DM FSBS Guideline

Mom is 82, a diabetic, and her sugars often drop below 100 and she feels lightheaded.  She’s been told that she should keep her sugars between 70 and 120 but we’ve noticed she often feels better if they are higher.  What is a good range of finger-stick sugars for her?

(more…)

Ketamine Protocol for In-Hospital Use

Purpose: Treatment of opioid-resistant pain and of opioid-induced neurotoxicity.

What is Ketamine: It is a “dissociative anesthetic” (the mind is ‘dissociated’ from the body and pain), meaning a patient ‘appears to remain awake’ but is actually unconscious and feels no pain when given full anesthetic doses.  With sub-anesthetic doses, pain/agitation are reduced without ‘loss of awareness/consciousness’.   It is particularly beneficial for neuropathic pain and opioid-resistant or difficult pain syndromes; and, as an adjuvant agent, can reduce the amount of narcotic required.
Physiological Effects to be expected (uncommon w/ sub-anesthetic doses):  tachycardia, increased secretions, diplopia, myoclonus, increased BP [occasionally hypotension].

(more…)

Recovering from a Stroke (aka Brain Attack)

What is a stroke?
It is a loss of blood supply to a part of the brain, due to a blood clot in an artery within the brain or to bleeding within the brain, often leading to a chronic disability.  A disability is defined by the World Health Organization as “any restriction or lack of ability to perform an activity in a manner or within the range considered normal for a human being.”

(more…)

Making Choices – Choosing Comfort (Palliative Care) When There is no Cure

As we get older, it is natural to expect at least a few health problems.  Aches and pains seem to go hand in hand with getting older and that we will have to endure more age-related symptoms. Several studies show that older people’s fears are related to unrelieved pain and/or to loneliness following the death of a spouse or friends.

(more…)