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Types of pain medications
Aspirin (blocks) Cox(enzyme) - prostaglandins - nerve sensitivity. (Blocked to decrease nerve sensitivity)
Tylenol has some other effects (pain thresholds)
Local analgesics: can be injected into site of injury or applied topically (ex. novocaine).
The losses and challenges of serious illness
1) Threatened self-image: loss of strength, breast cancer treatment, body integrity (understanding/accepting, ex. facial disfigurement), fear of rejection.
The losses and challenges of serious illness
2) 3) 4)
2) Interruption of work (source of identity vs income, as in retirement)
3) Loss of indep (basic needs)
4) Threats to cognitive func (progressive diseases)
The losses and challenges of serious illness
5) Threatened future (present vs. future orientation) 6) strain on relationships (emotional separation and phy, strong marriages become stronger, weak weaker, whom/how to disclose).
The losses and challenges of serious illness
6) 7)
6) Maintaining identity (same person?) 7) Explaining the illness to yourself (predict adjustment, often blame themselves, guilt or takign responsibility for control; others blaming you and you blaming others maladapative.
8) Pain; Med Treatment; Possibility of Death
The losses and challenges of serious illness
1) Threatened self-image 2) Interruption of work 3) Loss of indep 4) Threats to cognitive func 5) Threatened future 6) Maintaining identity 7) Explaining the illness to yourself 8) Pain; Med Treatment; Possibility of Death
Treatment of Death
1) Denial: sequester ill, dying, elderly, die in hospitals; Retirement communities (societal implic), looking young, funeral custums (looking best, slumber room, terms for death).
Grieving people
1) For themselves or others
2) Strong, acute expression often not supported well, ex. sedated grieving woman; strong for family, "will be ok." 3) Still-born babies to mother to say goodbye, to cope, naming, dress, ward with mothers. 4) uneven support, only immediate, religions with defined mourning periods, ex. first year.
Hospice Program (1970s)
Palliative, comfort care, supportive vs. curing, coming to homes, pain control, respite care volunteers, entire family help, nurses as liasons to physicians, spiritual counseling, bereavement counseling, basic care (ex. how to change sheets), facilitates disc, integ model, most time in homes, usu if < 6months, some wk with children.
Children's terminal illness
1) Do not want to let children die 2) Do not believe children should die 3) Less pain medic 4) Phy do not discuss dying 5) Continuity of car (number and variation of doctors).
Along with traditional medicine, ex. aromatherapy after surgery.
Instead of trad med.
Combining, alt ther with sci evid, ex. acupunc after surgery.
1) Alternative Medical sys
ex. homeopathic, naturopathic (western); chinese, herbal, indian (eastern)
Like causes cure like; small dose of substance. Earn ND (nat. doctor), healing power of body to heal; lifestye, counseling, dietary, herbs, exer, chinese med, homeopathic.
Naturopathic cont
Phy only facilit healing power; discover/treat cause vs symptom; treat whole person, phy as teacher to motivate; not licensed in virginia for ex.
Trad Chinese Medicine
Chi: vital energy through body, regulates spiritual, emotional, phy balance, or disease occurs; herbal remedies, exerc, medit, acupunc, massage.
Bad interactions, possible liver damage; false hope; chiropractic: sublexation (problem, nerve interference), done by hand, replacing vertebrae...indirect nerve pressure. Neuroscope: skin temp difff (like ying and yang); noise: dissolved gase removed, not bone alignment; neck manip safe, 100s/yr parallized, strokes?, religious belief sys.
2) Biologically Based Therapies
Medicines (herbs, etc) working in body but no evid for them (ex shark cartilage to treat cancer). PS SPEC (prostate cancer hope); trials: testos levels dec; eight herbs: chem actign as a hormone (DES? extrogen); plants vary in quality.
3) Manipulative and Body Based Methods
Chiropractic, third most practit after doctors/dentists; doubled in 15 yrs; 100,000 by 2010. Used by 11% of population, covered by most health insurance, not enough research support.
Osteopathic med and massage
Osteopathic mediciine: diseases of mus/skel sys; disturbances in one sys afect others, hands-on, movement. Massage: relaxing, curative claims by some.
Inc supported, Study: dogs with acup and fake acupun; less pain medic; mainstream med journal.
Up to 1000 usable points, popularity from reston; most meridians overlie major neural pathways; visual cortex lights up by stim toe, Longherst: stimulates opiates, lower peak blood pressure; other point (for intest) as effective.
Study: US med schools (with directors of CAM) 77% acupunc, 70% herbs/bot, 66% medit, 64% relax (electives)
4) Mind/Body Medicine
Enhance mind's capacity to heal (cognitive, prayer, music, tai chi, yoga, prog relax) ex. Tomatus method: music; psychoacoustics: energy change; the deep. Study: Music and post op pain, poor method, positive exp but not casual; plants germinate faster.
5) Energy Medicine
Therapeutic Touch
Music, though, 'chigung': flow of energy; raiki, spiritual energy.
Therapist's healing force; identify energy imbal and move, no proven effect on cancer cells, girl's jama study.
5) Energy Medicine
On head, feet, move energy; Static (consumer) vs. electromagnets (generate magnetic fields under elec currents, supervised with phy). Second most used after chir by arthritis patients. Alter cell func, blood as a conductor of mag energy; more neutrietnts to tissues; little evid for static magnets; Electromagnets after surgery approved by fda (ex. bone fractures, knee pain, still experimental).

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