Pain Treatment History: Fill & Download for Free

Good question, and I hope people will read this reply and understand why:Adderall and Ritalin can be addictive, but are usually not when properly prescribed by those of us who are well trained in diagnosing and treating ADHD.They are very closely scrutinized by those of us who treat our patients with them… we are careful to get a thorough history from our patients, and see them regularly.While they may have serious side effects in certain populations, they very rarely cause death, coma, or respiratory depression. Opioids, when misused, are implicated in many deaths around the country, and while we are aware of serious problems due to stimulants, they are not to the same degree as the opioids.Stimulants are generally prescribed by few physicians, usually to treat ADHD and some residual symptoms of depression. Their prescription is generally not done by many family physicians, dentists, orthopedic surgeons, urologists, or internists.Opioids may be prescribed legitimately by any physician who is treating acute pain, and sometimes, many more tablets are prescribed than most likely will be needed. This was done out of misguided kindness, before we became aware of the dangers of prescribing excess numbers of pills.Opioids are still effective treatments for chronic pain, although the pain physicians are recommending that we don’t prescribe them, there are often not too many other truly effective treatments available.There is no question that if we had more effective pain treatments that were not as potentially dangerous as the opioids, we would use them. In practice, when a person is sitting in front of you, crying in pain, you want to help alleviate their pain and suffering.

Yes, you do. More than one.The WPATH Standards of Care require two mental health professionals to endorse a patient for Sex Reassignment Surgery (SRS, also referred to as Gender Reassignment Surgery or GRS.)The relevant section from the SOC is below:Surgical treatments for gender dysphoria can be initiated by a referral (one or two, depending on the type of surgery) from a qualified mental health professional. The mental health professional provides documentation—in the chart and/or referral letter—of the patient’s personal and treatment history, progress, and eligibility. Mental health professionals who recommend surgery share the ethical and legal responsibility for that decision with the surgeon.One referral from a qualified mental health professional is needed for breast/chest surgery (e.g., mastectomy, chest reconstruction, or augmentation mammoplasty).Two referrals—from qualified mental health professionals who have independently assessed the patient—are needed for genital surgery (i.e., hysterectomy/salpingo-oophorectomy, orchiectomy, genital reconstructive surgeries). If the first referral is from the patient’s psychotherapist, the second referral should be from a person who has only had an evaluative role with the patient. Two separate letters, or one letter signed by both (e.g., if practicing within the same clinic) may be sent.[1]I had to go through the “just an evaluative role” part of the process a few months ago before I had surgery. The deep dive psych eval was nothing like a normal counselling or therapy session… it was an exhaustive probe into my understanding of the process, my motivations, expectations, support systems… There were a lot of questions to answer and this wasn’t a “there are no wrong answers” evaluation. It was intense and left me a little shaken for the afternoon.Psychologically, recovering from SRS is demanding. It isn’t just the weeks and weeks of pain and discomfort… there’s a whole lot that goes on during recovery and it isn’t like you just walk into the doctor’s office and say “one SRS please” then walk out and go home with a different package in your underwear. It’s hard. It’s permanent. It’s life altering…And the Standards of Care treat it accordingly with requirements for endorsement from two mental health professionals prior to surgery.Footnotes[1] https://www.wpath.org/media/cms/Documents/SOC%20v7/Standards%20of%20Care_V7%20Full%20Book_English.pdf

Diagnosis is made by the oral examination and by taking the history of the patient. History includes the onset, duration and type of pain the patient is suffering from. The pain might be continuous, sharp, dull, throbbing, lancinating, radiating or deep aching. Sometimes patients complain of pain while chewing food, and sometimes the pain might be spontaneous without any initiating factor.A decent way to sort things from home: What Your Dentist Doesn't Want You To Know!this is caused by the tooth decay or trauma. The treatment is started with the antibiotics and the pain treatment. Then your dentist will perform the root canal treatment. In the last stage, the weakened tooth can be strengthened with crown or veneer.What to do: See your dentist or endodontist to diagnose the problem before the pain becomes severe due to the development of an abscess. The tooth will likely need root canal treatment to remove the dying or dead pulp tissue to save the tooth.