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1. Breakthrough Pain

The Oxford American Pain Library provides practical guides that cover current approaches and new developments in the assessment and management of pain. The Diagnosis and Treatment of Breakthrough Pain is meant for doctors and nurses but can also provide some insight into treatment options for patients suffering from uncontrolled pain flares. In the excerpt below we learn what breakthrough pain really is.

The term “breakthrough pain” began appearing in the medical literature in the 1980s on the heels of the increased attention, brought about by the World Health Organization, to the global problem of undertreated cancer pain. During that time, it became apparent that cancer patients commonly experience intermittent exacerbations of severe pain against a background of continuous, or baseline, pain. Episodic pains that would “break through” during the treatment of background pain that was otherwise well controlled through the use of around-the-clock opioid therapy were catergorized by Portenoy and Hagen (1990) in a seminal work titled “Breakthrough pain: Definition, prevalence and characteristics.” The definition of breakthrough pain proffered in that article took root and has been used in pain management parlance ever since.

As opioid therapy has become more commonly used in the treatment of chronic noncancer pain over the last decade, it have become equally apparent that similar patern of supervening severe pain episodes can confound otherwise well-managed chronic pain (Seppetella et al., 2001). Recognizing the similarities of sympotms, independent of underlying pathophysiology, a group of pain managment experts came together in 2006 to create a unifying definition, based on a review of all the literature on the subject in all populations studied to date. The more generalized definition incorporates the additional observation that breathrough pain seriously disrupts the quality of patients lives. Therefore, the term breakthrough pain is now categorically determined to define the particular clinical circumstance wherein patients who have controlled baseline pain experience severe episodes of pain that breaks through the medical therapy (usually opioids) that has relieved the baseline pain.

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2. L ve

By Purdy, Director of Publicity

Michael Manner and I were English majors at Plattsburgh State before the days of email, before the days of the fax. Indeed, the modern technology of the time was floppy disk computers, and the CD was quickly replacing the cassette tape. Manner and I have kept in touch through the years and when we are together we often argue and bicker like a married couple about love, fear, greed, envy, lust, hypocrisy, music, cats v. dogs, words et al. I think the only thing we ever seem to agree on is that chocolate milk is the greatest invention ever. But enough about me, Manner is a freelance computer consultant living with his mangy, blind cat in Williamsburg Brooklyn, NY. His love of poetry dates back to when dinosaurs roamed the earth and he first heard the words “ugga bugga” uttered by a passing Neanderthal woman. He’s been writing verse since the Iron Age and one day hopes to be cited in the OED. His fave comic book hero is Batman. Despite all this I think is is a truly talented poet and have asked him to post some poems on this blog. You be his judge.

L ve

We need a new word.

I am too daunted by the current word to use it without humility.  Years of misuse have granted it too much of what it is not.

It is nausea.

It is transient –
escaping between the spaces of  I’m here and you’re there.

When angry, it is bitter and pitiful – Like the lonely 4 am drunk.

It is forgotten –
as a dream.  Sorely missed but once prideful and known.

It is the Odyssey of my life -
and I am the Devil’s jester.

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3. Crow's Nest


This is another piece from the pirate book I'm working on. This is the funnest book I've ever done. I'm slowly learning how to take this less seriously. If I'm not too serious about things I'm more liable to put in more hours. I also think it's the best work I've done. I payed close attention to the text and tried to see a world between the words. My book launch is in a few days and I'll be super busy for a while so I wont be able to post until after the weekend, but I'll make sure I visit everyone elses blog. Alicia Padron Requested that I make a list of five random things about myself. My wife, Julie and I collaborated on this list over dinner preparations. 1. I don't have a driver's licence 2. I wear glasses and can't wear contacts 3. I once had a library fine of 170.00 dollars. 4. I love Appalachian folk music 5. I used to work at a wine store and learned lots about wine. I would like to have 5 random facts from Ambera, Gretel, Viviene, Stephanie and Marie.
P.S. If anyone is able, I'd love to see you at my book launch. Everyone's welcome. It's in Lunenburg Nova Scotia at the Black Duck Gallery. It will be held between 1 pm and 3 pm on Saturday the 24th. I'll also be signing at the Historic Properties, downtown Halifax on Sunday. I'm not sure of the time. Please email me if you're interested.

26 Comments on Crow's Nest, last added: 11/25/2007
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