How to Smell a Dirty Rat Addict Prone Patient

Instead of treating pain patients, doctors have now been saddled with added responsibility of being a policeman for addiction prone patients. Part of the problem stems from fact that opioids only reduce pain on average by 1/10. Add- ons like cymbalta, pregabalin and gabapentin do little to help chronic back pain and sciatica. Despite some “raves” about marijuana, other studies have found help more marginal. So the non-interventional doctors, who may not even know what a quadratus lumborum is, might be tempted to push opioids beyond what is helpful.

I offer tongue – in -cheek advice on finding the addiction prone patient.
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Medial Knee OA Minimal Help by Lateral Heel Wedges

A 5° lateral heel tilt (comes out to about 5 mm lateral height) has been tried many times with mediocre results. They made it more likely by eliminating those with partellofemoral issues, and demanding a 2% reduction in KAM =external knee adduction moment (markers and 3d analysis needed for that). Still, drop in pain was […]

Isolated Lumbar Disc Disease Found and Treated

Isolated Lumbar Disc Disease Can be Determined by Non-Invasive Magnetic Resonance Spectroscopy (MRS) and Responds to Surgery. Non-Invasive Magnetic Resonance Spectroscopy scans for certain disc chemicals-  lactate (LA) and proteoglycan (PG), as quantifiable biomarkers for discogenic pain. It was found to have “total accuracy of 85%, sensitivity of 82%, and specificity of 88%. These increased to 93%, 91%, and 93%
respectively, in non-herniated discs” – when compared to provocative discography (PD).  Surgery to positive discs made it practical: :”when all MRS positive discs were treated, surgical success was 97% versus 57% when the treated level was MRS negative, or 54% when the non-treated adjacent level was MRS positive.”

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Dementia and Infection – Could It be That Simple?

Yeast like germs found in facial seborrhea (Malassezia and Candida species), and other fungi have been found in brains of alzheimer victims. Prior untreated facial cold sores increase dementia rate 3-10 fold. The beta amyloid we were so worried about is toxic to these organism and now thought to be just a protective agent. Mouse model of alzheimer’s is now shown to get candida granulomas in the brain. Very quickly there may be a paradigm shift of thinking of alzheimer causes from brain crud problem to infection. Researchers have also found an agent to interfere with prion virus like particles found in dementia. And now, more recently, gum disease bacteria is thought to be a major player in both dementia and maybe coronary artery disease. New theory links clotting factor leakage in brain to dementia.

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Drug Combos Do Not Work In Back Pain -But what you might try

It is commonly taught that drug combinations should be used in chronic pain – the most common pain being chronic back pain. Now it has been shown that little is gained from that. Only combo worth mentioning was buprenorphine plus pregabalin – the former is difficult if insurers won’t cover. There are other options that require actually treating the patient.

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