Discover and read the best of Twitter Threads about #pain

Most recents (24)

1/14 #Men and #women experience disease differently. This is reminiscent of #SyndromeX and other chronic disease like #MECFS, #slow #virus manifestations, and even #LongCovid and post-acute sequelae of #SARSCoV2.

A thread summary article 🧵

anu.edu.au/news/all-news/….
2/14 "#Women are up to 75 per cent more likely to experience #adverse #reactions to #prescription #drugs than #men because of a range of differences in #traits between the #sexes, according to a new study from The #Australian #National #University (#ANU)."
3/14 "The researchers believe more should be done to take this into account when treating #diseases."
Read 16 tweets
How a valuable possession slowly damaged a young man's nerve

1. 30-year-old Sidh consulted me with severe sharp shooting #pain from right buttock to the leg & foot for 3 months. Pain was more while sitting and lesser while standing or walking. Pain increased on lying down.
2. He was evaluated elsewhere.
MRI spine ruled out slipped disc and nerve compression in lower back region.
Nerve conduction studies had shown severe damage of right sciatic nerve (see the image below to see the location and course of sciatic nerve).
3. No cause for sciatic nerve damage was obvious. On detailed enquiry, he informed that he always carried a "fat wallet" in his right back pocket, which remained in his pocket while he sat in office during work (10 hours a day).
Now, I could guess the cause.
(Pic from internet)
Read 9 tweets
Consider lead toxicity due to Ayurvedic medications in patients with unexplained abdominal pain

1. In the past 6 months, we saw 5 patients with unexplained abdominal pain associated with weakness of hands and feet. All were taking Ayurvedic medicines for various reasons.
2. Blood lead levels were high in all of them (>25 mcg/dl). There was no history of occupational lead exposure in any of them.
They were treated with d-penicillamine (chelation therapy). Ayurvedic medicines were stopped.
#MedTwitter #NeuroTwitter #ayurvedicmedicine
3. Abdominal pain resolved. Weakness of hands and legs partially improved. Four patients had anemia and one had kidney damage (these showed only partial improvement).
Read 8 tweets
Today's #blog covers why the #pain #trade is likely higher over the next few weeks as #sentiment improves and too much money is offside.
realinvestmentadvice.com/the-pain-trade…
#Bullish optimism is building around:
- #Fed cutting rates
- #Economy will avoid #recession
- #Employment remains strong.
- #Earnings have corrected enough
Risk to that view remains a recession.
realinvestmentadvice.com/the-pain-trade…
It is called the “#paintrade” because it is the opposite of how #investors are currently positioned. Investor sentiment remains historically #bearish despite improvement since the October lows.
realinvestmentadvice.com/the-pain-trade…
Read 5 tweets
There's no friendly way to put this:

The new CDC Opioids Guidelines are a farce when it comes to saving patients' lives.

usatoday.com/story/opinion/… #chronicpain #opioids #opioidcrisis #fentanyl #lawenforcement #drugs #politics #health #disability #disabled #cancer #addiction #pain
The CDC 2022 update is not meant to reform the guidelines

It's meant to absolve the CDC of guilt & wash its hands of an opioid prohibition & crisis it helped create

usatoday.com/story/opinion/… @elizableu @yashar @chadfelixg @conor64 @lhfang @stillgray @joerogan @TaylorLorenz
Christopher Jones, acting director of CDC’s National Center for Injury Prevention & Control

Said the guideline is about "improving the lives of patients living with pain.”

Then why did the CDC push further & deeper restrictions against patients?
Read 13 tweets
#longcovid. I have had it twice now. Never recovered from first infection. I am no longer able to stand for very long or make meals for my family. I can no longer work as I continuously have #fatigue, #migraines, #nausea, nerve #pain and #brainfog. …“

1/4 Image
„I use to work full time and just started a new job with the IRS after a pause from working as a mail carrier for 12 years. I can no longer do my daily of walks of 3 to 5 miles. Or spend time hiking or kayaking. …“

2/4
„I enjoyed baking breads and pies and helping my older sister and aging parents out. I can no longer do that. I am a shell of myself. I have spent thousands of dollars and countless appts trying to figure out what was wrong with me in the beginning. …“

3/4
Read 4 tweets
#women with #endometriosis have a higher risk of #stroke

1. Endometriosis is a common cause of #pelvic #pain and is known to increase the risk of #coronary artery disease (CAD). A recent study looked at the association of endometriosis and stroke.
#MedTwitter #gynecologist
2. Women with laparoscopically confirmed endometriosis had a 34% greater risk of stroke as compared to those without a history of endometriosis.
3. Of the total association of endometriosis
with risk of stroke, the largest proportion was attributed to hysterectomy/oophorectomy (39% mediated) and hormone therapy (16% mediated).
Read 5 tweets
Longer daily #sedentary time increases the risk of #Knee, #Hip and #back #pain

1. 20-25% of people aged 50 or more suffer from orthopedic problems such as knee joint pain, hip joint pain, back pain and knee stiffness. Sedentary lifestyle is a major risk factor for them.
2. In a recent study, men with sedentary time of 7.5 hours or more/day had 45% higher risk of orthopedic problems as compared to those with daily sedentary time of <7.5 hours.
#MedTwitter #ortho
3. A pink-collar job, physical inactivity during leisure time, and passive (e.g. riding in a car or train) versus active (e.g. walking or riding a bicycle) transportation- were more commonly associated with orthopedic problems in people with daily sedentary time >7.5 hours.
Read 5 tweets
Case of a man who almost stopped eating and drinking, as the act of swallowing caused severe throat pain

1. 45-year old man presented with intense episodes of pain in throat, back of tongue and tonsils on the right side for three months. The pain radiated to ear.
#MedTwitter
2. #pain was excruciating and was triggered by eating, chewing or swallowing food, drinking water, sneezing or even yawning. Pain lasted for 30-45 seconds and occurred 10-15 times every hour. He was so scared to eat or drink that he lost 15 kg weight in those 3 months.
3. He consulted ENT and dental doctors, and detailed examination by them was normal.
He became depressed and also had suicidal thoughts. He consulted psychiatrist and was started on anti-depressant medications.
On his sister's (a medico) advice, he decided to take my opinion.
Read 6 tweets
Long-standing unwanted & unpleasant genital sensations in a woman of neurological origin

1. 41-year old woman presented with 3-year history of persistent abnormal sensations involving vagina, #clitoris and labia, without #sexual interest or #desire.
#MedTwitter #neurotwitter
2. She found it hard to describe the sensations but used terms like vibrating, tingling, painful, throbbing, pulsating and numbness in vagina & surrounding regions. There was a sense of imminent #orgasm. Sexual activity & orgasm, however, did not relieve her symptoms.
3. Symptoms got worse on sitting and on lying down, but were lesser on standing or walking. Tight clothing or underwear aggravated her symptoms. She also had #pain in both legs, and felt the urge to constantly move her legs to reduce pain & discomfort (in legs & feet).
Read 9 tweets
A teenager who continued enjoying the pleasurable #emotions induced by hot water bath until he became unconscious during one such bath

1. Here I am sharing the case of a 18-year old boy who used to experience extremely pleasurable emotions every time he poured water on his head
2. He loved taking #bath with #hot water. This was not just for the comfort of warm water sensation over his body, but also for the pleasurable sensations & emotions that used to start in his body & mind soon after he poured hot water on his head.
#MedTwitter #NeuroTwitter
3. He described the feeling as if he got transcended to another world, with feelings of extreme elation and happiness. These feelings increased as he continued pouring more hot water on his head. These had started about a year back. He hadn't shared this with his family members.
Read 7 tweets
#pain fluctuates over time. How does the brain make sense of these fluctuations? We show that sensory and motor regions in the brain encode and predict the "rhythm of pain" 🧵1/8 nature.com/articles/s4146…
We used a statistical learning task, in which healthy participants received probabilistic & volatile sequences of low and high pain stimuli and were asked to guess the probability of forthcoming low/high pain 2/8
Behavioral performance was best described by an optimal Bayesian inference model with dynamic update of beliefs (an HMM) 3/8
Read 8 tweets
Repeated abdominal pain and vomiting could be a sign of "Abdominal Epilepsy"

1/n
Abdominal pain & vomiting are common symptoms of many gastrointestinal disorders. However, in some patients, no obvious cause can be found despite extensive investigations.
Case report
#MedTwitter
2/n
22-year old woman presented with repeated episodes of epigastric #abdominal #pain associated with #vomiting of three months duration. Symptoms occurred almost on daily basis, more in evenings, post which she felt tired and lethargic. She was evaluated by gastroenterologist.
3/n
Extensive investigations- upper GI endoscopy, CT and ultrasound of abdomen, LFT, serum amylase, etc were normal. Symptomatic treatment also did not help. At this point she was referred for my opinion.
#gastroenterology #internalmedicine
Read 5 tweets
I continually see research papers and presentations given on how #childhood #trauma relates to likelihood of #chronicpain.

While I do not dismiss this may be a factor, I am very frustrated at the lack of introspection by many #physicians where #medicaltrauma due to care that 1/
was dismissive, shaming, manipulative and lacked transparency does a great deal of harm leading to PTSD & I would postulate the worsening of #pain & or #disease. It’s as if the model, is backwards. Don’t get me wrong I absolutely believe #trauma can have long lasting impacts 2/
impacts that impact multiple areas. What I don’t understand is how many physicians don’t understand how care for children & youth w #rare or #complex #health issues or/and ones that include #pain can lead to #MH issues (not always be the cause). Why is it difficult for some 3/
Read 7 tweets
officially doctors & nurses are not supposed to use gut checks to determine if a patient is actually in pain,

reality is many if not most do & this ends up hurting A LOT of medical-seeking people

It's happened to me & it's garbage
#chronicpain #disability #health #medtwitter
Autism, learning disabilities, those poor at reading body language,

anyone that sucks at communicating gets hit hardest by these gut checks & get a note on their chart for drug seeking & its game over man

hard to be taken seriously for pain after that
@TaylorLorenz @maiasz
we could be here all day:

medical professionals mad someone brought in food, mad that they talked too much, mad they didn't talk enough, mad cuz they seemed too eager to accept pain medicine, mad cuz they didn't seem grateful for pain medicine, mad for coming in unshowered
Read 10 tweets
SEMINAL ARTICLE re: #ICD11 Chapter 08 - Diseases of the #NervousSystem 🧠

Study Title: The #leptomeninges as a critical organ for normal #CNS development and function: first patient and public involved systematic review of #arachnoiditis (chronic #meningitis). @PLOSONE
LINK: journals.plos.org/plosone/articl… @PLOSONE

Abbreviations:
#CES- #CaudaEquina Syndrome
#DLM – Diseases of the #Leptomeninges
#ESI- #Epidural Steroid Injection
LM - #Leptomeninges
#LMF- #Leptomeningeal #Fibrosis
#NAA- #neuraxialanesthesia
PSR- PRISMA Systematic Review
#SAH- #Subarachnoid Hemorrhage
#SAS- #Subarachnoid Space

Key Findings:

1. A varyingly described, and poorly characterized #CNS disease called #arachnoiditis (aka #adhesivearachnoiditis) was exhaustively systematically-reviewed for the first time.
Read 27 tweets
„Goebel et al. gehen davon aus, dass #Fibromyalgie, #MECFS und #longcovid Autoimmunerkrankungen sind, die durch lokale (keine systemische) Entzündungen gekennzeichnet sind.“
Goebel et al. injizierten Mäusen #IgGs von an #Fibromyalgie erkrankten Patienten. Es dauerte 2 Tage bis sie überempfindlich gegenüber Druck, Kälte und Schmerz wurden und sich ihre Griffkraft verringerte. (Kontrollgruppe: IgGs gesunder Probanden > 🐭 blieben gesund)
Read 8 tweets
Robert Bransfield, MD: Thousands of peer-reviewed journal articles demonstrate the causal association between infections and #mentalillness 400+ peer reviewed scientific articles demonstrate the causal association between tick-borne disease and mental illness. #ILADS2022 #Lyme
2/Bransfield: Up to 40% of patients w/ #Lyme develop peripheral or central nervous system involvement. Psychiatric reactions include: #paranoia #dementia #schizophrenia #bipolar #panicattacks #depression #anorexianervosa, and #ODC #ILADS2022
3/Bransfield: Lyme is over represented in psychiatric patients. #ILADS2022
Read 15 tweets
#Peacetime #Reflections
To get a permanent liberation from #migraine, we, as the sufferers, need to be deeply respectful and committed to ourselves at both dimensions - body and mind. 1/7
What goes into the #gut and #mind determine how intense and lasting would the #pain and #affliction be! A doctor can help only to some extent. #Painkillers are affronts to the body and mind. They stop working anyway after a while. 2/7
As sufferers, we need to own it up. In an utterly devastated and vexed state, we need to turn around with fire in heart and tell ourselves - 'Enough of playing games with myself! Let me take charge of my own inner sacred space, deterge it, make a temple of it - NOW or NEVER' 3/7
Read 8 tweets
The Mask - Fathers Perspective.Each mask evolves as His Father Evolves in the future back then/(NOW).

Beneath The Mask - A Sons Perspective, speaking to his Father from the ‘Inside Out’. …

Does your future seem like one big past?
You all wear A mask, Do you see the Mirror?
My life is created into movies & put up on the Big Screen, It doesn’t bother me nor do I use it for personal gain/fame ..

Strictly for Teaching purposes, that’s it. Image
Read 7 tweets
🧵 on how I got where I am today, seems appropriate for #PainMonth:

At 16yo I was a senior in high school & sophomore in college, simultaneously.

At 18, w/ a double major & a minor within 2 semesters of #graduation, I quit college. I knew it wasn’t for me.

Do I regret it?
1st A bit about happened next:

I joined the #army to follow in my dad & grandpas footsteps.

Was seriously injured in the 1st half of training yet kept pushing. I made it through but needed extensive surgery & physical rehab & still have #Pain.

I came home feeling I failed.
Once I was home & healing, I turned the page.

I spent next years climbing a corporate ladder, making over $100k/yr at 20.

And I HATED every second of it!

I happily accepted a promotion to ‘head cook & chief bottle-washer’. I was married & raising a healthy baby girl.
Read 14 tweets
This week, people have been discussing if eating #oysters conflicts with following a plant-based diet.

Today, we’re taking a look at the definition of sentience and #veganism—and at animal species that have been proven to be more sentient than humans used to think. 👇1/14 Image
Although there is legal and scientific disagreement about #sentience, there are some standards that are broadly accepted.

According to @SentienceInst, sentience is simply the ability to have positive and negative experiences, including pain. 2/14
sentientmedia.org/sentient-being/
The concept of animal #sentience is important for ethical reasons.

If #animals are sentient beings capable of feeling pain, most humans would agree that it is morally wrong to cause unnecessary pain or suffering to them. 3/14
sentientmedia.org/sentience-what…
Read 14 tweets
Every now and then I jump into spaces and hear #Bullish propaganda. This thread will be a collection is why there is more #pain coming.

1/n
#Germany next. The people have had enough. How will they survive the winter? 🤷‍♂️

Read 16 tweets
11 super interesting facts about the PAIN NEURO MATRIX that everyone should know:
👇 follow the thread 👇
#1 ... is a matrix of brain structures🧠that process and regulate pain information
#2 ... includes various nuclei in the brainstem, the amygdala, hypothalamus, thalamus and areas of the cerebral cortex
Read 13 tweets

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