time mag

Time Magazine had quite a piece on chronic pain. I gues the bottom line is that CP is a complex syndrpme that is best treated in a multi-disciplinary setting. Unfortunately there are not many of those kind of clinics around. It's like trying to do neurosurgery with no neurosurgeon available.

fda approves cox 2s

Today the FDA by a small majority allowed the Cox 2s (including Vioxx) to continue to be presribed and sold. However nothing has changed. They sstill in some circumstances can lead to cardiac and CNS problems. Caveat Emptor...... User beware. I will not prescibe these medications for my patients.

We know that there is no specific and reliable medication for the treatment of chronic pain. Medication often either doesn't work or is associated with intolerable side effects. The pschological approach has therefore an important place in treatment. You might want to check out the mindfulness program run by Dr. Jackie Gardner-Nix at either Sunnybrook Hospital or St.Michael's in Toronto. In some patients this really seems to work, either in conjunction with or apart from the pharmacological approach.At the Wasser Pain Clinic at Mount Sinai we also offer cognitive - behavioural therapy, which includes relaxation and developement of coping skills.

cuba

I recently went to Cuba and took down a case load of medication including NSAIDs and anti-migraine meds. They are in desperate need for any meds. (Alsao school supplies and clothes)There is an organization in Toronto which tries to coordinate deliverers and Cuban doctors. If you can help contqact me.

NSAIDS

Vioxx off the market. Significant questions about Celebrex and Bextra although they are still available.These medications are now the gold standard with regard to the treatment of Rheumatoid Arthritis and taking these medications off the market would cause a lot of suffering. Most of these patients on these Cox 2s could not tolerate the Cox 1s. What to do? Do we have people suffer agony for years because there is a chance that the chronic use of these medications will have the potential for causing severe cardio-vascular effects? If nothing else it may be a question of medical ethics.Should the patient, after getting all the facts, decide, not the care giver?

advice

I will give advice on all aspects of non-cancer chronic pain.Objective- no strings atached.

A Canadian View on Chronic Pain

My name is David Evans and I am a specialist in chronic pain in Toronto. I'm starting this blog to inform and educate professionals and patients about diagnosis and treatment and up-to-date information.