Central Florida Manejo del Dolor, y no solo una pildora o una aguja

EL enfoque multidisciplinario para el manejo del dolor de la Dra. Lipson es importante.

Los tratamientos para el manejo del dolor a menudo pueden incluir el uso de una pildora o una aguja , sin embargo , la Dra. Ana Lipson ha encontrado que puede ser necesario un enfoque bien redondeado para el exito de manejo del dolor .

Muy a menudo se requiere una combinación de medicamentos , inyecciones , terapia física, los cambios de estilo de vida , ejercicio y tratamientos psicológicos .Para lograr esta combinación de tratamientos y cambios de estilo de vida , la Dra. Lipson a menudo tiene que colaborar con otros especialistas , es decir , los neurólogos , neurocirujanos , cirujanos ortopédicos, reumatólogos y fisioterapeutas .

La construcción de relaciones con los pacientes , con el tiempo , ayuda a Dr. Lipson para entender las muchas capas de su actual estado de dolor físico. A través de este proceso , la Dra. Lipson es capaz de diagnosticar y tratar muchas de las causas profundas de dolor físico. Dra. Lipson amenudo alienta a los pacientes para ver otros especialistas médicos y hacer los cambios de estilo de vida necesarios para tener éxito en reducir su dolor.

Bad sleep or good sleep…there is hope beyond the sleep aids…

People may develop mild cases of insomnia as a result of stress, pain, everyday life challenges, including: college studies, parenting, financial strain, and normal sleep requirements based on age and activity levels.

What is sleep? A condition of body and mind such as that which typically recurs for several hours every night, in which the nervous system is relatively inactive, the eyes closed, the postural muscles relaxed, and consciousness practically suspended. Both REM (25% of sleep cycle) and NREM (75% of sleep cycle) are required to achieve

NREM (75% of night): As we begin to fall asleep, we enter NREM sleep, which is composed of stages 1-4

Stage 1
* Between being awake and falling asleep
* Light sleep

Stage 2
* Onset of sleep
* Becoming disengaged from surroundings
* Breathing and heart rate are regular
* Body temperature drops (so sleeping in a cool room is helpful)

Stages 3 and 4
* Deepest and most restorative sleep
* Blood pressure drops
* Breathing becomes slower
* Muscles are relaxed
* Blood supply to muscles increases
* Tissue growth and repair occurs
* Energy is restored
* Hormones are released, such as: Growth hormone, essential for growth and development, including muscle development

REM (25% of night): First occurs about 90 minutes after falling asleep and recurs about every 90 minutes, getting longer later in the night
* Provides energy to brain and body
* Supports daytime performance
* Brain is active and dreams occur
* Eyes dart back and forth
* Body becomes immobile and relaxed, as muscles are turned off

Sleep Aids
Tens of millions of Americans take prescription sleep aids daily to obtain sleep. Often people initially seek sleep aids because of their inability to sleep or stay asleep. Often leading to the chronic use of these medications. Over time patients may become tolerant and dependent on these medications, requiring a change of sleepers or an increase in dosing.

The cycle:

• patients may be experiencing an inability to fall or stay asleep
• minimal amounts of sleep aids are used to address short term insomnia
• initially the sleep aids work
• then they need more to fall or stay asleep
• the dependency cycle begins

Obtaining REM and NREM
In order to obtain the appropriate levels of REM and NREM sleep patients may want to consider the following, before taking a prescription:

• avoidance of caffeine after noon
• don’t nap during the day
• exercise daily
• evaluate your room environment, including: temperature, brightness, sleep partners snoring, mattress, pillows, blankets – you need to be comfortable!
• use room darkening curtains, sleep masks, ear plugs, white noise machines
• stick to the same bed time and wake up times
• turn the TV off!
• seek natural sleep remedies, including chamomile teas, melatonin, relaxation techniques, including: breathing and soft music

There are some cases where short term use of sleep aids may be indicated, however, the chronic use of sleep aids should be discouraged to avoid dependency.

Contact Central Florida Pain Management Today, Your Pain Free Life Is Waiting.

410 First Street South
Winter Haven FL 33880
Phone: 863-293-4800
Web Site: http://www.analipsonmd.com/

Ana Lipson MD
Central Florida Pain Management
Winter Haven Florida 
863-293-4800

My rib pain is unbearable…

When a patient is experiencing pain along the rib cage, discomfort when breathing and/or coughing, and torso pain interfering with their day-to-day activities, they may have the rare condition intercostal neuralgia.

Some of the causes of intercostal neuralgia include:

• Chest or rib injury, such as a broken rib or bruised chest
• Intercostal nerve entrapment
• Nerve degeneration
• Neuritis, which is inflammation of a nerve or group of nerves
• Pregnancy, which can cause the rib cage to expand
• Pulled or strained muscle in the chest wall, shoulders, back or arm
• Rib infection
• Shingles (reactivation of the varicella zoster virus)
• Surgery on organs, bones and tissues in the thoracic cavity, such as kidneys, ribs and spine
• Tumors in the chest and abdomen, which can press on the intercostal nerves

It is very important that a patient informs their primary care physician of their torso pain so that cardiac disease, chest malignancies, or pulmonary conditions may be ruled out.

Intercostal neuralgia may resolve on its own or it may require treatment. There are two treatment approaches that Dr. Lipson recommends for this condition:

• Non-steroidal anti-inflammatory drugs, such as ibuprofen, naproxen, and indomethacin. NSAIDS help reduce inflammation and pain.

• Intercostal nerve blocks, which are injections of a local anesthetic or a corticosteroid around the affected intercostal nerve

Some patients may experience relief from pain for 6-12 months, and in some cases indefinite relief is possible.

Contact Central Florida Pain Management Today, Your Pain Free Life Is Waiting!
863-293-4800  OR  ana@analipsonmd.com  OR  http://analipsonmd.com

Ana D Lipson MD Central Florida Pain Management

 

 

This is a pain in my butt!

Sacroiliac Joint Dysfunction
Ana Lipson MD
Central Florida Pain Management, Winter Haven Florida
863-293-4800

Sacroiliac Joint Dysfunction

Description:
The sacroiliac joint connects the sacrum and the right and left iliac bones. We often find that patients struggling with lower back pain may actually be suffering from Sacroiliac Joint Dysfunction. In addition to lower back pain patients may complain of pain in the buttocks, thigh, down the back of one or both legs, and complain of difficulty sitting or standing for long periods of time.

Symptoms of Sacroiliac Joint Dysfunction:

• Lower Back Pain
• Buttocks Pain
• Thigh Pain
• Pain Down the Back of Leg
• Difficulty Sitting in One Place for Too Long

Causes:

• Injury
  • Direct Fall
  • Motor Vehicle
  • Pelvic Injury
• Abnormalities of the pelvic bone
• Childbirth
• Multiple pregnancies

Diagnosis:

• History and Physical
• X-ray of the sacroiliac joint

Treatments:

• Physical therapy
• Non-steroidal anti-inflammatories
• Procedures including:
  • Sacroiliac steroid injections
  • Radio-frequency ablation
• Surgery – Sacroiliac Fusion

Success in treatment varies from patient to patient. In young patients treatment can be a permanent resolution to the problem. In older patients, suffering for a long time, ongoing pain management may be required.

Contact Dr. Ana Lipson today, your pain free life is waiting!

Central Florida Pain Management
410 First Street South
Winter Haven, Florida 33880
863-293-4800
http://www.analipsonmd.com

Ana Lipson MD
Central Florida Pain Management
Winter Haven Florida

Understanding the different types of pain…Neuropathic…

It is important to understand that there are different types of pain based on where in the body the pain is felt. Pain of all three types can be either acute or chronic. The three pain types can be felt at the same time or at different times. They respond to different medication and nerve blocks. The three types of pain are:

• Neuropathic
• Somatic
• Visceral

Neuropathic pain is pain caused by damage or disease that affect nerves. Some common causes of neuropathic pain include:

• alcoholism
• amputation
• back, leg, and hip problems
• chemotherapy
• diabetes
• facial nerve problems
• HIV or AIDS
• shingles
• surgery on the spine

Treatment options include:

Medication, which can be divided into three groups:

• Anticonvulsants (Neurontin, Lyrica, Tegretol, Topamax, Lamictal, Gabitril)
• Antidepressants (Elavil, Cymbalta, Remeron, Sinequan, Desyrel)
• Opioids (narcotics) are only used when the anticonvulsants and antidepressants fail

Nerve blocks

• stellate ganglion blocks
• lumbar sympathetic block
• epidurals

Or sometimes a combination of both

In addition patients may reduce their pain levels through exercise, the use of a tens unit, massage, biofeedback, and acupuncture.

Contact Dr. Lipson today, your pain free life is waiting!
Central Florida Pain Management
410 First Street South
Winter Haven, Florida 33880
863-293-4800
http://www.analipsonmd.com

Ana Lipson MD
Central Florida
Pain Management

 

artritis, 120 enfermedades; 360 articulaciones; 52,000,000 adultos…

Ana Lipson MD
Central Florida Pain Management
Winter Haven Florida

Las artritis, a menudo referido como “Arthur” por nuestra población de edad avanzada, afecta a aproximadamente 52 millones de adultos.

Hay unos 120 tipos diferentes de artritis, los tipos más comunes son:

• reumatoide
• artritis inflamatoria
• artritis degenerativa
• osteoartritis
• lupus
• psoriasis
• gota
• espondiloartropatías

Los síntomas, inlcuyen:

• dolor en las articulaciones
• rigidez
• hinchazón de las articulaciones
• adormecimiento y hormigueo
• fatiga
• deformaciones
• disminución de la amplitud de movimiento

Causas, inlcuyen:

• enfermedad sistémica
• enfermedad autoinmunologica
• enfermedad degenerativa
• genético
• ambiental
• hormonal

Diagnóstico:

Consulte a su médico de atención primaria, quien hará una historia clínica completa y un examen físico, así como:

• x-ray
• análisis de sangre
• remisión a un reumatólogo

Tratamientos:

• la terapia física y el ejercicio
• anti-inflamatorios
• esteroides
• medicamentos biológicos administrados por un reumatólogo
• derivación a un especialista en el manejo del dolor

Los médicos de manejo del dolor a menudo trabajan en estrecha colaboración con el reumatólogo en el tratamiento de las condiciones de dolor crónico, utilizando un enfoque multidisciplinar, garantizando una coordinación de los pacientes:

• medicamentos
• inyecciones
• fisioterapia
• cambios de estilo de vida
• ejercicio
• tratamientos psicológicos

Contact Dr. Ana Lipson today, your pain free life is waiting!

Central Florida Pain Management
410 First Street South
Winter Haven, Florida 33880
863-293-4800
http://www.analipsonmd.com

Ana Lipson MD
Central Florida Pain Management
Winter Haven Florida

CFPM knows that there is nothing cute about acute pain…

Acute pain defined…

Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. There are several events or circumstances that may be the cause of acute pain, including:

• Surgery
• Broken bones
• Dental work
• Burns or cuts
• Labor and childbirth

Acute pain may be mild and last for just a moment, or it may be severe and last for weeks or even months. In most cases, acute pain does not last longer than six months, and it disappears when the root cause of the pain has been treated or once the injury that initially caused the pain has healed. It is important to know that unrelieved acute pain could lead to chronic pain. Early treatment of acute pain can prevent chronic pain syndrome.

If you, or a family member, is in pain contact Central Florida Pain Management (CFPM). The CFPM team will be happy to guide you through the steps of scheduling an appointment to see Dr. Ana Lipson.

Contact Central Florida Pain Management Today, Your Pain Free Life Is Waiting!
863-293-4800   OR   ana@analipsonmd.com   OR   http://analipsonmd.com

Ana Lipson MD
Central Florida Pain Management

lo que esta pasando en las farmacias acerca de narcoticos…

Central Florida Pain Management
Winter Haven, Florida
863-293-4800

Lo que esta pasando en las farmacias acerca de narcoticos…

Los pacientes han estado informando de nuevo a mi oficina que ellos están luchando para obtener recetas de narcoticos que surge en una cadena de farmacias que han utilizado una y otra vez. Muchos han pensado que esta nueva dificultad fue en respuesta al nuevo cambio de la DEA en la programación de hydrocodone y tramadol.

Lo que esta realmente detrás ……

Walgreens multado con $ 80 millones

Observadores de la industria dicen que la decisión de Walgreens para cambiar su política con respecto a la distribución de pastillas para el dolor fue llevado por necesidad.

La compañía presentó su lista de Buena Fe dispensación y distribución general de alimentos a principios de este año, ya que se vio envuelto en una investigación masiva por el Departamento de Justicia de Estados Unidos y la Administración de Control de Drogas de Estados Unidos. Los agentes federales dirigidos seis farmacias Walgreens y un centro de distribución de Walgreens en Florida, donde tomaron la empresa de llenado repetidamente recetas falsas para pastillas para el dolor.

“Estas farmacias minoristas llenaron las recetas de narcóticos con receta adictivas a pesar de las banderas rojas obvias que indicaban claramente las prescripciones eran ilegítimos, y las drogas eran propensos a ser desviados para uso en la calle”, dijo el fiscal federal Wilfredo Ferrer, que culminó una investigación de un año por la Agencia Antidrogas de Estados Unidos.

Walgreens aceptó pagar una multa de $ 80 millones para los violaciónes, y como parte de su liquidación, la empresa se comprometió a mejorar sus políticas y procedimientos para ayudar a reducir el abuso de medicamentos recetados para el dolor que implica narcóticos adictivos.

Fue entonces cuando Walgreens lanzó su lista de comprobación DLG, y le dijo a sus empleados para su ejecución – en voz baja.

“Los directivos dejaron en claro … no queremos a los pacientes a ser informados esto lo que estamos haciendo”, dijo Ryan a 13 Investiga. “Ellos realmente nunca explicó por qué. Me imaginé que teníamos que hacerlo para dar cobertura a causa de lo que pasó en la Florida Walgreens.”

http://www.wthr.com/story/23469086/2013/09/18/walgreens-secret-checklist-reveals-controversial-new-policy-on-pain-pills

Cuando se enfrentan a luchas similares a adquirir sus medicamentos de tratamiento del dolor llenaron, vuelva a su médico y buscar orientación. Decisión precipitada de una farmacia para negar su receta, sin datos que sugieren un problema, puede ser la discriminación. En la Florida Central Manejo del Dolor, trabajamos diligentemente para asegurar que nuestros pacientes están utilizando medicamentos de tratamiento del dolor adecuadamente. Nos esforzamos por tener una relación con nuestros pacientes y nuestras farmacias locales.

Contacto agentes Central Florida Dolor Hoy en día, su dolor Vida Libre está esperando…

Ana Lipson MD
Central Florida Pain Management
Winter Haven Florida 
863-293-4800

 

Central Florida Pain Management, Not just a pill or a needle

Dr Ana Lipson’s Multidisciplinary Approach to Pain Management

Central Florida Pain Management, Not just a pill or a needle

Treatments for pain management may often include the use of a pill or a needle, however; at Central Florida Pain Management, Dr Ana Lipson has found that a well-rounded approach to managing pain may be needed.

Quite often a combination of medications, injections, physical therapy, lifestyle changes, exercise, and psychological treatments is required.

In order to accomplish this combination of treatments and lifestyle changes, Dr. Lipson often has to collaborate with other specialists, i.e., neurologists, neurosurgeons, orthopedic surgeons, rheumatologists, and physical therapists.

Building relationships with patients, over time, helps Dr. Lipson to understand the many layers of their current state of physical pain. Through this process, Dr. Lipson is able to diagnose and treat many of the root causes of physical pain. Dr. Lipson often encourages patients to see other medical specialists and make the lifestyle changes required to succeed in managing or reducing their pain.

Dr. Ana D. Lipson
Central Florida Pain Management
863-293-4800
ana@analipsonmd.com
http://analipsonmd.com

Ana Lipson MD Central Florida Pain Management

 

Lumbar Transforaminal Epidural Steroid Injection

Lumbar Transforaminal Epidural Steroid Injection

The lumbar transforaminal epidural steroid injection is an outpatient procedure used to relieve pain in the lower back and pain that radiates from the back to the legs. The medication injected helps to reduce swelling and inflammation of the irritated spinal nerves.

Procedure:

• Patient lies face down with a cushion under the abdomen to allow the spaces (foramina) on the sides of the spine to open
• Physician administers local anesthetic to numb the skin and the tissue that covers the spine
• Physician guides needle into the foraminal space that surrounds the irritated nerve root
• Physician injects contrast solution
• Physician uses fluoroscope (a type of x-ray device) to confirm position of the needle
  
• Physician injects a steroid-anesthetic medication & then removes the needle
• Physician bandages the insertion site

Most patients feel significant relief after just one injection, but some patients do require multiple injections before they feel the full benefit.

If you, or a loved one, is suffering from acute or chronic pain, give us a call and we’ll provide you with the step-by-step process of scheduling an appointment with Dr. Lipson.

Contact Central Florida Pain Management Today, Your Pain Free Life Is Waiting…
Dr. Ana Lipson
Central Florida Pain Management
410 First Street South
Winter Haven FL 33880
Phone: 863-293-4800
Web Site: http://www.analipsonmd.com/