A national Pain Crisis Protocol is imperative

There should be a pain crisis protocol for dealing with patients who present to the ER or urgent care with significant pain that is not related, or is disproportionate, to obvious pain causes (such as trauma, fractures, infections, heart attacks, organ disease, etc. — the issues that ERs are used to handling.)

The main function of the ER is to … Continue reading..


Mitochondria get nasty when they get hurt

This is the full text of a very dense little article with a lot of gold embedded in it:

Mitochondrial reactive oxygen species drive proinflammatory cytokine production

Mitochondria are an appropriate fascination for any science writer who covers neurology, immunology, inflammation, or intracellular mechanisms — so here’s the BioWizardry primer on mitochondria.

Good primer from this article, … Continue reading..


Of Mice, Medicine, and Malefactors

Older Brother and his wife, Aunt Krusty, sent me a fabulous little doohicky from a medieval town they visited. It’s a brooch of a common design element used in the Middle Ages: a tabby cat with two tails and fabulous eyebrows offering a mouse, with the legend, “visis mu” — “here’s the mouse.”

The enclosed card contains the usual wonderfully … Continue reading..


The hidden simplicity of diagnosing Complex Regional Pain Syndrome

CRPS, formerly known as Reflex Sympathetic Dystrophe (RSD) or Causalgia, sometimes called Sudeck’s Atrophy, and elsewhere called Neuroalgodystrophy (among other things), is confusing to label accurately because it’s not only complex, but it’s a disease of exceptions.

In many cases, pain is not sympathetically maintained; hence the deprecation of the name RSD. Atrophy doesn’t always happen; hence the deprecation of … Continue reading..


Intrathecal Baclofen vs. intramuscular Botox for CRPS-related dystonia

If you’re considering injectable therapy for CRPS-related dystonia, you have probably heard of Botox (which is commonly used in spine-injured people to help with spastic bladders and other muscular issues), and you may have tried oral baclofen, which has the systemic and cognitive effects of its class. You may not know that baclofen can be injected into the spinal cord … Continue reading..


Teaming with other orgs? (With annotated list of online CRPS resources for patients and professionals)

One of my compatriots posed interesting questions on one of my online groups: why don’t we work with larger and better-funded orgs? Why do we have no chapter-based organizations for this disease?

I strongly suspect that there are several issues intertwining to create this lack:

  • Until recently, this disease was so poorly understood that there were no stable diagnostic … Continue reading..
  • Good findings and bad conclusions on post-op pain treatment

    Today’s “egg in your face” article from the American Academy of Orthopaedic Surgeons (via Science Daily) says:
    One out of five adult orthopaedic trauma patients sought additional providers for narcotic prescriptions


    Link to the original JBJS article: http://jbjs.org/content/96/15/1257.long


    Sadly, the orthopedic industry is still blaming the patients:

    “Many suspect that orthopaedic trauma patients may be … Continue reading..


    Pain rating scales must describe reality, or they are meaningless

    This article got thrashed in the last WordPress update. Correcting and reposting it have been added to the high-priority list… which is only a month long. // ed. 12/2015

    The value of valid reporting in medicine is so fundamental there’s no question about it when the issue is explicity raised. Unfortunately, it’s implicitly absent in too many aspects of … Continue reading..


    New type of nerve cell in brain. POTSers, take note… and hope

    This article discusses the discovery of a new type of neuron in the hypothalamus. 

    A new type of nerve cell found in the brain

    This specific type of nerve cell handles cardiovascular functions, playing some sort of role in regulating heart rate and blood pressure. The cardiovascular system being the interlocked system  that it is, this presumably also … Continue reading..


    Makes my brain explode — but now it can be repaired

    It’s almost impossible to discuss this article without leaping out of the chair and waving my arms around, squealing with the sheer thrill of its deep and wide implications for treatment and understanding:

    Precisely Engineering 3-D Brain Tissues

    Using a 3-D printer, transparencies, and binder clips, these wunderkinder can create neural tissues that mimic the cellular proportions and relationships … Continue reading..