Recent content by manowar rules

Nothing intrathecal about that picture. But who knows if the needle moved a bit at some point. Was it a young patient?

This is one of the underrated aspects of practicing in a more rural area. My staff don’t act like they’re too good for their jobs. My patients are generally grateful. And they bring me fresh eggs.

Bilaterals are annoying but no other contraindication. Hips are the fastest procedure I do.

The guy may not have updated his website in the last decade, but I found thepainsource.com website very helpful when I started out doing msk injections under fluoro. I inject 5cc of bupi or lidocaine with 40mg kenalog into a hip

I know that CRPS is supposed to be in the pain doctor's wheelhouse, but I always find these referrals unsatisfying. Perhaps someone can teach me the error of my ways? I don't doubt that legit CRPS is out there. I've heard the pathophysiological theories, and that SCS can be a home run for...

I do a bunch of hips as part of an ortho group. I used to do lateral positioning for the massively obese, BMI 50+. But honestly, everyone under our table limit of 450 lbs can be done supine in under 30 seconds If a pannus must be lifted, the patient gets the honor of carrying out that duty.

How are your outcomes with these? What type of patient is your ideal candidate?

I do the call after the MBB, I think it’s better in the long game. Sure you can bring them in if you’re desperate for a 99213, but that would annoy a lot of patients and let’s face it, is medically unnecessary. You don’t have to work yourself to the bone for patients, but if your save them some...

The one time that I can find facet steroid injections helpful is when I have a patient with a significant degenerative scoliosis. Like initial MBBs will help, but the RFA will often produce lukewarm results. Then I go back with intraarticular facet steroid that gives better results, albeit only...

Ugh it’s Papa John’s and the only soda is diet…

In retrospect on your interactions with him, did this resident have behaviors suggestive or diversion/addiction?

This is sad. Promising life ahead of him and he threw it away. Don’t understand wanting to look at kids at all, it’s got to be some mental illness or severe insecurity. But not only has this guy lost a good career, he will also be ditched by friends and possibly family. I knew a person in...

If someone has progressed to vertebra plana, fracture < 3 months old and pain still present, how frequently do y’all notice MBBs are helpful? I honestly don’t seem to notice much aside from perhaps the usual transient relief of the local.

Autonomy is King. And I never have to hear another tone page again.

A mandatory exercise program would be more effective with less negative side effects. ECT is cool in refractory cases but can definitely cause memory issues. Never seen it used for chronic pain. I imagine it would end up in the realm of money making gimmicks like ketamine infusion clinics.