Chronic pain - why is it so expensive?

Yet another article has come out about how chronic pain not only affects quality of life, but it hits the pocket book hard. A CBC article, Chronic pain poorly understood, costing Canada billions, says that one in five Canadians lives with chronic pain and that this costs society "billions of dollars a year in health costs, lost productivity..."

It's not hard to imagine why chronic pain would be expensive, whether you live in Canada, the U.S., or any other country. Doctors' visits aren't cheap, no matter who pays for them - the government, the patient, or an insurance company. Therapies, such as physical therapy, acupuncture, massage therapy, and others, are expensive. Medications add up in cost, even if they are over-the-counter drugs. There are the devices that people buy to try to ease the pain, like TENS machines, splints, and more. And that's just for treatments. People who have chronic pain may find it harder to take care of themselves - shop for and cook healthy meals, exercise, and more. This can lead to other illnesses, which are costly in themselves.

There are also other costs associated with chronic pain. People with chronic pain may not be able to do the job they originally trained for or love to do. And while at work, they may not be able to be as effective as they would like to be or should be. People who are in pain may not go out shopping and buy products, go to movies, spend money.

I've written about chronic pain quite a bit, in articles and for this blog. It's a topic I've spoken about to university psychology students as well, in an effort to help them understand what it's like to live with chronic pain - how it can be isolating, angering, depressing. Here are a couple of the pain-related posts I've written for this blog:

Three Issues Interfering with Pain Management
Managing Pain Properly - No Matter What Age

Chronic pain is a real problem and as we continue to have an aging population, it really does need to be addressed and treated properly.

Paging Dr. Google...

When you or a family member becomes ill, do you Google their symptoms? Do you dig deeper and deeper until you've scared yourself half to death and now you feel that you've gotten some incurable illness?

According to the Pew Research Internet Project, over half of Internet users are looking for information on a disease, medical problem, medical treatments, or medical procedures. The article also lists the most commonly searched illnesses (as per WebMD) as:

• Shingles
• Gallbladder
• Gout
• Hemorrhoids
• Lupus
• Skin Problems
• Allergies
• Heart Disease
• Diabetes
• Sleep Disorders

and the most commonly searched treatments as:

• Pain relievers
• Anti-depressants
• High blood pressure medication
• Corticosteroids
• Hysterectomy
• Diabetes medication
• ADHD medication
• Antibiotics
• Colonoscopy
• Cholesterol-lowering medication

Cyberchondria

While the Internet has been a tremendous help for people who want to learn more about an illness or to connect with others who have the same issues, it also has given birth to a condition called cyberchondria. It's so real that there's even a Wikipedia page on it. ;-) But as much as some may laugh about cyberchondria, it can be a serious problem. Serious enough that people who have been to see a doctor, even getting a second opinion, may not be satisfied and may continue to seek medical help even though they get the same responses.

While most people don't fall into the extreme of cyberchondria, many do end up worrying needlessly because the symptoms of a simple stomach bug may be seen as stomach cancer. Itching skin may be seen as something wrong with the liver. A swollen lymph gland may be seen as lymphoma, a type of cancer. This isn't too different from the days when families discussed illnesses and someone in the family would say that your symptoms sounded just like their friend's cousin's brother-in-law's best friend's sister's illness, which turned out to be the plague. Except with the Internet, the information is relayed much more quickly.

If you are looking for health information, it's essential that you look at reputable sites - not ones that are trying to sell you miracle cures. I wrote a post about it several years ago, but the information is still valid: How to search for health info on the Internet.

So, look for information, but don't rely on what you read. Dr. Google doesn't have a medical degree. Yet.

Should you listen to Dr. Oz?

Dr. Mehmet Oz is in the news again. The celebrity physician - who actually has pretty good credentials - has been sharing on his daily television show miracle diet and weight loss tricks, and best ways to detox your body. I am not a Dr. Oz fan. While I do appreciate that he does discuss topics that most people try to avoid (such as bathroom habits), I've always cringed at his pronouncements for miracle cures, particularly the ones that he claims get you into shape.

There are no miracle cures for weight loss. There are no magic food combinations. There are no special foods or drinks (like the green coffee Oz was touting at one point). There is nothing magic about losing weight. And Oz, as a respected physician, knows that. He also defends himself by saying that he does not promote any particular product or brand and he doesn't allow his name to be used to do so. But why does he mention these things at all?

There have been articles and blog posts in the past that criticized Oz's message, but they were often drowned out by his many fans. And I get that he has fans. He seems pretty down to earth. He's not unpleasant to look at. He explains things in terms that everyone can understand. But what the fans need to know is that this package doesn't mean anything if he's telling you garbage - and his miraculous weight loss ideas are just that.

Finally, someone more influential is speaking up and taking Oz to task for some of his more outrageous claims. He was called to testify in front of Sen. Claire McCaskill, chairwoman of the Commerce subcommittee on Consumer Protection, Product Safety and Insurance. She wanted to know why he said the things he did. And while Oz admitted that he may have gone overboard with his comments, after the hearing, McCaskill said that “it is hard to tell sometimes with Dr. Oz where the doctor begins and ends, and where the entertainer begins and ends,” according to an article in the St. Louis Dispatch.

Are you a fan of Dr. Oz? What about the other medical shows?

Whooping cough (pertussis) numbers rising in the U.S.

Whooping cough, pertussis, is making a comeback - unnecessarily.

Before a whooping cough vaccine became available in North America in 1940s, each year, approximately 200,000 children in the U.S. caught the disease  - and between 5,000 and 10,000 died. Since vaccination began, the numbers of who got whooping cough decreased significantly to between 10,000 to 40,000 per year, and those who died from the disease dropped to fewer than 10 to 20 deaths per year. But now, the number of people who are getting whooping cough is rising again. According to the CDC, there have been almost 10,000 reported cases of whooping cough between January 1 and June 16, 2014 alone, a 24% increase over the same time period this time last year.

Whooping cough is a bacterial illness that is the most serious among infants and children, although anyone can get it. If you are exposed to the bacteria, it may seem at first that you have a cold, but within a week or so, the tell-tale cough - that ends with a whooping sound - appears. In very young babies, this severe cough may not appear at all though. In fact, they may have periods of apnea (pauses in breathing) instead.

After the initial cold-like symptoms, the following can occur:

• Paroxysms (fits) of many, rapid coughs followed by a high-pitched "whoop"
• Vomiting
• Exhaustion after coughing fits

Coughing can occur for up to three months.

Treatment of whooping cough

Treatment is with antibiotics, as early as possible to lessen the severity of the illness.

Unfortunately, complications can and do occur with whooping cough, which is why it is so important to prevent the illness in the first place. The CDC has divided the complications by age group:

In infants younger than 1 year of age who get pertussis, about half are hospitalized. The younger the infant, the more likely treatment in the hospital will be needed. Of those infants who are hospitalized with pertussis about:

• 1 in 4 (23%) get pneumonia (lung infection)

• 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)

• Two thirds (67%) will have apnea (slowed or stopped breathing)

• 1 in 300 (0.4%) will have encephalopathy (disease of the brain)

• 1 or 2 in 100 (1.6%) will die

Teens and adults can also get complications from pertussis. They are usually less serious in this older age group, especially in those who have been vaccinated with a pertussis vaccine. Complications in teens and adults are often caused by the cough itself. For example, you may pass out or fracture a rib during violent coughing fits.
In one study, less than 5% of teens and adults with pertussis were hospitalized. Pneumonia (lung infection) was diagnosed in 2% of those patients. The most common complications in another study of adults with pertussis were:

• Weight loss (33%)

• Loss of bladder control (28%)

• Passing out (6%)

• Rib fractures from severe coughing (4%)

Pneumonia or any other type of resulting infection can result in sepsis - which can be fatal.

When my nephew was 6 weeks old, he caught whooping cough. He was too young to vaccinate and he became ill when he exposed to it. When he coughed, his whole body lifted up off the mattress. The cough was that violent. It was a very frightening sight. Thankfully, he was diagnosed and treated - and suffered no lasting effects. But it was scary. As more people refuse to vaccinate their children, more children will likely get the disease. And more will die.

Dr. House of Cards - getting the message across in a unique way

Are you a fan of the Netflix series, House of Cards, starring Kevin Spacey? Were you a fan of the medical show, House, which starred Hugh Laurie? If you liked both shows, you should get a kick out of a couple of recently released YouTube videos, called Dr. House of Cards - by ZDoggMD.

ZDoggMD is actually Dr. Zubin Damania, an internist who likes to write music and rap to help bring the topic of healthcare to everyone. According to an article in The Atlantic:

Damania, assuming the persona of ZDoggMD, began making music videos in 2010. He parodied songs by Notorious B.I.G and the Black Eyed Peas, in so doing addressing some of the serious problems he noticed while treating patients in the hospital. He has since made more than 60 PSA-style videos that have amassed close to 1.2 million YouTube views—from “Immunize: the Vaccine Anthem,”—which plays off the Travie McCoy and Bruno Mars song, “Billionaire,” and urges vaccine deniers to “get your shot on”—to “Pull and Pray,” which explains “ST to the Ds” and other dangers of unsafe sex in graphic detail.

His latest offerings are two Dr. House of Cards videos. In episode one, ZDoggMD challenges an intern on a diagnosis, and in episode two, he takes on a mother who is anti-vaccine.

While his approach and style are definitely unique, he just may be on to something if the popularity of his videos is any indication.

You can read more about ZDoggMD in this  USA Today article.

What are cataracts? Cataract Awareness Month

June is Cataract Awareness Month - but what exactly are cataracts and what causes them?

Cataracts are a clouding over of the eye - they can happen in one or in both and they are often associated with aging, but they can also occur in younger people and for reasons other than aging. Estimates by the U.S. National Eye Institute are that at least half of people who are 80 years old have either had a cataract or have one.

Cataracts can be congenital, meaning that you are born with them or they can develop later in childhood. Cataracts can also form as the result of another eye problem (such as glaucoma), illness (such as diabetes), an effect of medications (such as steroids), trauma (injury or surgery), or by radiation. But, the most common reason is aging.

The best way to reduce the risk of developing age-related cataracts is by caring for your eyes while you are younger - by shielding your eyes from the sun. The same rays that damage your skin, both UV-A and UV-B, can speed the development of cataracts. This means wearing proper sunglasses, wearing hats, and not looking directly into the sun. Sunglasses are more popular in the summer time, but winter sun - rays bouncing off the glaring snow - is also dangerous. Where you are also plays a role. If you are on a mountain, the altitude affects the ultraviolet exposure too. For each 1000 feet you go up on a mountain, your UV exposure to your eyes increases by about 5 percent. This increases even more if the area includes snow.

It's never too early or too late to start protecting your eyes. Children should also wear sunglasses, but they need to be real ones - not the play ones that you find in dollar stores or the toy aisles. These could end up doing more damage because you or the child believe that the eyes are protected, when they are actually getting more sun exposure because of that belief.

Symptoms of cataracts include (from the Mayo Clinic):

• Clouded, blurred or dim vision

• Increasing difficulty with vision at night

• Sensitivity to light and glare

• Seeing "halos" around lights

• Frequent changes in eyeglass or contact lens prescription

• Fading or yellowing of colors

• Double vision in a single eye

Treatment for cataracts has improved significantly over the past few decades. When I first began working as a nurse in the early 80s, patients who were having cataract surgery were admitted at least one or two days before their surgery and they stayed at least a day or so after. Now, it's an outpatient procedure and people are sent home within hours. The clouded lens is removed and replaced with an artificial lens. If both eyes are affected, only one eye will be done at a time, usually.

If you are concerned that you may be developing cataracts, you should visit your eye care specialist.

Week 2 - Blogathon overview

And week two is finished! I'd say time flies and all that, but blogging every day isn't easy. While there are many interesting things to write about, it can be difficult to sit down and decide what to write and actually do the writing sometimes. But, we're halfway through and I'm still standing, so that has to count for something, right?

Last week, we had a few controversial topics and a few good discussion starters. The week began on June 9 with the sad story of Casey Kasem and the fight over his care (Casey Kasem, his family's public battle, and the importance of planning). Since writing this, I learned that Kasem had, indeed, signed over the medical decisions to his daughter but his wife went to court to have this changed. Sad story all around.

June 10's post was a bit controversial, Should healthcare workers be forced to receive flu vaccine? This question is going to come up again, like clockwork, next flu season.

The next day's post, on June 11, was about something I'm all too familiar with: back pain (Back pain - medical interventions and surgery aren't always the answer). It's a reminder that we don't always need complicated medical interventions to obtain relief from back pain.

On June 12, I wrote about breast density notification laws (Are breast density notification laws helpful?) Does your state have a mandatory notification law?

On Friday, the 13th, I discussed how the number of people with diabetes continues to rise in the United States (Diabetes numbers rising in the U.S.). This is something to be concerned about because - in many cases - diabetes can be avoided or if not avoided, made less severe.

Finally, yesterday, June 14th, I wrote about how only 6,000 steps a day can  help people who are at risk of developing osteoarthritis of the knee or who may already have it (Only 6,000 steps a day will help osteoarthritis of the knee).

I've had a few requests for blog post topics - is there something you would like to see covered?