CNMRI

Important! Very good podcast and book on pain management. Take a look.

This Book Changed My Relationship to Pain — The Ezra Klein Show Physical pain is a universal human experience. And for many of us, it’s a constant one. Roughly 20 percent of American adults — some 50 million people — suffer from a form of chronic pain. For some, that means having terrible days from time to time. For others, it means a life of constant suff...

New evidence confirms that gradually increasing activity and early return to school after a concussion is better than being a couch potato for an extended period. Like most injuries, early mobilization is the way to go.

Early Return to School Following Acute Concussion and Symptom Burden at 2 Weeks Postinjury This cohort study examines the typical time to return to school after a concussion and evaluates whether an earlier return to school is associated with symptom burden at 14 days postinjury at 9 pediatric emergency departments in Canada.

Wow, the new Pros from are amazing. Why spend thousands on hearing aids?

“the custom Apple H2 headphone chip, samples external sounds 48,000 times per second (compared to 700 times per second for Phonak’s certified hearing aids) and supports Bluetooth 5.3. This second generation hearable also improves upon the first version by adding sound augmentation for media playback; a feature not available in the original model when tested. And the sound processing, all done lightning fast locally on the earbuds, is customized for my mild to moderate hearing loss.

Using a third-party hearing test app, I was able to upload my audiogram to my iPhone and have the sound tailored based on my test results.”

The AirPods Pro 2nd gen as smart hearables puts a smile on my face - Stacey on IoT | Internet of Things news and analysis Now that OTC, or over the counter, hearing aids are available in the U.S. I decided to revisit my auditory challenge. Technically, I was reminded to revisit it. My wife knows I have trouble hearing her at times. She also prefers not to watch television with me because I constantly ask her to boost t...

“A healthy diet was deemed as eating at least seven out of 12 food groups: fruits, vegetables, fish, meat, dairy, salt, oil, eggs, cereals, legumes, nuts and tea.

Writing, reading, playing cards or other games at least twice a week was the second area of healthy behaviour.

Other areas included drinking no alcohol, exercising for more than 150 minutes a week at moderate intensity or more than 75 at vigorous intensity, and never having smoked or being an ex-smoker.

Social contact at least twice a week was the sixth healthy behaviour, including activities such as visiting family and friends, attending meetings or going to parties.”

Six lifestyle choices to slow memory decline named in 10-year study Over-60s who combined more healthy lifestyle choices enjoyed most benefit, found Beijing researchers

“Sleep researchers say that what we think about as we try to go to sleep is just as important. They recommend that as we prepare to drift off, we practice something called savoring, which is imagining a positive experience we’ve had in great detail.

Savoring is well-studied as a strategy to improve our general well-being. A considerable body of research shows that it can boost mood and help reduce depression and anxiety. Now, psychologists believe it can help us fall asleep and have better sleep quality, and are starting to study its effectiveness.”

A Happy Memory Can Help You Fall Asleep, if You Know How to Use It Trouble sleeping? Try a technique called savoring, or imagining a positive experience in great detail.

One of our Botox patients recommend this App (and earplugs) for 'weather-related’ migraine

Interesting approach: The App alerts you to barometric pressure changes and you’re to put in special earplugs to avoid the migraine.

Please comment if you try it so we know whether to recommend to patients

WeatherX Earplugs Introducing WeatherX, a complete, proactive way to manage weather pressure changes, before they start.

“On Saturday evening we discovered that my Al had gone missing. He left the house around 5:30pm and was last seen going south towards the lake on the west side of Toronto.

For anyone who has had to take care of someone with dementia, you know this is one of the worst scenarios imaginable.”

How an Apple AirTag May Have Saved My Father-In-Laws Life It’s a must have accessory for any dementia sufferer.

What a sad situation. We need better comprehensive hospice and legislation to legalize medical-aid-in-dying in Delaware.
Paul Baumbach

This is Not How Americans Should Have to Die Dying on your own terms when you’re in miserable pain and just a step short of that eternal portal is, after all, the humane thing to do. The dignified thing to do.

Michael J Fox’s done so much for Parkinson’s disease!

Still: A Michael J. Fox Movie, the latest documentary from Oscar winner Davis Guggenheim, tells the whirlwind story of how an undersized kid from Canada moved to Hollywood on his last dime, became the "boy prince of Hollywood," and ultimately channeled his greatest challenge into a beacon of hope for millions suffering from Parkinson's disease

Michael J. Fox opens up about alcoholism, broken bones, and 'crazy Crispin' Glover in new doc EW breaks down everything we learned from AppleTV+'s 'Still: A Michael J. Fox Movie,' which debuted at Sundance on Friday.

Could this have been avoided if we had better medical aid in dying legislation and comprehensive hospice care?

Wife Fatally Shot Terminally Ill Husband in Florida Hospital, Police Say Ellen Gilland, 76, had made a pact with her 77-year-old husband and had planned to also fatally shoot herself, but, in the end, “she couldn’t go through with it,” the police said.

Why writing a will and planning for your death is a 'lifetime gift' to loved ones

Why writing a will and planning for your death is a 'lifetime gift' to loved ones : Life Kit Talking about death makes many of us uncomfortable, so we don't plan for it. But the reality is that even a small amount of planning ensures our final wishes are honored — and makes it easier on our family and friends. This episode will help you get started on making a will and an advance directiv...

“Harvard Medical School Professor Rebecca Robbins told me that that sleep is so important for your health that even going from 7 to 6 hours puts your body in the red”

Get Some Rest! Science-Based Secrets to Better Sleep Sleep isn’t just for the weekends.

Another save 👍❤️🙏

“One pregnant California mother thought she was coming down with a stomach bug her son had, but when her Apple Watch wouldn't stop alerting her about her heart rate she went to the hospital to find out she had a severe pregnancy complication known as placenta abruption.”

Video: She thought she had a stomach bug. Her Apple Watch alerted her it was more | CNN One pregnant California mother thought she was coming down with a stomach bug her son had, but when her Apple Watch wouldn't stop alerting her about her heart rate she went to the hospital to find out she had a severe pregnancy complication known as placenta abruption.

Hilarious that the worst punishments of childhood
are the best rewards of adulthood:

• Go to bed early
• Time alone in your room
• Not allowed to go out
• Eat dinner alone

-- Sahil Bloom

30% of patients with chronic pain or using medical ma*****na to help with pain management.

“Among adults with chronic pain in states with medical cannabis laws, 3 in 10 persons reported using cannabis to manage their pain. Most persons who used cannabis as a treatment for chronic pain reported substituting cannabis in place of other pain medications including prescription opioids. The high degree of substitution of cannabis with both opioid and nonopioid treatment emphasizes the importance of research to clarify the effectiveness and potential adverse consequences of cannabis for chronic pain.”

Use of Cannabis and Other Pain Treatments in US States With Medical Cannabis Programs This cross-sectional study uses a survey to estimate use of cannabis and other pain treatments among adults with chronic pain in areas with medical cannabis programs in 36 US states and Washington, DC.

👎 Don’t waste your time or money on this screening test.

And if you’re having stroke or cardiac symptoms, better to see your doctor for a proper evaluation and treatment plan.

"Congress was full of good intentions when it directed the Department of Health and Human Services to make sure patients get their test results as soon as they’re available.

But the implementation of that directive has set off a battle between doctors on one side and HHS and patient advocates on the other, and raised a fundamental question: How should patients get bad news? The debate underscores how medicine’s digital transformation is changing the doctor-patient relationship and upending ingrained practices."

The fight over how to deliver bad news to patients HHS has frustrated some doctors by requiring them to send patients test results before they have a chance to explain them.

Novel new drug may help sleep apnea and reduce the need for CPAP.

Nasal spray treatment may help patients with obstructive sleep apnea A drug administered through a nasal spray may be an alternative treatment option for patients with obstructive sleep apnea by improving upper airway collapsibility, according to a study published in CHEST.This is the first time the drug, a novel, potent, TWIK-related acid sensitive K+ (TASK) 1/3 cha...

Book recommendation from Dr. Varipapa

“Amazing strategies that are based on the understanding of autism NOT the understanding of making your child “act normal”. I feel well prepared as a mother of a 2 year old who may be neurotypical . It’s also very crazy how I started paying attention to the details (he describes which details to notice) that may make the child uncomfortable. The example of the child hearing a dog miles away is the perfect example of a strategy I immediately found handy. I now pay attention to far away noises and it helps me understand my son and why he may be acting.”

Uniquely Human: Updated and Expanded: A Different Way of Seeing Autism Uniquely Human: Updated and Expanded: A Different Way of Seeing Autism

Get ready for a new drug for Alzheimer’s

1. Expensive $26,000 per year
2. Requires initial MRI and then FU in 3 months
3. IV infusion twice a month
4 Lots of potential side effects, including brain swelling and bleeding (20%)
5. Will need amyloid PET scan (~$3,000 and not presently covered by Medicare) or spinal tap

TL:DR
"In the Clarity study which involved 1800 patients participants’ health declined whether they received the treatment or a placebo but the lecanemab group deteriorated 27 percent more slowly. At 18 months those patients scored a half-point better than the placebo group on an 18-point dementia test involving memory judgment and other areas"

NB: Half a point improvement doesn't sound like much to me, especially considering the expense and risk factors!

https://www.washingtonpost.com/health/2023/01/06/alzheimers-drug-lecanemab-fda-approval/

Are you keeping up with your exercise goals for 2023?

4 exercises that can prevent (and relieve!) pain from computer slouching and more : Life Kit Vinh Pham, physical therapist and author of "Sit Up Straight: Futureproof Your Body Against Chronic Pain with 12 Simple Movements," explains why mobility exercises and good posture may be your best defense against muscle and joint pain.

It’s all about the money — a big problem in American healthcare.

“The downfall of Aduhelm, the first new treatment for Alzheimer’s disease in two decades, is largely the story of a drug company choosing to maximize its potential profits at the expense of patients and taxpayers”

Seeking maximum profits, Biogen set an 'unjustifiably high price' for Alzheimer's treatment, investigation finds The downfall of Aduhelm is largely the story of Biogen choosing to maximize its potential profits at the expense of patients and taxpayers, investigators found.

Understanding obesity

"Emma Court’s Losing It podcast, explained how weight loss, calories and diets are more complicated than we think. Different people’s bodies react to foods in varying ways, meaning that the same weight-loss strategy might lead to success in one, and frustration in another. “The science has a lot of nuance that the popular wisdom simply doesn't capture,” Emma concluded."

‎Prognosis: Losing it: Introducing: Losing It on Apple Podcasts ‎Show Prognosis: Losing it, Ep Introducing: Losing It - Jul 2, 2022

Good news!

"Buffalo Bills safety Damar Hamlin "has shown remarkable improvement" in the last 24 hours and "appears to be neurologically intact," the Buffalo Bills said Thursday, citing University of Cincinnati Medical Center physicians"

Damar Hamlin shows improvement, "neurologically intact," Buffalo Bills say Damar Hamlin appears to be "neurologically intact" and is showing improvement, according to the Buffalo Bills.

Let your Apple Watch monitor your stress level

Stress Monitor for Watch

The AMA’s 10 recommendations for a healthier new year:
https://www.ama-assn.org/press-center/press-releases/ama-offers-10-health-recommendations-new-year-0

Good piece on obesity on 60 minutes. Check it out and contact Dr. Varipapa if interested in trying Mounjaro.

Recognizing and treating obesity as a disease Lesley Stahl reports on how obesity is misunderstood, and the struggle to get new weight loss drugs to people who need them.

“In a new study spotted by MyHealthyApple, researchers found that Apple Watch is indeed precise enough to monitor stress. The study used six ECG readings per day with participants to create their HRV measurements which were used to discern their stress levels.

“The researchers found that “In general, the “stress” models had a high level of precision but lower recall. The “no stress” models performed generally well with a recall typically above 60%. Considering the ultra-short duration of the ECG measurements performed here compared to the standard, as well as the nature of real-life measurements, the results presented were quite promising.”

The study also noted that Apple Watch tracking sleep and activity in addition to heart rate measurements could enhance a stress monitoring experience.”

Study proves Apple Watch is ready for stress monitoring; here are 3 tracking apps so you don't have to wait A new study has been published that demonstrates Apple Watch has the accuracy with its heart rate sensor to help users track stress. Fortunately, while we wait to see if Apple will launch a native stress monitoring experience, its wearable already tracks an important stress-related metric that third...

“Obesity is often included in the litany of chronic diseases that plague six in 10 Americans — except by Medicare, which currently refuses to cover treatment for obesity until it causes significant health problems like diabetes or heart disease.

The growing number of Americans with obesity is helping drive the chronic disease crisis in the U.S. and deepening existing health inequities. The government’s failure to recognize and treat it like other diseases may be making matters worse. Policymakers need to treat obesity like the disease it is and give health care professionals and their patients access to the tools necessary to treat it”

To effectively combat diabetes, policymakers must treat obesity like other diseases Rather than waiting for people to develop obesity-related diseases, health care professionals should be able to treat obesity as the underlying root cause of what ails so many of their patients.

Revealing analysis of a flawed and clearly bungled drug approval.

“Congressional investigators sorted through more than 500,000 pages of documents from the Food and Drug Administration and Biogen to chronicle how a controversial Alzheimer’s disease drug was approved, and how it went from what was supposed to be the biggest drug launch in history to a financial catastrophe.”

FDA, Biogen, and an Alzheimer's drug approval: 8 key takeaways from congressional investigation Here are eight key takeaways from the congressional investigation of the FDA's approval of the Biogen Alzheimer's drug Aduhelm.