Overview of Dementia

From Primary Care RAP: Dementia Rob Orman MD and Heidi James MD ● Contrary to popular belief, dementia is not a normal part of aging. It affects approximately 5.2 million Americans over the age of 65. After the age of 65, the lifetime risk of developing dementia is roughly 20%. ● The DSM-5 renamed dementia;… Continue reading Overview of Dementia


Pregabalin Effective (~10%) for Fibromyalgia Pain

Derry S, Cording M, Wiffen PJ, et al. Pregabalin for pain in fibromyalgia in adults. Cochrane Database Syst Rev. 2016 Sep 29;9:CD011790. (Review) BACKGROUND: This review updates part of an earlier Cochrane review on 'Pregabalin for acute and chronic pain in adults' (Moore 2009), and considers only fibromyalgia pain.Antiepileptic drugs have been used in pain… Continue reading Pregabalin Effective (~10%) for Fibromyalgia Pain

Inpatient Pain Managment

From lecture by Dr Chris Taggart, 2016: Review of somatic v visceral v neuropathic pain. Opiates: - directly stimulate pain receptors - directly stimulate reward centers of brain, especially if delivered quickly to CNS - tolerance quickly develops for anesthetic and euphoric effects - tolerance slowly develops for respiratory center effects (resp depression)    … Continue reading Inpatient Pain Managment

Home Visits – Issues to Address and Billing Codes

Issues to Assess During Home Visits: the INHOMESSS Mnemonic I Immobility N Nutrition H Housing O Other people M Medications E Examinations S Safety S Spiritual health S Services by home health agencies Home visits: new patients 99341 Low severity 99342 Moderate severity 99343 Moderate to high severity 99344 High severity 99345 Unstable Home visits:… Continue reading Home Visits – Issues to Address and Billing Codes

Palliative Care Overview

Primary vs Secondary Palliative Care Primary - skills applicable to all clinicians (basic pain and symptom control, having goals of care discussions) Secondary - "specialty" palliative care skills Values-based Goals of Care discussion Connect:  get curious, active listening, create a safe place for any emotion Active listening means entering a conversation with NO idea where… Continue reading Palliative Care Overview