Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a d...Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim: This case report aims to discuss the multimodal approach in the management of a patient who presented with ongoing poorly controlled pain secondary to CRPS from an injury that happened years prior. Case Presentation: A 45-year-old female was involved in a motor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her mobility and quality of life. She presented to the pain clinic years after her initial injury and a multimodal regimen was started for her resulting in significantly improved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and management are important, ongoing management in the outpatient chronic pain setting is important in maintaining a good level of function.展开更多
Background: Necrotizing soft tissue infections (NSTIs) are potentially life threatening medical emergencies associated with devastating and rapidly spreading destruction of soft tissues. Atypical presentations and del...Background: Necrotizing soft tissue infections (NSTIs) are potentially life threatening medical emergencies associated with devastating and rapidly spreading destruction of soft tissues. Atypical presentations and delayed early diagnosis can be significant challenges in managing NSTIs. The infectious process can start at any part of the body with rapid progression leading to limb amputation and high mortality rate. We present a case of a patient with NSTI, the sequelae and management of the chronic pain that developed. Aim: This case report looks to shed light on the importance of a plan for management of subacute and chronic pain in treating patients who present with Necrotizing soft tissue infection. Case presentation: A 53-year-old female who presented with septicemia and was subsequently admitted and treated for NSTI in 2014 resulting in amputation of her distal foot, toe digits, and now with ongoing chronic wound of the lower extremities along with chronic pain. Conclusion: Chronic pain as part of the sequelae of Necrotizing soft tissue infections needs to be anticipated by the health care management team in order to optimize patient care post operatively.展开更多
Background: Narcolepsy type 1 is a sleep disorder characterized by excessive sleepiness along with cataplexy and/or hypocretin deficiency. We present a case of narcolepsy type 1 in which the cataplexy symptoms were re...Background: Narcolepsy type 1 is a sleep disorder characterized by excessive sleepiness along with cataplexy and/or hypocretin deficiency. We present a case of narcolepsy type 1 in which the cataplexy symptoms were reduced while on suboxone. Aim: This case report aims to note the reduction of cataplexy symptoms with suboxone. Case Presentation: A 39-year-old female patient with narcolepsy type 1 was referred to our pain clinic for management with suboxone. The patient had tried various other medications for the management of narcolepsy. With opioid management, the patient reported reduced cataplexy symptoms. Conclusion: The case illustrates the scientific thought that opioids could increase hypocretin and reduce symptoms in narcolepsy type 1.展开更多
<b>Background:</b> Accidental awareness during general anesthesia (AAGA) is an uncommon condition with possible long-term sequela. Here, we identify and describe a case of awareness in the perioperative se...<b>Background:</b> Accidental awareness during general anesthesia (AAGA) is an uncommon condition with possible long-term sequela. Here, we identify and describe a case of awareness in the perioperative setting and the resulting sequelae of symptoms consistent with post-traumatic stress disorder using the first-hand experience of a patient with awareness during anesthesia. <b>Aim:</b> This case report aims to identify and describe the symptomatic sequelae of perioperative awareness events and the importance of close patient follow-up and management. <b>Case Presentation:</b> A 34-year-old female developed uncontrolled tonsillar hemorrhage 2 days after successful adenotonsillectomy that necessitated bedside intubation. During regular clinic follow-up, the patient presented with symptoms suggestive of post-traumatic stress disorder (PTSD) secondary to recall events while under anesthesia. <b>Conclusion:</b> The contributory factors predisposing to perioperative awareness in the surgical environment need to be understood and avoided as much as possible. When awareness is suspected or known to have occurred the patient needs to be assisted through the post-op period and guided through the psychological sequelae that follow.展开更多
Background: Medical marijuana use has seen a rise and acceptance in the last several years and while its efficacy has been spoken and discussed in lore, data on efficacy still remains scarce. Aim: We conducted a surve...Background: Medical marijuana use has seen a rise and acceptance in the last several years and while its efficacy has been spoken and discussed in lore, data on efficacy still remains scarce. Aim: We conducted a survey on chronic pain patients certified for medical marijuana to assess pain relief and efficacy. Findings: Our survey found that the pain score with the use of medical marijuana was halved in our 20 respondents and sleep was improved. Overall function improved. Conclusion: The survey shows that medical marijuana is efficacious in chronic pain patients and further studies need to be done and access to the medication needs to be improved so as to benefit more patients.展开更多
文摘Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim: This case report aims to discuss the multimodal approach in the management of a patient who presented with ongoing poorly controlled pain secondary to CRPS from an injury that happened years prior. Case Presentation: A 45-year-old female was involved in a motor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her mobility and quality of life. She presented to the pain clinic years after her initial injury and a multimodal regimen was started for her resulting in significantly improved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and management are important, ongoing management in the outpatient chronic pain setting is important in maintaining a good level of function.
文摘Background: Necrotizing soft tissue infections (NSTIs) are potentially life threatening medical emergencies associated with devastating and rapidly spreading destruction of soft tissues. Atypical presentations and delayed early diagnosis can be significant challenges in managing NSTIs. The infectious process can start at any part of the body with rapid progression leading to limb amputation and high mortality rate. We present a case of a patient with NSTI, the sequelae and management of the chronic pain that developed. Aim: This case report looks to shed light on the importance of a plan for management of subacute and chronic pain in treating patients who present with Necrotizing soft tissue infection. Case presentation: A 53-year-old female who presented with septicemia and was subsequently admitted and treated for NSTI in 2014 resulting in amputation of her distal foot, toe digits, and now with ongoing chronic wound of the lower extremities along with chronic pain. Conclusion: Chronic pain as part of the sequelae of Necrotizing soft tissue infections needs to be anticipated by the health care management team in order to optimize patient care post operatively.
文摘Background: Narcolepsy type 1 is a sleep disorder characterized by excessive sleepiness along with cataplexy and/or hypocretin deficiency. We present a case of narcolepsy type 1 in which the cataplexy symptoms were reduced while on suboxone. Aim: This case report aims to note the reduction of cataplexy symptoms with suboxone. Case Presentation: A 39-year-old female patient with narcolepsy type 1 was referred to our pain clinic for management with suboxone. The patient had tried various other medications for the management of narcolepsy. With opioid management, the patient reported reduced cataplexy symptoms. Conclusion: The case illustrates the scientific thought that opioids could increase hypocretin and reduce symptoms in narcolepsy type 1.
文摘<b>Background:</b> Accidental awareness during general anesthesia (AAGA) is an uncommon condition with possible long-term sequela. Here, we identify and describe a case of awareness in the perioperative setting and the resulting sequelae of symptoms consistent with post-traumatic stress disorder using the first-hand experience of a patient with awareness during anesthesia. <b>Aim:</b> This case report aims to identify and describe the symptomatic sequelae of perioperative awareness events and the importance of close patient follow-up and management. <b>Case Presentation:</b> A 34-year-old female developed uncontrolled tonsillar hemorrhage 2 days after successful adenotonsillectomy that necessitated bedside intubation. During regular clinic follow-up, the patient presented with symptoms suggestive of post-traumatic stress disorder (PTSD) secondary to recall events while under anesthesia. <b>Conclusion:</b> The contributory factors predisposing to perioperative awareness in the surgical environment need to be understood and avoided as much as possible. When awareness is suspected or known to have occurred the patient needs to be assisted through the post-op period and guided through the psychological sequelae that follow.
文摘Background: Medical marijuana use has seen a rise and acceptance in the last several years and while its efficacy has been spoken and discussed in lore, data on efficacy still remains scarce. Aim: We conducted a survey on chronic pain patients certified for medical marijuana to assess pain relief and efficacy. Findings: Our survey found that the pain score with the use of medical marijuana was halved in our 20 respondents and sleep was improved. Overall function improved. Conclusion: The survey shows that medical marijuana is efficacious in chronic pain patients and further studies need to be done and access to the medication needs to be improved so as to benefit more patients.
