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A Paradigm Shift in Pain

Not long ago, even palliative care patients struggled for pain relief, prompting the World Health Organization among many other organizations to focus on pain care access. What started in the late 1980s as an effort to encourage compassionate care for terminal conditions evolved into the largest iatrogenic epidemic in history; the US is now the … Continue reading

The Elephant in the Room

Opioid addiction is an unfortunate epidemic which has recently surpassed motor vehicle related injuries as the 4th leading cause of death in the United States. In 2014, CDC reported that 18,893 deaths were related to overdose of opioid medications. And, sadly, Kentucky is the most afflicted state. (Graph 1 displays the rate of death from … Continue reading

Opioids and the management of musculoskeletal conditions

Musculoskeletal conditions represent a significant portion of patient visits to primary care providers in the United States. Management of acute and chronic musculoskeletal conditions can be challenging for both primary care providers and for specialty providers. Opioid medications are used more commonly to treat musculoskeletal conditions, including osteoarthritis. The expansion of indications for opioids has … Continue reading

PROFILE IN COMPASSION: Russell Eldridge and Compassionate Cancer Care

I first became aware of the quality of Russell Eldridge’s doctor-patient relationship as my own patients and their families told me about their experiences under his care. I was particularly appreciative of the compassionate care provided to patients for whom there were no further treatment options. When asked how he has matured as a compassionate … Continue reading

“Dying as Desired”

Lexington Medical Society Essay Contest 2015 Active Physician: Charles G. Ison, MD “The day of my birth, my death began its walk. It is walking toward me, without hurrying.” –Jean Cocteau, “Postambule” We are all going to die. If one wants to bet on a sure thing, bet on that cold fact. As medical professionals, … Continue reading

Recent Federal Guideline and Marketing Changes in Opioid Prescription Policy

Larochelle et al. (2016) published research on 2,848 commercially insured patients, with ages between 18 and 64 years, who sustained a nonfatal opioid overdose during long-term opioid therapy for non-cancer pain between May 2000 and December 2012. Patients were followed over a median time interval of 299 days. Physicians re-dispensed opioids to 91% of patients … Continue reading

Post Operative Analgesia Following Abdominal and Urologic Endoscopic Surgery

Postoperative analgesia can be a challenge to both patients and surgeons. For patients, postoperative abdominal pain can limit mobility, inspiration effort and appetite potentially leading to DVT, deconditioning, atelectasis, pneumonia and dehydration. It is clear that pain can cause significant morbidity, and it is paramount that the surgeon has knowledge of multiple treatment modalities that … Continue reading

Letter from the Editor: Spring 2016

Them’s fight’n words: Opioid abuse is now the largest iatrogenic epidemic in American history. Danesh Mazloomdoost MD, our featured LMS physician in this Spring Edition of KentuckyDoc magazine, has correctly guided us to a severe problem linked to the care of our patients with chronic pain. His article entices us with a panoply of evidence-based … Continue reading