Health Blog | I Give You Health

Understanding cancer pain Dr (Maj) Pankaj N Surange Introduction

When you or a loved one receives a diagnosis of cancer, it isn’t long before you begin to think of the pain many people associate with cancer. It can be a frightening time. What will the pain be like? What will it do to our lives? Many people with cancer eventually experience pain due to their condition. Approximately twenty percent of patients with newly diagnosed malignancies complain of pain. Thirty percent of patients undergoing cancer treatment complain of pain, and up to ninety percent of those with advanced cancer experience pain (Grossman 1994).
Pain associated with cancer can take many forms and is experienced differently by each patient. Pain can be sharp and severe, or it can be a dull constant ache. Regardless of the type of pain, a diagnosis of cancer does not mean you have to suffer with debilitating pain.
Today, most concerns about cancer-related pain can be relieved by understanding the facts about cancer pain, and learning about the help that is available for pain relief.

How pain happens?

Pain is transmitted through the body by the nervous system when our nerve endings detect damage to a part of the body. The nerves transmit the warning through defined nerve pathways to the brain, where the signals are interpreted as pain. Sometimes pain results when the nerve pathways themselves are injured. You feel pain when your brain receives the signal from your nerves that damage is occurring. All types of pain are transmitted this way, including cancer pain.
Pain can be acute or chronic: Acute pain usually starts suddenly, may be sharp, and often triggers visible bodily reactions such as sweating, an elevated blood pressure, and more. Acute pain is generally a signal of rapid-onset injury to the body, and it resolves when pain relief is given and/or the injury is treated.
Chronic pain lasts, and pain is considered chronic when it lasts beyond the normal time expected for an injury to heal or an illness to resolve. Chronic pain, sometimes called persistent pain, can be very stressful for both the body and the soul, and requires careful, ongoing attention to be appropriately treated.
Along with chronic cancer pain, sometimes people have acute flares of pain when not all pain is controlled by the medication or therapy. This pain, usually called breakthrough pain, can also be controlled by medications.
Cancer pain can be caused by many different sources. Pain can be experienced when a tumor presses on nerves or
expands inside a hollow organ. Pain also commonly originates from bone destructive lytic lesions. Bone marrow infiltration commonly cause bone pain that can be severe. Unfortunately, the radiation and chemotherapeutic treatments that are frequently used to treat cancer can also cause pain.
Assessment of your pain
The first step in getting your pain under control is talking honestly about it.
This means telling them:
• Where you have pain
• What it feels like (sharp, dull, throbbing, constant, burning, or shooting)
• How strong your pain is
• How long it lasts
• What lessens your pain or makes it worse
• When it happens (what time of day, what you’re doing, and what’s going on)
• If it gets in the way of daily activities
Your pain physician may ask you to describe your pain in a number of ways. A pain scale is the most common way. The scale uses the numbers 0 to 10, where 0 is no pain, and 10 is the worst. You can also use words to describe pain, like pinching, stinging, or aching. Some doctors show their patients a series of faces and ask them to point to the face that best describes how they feel.

Your Pain Control Plan

Only you know how much pain you have. Telling your doctor and nurse when you have pain is important. Not only is pain easier to treat when you first have it, but pain can be an early warning sign of the side effects of the cancer or the cancer treatment. You have a right to pain relief, and you should insist on it.
Cancer pain can almost always be relieved.
There are many different medicines and interventions available to control cancer pain. You should expect your doctor to seek all the information and resources necessary to make you as comfortable as possible. However, no one doctor can know everything about all medical problems. If you are in pain and your oncologist suggests no other options, ask to see a pain specialist or have your doctor consult with a pain specialist.
Controlling your cancer pain is part of the overall treatment for cancer.
Your pain physician wants and needs to hear about what works and what doesn’t work for your pain. Knowing about the pain will help your doctor better understand how the cancer and the treatment are affecting your body.
Preventing pain from starting or getting worse is the best way to control it.
Pain is best relieved when treated early. You may hear some people refer to this as “staying on top” of the pain. Do not try to hold off as long as possible between doses. Pain may get worse if you wait, and it may take longer, or require larger doses, for your medicine to give you relief.
You have a right to ask for pain relief.
Not everyone feels pain in the same way. There is no need to be “stoic” or “brave” if you have more pain than others with the same kind of cancer. In fact, as soon as you have any pain you should speak up.
People who take cancer pain medicines, as prescribed by the doctor, rarely become addicted to them.
Addiction is a common fear of people taking pain medicine. Such fear may prevent people from taking the medicine. Or it may cause family members to encourage you to “hold off” as long as possible between doses. Addiction is defined by many medical societies as uncontrollable drug craving, seeking, and use. When opioids (also known as narcotics) — the strongest pain relievers available — are taken for pain, they rarely cause addiction as defined here. When you are ready to stop taking opioids, your pain physician gradually lowers the amount of medicine you are taking. By the time you stop using it completely, the body has had time to adjust.

Treatment options

There is more than one way to treat pain. A simple, well-validated and effective method for assuring the rational titration of therapy for cancer pain has been devised by WHO. It has been shown to be effective in relieving pain for approximately 90 percent of patients with cancer and over 75 percent of cancer patients who are terminally ill. The World Health Organization (WHO) in 1986 established a stepladder approach for treatment of patients with cancer pain (fig.). The goal for this ladder was to provide treatment guidelines that healthcare practitioners could easily follow. The five essential concepts in the WHO approach to drug therapy of cancer pain are:
i) By the mouth. ii) By the clock. iii) By the ladder. iv) For the individual.
v) With attention to detail.
Medicines
Non opioids
Opioids
Adjuvants

Medicines are prescribed based on the kind of pain you have and how severe it is. In studies, these medicines have been shown to help control cancer pain. Doctors use three main groups of drugs for pain: nonopioids, opioids, and other types
1. Nonopioids – for mild to moderate pain
Nonopioids are drugs used to treat mild to moderate pain, fever, and swelling. On a scale of 0 to 10, a nonopioid may be used if you rate your pain from 1 to 4. These medicines are stronger than most people realize. In many cases, they are all you’ll need to relieve your pain. You just need to be sure to take them regularly.
You can buy most nonopioids without a prescription. But you still need to talk with your doctor before taking them. Some of them may have things added to them that you need to know about. And they do have side effects. Common ones, such as nausea, itching, or drowsiness, usually go away after a few days.
2. Opioids - for moderate to severe pain
If you’re having moderate to severe pain, your doctor may recommend that you take stronger drugs called opioids. Opioids are also known as narcotics. You must have a doctor’s prescription to take them. They are often taken with aspirin, ibuprofen, and acetaminophen. Getting relief with opioids
Over time, people who take opioids for pain sometimes find that they need to take larger doses to get relief. This is caused by more pain, the cancer getting worse, or medicine tolerance (see Medicine Tolerance and Addiction). When a medicine doesn’t give you enough pain relief, your doctor may increase the dose and how often you take it. He or she can also prescribe a stronger drug. Both methods are safe and effective under your doctor’s care. Do not increase the dose of medicine on your own.
3.Adjuvants
They can be used along with nonopioids and opioids. Some include:
Antidepressants. Some drugs can be used for more than one purpose. For example, antidepressants are used to treat depression, but they may also help relieve tingling and burning pain. Nerve damage from radiation, surgery, or chemotherapy can cause this type of pain.
Antiseizure medicines (anticonvulsants). Like antidepressants, anticonvulsants or antiseizure drugs can also be used to help control tingling or burning from nerve injury.
Steroids . Steroids are mainly used to treat pain caused by inflammation (swelling.)

Interventions

]]>

While opioids are the mainstay of cancer pain management, they have their limitations. Some patients may only tolerate moderate doses of

Article by Diabetic Care Services

People living with diabetes test their blood glucose anywhere from weekly to three to seven times daily or more. When performed properly, regular and frequent testing is an important diabetes management tool that can help people with diabetes avoid long-term risks and complications. However, even slight environmental variations can skew results and lead to problems including costly retesting and inaccurate adjustments to blood glucose levels.

Marc Wolf, a registered pharmacist with more than 28 years of experience helping patients with diabetes management and founder and CEO of Diabetic Care Services (www.diabeticcareservices.com), offers supply storage, usage and testing procedure tips to ensure accurate glucose readings for improved diabetes management.

Diabetes Testing Supply Storage* Avoid storing meters and test strips in areas that experience varied temperatures, including heat, cold, sunlight or moisture. This can cause glucose meters to produce error messages or damage chemical reagents on test strips, which can cause inaccurate readings and disrupted diabetes management.* Only use test strips within 30 days of the date you first open the vial. Write the expiration date in permanent marker on the outside of the vial to help remember the date. * Always store strips in their original vial and replace the vial cap immediately after removing the strips to avoid damage to strips, exposure to airborne contaminants and inaccurate readings.* Never use strips that are stored in cracked or damaged bottles.

Diabetes Testing Supply Usage* For accurate diabetes management, always use the test strip that is specific to your blood glucose meter to ensure compatibility. Some strips are physically but not chemically compatible with other meters, and will produce inaccurate readings. Follow meter instructions carefully for proper coding. Also, check that your meter batteries are fully charged, as low batteries can skew results.* Ensure the glucose meter is prepared to receive a blood droplet before drawing the sample. * Avoid testing for diabetes management near rooms where there may be high levels of humidity-like the bathroom-as this can alter readings. * Change lancets for every test, to avoid irritation from dull needles.

Blood Glucose Test Site * While some new meters allow for alternate site testing, the fingertip is the most accurate test site for diabetes management because it registers changes in blood glucose more quickly than the rest of the body. To avoid calluses, soreness and infection, prick the finger on the sides-not the pads-, alternating between different sides and all ten fingers. * Properly clean testing site with soap and water before drawing a sample. Even the smallest bits of food, sugar and glucose tablet residue can alter a reading. Make sure the site is entirely dry because even water can affect results.* Try to test at approximately the same time each day, which will make it easier for you to identify patterns or sudden changes in your results.

Blood Glucose Sample* Dehydration can cause false high glucose readings, so make sure you are properly hydrated before testing.* Washing hands in warm water before testing can improve circulation and make it easier to obtain a sample. Pointing hands downward below heart level will also increase circulation.* Gently squeezing and massaging your finger before pricking can increase blood flow, but do not squeeze finger immediately after prick, as this will actually decrease blood flow. Instead wait a moment and then gently milk the finger. * When applying blood to the prepared test strip, avoid allowing your finger to touch the strip, as it may cause contamination. Make sure to fill the strip entirely; you may receive an error message if you do not.

After Blood Glucose Testing* Record results to compare levels before and after meals and between days. If you have trouble remembering to record results, use a meter that stores results in its memory to assist with your diabetes management. The WaveSense Jazz no code meter, available exclusively at http://www.diabeticcareservices.com and http://www.diabeticexpress.com, can hold up to 1,875 readings. * If the test numbers do not coincide with how you are feeling, a personal indicator of where your general numbers should be, then test again. If you are still unsure, use an alternate meter. Do not ignore your intuition just to avoid retesting. It is important to check every detail for successful diabetes management.

About the Author

Diabetic Care Services, headquartered in Cleveland, is one of the nation’s leading mail order durable medical equipment suppliers dedicated exclusively to diabetic supplies and prescription medications for patients with diabetes. For more information, call 800.633.7167 or visit http://www.DiabeticCareServices.com.

Living With Diabetes – Symptoms, Causes & Effects of Diabetes. Living With Diabetes – Symptoms and Effects of Diabetes. Care World Channel has ‘Living With Diabetes’, a show dedicated to providing vital information about diabetes, like the symptoms, causes and effects of the dreaded disease, all by expert doctors. This episode explains the symptoms of diabetes. Dr. Anwar Amir Ansari, professor of Pune University, talks about the dreaded disease and also the difference between homeopathy and allopathy as different schools of thought to cure diabetes. Log on to www.rajshri.com to watch more beauty, health & Yoga tips.
Video Rating: 5 / 5

More Diabetes Articles

phoenixnutritionals.com (CLICK HERE) Cholesterol has become a national obsession! It seems that everyone either has elevated cholesterol or is worried about having elevated cholesterol. As a result there is a great demand to find ways to natural cholesterol lower. Natural cholesterol cures abound, from special diets to supplements and many of them are very effective. In order to determine the most effective natural cholesterol treatments, it is important to understand how the body makes and uses this extremely important substance. As we will soon see, natural cholesterol remedies involve the use of key dietary supplements and increased fiber. The most effective natural cholesterol supplements combine both into one convenient formula for the user. Medicine approaches elevated cholesterol as if it were a disease and attacks it with powerful and potentially dangerous drugs called statins. There are many forms of statin drugs on the market and all have the same dangerous side effects, as we will see soon. For this reason, methods to naturally lower cholesterol have become increasingly popular. To get your bodys natural cholesterol lower, is not that difficult and the best part is that the natural cholesterol supplements pose no threat to your health and have virtually no side effects, even with long term use. Before we can discuss the natural cholesterol cures that are available, it is important to discuss the myths surrounding cholesterol. Cholesterol Myths In an attempt to …
Video Rating: 4 / 5

Video Rating: 5 / 5

Scientists find several common findings on diabetes management
Diabetes is on the rise. The seventh leading cause of death in the U.S. today, it affects 24 million people, nearly 3 times the number in 1980. Another 57 million have a condition that puts them at heightened risk of the illness.

Read more on News-Medical-Net

Health Heroes, an educational healthcare show on the Discovery Channel, have aired (on April 30, 2010) an exciting segment that features asthma managemnt by measuring the airway inflammation. NIOX MINO, which measures the quantity of nitric oxide in the exhaled breath, was selected due to its innovation an exciting new technology that can help millions of patients. The segment was filmed at the Cleveland Clinic (Ohio) with Dr Dweik and also at Urban Health in Bronx, NY with Drs Muhammad and De Leon.

Weight Management and Weight Loss Diet in Malaysia-Watch if you dare!
Category: Items & Merchandise User : jaong1 Date : Thursday, 09/09/10 – 11:33AM Description : Weight Management and Weight Loss Diet in Malaysia-Watch if you dare! My uncle lost 5 inches in 2.5 months, 26 kg in 6 months. If you are looking for the best weight management, improve your health or increase your energy, or simply maintain your shape forever with a proven weight loss diet, see how …

Read more on KLue

Diabetes Mellitus, or diabetes, is a disease that is caused by the body’s inability to turn sugars into energy. Diabetes causes the sugars that your body does not turn into energy to enter your blood stream and causes your kidneys, which filter the blood, to work harder than is necessary. If your kidneys cannot properly filter the sugars from your blood, the result is more frequent urination, dehydration, and loss of energy.

Diabetes Mellitus is diagnosed when your body’s fasting blood glucose level (amount of sugar in the blood) reaches 126 milligrams/deciliter. You can be diagnosed as having different stages of diabetes mellitus. One diagnosis is pre-diabetes. You are diagnosed with pre-diabetes if your blood glucose levels are higher than is normal when tested, but you are not yet experiencing the symptoms of diabetes. People who are diagnosed with pre-diabetes are at higher risk of developing type-2 diabetes at a later time, and are at a higher risk for heart disease and stroke. If you are diagnosed with pre-diabetes, your physician will suggest changes in your lifestyle in order to offset the risk of developing type-2 diabetes. This will include eating a healthy diet and getting regular exercise.

Diabetes Mellitus – Metabolism Disease

Diabetes Mellitus is a metabolic disease – caused when the pancreas does not produce enough insulin. Insulin is the natural hormone in your body that helps turn sugars into energy by moving these sugars from the blood stream to the muscle, fat, and liver cells. The muscle, fat, and liver cells then use the sugars as fuel for your body. Your body needs a certain level of energy to enable your internal organs to function properly. Your body also needs energy to perform the daily activities involved in leading a normal life.

If your body does not produce enough energy for your internal organs to function and for you to perform activities, you have a low metabolism – and you can often be tired, irritable, and experience bouts of fatigue. If your body produces more energy than you are using, you have a high metabolism and may be restless, fidgety, and experience bouts of hyperactivity.

Other Risks Involved With Diabetes Mellitus

There are other health risks involved with diabetes mellitus. The risk of heart disease and strokes is increased in patients who have been diagnosed with diabetes and other risk factors, such as high blood pressure, obesity, abnormal cholesterol, and high triglycerides. The more factors involved, the more your chance of dying from heart disease or stroke increases.

The Importance of Preventive Measures in Diabetes Mellitus

Although diabetes mellitus is a controllable disease, the combination of diabetes and other risk factors decreases your chance of living a normal life span. It is very important that you take steps before you are diagnosed with diabetes to prevent its onset or to delay the onset as long as possible.

The single most important step you can take in the prevention of diabetes is to live a healthy lifestyle. A healthy lifestyle includes many different aspects of your life. Eating a healthy diet is essential to helping your body to perform its normal tasks as naturally as possible. A regular exercise routine is essential to maintaining a healthy weight and in keeping your muscles toned, which allows your muscles to assist your internal organs in performing their tasks. Avoiding stress, or learning how to deal with stress in a healthy manner, helps your brain and nervous system to work with other parts of your body to perform the tasks needed to sustain life.

It is important that you realize how your body works together – and how the things that you do on a daily basis can prevent your body from performing the tasks necessary. Beginning a healthy lifestyle as early as possible gives you the best chance to avoid the risks associated with diabetes mellitus – and decreases the chances of the other factors that may come into play – thereby decreasing your risks of more serious diseases such as heart disease and stroke. Both your physical condition and your mental condition play an important role in your overall health.

Body pain is a condition experienced by most individuals once in a while. Pain management clinics help in providing total relief from pain. At Brooklyn, in New York there are a number of pain management clinics providing value added services to a wide range of patients.

Acute pain usually occurs due to physical injuries and this can be cured by proper diagnosis and treatment, whereas for chronic pain diagnosis and treatment are difficult. Pain management clinics in Brooklyn, NY utilize pharmacologic, non-pharmacologic and psychological measures to relieve acute and chronic pain. These pain management clinics have medical practitioners such as anesthesiologists, neurologists, and psychiatrists for providing effective pain management. Some practitioners concentrate on pharmacologic treatment, some others focus on interventional procedures such as steroid injections, neurolytic blocks, spinal cord stimulators, facet joint injections, and intrathecal drug delivery system implants. Physiotherapists, clinical psychologists, occupational therapists and chiropractors offer their services in advanced pain management clinics in Brooklyn.

Dentists for treating facial pain and specialists to help in improving relaxation are also part of pain management clinics. These practitioners coordinate to provide proper pain management. Anti-inflammatory drugs are delivered orally to relieve the pain. Some drugs are delivered transdermally, rectally or as injections. Neuro stimulation and electrical stimulation facilities are available in pain management clinics to reduce the sensation of pain. Other sophisticated devices for relieving pain are also available in these pain management clinics in Brooklyn, NY.

Physiotherapists administer appropriate exercise techniques to patients that help in controlling body movement and restoring the functions of muscles and joints. Pain management programmes in these clinics which last for 2 to 4 weeks help patients recover their overall health. Surgeries are provided for correcting the underlying problems that are causing the painful condition. Some pain management clinics in Brooklyn also make available alternative therapies which include Chinese healing methods like acupuncture.

If you are one suffering from acute or chronic pain, avail yourself of the service of a pain management clinic in Brooklyn and lead a happy and pain free life.

Video sample of Envision’s educational healthcare training program on pressure ulcers (bed sores) developed with the American Association of Critical-Care Nurses (AACN). The program includes strategies to prevent & manage pressure ulcers, patient risk factors and wound care. To preview the entire video, visit www.EnvisionInc.net or call:1-866-321-5066.

Children with Diabetes. Diabetes occurs in individuals of any age. More than 13000 kids in the United States have type 1 diabetes. It is among the most common long term diseases in school age children. Obesity, lack of exercise and unhealthy eating habits are primarily the causes of the condition among children. Type 2 diabetes is not a common occurrence among school kids. In just over 20 years, incident rates among kids and teenagers have almost tripled.