About the blogger
I am Gilbert Fanciullo and will be the person who will write the posts for the PainPointsBlog. I am an Anesthesiologist who specializes in Pain Medicine and has been practicing Pain Medicine and Palliative Medicine for 20 years. I am a Professor at Dartmouth Medical School and teach medical students, residents and fellows about pain diagnosis and treatment. I am the Director of the Pain Center at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire. I conduct research specifically addressing the use of opioids for the treatment of chronic pain and the use of computers as a tool in the care of patients with pain. I have been involved with many national pain organizations and held many positions and spoken numerous times at national and occasionally international meetings. Prior to coming to Dartmouth, where I have been now for 14 years, I was in private practice in Northern New Jersey for 2 years and was at Brigham and Women’s Hospital in Boston before that.
About PainPoints
This blog is sponsored by Wiley-Blackwell who is the publisher of Pain Medicine, the premier source of peer reviewed research and commentary on matters relevant to the multidisciplinary clinical practice of pain medicine. Wiley-Blackwell, created in February 2007 by merging Blackwell Publishing with Wiley’s Global Scientific, Technical, and Medical business, is one of the world’s foremost academic and professional publishers and the largest society publisher. Pain Medicine is the official journal of the American Academy of Pain Medicine (AAPM), the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists, and the International Spine Intervention Society. The American Academy of Pain Medicine is the principle society in the United States representing physicians, patients and others in the practice of Pain Medicine. The mission of the AAPM is to advance the specialty of Pain Medicine and the comprehensive care of patients with pain through promotion of best clinical practices, research, advocacy, and continuing medical education.
The mission of this blog is, as well, to advance the specialty of Pain Medicine and the comprehensive care of patients with pain through promotion of best clinical practices, research, advocacy, and continuing medical education. The use of a blog enables us to open the floor for discussion of topics of interest to us all. We will enable best clinical practice by creating dialogue surrounding interesting cases; research by discussing articles in Pain Medicine and other Journals and ideas; advocacy by including patients and their advocates to join in the dialogue; and education by learning from each other. I am hoping that while we are waiting for a flight, or sitting in the office, or attending a meeting, we will not be inhibited and will relay our thoughts to our friends and colleagues and interact, network, teach and learn from each other. I want to hear from Allen, Seddon, Jane, Nat, Scott, Perry, Carmen, Michael, Zahid, Michel, Dan, Charlie, Steve, Lynn, Knox, Ajay, Way, Jianren, Mischa, Bob, and all the others whose names I may have neglected to put down. If we all contribute we could have something pretty cool.
Gil.
I read the essay by Allen Burton in your January 2011 archive. I was rather saddened by it. Dr. Burton noted the problems that have increased with the more widespread use of chronic opiod therapy, and they are real. However his conclusion that with new patients who appear to have an unpromising prognosis for their pain improving, he has basically decided to say “I can do no more for you.” Who then is left to advocate for patients with chronic pain??? There is overuse and abuse of Viagra too. Yet I don’t hear the doctors who prescribe it for legitimate problems saying they will stop prescribing it for those patients because some other group of people is abusing it. The problems with the pill mills need to be solved, yet how easy it is, in our society which looks so harshly on people with chronic pain, to start blaming the victims. If this is the viewpoint of doctors on this pain blog, we with chronic pain are in trouble.
Great blog.
Thanks Scott. If you would like to add a post please send to me. I would appreciate it and I would be interested to see what you are passionate about. Gil.
I just stumbled upon this blog! Love the idea of a dialogue here. Dr. Fanciullo? Anyone out there?
Hi Nancy. What are you thinkning about for topics?
Hi! Well…. I am a patient who suffers from a connective tissue disorder, called Ehlers-Danlos Syndrome. I don’t know if you are familiar with it, but it causes the production of faulty collagen. This leads to chronic, dislocations, injuries, surgeries, and wide-spread acute and chronic muscluoskelatal pain. There is no cure, and treatment is based primarily on symptom management….the worst of which is pain. I am a member of the Ehlers-Danlos National Foundation (EDNF.org), as well as an online support community with people with EDS from all over the country (& world).
A dark cloud has been looming over our discussions lately, as the current climate of pain treatment seems to be anti-opioid. Many of us rely on this medication to function due to the severity of both chronic and acute pain episodes… With the closing of the pain foundation, the media attention to groups like PROP, etc…, the new BCBS policy limiting access to opioids starting July 1, 2012, we are becoming increasingly concerned about our future, and having access to adequate pain treatment…including the use if opioids. Many of us have spent a lifetime trying to get diagnosed. I was finally diagnosed by a geneticist in Boston, at age 40! This was after a lifetime of chronic joint dislocations, multiple joint surgeries, injuries, OA, joint damage…. And misdiagnosis….over and over.
I have finally found some pain relief in opioid therapy, can fuction, and sleep, and this has eased my depression and hopelessness significantly. NOW????? It’s seems the whole world has gone crazy! I understand that these medications have been diverted, and abused. BUT, to say they don’t work long-term ? Shouldn’t be used in non-cancer chronic pain? Huh? What will happen to people like me when access becomes more and more limited? Where is the compassion for the suffering we endure? nothing else, and I’ve tried it ALL, offers real relief. When I came across your Blog, I was thrilled. You seem like an intelligent, experienced, practitioner with a sense of humor! Can you shed some light on what is happening? Thank you!
-Nancy
p.s. This isn’t a “curbside” !
Thanks for the discussion!