March 11, 2014
In this second of a two-part series, John Bailey, MD explores how physicians can better assess back pain patients in an effort to diagnose and treat their conditions.
In 2007, the American College of Physicians and the American Pain Society developed the Joint Clinical Practice Guidelines, to simplify and standardize the assessment of back pain patients.
The guidelines divide patients into three groups. The first priority in evaluating low back pain patients is to identify the “do not miss” group. This group of patients will have signs and/or symptoms that will require rapid evaluation for certain emergent conditions. This group can include cancer and other conditions which may trigger immediate imaging of the low back with x-rays, CT scans or MRI’s. Consultation with a surgeon specializing in the spine will often occur. These emergencies may include cauda equina syndrome (which is often caused by a herniated disc which traps and can damage spinal nerves), epidural abscess and hematoma. Unless recognized and promptly treated permanent deficits such as paralysis, loss of sensation, or loss of bladder function may result.
The second group includes patients with pain being triggered by nerve or spine joint triggers. This group includes: radiculitis (radiating pain) / radiculopathy ( neurological deficit), spinal stenosis (narrowing), facet pain, discogenic pain, and sacroiliac pain. Many of these pain triggers respond very well to interventional pain therapies such a
March 5, 2014
This is Part 1 in a two part series addressing pain. In addition to his fellowship in interventional pain, Dr. Bailey completed a two year addiction medicine/pain fellowship in the UF Department of Psychiatry. He also served as Medical Director for “The Refuge”, a rehabilitation facility specializing in patients with PTSD and co-existing psychiatric disorders.
I have found my background in Post-Traumatic Stress Disorder (PTSD) to be especially important since it is a condition I recognize in patients every day. It is extremely common that patients with pain symptoms which are out of proportion to physical findings suffer from co-existing PTSD. Sometimes careful and sensitive questioning uncovers PTSD signs and indicates a patient who would benefit from appropriate therapy.
Criteria for Post-Traumatic Stress Disorder include:
- re-experiencing the original trauma(s) through(flashbacks or nightmares)
- avoidance of anything associated with the trauma
- increased arousal(insomnia difficulty falling or staying asleep, anger, and hyper vigilance).
- “disassociating”, staring off into space, and entering into a fugue state, “blank out”.
There is evidence that PTSD, especially complex PTSD produces permanent structural and physiologic changes in the brain that profoundly influence behavior, impulse control, relationships, and the interpretation of physical and emotional input. At the root is dysfunction of brain areas such as the prefrontal cortex that change incoming physic
March 4, 2014
Although a patient might have both conditions, they are unrelated. The thick cords that patients feel when they develop Dupuytren’s are not swollen tendons. Dupuytren’s does not normally cause much pain but can impair someone’s ability to use their hands effectively for work, sports, or other simple functions including hand washing.
If you would like an appointment to evaluate any hand issue including Dupuytren’s, Trigger Finger or hand & wrist injuries, call SIMED’s Hand Center at 352-751-0981 or request an appointment online.
March 3, 2014
The U.S. Food and Drug Administration today proposed to update the Nutrition Facts label for packaged foods to reflect the latest scientific information, including the link between diet and chronic diseases such as obesity and heart disease. The proposed label also would replace out-of-date serving sizes to better align with how much people really eat, and it would feature a fresh design to highlight key parts of the label such as calories and serving sizes.The changes proposed affect all packaged foods except certain meat, poultry and processed egg products, which are regulated by the U.S. Department of Agriculture’s Food Safety and Inspection Service.
Some of the changes to the label the FDA proposed today would:
- Require information about the amount of “added sugars” in a food product.
- Update serving size requirements to reflect the amounts people currently eat.
- Present “dual column” labels to indicate both “per serving” and “per package” calorie and nutrition information for larger packages that could be consumed in one sitting or multiple sittings.
- Require the declaration of potassium and vitamin D, nutrients that some in the U.S. population are not getting enough of, which puts them at higher risk for chronic disease. Vitamin D is important for its role in bone health. Potassium is beneficial in lowering blood pressure. Vitamins A and C would no longer be required on the label, though manufacturers could declare them voluntarily.
- Revise the Daily Values for a variety of nutrients such as sodium, dietary fiber and Vitamin D.
- While continuing to require “Total Fat,” “Saturated Fat,” and “Trans Fat” on the label, “Calories from Fat” would be removed because research shows the type of fat is more important than the amount.
- Refresh the format to emphasize certain elements, such as calories, serving sizes and Percent Daily Value, which are important in addressing current public health problems like obesity and heart disease.
February 24, 2014
SIMED is pleased to announce the arrival of two new physicians.
Joseph Gentile, MD
Dr. Gentile is accepting patients at SIMED’s Gainesville location:
4343 Newberry Road, Ste 2, Gainesville
To schedule an appointment with Dr. Gentile, please call (352) 332-7246 or you can click here to
request an appointment online.
Tenley Noone, MD
Dr. Noone is accepting patients in Primary Care & Urgent Care at these SIMED locations:
20410 10th Street, McIntosh
4343 Newberry Road, Ste 10, Gainesville
To schedule an appointment with Dr. Noone, please call (352) 224-2225 or you can click here to
request an appointment online.
February 24, 2014
A special "Thank You" goes out to our employees and their families who are helping to make SIMED a top Wellness company in North Central Florida!
November 22, 2013
You can also help us recognize our outstanding SIMED employees by nominating them for our Starfish Employee Recognition Program if they've done something to Make Your Day while you were visiting a SIMED location.
It's easy! There are 3 ways to nominate any SIMED employee:
- Through the Online Patient Survey
- By Requesting a paper nomination form at any SIMED location
- By telling any SIMED manager!