Am J Emerg Med. 2021 Mar;41:84-89.doi: 10.1016/j.ajem.2020.12.066. Epub 2020 Dec 28.Is “pain before vomiting” useful?: Diagnostic performance of the classic patient history item in acute appendicitisToshihiko Takad et al Comment – Finding pain before vomiting helps with the diagnosis but can miss 5/6 cases if absent.

I have seen a case that I read in:

http://butmaybetomorrowkd.blogspot.com/

I have 4 patients that she is a composite of so I’d like to go over what made a difference to them. Most of the treatments are out of the box treatments that can be helpful.
Continue reading “Chronic Severe Failed neck Surgery Pains”

Standard practice is to add colchicine to allopurinol in first 6 months of gout treatment.  Allopurinol treatment dissolves crystals of uric acid which can irritate tissues in that process. ” Subjects treated with colchicine experienced fewer total flares (0.52 vs 2.91, p = 0.008), fewer flares from 0 to 3 months (0.57 vs 1.91, p = 0.022), fewer flares 3–6 months (0 vs 1.05, p = 0.033), less severe flares as reported on VAS (3.64 vs 5.08, p =0.018), and fewer recurrent gout flares (p = 0.001). Colchicine was well tolerated.”

Continue reading “Yes, Colchicine Does Prevent Allopurinol Flare-ups in 1st 6 Months Gout RX”

Re older antidepressants  – A metanalysis of studies concluded the benefits were “small”Salerno, Stephen M., Robert Browning, and Jeffrey L. Jackson. “The effect of antidepressant treatment on chronic back pain: a meta-analysis.” Archives of Internal Medicine 162.1 (2002): 19-24.“In conclusion, adjunct antidepressant therapy at doses therapeutic for depression is associated with a small but significant […]

Excessive sweating in buttock/groin area called Perineal Hyperhidrosis can be embarrassing and I’ve seen recent request for advice re this.

Continue reading “Perineal Hyperhidrosis”

“Pain was experienced by over-indebted individuals more frequently (71.3%) compared to the general population (59.6%)”. They found opioid use was less but this would not work where I am as poor have drugs mostly covered by government.

Continue reading “Poverty Impacts Pain”

Came across a book that gives great pics of Neuralgia sites.

Trescot, Andrea M., and FIPP ABIPP, eds.
Peripheral nerve entrapments: clinical diagnosis and management.
Springer, 2016.
https://leseprobe.buch.de/images-adb/08/d5/08d58d41-51a2-466a-a7d6-b5693550c223.pdf

Continue reading “Head and Neck Neuralgia Sites”

Malassezia is well known for its association with facial skin rash Seborrheic Dermatitis. It has been found teaming around pancreatic cancer tissue in mice and humans and there is even the suggestion it might be oncogenic. Mast cell are found around  pancreatic cancer cells as well, and a ketotifen, a drug to control mast cell degranuation, might help in pain control.  Pancreatic cancer tends to occur in cases who had previous pancreatic issues and diabetes, smokers and ppi users; prophylactic metformin could reduce those chances by over 50%

Continue reading “Pancreatic Cancer – fungal and Mast Cell connection”

For people worried re side effects, it is nice to know some drugs have benefits. Calcium channel blocks (L type are what are being used) have been shown to stabilize moods and potentially help slow down Alzheimers. I’m going to switch my blood pressure med to one of those…

Continue reading “Benefits of Calcium Channel Blockers – Dementia and Psychiatric”