pain may require referral to a physician with expertise in the treatment of severe chronic intractable pain. In some cases, severe chronic intractable pain is best treated by a team of clinicians in order to address the associated physical, psychological, social, and vocational issues.
(f) In the hands of knowledgeable, ethical, and experienced pain management practitioners, opiates administered for severe acute and severe chronic intractable pain can be safe.
(g) Opiates can be an accepted treatment for patients in severe chronic intractable pain who have not obtained relief from any other means of treatment.
(h) A patient suffering from severe chronic intractable pain has the option to request or reject the use of any or all modalities to relieve his or her severe chronic intractable pain.
(i) A physician treating a patient who suffers from severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve severe chronic intractable pain as long as the prescribing is in conformance with the provisions of the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.
(j.) A patient who suffers from severe chronic intractable pain has the option to choose opiate medication for the treatment of the severe chronic intractable pain as long as the prescribing is in conformance with the provisions of the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.
(k) The patient’s physician may refuse to prescribe opiate medication for a patient who requests the treatment for severe chronic intractable pain. However, that physician shall inform the patient that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates.
124961. Nothing in this section shall be construed to alter any of the provisions set forth in the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code. This section shall be known as the Pain Patient’s Bill of Rights.
(a) A patient suffering from severe chronic intractable pain has the option to request or reject the use of any or all modalities in order to relieve his or her severe chronic intractable pain.
(b) A patient who suffers from severe chronic intractable pain has the option to choose opiate medications to relieve severe chronic intractable pain without first having to submit to an invasive medical procedure, which is defined as surgery, destruction of a nerve or other body tissue by manipulation, or the implantation of a drug delivery system or device, as long as the prescribing physician acts in conformance with the provisions of the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.
(c) The patient’s physician may refuse to prescribe opiate medication for the patient who requests a treatment for severe chronic intractable pain. However, that physician shall inform the patient that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates.
(d) A physician who uses opiate therapy to relieve severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve severe chronic intractable pain, as long as that prescribing is in conformance with the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.
(e) A patient may voluntarily request that his or her physician provide an identifying notice of the prescription for purposes of emergency treatment or law enforcement identification.
(f) Nothing in this section shall do either of the following:
(1) Limit any reporting or disciplinary provisions applicable to licensed physicians and surgeons who violate prescribing practices or other provisions set forth in the Medical Practice Act, Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code, or the regulations adopted thereunder.
(2) Limit the applicability of any federal statute or federal regulation or any of the other statutes or regulations of this state that regulate dangerous drugs or controlled substances.

http://www.paincare.org/pain_management/advocacy/ca_bill.html

Addiction and Chronic Pain


Addiction and Chronic Pain

By: Jennifer P. Schneider, PhD
Chronic pain, especially chronic pain unrelated to cancer, is notoriously under-treated. In 1999, the American Pain Society surveyed 805 people who had chronic pain about the adequacy of treatment they received from their physicians.1 More than 50% of the survey respondents had been in pain for more than five years, and more than 40% of respondents with moderate-to-severe pain could not find adequate relief. For most sufferers, the cause was arthritis or back disorders. Almost half of the 805 patients had changed doctors at least once. The most common reasons for changing doctors were


•too much pain (42%),
•didn't know a lot about pain management (31%),
•the belief that the doctor didn't take their pain seriously enough (29%), and
•the doctor's unwillingness to treat their pain aggressively (27%).
Only 26% of those respondents who had "very severe" pain reported taking opioids (i.e., narcotics— the strongest pain relievers available) at the time of the survey.

Opioids are medications derived from morphine or chemically similar drugs created in the laboratory. They are the most effective pain relievers we have. Opioids have been used to treat pain for thousands of years. The most commonly used opioids are morphine, oxycodone, hydrocodone, fentanyl, hydromorphone, and methadone. All except methadone are short-acting medications. If your pain is present around the clock, you are likely to do better with formulations that are released slowly in the body, lasting longer before you need another dose. Morphine, oxycodone and hydromorphone are available in pills that need to be taken only once or twice a day, and in rare cases, three times. Fentanyl is available in a patch that lasts two to three days after it is applied to the skin. Hydrocodone is available only in a short-acting form in combination with aspirin or acetaminophen.


The Myths Surrounding Opioids

Why are some physicians reluctant to treat chronic pain with opioids – the most effective available class of medications for treating pain? It's for the same reasons that many patients fear strong pain medications – the many myths surrounding the use of opioids. These myths include:


•using opioids means you are a bad or weak person,
•opioids damage the body,
•people who use opioids are likely to become addicted, and
•the body gets used to the opioid dose, which then needs to be increased again and again in order to continue getting pain relief.
Every one of these beliefs is incorrect. Below we'll go over the facts one by one and see what the reality is.

Myth – Using opioids means you are a bad or weak person
Fact – Opioids are just another drug treatment for pain
Over and over again, when I've suggested an opioid to suffering patients, they say, "Morphine! That's a dangerous drug. My family would think I'm an addict," or "Methadone? That's what heroin addicts use. Not me!" Because opioids can be abused, their legitimate use for pain has become stigmatized. As a result, too many people suffer with pain.

Myth – Opioids damage the body
Fact – Opioids are very safe drugs when used as directed
You may be surprised to learn that the American Geriatric Society has determined that opioids are safer for older people than anti-inflammatories (NSAIDS) such as ibuprofen or naproxen. NSAIDs can increase the blood pressure, cause gastrointestinal bleeding, and damage the kidney. Opioids do not — opioids do not damage any organs. They do have some side effects, such as nausea and sedation, but these effects rapidly diminish as you continue using the drugs. Other side effects, such as constipation, don't lessen with time, but can be prevented or minimized by taking stool softeners and bowel stimulants on a regular basis. Some men on high doses of opioids experience decreased testosterone levels, but this hormone can be replaced by using a testosterone gel or patch.

Myth – People who use opioids are likely to become addicted
Fact – Most people who are treated with opioids do not become addicted
Addiction is a psychological and behavioral disorder. Addiction is characterized by the presence of all three of the following traits:


•loss of control (i.e., compulsive use),
•continuation despite adverse consequences, and
•obsession or preoccupation with obtaining and using the substance.
As an addiction advances, the person's life becomes progressively more constricted. The addiction becomes the addict's number one priority, and relationships with family and friends suffer. The addict's inner life becomes filled with preoccupation about the drug. Other activities are given up. Life revolves around obtaining and using the drug. This constriction is an important characteristic that distinguishes use of a drug by an addict from its appropriate use by a patient with chronic pain. Patients who take opioids for chronic pain hopefully expand their life, the opposite of what happens with addicts. Pain patients feel better and are able to increase their activities. They may begin gardening, going to movies, playing with children and grandchildren, and many are able to return to work.

A patient who is addicted to drugs may keep increasing the dose without discussing it with the doctor, might repeatedly use up the medications early, go to several physicians for opioids and lie about seeing other doctors, might inject their oral or topical drugs, or sell drugs to get money with which to buy other drugs. These behaviors are not typical of most pain patients.

Most pain patients taking opioids are not addicted to drugs. What is true of them is that they usually become physically dependent on the drug. Physical dependence has nothing to do with addiction. It simply means that a habituated user will experience certain symptoms if the drug is stopped abruptly. For opioids these withdrawal symptoms can include: anxiety, irritability, goose bumps, drooling, watery eyes, runny nose, sweating, nausea and vomiting, abdominal cramps, and insomnia. Withdrawal from morphine starts six to 12 hours after stopping the medication and peaks at one to three days. Longer-acting opioids, such as methadone, have a slower onset of these symptoms, and they are less severe than with shorter-acting drugs such as morphine and hydromorphone. Withdrawal symptoms can be avoided simply by tapering the drug dose over several days.

Myth – Opioid dosages will have to be increased because the body gets used to the drug
Fact – Significant tolerance to the pain-relieving effects of opioids is unlikely to occur
Tolerance means that a person needs more medication to continue getting the same effect. This is also true of addiction. With time, the addict needs more of the drug to obtain the same mood-altering effect. This is why cigarette smokers tend to increase the number of cigarettes they smoke. When opioids are taken for chronic pain, tolerance develops to some of the opioids' effects (e.g., nausea and sedation will lessen) but not to others (e.g., constipation and pain relief will continue as long as a patient takes the opioid). Unless the source of your pain progresses, as is true of many cancer patients, you are likely to remain on the same dose that gave you adequate pain relief when you first took the drug.


Tips for Getting the Treatment You Need

The treatment you need depends, first of all, on the diagnosis, so ask your doctor whether he or she is satisfied (s) he has finished working up your problem. For example, the solution to severe ongoing knee pain might be surgery to replace a knee joint damaged by osteoarthritis. You will need to be evaluated by an orthopedic surgeon. If medications are the key to treatment and non-opioids have not given you enough pain relief, ask your doctor what (s) he thinks about a trial of an opioid. Some doctors will be uncomfortable with this approach. You can also ask your doctor for referral to a pain clinic, where various options are available, including injections and medications. If you have been addicted to alcohol and/or drugs in the past, your doctor will be understandably reluctant to prescribe opioids. In that case, it would be worthwhile to get a consultation with a pain specialist who also understands addiction. A pain specialist with training in addiction can figure out a treatment plan that will provide you with pain relief but also addresses safety so as to minimize your chances of relapsing. This plan may or may not include opioids, depending on what substance you were addicted to, how long you've been clean and sober, and what you are doing to maintain recovery. If you have an active addiction as well as severe chronic pain, you will need addiction treatment before a physician will even consider treating your pain with opioids.

You can learn more about the various treatments for chronic pain, including medications, physical modalities, surgery, psychological approaches, and alternative treatments, by reading my book, living with Chronic Pain (2004). The book also addresses the issues relating to pain and addiction.

Jennifer Schneider, MD, PhD, practices pain medicine and addiction medicine in Tucson, Arizona. She is the author of Living with Chronic Pain (2004), available from www.amazon.com.

References
1. MDs struggle to treat chronic pain. The Quality Indicator Compendium on Pain, Nov. 2002, pp. 9-10.

http://www.nationalpainfoundation.org/articles/134/addiction-and-chronic-pain