We have talked extensively about how various disabilities, such as arthritis, carpal tunnel syndrome, and chronic neck and back pain, can affect you and your practice. One of the ways of dealing with all of these disabilities is to take painkillers such as Advil and Aleve, or NSAIDs (non-steroidal anti-inflammatory drugs). Many people will be prescribed these medications, or take them over-the-counter, for issues ranging from a small headache to disabling pain.
However, just because these drugs are common doesn’t mean they’re completely foolproof or safe. Recently, the FDA has announced that there should be changes made to the labels of NSAIDs regarding their risks. Instead of saying that they “may cause” an increased risk of heart attack or stroke, the FDA urges that the wording should state that they do “cause an increased risk”.
In 2013, a study found that high doses of NSAIDs heightened the risk of heart attack by one-third. In a 2014 study, people taking NSAIDs were 19% more likely to die from a stroke. It is also important to understand that while higher risks occur at higher doses, the FDA warns that the increased chance of heart attack and stroke can occur as early as one week into treatment. Also noteworthy is that if you, or your family, have a history of heart disease, you are even more susceptible.
Even more interesting is that taking antidepressants and NSAIDs at the same time has been shown to heighten one’s risk for intracranial hemorrhage, which is bleeding that occurs around the brain. While the occurrence of bleeding was still relatively low (only about 6 per 1000 people studied), the combination of the two drugs increased occurrence by 60%.
This is especially relevant not only due to doctors and dentists having a great chance to develop debilitating pain due simply to their professions, but also because it is shown that doctors and dentists are also at a higher risk for depression and mental illness.
While we certainly don’t encourage you to stop taking your NSAIDs, we simply advise that you stay educated about what these medications mean for your health. We also recommend speaking with a doctor about your options and what would be best for your specific health needs. If your pain is so incapacitating that you you think you may need to file for disability, be sure to contact a disability insurance lawyer so they they can help you with the process.
We’ve talked about how medical professionals are more susceptible to mental health issues, so it shouldn’t be shocking that doctors and dentists are also more stressed out than the general populace. In fact, a study has shown threshold levels of stress that stay constant at about 28%, which is quite a bit higher than the general working population’s level of 18%. This shouldn’t be surprising, even if you disregard all the data associated with medical professionals and mental health; physicians are put in high risk situations every day.
While many physicians may assert that they have been dealing with stress their whole life and thus know how to handle it, it is important to be sure that you know how to recognize the signs of stress and how to properly decrease stress levels. Simply working through it or ignoring your stress may not get rid of it, and could even lead to other complications. For instance, stress increases the risk of conditions such as heart disease, Alzheimer’s, diabetes, depression, and obesity.
We created a list of some of the signs of stress, as well as a list of things that you can do to make your life a little less stressful both during work and outside of the office.
Signs of Stress
Some of these signs are very noticeable, and you could probably identify them in a second, but others are more subtle. If you suffer some of these symptoms on a daily basis, you may think that they are just part of your daily life, but it is important to note that many of these symptoms can be prevented.
Apparently, the Unum employee suffered from carpal tunnel—due to all the typing that her job required—and also suffered a back injury in her home office. Naturally, the Unum employee saw a hand specialist for the carpal tunnel, and a back specialist for the back injury. After the Unum employee had surgery on her hand to treat the carpal tunnel, the Unum employee’s primary care physician placed her on work restrictions. However, the primary care physician did not send the work restrictions to Unum because she thought that the other doctors had already documented the restrictions.
Unfortunately for the Unum employee, the other doctors had not forwarded the restrictions to Unum. Instead of reaching out to the Unum employee’s doctors to see if the disability claim was legitimate, Unum simply denied the long term disability claim due to a lack of documentation. At that point, the primary care physician came forward and expressly told Unum that she supported the restrictions, but Unum still refused to pay any benefits.
 See http://www.lawyersandsettlements.com/articles/first_unum/interview-unum-lawsuit-insurance-29-20883.html#.VfhBwxFVikp.
Chronic back pain is one of the issues that countless doctors and dentists face every day. Many of our clients have suffered from pain that doesn’t allow for effective practice, and thus have had to deal with the disability insurance claims process. According to the American Society of Anesthesiologists, there is a new treatment that could help alleviate some forms of back pain in certain patients. We’re going to be taking a look at the study they published regarding spinal cord stimulation (SCS), as well as answer some questions about SCS for those who don’t know about it.
This study compared the effectiveness of high frequency to traditional SCS therapy for back and leg pain. Researchers treated 90 patients with high frequency therapy while 81 received the traditional SCS. After three months, 85% of back pain patients, and 83% of leg pain patients reported a 50% or greater reduction in pain, while only 44% of back pain patients and 56% of leg pain patients in the traditional SCS group experienced a 50% reduction in pain.
Also, more patients (55% to 32%) in the high frequency group stated that they were “very satisfied” with their pain relief. Patients of the high frequency treatment didn’t experience any paresthesia, which is commonly associated with SCS.
- What is SCS?
SCS is therapy that delivers low-level electrical signals to the spinal cord or to specific nerves in order to block pain signals from reaching the brain.
- How does SCS work?
A device is implanted in the back near the spinal cord through a needle and generator is placed through a small incision in the upper buttock. The patient is able to adjust the intensity of the signals or turn the current on or off.
- How does the SCS stay charged?
It depends on the device: some SCS systems have a pulse generator, which is like a battery, some have a rechargeable pulse generator system that can be charged through the skin, and others do not require recharging but last a shorter time before they need to be replaced.
- How much higher is the high frequency SCS?
The high frequency SCS pulses at 10,000 Hz, while traditional SCS has a frequency between 40 and 60 Hz.
- What is paresthesia?
Paresthesia is a sensation such as tingling or buzzing that is commonly associated with SCS. It is thought to potentially mask a patient’s perception of pain, and is often distracting or uncomfortable, thus limiting the effectiveness or desirability of SCS treatment.
- What are the risks of SCS?
SCS doesn’t address the source of the pain; it merely interrupts the pain signals sent to the brain from your body. If you have pain that stems from a correctable anatomical problem, it is probably best to look for treatment that will address this problem first. SCS also involves an implant and surgery, which naturally comes with risks and potential complications.
- Allergic reactions to the implanted material
- Weakness, numbing, clumsiness, paralysis
- Fluid lead from the spinal cord
- Migration of the electrode
- What is this treatment called?
The treatment is being called HF10™.
This study is just the first step in a new treatment that could bring relief to people suffering from chronic pain. We encourage you to speak with your doctor before starting any sort of treatment.