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Date:         Mon, 20 Jul 1992 10:44:31 EDT
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From:         Bill McGarry <wtm@sheldev.shel.isc-br.com>
Subject:      Handicap Digest # 2792
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                             THE HANDICAP DIGEST

                                 Issue # 2792

                            Friday, July 17, 1992

Today's Topics:


                                ******


                              EL PASO & DR. RYU
                                   Nerves
                              Let's get started
                              Let's get started
                                  Flexaril
                                Sciatic Pain
                              Pain Meds & Time
                               NEED INFO STAT!
                          Chronic Cluster Headaches
                                    Pain
                                 Pain Relief


                                ******


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Subject: EL PASO & DR. RYU
From: Wayne.Briggs@p3.f26.n392.z1.fidonet.org (Wayne Briggs)
Organization: FidoNet node 1:392/26.3 - Star Express, Abilene Tx


[This is from the Chronic Pain Conference]

Anyone know anything posititve or negative about DR. RYU &
prosthestists at University of Texas Medical Branch at EL PASO -
exspecially those doing upper extremity ?  or anything about EL
PASO temporary boarding homes or motels with low prices for medical
patients& families ?

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Subject: Nerves
From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC


[This is from the Chronic Pain Conference]

Hello Linda!

02 Jul 92, Linda Cummings writes to Arthur Saus:

 >>  LC> Can't damaged nerves heal?

 >> Slowly....excruciatingly slowly.  Current thinking is that a
 >> damaged nerve from the peripheral nervous system grows back at a
 >> rate of about 1 millimeter per month, but there is no appreciable
 >> regrowth of a damaged nerve in the central nervous system.

 LC> Forgive my ignorance, but how about the sciatic nerves?

Well, it's part of the peripheral nervous system.  However,
remember that the sciatic nerve is composed of thousands of
individual nerves.  I don't know if you have ever seen a cut
telephone cable that has many individual wires going to different
phones, but the sciatic nerve is something like that.  It is a
major cable carrying a bunch of nerves.

 LC> Also, any
 LC> educated guesswork (and I know you hate this) on why the right sciatic
 LC> nerve is starting to hurt more extending down where it's never hurt
 LC> before?  The pain always stopped about mid calf and now I find sometimes
 LC> the pain extends almost to the foot.

What you are describing sounds like the "natural history" of disc
disease for many people, the pain progressively extends farther
down into the leg and foot with time.

Arthur

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Subject: Let's get started
From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC


[This is from the Chronic Pain Conference]

Hello Linda!

02 Jul 92, Linda Cummings writes to Arthur Saus:

 LC> But the interesting part of our discussion was that
 LC> we both started having back trouble after we had had an epidural during
 LC> childbirth. Now, that question is: Is there a connection between the
 LC> epidural and the disc problems?

We don't think so.  There is absolutely no evidence to support
this.  There is certainly plenty of evidence that many physiologic
changes occur due to the process of pregnancy and childbirth
however.  Anyone who has gone through that realizes there are back
pains that occur during pregnancy long before an epidural is placed
to help with the labor pains.

Arthur

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Subject: Let's get started
From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC


[This is from the Chronic Pain Conference]

Hello Linda!

02 Jul 92, Linda Cummings writes to Arthur Saus:

 LC> I am also wondering if these injections into the disks aren't
 LC> causing weakening and eventually buldging or rupturing of the disks.

The injections aren't "into the discs".  The needle is placed on
the other side of the spinal canal from the discs.  After the
injection, the medication "washes around" to the area where the
discs are, but the medication is injected into the epidural space,
not into the discs.  Likewise, a "spinal tap" for diagnostic
purposes (or even medication administration) places the needle into
the "spinal fluid" which also lies posterior to the intervertebral
discs.  The vertebral bodies or the discs that lie between them are
not involved in the injections in any of these procedures.

Arthur

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Subject: Flexaril
From: Delia.Stark@f218.n260.z1.fidonet.org (Delia Stark)
Organization: FidoNet node 1:260/218 - <NF2G and N2PHA, Rochester NY


[This is from the Chronic Pain Conference]

 > Hi Linda...  they're going to start me on Flexaril in 2 wks. and the
 > one thing that the doc emphasized was that it WASN'T addictive.

Ruthie.... I was on Flexaril for a long time... and none of the
doc's that saw me were concerned about tolerance or addiction.  The
only thing they were surprised by was that it worked for so long
with me, and after a year or so it just quit working.  So now I
take another one.

   D.

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Subject: Sciatic Pain
From: Wayne.Briggs@p3.f26.n392.z1.fidonet.org (Wayne Briggs)
Organization: FidoNet node 1:392/26.3 - Star Express, Abilene Tx


[This is from the Chronic Pain Conference]

The EMG's I've had during the last 4 years were done differently &
a lot less painful than those from 67-88.

Good luck!

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Subject: Pain Meds & Time
From: Wayne.Briggs@p3.f26.n392.z1.fidonet.org (Wayne Briggs)
Organization: FidoNet node 1:392/26.3 - Star Express, Abilene Tx


[This is from the Chronic Pain Conference]

By my choice, All my pain med comes from 1 Dr. Anything anyone else
suggests or writes 1 time is reviewed by him before it is taken.
From second visit I would bring bottle to office with report as to
# taken, with ranges per day, mean and median. I noticed when
swelling, pain RSD synptoms increased, median increased over months
from 2 pills to 3 pills to 4 pills a day(Rx 1-2 prn max 6 a day).
Now after a year, I noticed real withdrawl (gut pain, sweats, etc)
after I had used 2x in a row. I now seldom ever take in AM & lie
down & elevate arm (it is normally in Varney sling above opposite
breast) to reduce swelling & pain, found that I'm not new TENS pads
that are flesh colored tabe & need no Gel & use TENS aggrerssively
PRN . Try to limit Loratab to HS or evening & HS. Some days use 0,
most days 1-2 times, now usually no longer have self-observable
symptoms of withdrawl. This means more pain at times. However, is
this approach effective at maintaining usefulness of narcotics over
time ?

By the way, block #11 lasted only 3 days (great 24 hrs) but
effectice reduction 72 hrs. #14 lasted only 24 hrs. Both had
Horners, skin temp changes per Dr.These last two also had morphine
& somethin else plus the local. I've declined a dorsal stimulator
and also a morphine & local pump because of long term risk of
infection. Had MSRA from endoprosthesis surgery & complications
from surgery on stellate gangilion & infection after 1 of the
blocks.

Dr. Ramarize at Parkland, your kind of guy. lots of time with
patients, hits the spot with 1 stick, god sense of humor. He gave
up good cardiac surgery practice for anes residency & pain
fellowship. He is going to France to study their pain management
techniques this summer - he heard about something he wants to
follow up on.Major ortho grou in Dallas offered to send their
patients to him & he has decided to only private half-time & the
other half see patients at Parkland(where staff MD's are paid $25
hr but the system actually works t de;liver a lot of care to a lot
of people.) He is the kind of guy that you mightenjough have dinner
or a drink with at a conference.

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Subject: NEED INFO STAT!
From: Wayne.Briggs@p3.f26.n392.z1.fidonet.org (Wayne Briggs)
Organization: FidoNet node 1:392/26.3 - Star Express, Abilene Tx


[This is from the Chronic Pain Conference]

Monday 7-6-92 Dr.Marybeth Eczaki upper ext. ortho sub-specialist
saw me as research patient and recommended amputation (shoulder
disart.) because of increasing swelling, loff of function etc. She
said she will call tomorrow with date of surgery. She practices
primarily with kids at Scotish Rite in Dallas. She was surprised
about regional blocks (but willing to ask anes. to consider) and
said she had been doing a local on each nerve while patient is
under general.

1.How long should patient be awake between regional & general ?
2.What is a safe optomsl window ?
3.What info do you have on research or past exp with local injection
of individual nerves while patient is under general ?
4. Would #3 increase pain problems ?
5. If each nerve gets a local should it be next to nerve or in nerve ?
6. I'm 6' tall & was fat until within last year as pain increased gained
70# & became very obsese. Now I weight about 316#. Would this prevent
an interscalene block ?
7. What do you use for interscalene blocks for shoulder disarticulation ?
(Hope you don't do too many of these!(insert laughter).

WOULD YOU PLEASE CALL ME COLLECT AT XXX/XXX-XXXX TODAY REGUARDLESS OF TIME ?
ALSO WOULD YOU PLEASE REMIND  ME TO ASK YOU DATE OF NEXT OER & DATE OF INFORMAL
 DRAFT REVIEW WITH YOUR PRIMARY ?

Thanks!

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Subject: Chronic Cluster Headaches
From: Wayne.Briggs@p3.f26.n392.z1.fidonet.org (Wayne Briggs)
Organization: FidoNet node 1:392/26.3 - Star Express, Abilene Tx


[This is from the Chronic Pain Conference]

Have you contacted National Institutes of Health in Bethesda,
Maryland to see who is doing research, experimential treatments ?

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Subject: Pain
From: Wayne.Briggs@p3.f26.n392.z1.fidonet.org (Wayne Briggs)
Organization: FidoNet node 1:392/26.3 - Star Express, Abilene Tx


[This is from the Chronic Pain Conference]

Dear Yursil:

Suggest you immediately contact a doctor. Avoid GP.Try a board
certified specialist in family practice or internal medicine as a
place to start for the lowest cost & most conservative initial
treatment. After some basic medical problems are rule out, they
then could refer you to other specialists if needed.

Those of us who use this BBS for sharing ideas on locating
doctors/clinics/treatment approaches and also what we can do on our
own to deal with or reduce or prevent pain or just giving each
other support or a place to talk are good at all these things.

HOWEVER, IT CAN BE DANAGEROUS TO ANOTHER MEMBERS HEALTH IF THAT
PERSON NEEDS A DOCTOR AND WE PATIENTS ATTEMPT TO PRACTICE MEDICINE
WITHOUT THE 8 YEARS OF MEDICAL SCHOOL & RESIDENCY TRAINING OR A
LICENSE TO PRACTICE MEDICINE.

It sounds sore! I had pain in the same area for 3 different reasons
and needed diagnosis & treatment from 3 different types of medical
specialists.

GOOD LUCK !

If you have time & would want to do so, want to let me know what
you find out & how it turns out for you ?

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Subject: Pain Relief
From: Joseph.Vasterling@f429.n275.z1.fidonet.org (Joseph Vasterling)
Organization: FidoNet node 1:275/429 - HandiNet B B S, Virginia Beach VA


[This is from the Chronic Pain Conference]

Does anyone know how I can order, purchase  a T.N.S. unit??
    It is a nerve stimulator that "shorts" across two or more nerve
endings to bypass the pain sensation. Most physical therapists use it..
I am looking for this due to chronic shin splints and knee pain from
the shin splints.... Any help is deeply appreciated.........

Thanks

         joe

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                                ******

                  End of Issue # 2792 of the Handicap Digest

                                ******
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