“This seminar series is about helping individuals achieve healthy balance in maintaining physical & emotional health, while accomplishing those things that they want & need to do while also caring for loved ones," according to Dr. Blotner.
Memphis, TN, July 26, 2009: Achieving healthy balance is the challenge that we all face, as each of us strives accomplish our goals as parent, spouse, friend, adult son or daughter to aging parents, & work, as well as participating in community & church activities.
It is no wonder that burnout effects so many of us, with so many things that we expect ourselves to do. With the recent increase in financial challenges that so many of us are facing, it is more difficult than ever to find the time & energy to do all of the things that we want to do for those we care about most, as well as the challenge of maintaining our own health at the same time.
According to Dr. Blotner, "It's like the fable of The Goose & the Golden Eggs: If you want the golden eggs (your ability to do for others), then you've got to take care of the goose (yourself)."
Dr. Blotner has over 20 years experience in the comprehensive management of chronic pain, mood, anxiety, & sleep disorders. He has always been interested in the physical as well as emotional impact of stress, and how individuals can learn to reduce the impact of stressful situations on mind & body.
"The purpose of these seminars is to share stress reducing methods & techniques that can be done right away, to enhance each person’s ability to accomplish what is really important to them, and to enhance their ability to enjoy your healthy sources of pleasure & fulfillment," says Dr. Blotner.
These will be ample time for seminar attendees to have their own questions & concerns addressed during "Q&A" as part of each seminar.
Seminars begin at 7:30am on one Friday per month, at a cost of $30 each. A light breakfast will be served. The first seminar is September 9, 2009:
“Rx for Burnout: Caring for Yourself & Those You Love”
SEMINAR DATES & TOPICS
9/11/09 Home, School, Work: Achieving Healthy Balance
10/9/09 Managing Holiday Finances
11/6/09 Managing Holiday Stress
12/11/09 Enjoying YOUR Holidays
1/15/10 Healthy Beginnings for Your New Year
2/6/10 Enhance Your Romance: Valentine’s Day & more
3/12/10 Reducing Stress at Tax Time
4/9/10 Spring Break-Give ME a Break!
5/14/10 School’s Out: Oh, No, Now What?
6/11/10 Beating the Heat: Enjoying YOUR Summer
7/16/10 How to NOT need a Vacation After Your Vacation
8/13/10 Family and Friends: Achieving Healthy Balance
About Dr. Blotner
Dr. Blotner specializes in the comprehensive management of chronic pain, mood, anxiety, and sleep disorders since 1988, emphasizing healthy physical activity, non-addictive medications, stress management and lifestyle adjustment as the foundation of health and healing.
For reservations & information contact Joanna
Phone: 901-761-3255 x302,
Email: jwhitney@lshmedicalbill.com
Showing posts with label Depression. Show all posts
Showing posts with label Depression. Show all posts
Sunday, July 26, 2009
Monday, July 20, 2009
WHAT ABOUT SLEEP MEDICATIONS? ARE THEY SAFE?
Over-the-counter medications promoted as sleep aids are primarily anti-histamines & work well for many with mild sleep disorders (especially if you have a chronic sinus allergies). Some people experience side effects of daytime drowsiness, disorientation, blurred vision or dry mouth, which makes this otherwise safe medication too difficult to tolerate. They do not provide effective and sustained relief for more severe sleep disorders.
The "benzodiazepines" are the most widely used prescription medications indicated for short-term treatment of anxiety and/or insomnia. These prescription medications bind to the GABA receptor complex reducing anxiety, inducing muscle relaxation and inhibiting convulsions as well as promoting sleep.
They are generally safe and effective for short-term use. They include Temazepam (Restoril), Triazolamm (Halcion), & Lorazepam (Ativan). Their possible side effects include decreased daytime alertness, energy, concentration, and/or memory functioning, and possibly even depressed mood. With regular use for more than several weeks at a time, these medications may significantly reduce time spent in REM sleep, resulting in these and other side effects including mood swings, irritability, temper outbursts, anxiety, and (ironically) insomnia.
Because they are potentially habit-forming or addictive, regular use of benzodiazepines for more than several weeks at a time should be avoided, except in rare cases. In addition to the side effects noted above, the negative consequences long-term daily use include the need for increased dose to achieve the desired effects (becoming "immune" to the medication or "tolerance"); the urge to take more medication than is prescribed ("abuse"); and the uncomfortable and potentially dangerous withdrawal symptoms on attempts to discontinue the medication (due to "physiologic dependence").
Care should be taken when by anyone with liver and kidney disease to those who are heavy snorers, and to the elderly. These medications have been associated with birth defects when taken by pregnant women. It is extremely important for women of childbearing age to use the most reliable methods of contraception possible when taking these medications.
Zaleplon (Sonata) & Zolpidem (Ambien) are non-benzodiazepine prescription medications for insomnia. They have minimal adverse effects on sleep architecture, and no evidence of rebound insomnia at recommended doses. Side effects can include memory impairment, sleepwalking, and morning drowsiness.
For chronic insomnia associated with other symptoms of Clinical Depression, I have had excellent results with the so-called "anti-depressant" medications. They are not habit-forming, restore sleep architecture to normal, have minimal to no side-effects when properly selected and dosed. They tend to improve all symptoms of the syndrome of Clinical Depression, as well as reducing a wide variety of aches & pains. Examples include Trazodone (Desyrel), Amitriptyilne (Elavil), and Remeron (Mirtazapine).
Regarding “anti-depressant” medications, talk to your healthcare provider about trying the lowest dose possible and about gradual increase of the dose until your symptoms are resolved. These agents can potentially have a wide variety of side effects, including daytime drowsiness & decreased impaired daytime energy, which are usually minor and temporary. In some individuals, these medications can actually worsen sleep disturbance & mood.
Remember: what counts is how you feel, not how many hours of sleep you've had. If you are alert, feel rested, and function well during the day, chances are you're getting enough sleep.
Sweet Dreams!
For more information: National Sleep Foundation http://www.sleepfoundation.org
The "benzodiazepines" are the most widely used prescription medications indicated for short-term treatment of anxiety and/or insomnia. These prescription medications bind to the GABA receptor complex reducing anxiety, inducing muscle relaxation and inhibiting convulsions as well as promoting sleep.
They are generally safe and effective for short-term use. They include Temazepam (Restoril), Triazolamm (Halcion), & Lorazepam (Ativan). Their possible side effects include decreased daytime alertness, energy, concentration, and/or memory functioning, and possibly even depressed mood. With regular use for more than several weeks at a time, these medications may significantly reduce time spent in REM sleep, resulting in these and other side effects including mood swings, irritability, temper outbursts, anxiety, and (ironically) insomnia.
Because they are potentially habit-forming or addictive, regular use of benzodiazepines for more than several weeks at a time should be avoided, except in rare cases. In addition to the side effects noted above, the negative consequences long-term daily use include the need for increased dose to achieve the desired effects (becoming "immune" to the medication or "tolerance"); the urge to take more medication than is prescribed ("abuse"); and the uncomfortable and potentially dangerous withdrawal symptoms on attempts to discontinue the medication (due to "physiologic dependence").
Care should be taken when by anyone with liver and kidney disease to those who are heavy snorers, and to the elderly. These medications have been associated with birth defects when taken by pregnant women. It is extremely important for women of childbearing age to use the most reliable methods of contraception possible when taking these medications.
Zaleplon (Sonata) & Zolpidem (Ambien) are non-benzodiazepine prescription medications for insomnia. They have minimal adverse effects on sleep architecture, and no evidence of rebound insomnia at recommended doses. Side effects can include memory impairment, sleepwalking, and morning drowsiness.
For chronic insomnia associated with other symptoms of Clinical Depression, I have had excellent results with the so-called "anti-depressant" medications. They are not habit-forming, restore sleep architecture to normal, have minimal to no side-effects when properly selected and dosed. They tend to improve all symptoms of the syndrome of Clinical Depression, as well as reducing a wide variety of aches & pains. Examples include Trazodone (Desyrel), Amitriptyilne (Elavil), and Remeron (Mirtazapine).
Regarding “anti-depressant” medications, talk to your healthcare provider about trying the lowest dose possible and about gradual increase of the dose until your symptoms are resolved. These agents can potentially have a wide variety of side effects, including daytime drowsiness & decreased impaired daytime energy, which are usually minor and temporary. In some individuals, these medications can actually worsen sleep disturbance & mood.
Remember: what counts is how you feel, not how many hours of sleep you've had. If you are alert, feel rested, and function well during the day, chances are you're getting enough sleep.
Sweet Dreams!
For more information: National Sleep Foundation http://www.sleepfoundation.org
Wednesday, July 15, 2009
How We Measure Pain: The “Four A’s”
Because we don’t have a blood test or x-ray that measures pain, it can be difficult to explain, evaluate, and track. So, how can we “measure” in the doctor’s office?
One of the best methods that we have is to follow the “Four A’s:” Analgesia (pain relief), Activities of Daily Living (functioning at home & work), Adverse Effects (medication side effects), and “Aberrant Behaviors” (warning signs for addiction).
For “Analgesia” (pain relief), the standard method at this time is to use the “1-to-10” scale, where “10 is the worse pain you can imagine” and “1 is barely noticeable pain.” Variations on this scale include pictures of the scale with more detailed descriptions of each level of pain.
For many people, this is not an easy scale to use. But it is an important tool to help the healthcare provider to understand how much relief a person is getting from their current treatment. I often suggest “imagine that we stop all of your medication…let’s call that a ’10’…so, WITH the medication you are now taking, how far away from a ‘10’ does that get you? Is there a 50% reduction in your pain, or 20%, 80%...?”
This scale is a tool to help the healthcare provider understand if the pain is better or worse since the last change in medication dosage. It is also important to communicate about changes in how much medication was actually taken, any unauthorized dosage increases, or running out of medication early, and how changes in the amount of medication taken affected the pain.
“Activities of Daily Living” (ADL’s) refer to a person’s ability to perform usual activities in important areas of their life: as parent, spouse, friend, family member, work, leisure, and community activities. Sometimes, the level of pain does not change because the person will increase their activity until they get to a certain level of pain. So, if pain has stayed the same but the person is able to do twice as much activity as before, this would be considered a positive treatment outcome.
“Adverse Effects” refer to medication side effects. It is important for those taking medication to inform their healthcare provider of any symptoms that get worse with an increase in any medication dosage. Some Adverse Effects are not medically dangerous (such as dry mouth), what I think of as “nuisance” side effects. Others can be medically dangerous, such as heart rhythm abnormalities, or changes in liver or kidney functioning. Some medications have Adverse Effects can be detected early only with blood work, and can cause severe illness if the one waits until they feel sick before they investigate.
The most important thing here is the communication between healthcare provider and the patient regarding any worsening of any symptoms, and being informed about any “routine” tests which should be performed for medication(s) being taken on a regular basis.
“Aberrant Behaviors” is a term that healthcare providers use to refer to those behaviors that may be a “warning sign” for addiction, which can occur with narcotic pain medication (or other potentially habit-forming medication) in genetically susceptible individuals.
Examples of “Aberrant Behaviors” include taking pain medications for symptoms other than pain (such as anxiety or sleep); unauthorized dosage increases, adverse effects on mood, irritability, anxiety, or sleep; intoxication; or motor vehicle accidents. Each of these alone would not result in a diagnosis of addiction, but it is best for the healthcare provider, the person taking the medication, and the family should all “be on the lookout” for any adverse behavior changes that continue or worsen over time when taking any potentially habit-forming medication on a regular basis. It is also important to avoid drinking alcohol with narcotic pain medication.
Healthcare providers can provide safe and effective treatment for pain conditions, but only with good communication about “the Four A’s” can the best possible treatment outcomes be safely achieved.
One of the best methods that we have is to follow the “Four A’s:” Analgesia (pain relief), Activities of Daily Living (functioning at home & work), Adverse Effects (medication side effects), and “Aberrant Behaviors” (warning signs for addiction).
For “Analgesia” (pain relief), the standard method at this time is to use the “1-to-10” scale, where “10 is the worse pain you can imagine” and “1 is barely noticeable pain.” Variations on this scale include pictures of the scale with more detailed descriptions of each level of pain.
For many people, this is not an easy scale to use. But it is an important tool to help the healthcare provider to understand how much relief a person is getting from their current treatment. I often suggest “imagine that we stop all of your medication…let’s call that a ’10’…so, WITH the medication you are now taking, how far away from a ‘10’ does that get you? Is there a 50% reduction in your pain, or 20%, 80%...?”
This scale is a tool to help the healthcare provider understand if the pain is better or worse since the last change in medication dosage. It is also important to communicate about changes in how much medication was actually taken, any unauthorized dosage increases, or running out of medication early, and how changes in the amount of medication taken affected the pain.
“Activities of Daily Living” (ADL’s) refer to a person’s ability to perform usual activities in important areas of their life: as parent, spouse, friend, family member, work, leisure, and community activities. Sometimes, the level of pain does not change because the person will increase their activity until they get to a certain level of pain. So, if pain has stayed the same but the person is able to do twice as much activity as before, this would be considered a positive treatment outcome.
“Adverse Effects” refer to medication side effects. It is important for those taking medication to inform their healthcare provider of any symptoms that get worse with an increase in any medication dosage. Some Adverse Effects are not medically dangerous (such as dry mouth), what I think of as “nuisance” side effects. Others can be medically dangerous, such as heart rhythm abnormalities, or changes in liver or kidney functioning. Some medications have Adverse Effects can be detected early only with blood work, and can cause severe illness if the one waits until they feel sick before they investigate.
The most important thing here is the communication between healthcare provider and the patient regarding any worsening of any symptoms, and being informed about any “routine” tests which should be performed for medication(s) being taken on a regular basis.
“Aberrant Behaviors” is a term that healthcare providers use to refer to those behaviors that may be a “warning sign” for addiction, which can occur with narcotic pain medication (or other potentially habit-forming medication) in genetically susceptible individuals.
Examples of “Aberrant Behaviors” include taking pain medications for symptoms other than pain (such as anxiety or sleep); unauthorized dosage increases, adverse effects on mood, irritability, anxiety, or sleep; intoxication; or motor vehicle accidents. Each of these alone would not result in a diagnosis of addiction, but it is best for the healthcare provider, the person taking the medication, and the family should all “be on the lookout” for any adverse behavior changes that continue or worsen over time when taking any potentially habit-forming medication on a regular basis. It is also important to avoid drinking alcohol with narcotic pain medication.
Healthcare providers can provide safe and effective treatment for pain conditions, but only with good communication about “the Four A’s” can the best possible treatment outcomes be safely achieved.
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