The Pain Chronicles

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED moderator and administrator, Tufts University School of Medicine

One in 10 people in the United States identifies themselves as having chronic pain.  Over $90 billion is spent annually in the United States on the associated costs of chronic pain, including disability, medical costs, and loss in productivity.  The global impact of chronic pain is immense. Yet treatment of chronic pain remains as elusive to our modern medical treatment methods as it did to the ancient Greeks.  In The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing and the Science of Suffering, author Melanie Thernstrom masterfully weaves her personal pain narrative into a rich tapestry of the science, history, culture and ethical underpinnings of the study of pain.  The PREP program’s director, Dr. Daniel Carr, lends a pivotal voice in Ms. Ternstrom’s understanding of the challenges of pain medicine, along with other pain medicine luminaries such as Dr. Scott Fishman and Dr. Clifford Woolf.  What makes The Pain Chronicles so compelling  are the multiple layers of inquiry that unfold throughout the book, often challenging the reader to ask more questions than find answers on the nature of pain and suffering.  Ms. Thernstrom’s use of the patient voice from the perspectives of authors such as Elaine Scarry (The Body in Pain) and Arthur Frank (At the Will of the Body) help to  illustrate the complex interaction between pain perception and suffering.   The Pain Chronicles allows a deeper understanding of  the disease of pain, and should be “required reading” for both patients and health practitioners for whom chronic pain plays a role in their lives.

The Tufts Pain Education and Policy Program, with assistance from the Tufts University Public Health and Professional Degree Student Activity Fund, is pleased to be hosting author Melanie Thernstrom on Tuesday, April 12 at 4:00 PM in the Wolff Auditorium at Tufts Medical Center.  The event is free and open to the public.  Signed copies of The Pain Chronicles will be available.  Please join us!

Here is a link to Melanie Thernstrom’s lecture on April 12: http://www.tufts.edu/med/education/phpd/msprep/prepforum.html

1 comment April 11th, 2011

Top 4 Reasons to Return to Tufts

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED moderator and administrator, Tufts University School of Medicine

The Pain Research, Education and Policy Program(PREP) is the first and only multidisciplinary university-based pain curriculum program in the nation.  There are numerous reasons to become part of the PREP program: small class sizes, diverse student backgrounds, and expert faculty are a few of the unique qualities of the program.  What also sets the PREP program apart is the continued connection with PREP alumni, who are are welcomed and encouraged to remain an integral part of the PREP program.  

Here are 4 top reasons for PREP Alumni to return to Tufts:

#4 Meet world renowned speakers and authors:

Please join us to hear two prominent pain experts lecturing in April.  Melanie Thernstrom will be speaking about her acclaimed book, The Pain Chronicles on April 12, 2011 at 4pm in the Wolff Auditorium at Tufts Medical Center. 

Dr. Rollin (Mac) Gallagher of the University of Pennsylvania and the VA Administration will describe recent efforts to alleviate pain and suffering beginning in the battlefield and extending through rehabilitation.  He will be speaking in the Wolff Auditorium at Tufts Medical Center at 4pm.  The date of his lecture is April 21, 2011.

#3 Network with New Alumni 

Come and hear our graduating MS student capstone presentations on Monday, May 2 from 3:30pm to 5:00pm in Conference Room 1, M&V Building.   We would love your support and networking with our hard-working graduates. 

#2 Enroll in a Tufts course and save 75% 

Did you know that all alumni from the Public Health and Professional Degree programs are able to enroll in a maximum of three courses in PHPD (one per year) at a 75% savings???  Yes, you can take that elective that you always wanted to and spend only 25% on that course!  Contact Lauren Budd, Assistant Registrar at lauren.budd@tufts.edu  for more information.

#1 Expand your world by connecting with PREP’s social media sites

In addition to PREP-AIRED, the PREP program’s widely read blog, the PREP program now has its own Facebook page.  Join the community of current students, policy makers, leaders in the pain conversation and alumni by “liking” our page.  Here is the link: http://www.facebook.com/#!/pages/PREP-Pain-Research-Education-and-Policy-Graduate-Program-Tufts/198047410219415

What are your top reasons for returning to Tufts?

Add comment April 6th, 2011

Belief of Relief

Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator and administrator, Tufts University School of Medicine

Beliefs and expectations of a medication’s pain reducing ability may influenceBelief in Relief the amount of pain relief a patient receives from the drug, suggests a study recently published in the journal Science Translational Medicine Science.  In the study, The Effect of Treatment Expectation on Drug Efficacy: Imaging the Analgesic Benefit of the Opioid Remifentanil,  investigators observed that the expectation of efficacy or lack of efficacy of the potent opioid Remifentanil shaped  both therapeutic and adverse effects of the medication.  Those participants who believed that the drug would have a positive effect on the experimental pain condition had double the pain relief benefit as compared to those who believed that the drug would have a negative or exacerbating effect on their pain.  Evidence from behavioral and neuroimaging  data suggest a multifocal expression of pain in the study participants with brain activity changes correlated to the expectation of efficacy of the analgesic.  The study authors conclude that integrating patients’ beliefs and expectations into pain management may produce better treatment outcomes in the future.

Add comment March 6th, 2011

PREP Capstone Presentations

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog administrator and moderator

Congratulations to two MS-PREP candidates who recently presented their capstone projects to a group of faculty, alumni and students of the Tufts University School of Medicine’s Pain Research, Education and Policy Programs and the New England School of Acupuncture

Kai-Yin Hsu investigated the clinical use of the MYMOP form and outcome of acupuncture treatment from a U.S. traditional Chinese Medicine teaching clinic.

Pratchi Morajkar conducted a systematic review of Dexmedetomidine and its implications for non-narcotic-based analgosedation in cardiac surgery.

Prachi Morajkar, Dr. Libby Bradshaw, PREP academic director, Kai-Yin Hsu

Both presentations reflect the diverse interests and broad scope of the Tufts University Pain Research, Education and Policy Programs.

Kai-Yin Hsu presenting her PREP capstone project

2 comments January 13th, 2011

A New Year…What Advances in Pain Management Will We See in 2011?

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED Blog Administrator and Moderator

As we enter a new year, pain is still the #1 reason individuals seek out medical care (American Pain Foundation data).  Those who are involved in research, as well as direct caregivers of patients, know that pain is complex and needs to be addressed by a multi-modal and interdisciplinary approach.  Let’s take stock of where we are and where we hope to go in 2011.  We invite you to comment, discuss and brainstorm ways that we can more effectively manage pain on this site  Let’s envision a day when pain is no longer the #1 reason individuals seek medical care.

Happy New Year…may your year be filled with opportunities and possbilities.

Add comment January 3rd, 2011

Progress and Challenges in Pain Research

By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student, PREP-AIRED blog moderator and administrator

Thank you to Dr. Daniel Carr, founder of the Tufts University School of Medicine’s Pain Research Education and Policy Programs (PREP) for alerting us to a collection of articles in a recent edition of Nature Medicine which review progress and challenges in pain research from the bench to the bedside.  Take a look at some of the interesting issues being addressed with a focus on pain research and treatment.

Click here to view the table of contents

Add comment December 10th, 2010

The Pain Research, Education, and Policy Programs at Tufts University Welcome Wendy Williams

By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator

You may see a new face if you are on the Tufts University School of Medicine campus in Boston these days.  Wendy Williams, BSN, M.Ed, is in a new role with the Pain Research, Education and Policy Programs at Tufts University School of Medicine, focusing on program development and administration. I recently had the opportunity to sit down with Wendy to ask her a few questions about herself and her visions for the PREP programs.  

Welcome Wendy…Can you tell us a bit about yourself?

I just arrived at Tufts from spending 8 years at Northeastern University in the School of Nursing working to ensure high quality clinical nursing education placements for both the undergrad/pre-licensure students and the advanced practice students seeking both clinical and non-clinical nursing master’s degrees.   My own clinical nursing background centers around oncology and HIV/AIDS.    I spent wonderful years at both Dana Farber Cancer Institute, during the time they had inpatient units, and at Harvard Community Health Plan/Harvard Vanguard with other highly skilled nurses on the HIV/AIDS Resource Team.I married a great guy back in 1996 who had a couple of sweet little boys who are now terrific college age young men, studying here in Boston.  My husband, Jeff, and I live in Framingham with our 3-legged cat, Punky, and hairless dog, Diddy.

What interests you about the PREP programs?

The concern for under-treated pain and pain management are steady threads that ran throughout my own clinical practice.  Ensuring adequate pain management is a strong cornerstone of quality nursing care and practice, so the PREP programs of study are very attractive to me and tie together much of what I value.  The chance to work collaboratively with the three program leaders (who are also physicians), Dr. Dan Carr and Dr. Richard Glickman-Simon and Dr. Ylisabyth Bradshaw, is an opportunity I want to leverage.I have long sought ways to be a force behind strengthening linkages between medicine and nursing and other health care disciplines to encourage both multidisciplinary and interdisciplinary approaches to health care.  The PREP programs present an ideal setting to have broad-based conversations around the area of pain issues.  Also, my own master’s degree is in education, specializing in adult and organizational learning, so .  the opportunity to develop a program of study and optimize learning for students globally is a really strong draw for me to be here at Tufts working with the PREP programs.

What do you see as the strengths and challenges of the PREP program?

A real strength of the PREP programs is its unique position in masters level education  that delves deeply into the many physical/clinical, social and scientific aspects of pain.  There is not a population of people, worldwide, that is not impacted by pain issues.  Also, the fact that the PREP programs are not solely clinically based creates a rich learning environment for many types of students… clinicians seeking to be subject matter experts in pain issues learn side by side with non-clinicians who may be seeing the PREP programs as a way to become well-informed advocates for pain issues.  After about a month in this role, I see two challenges to the PREP programs that I would like to positively impact.  One challenge is getting more and more people in the greater Boston area to know about this great set of programs and to become students in the program.  I happen to know one graduate of the program, Hallie Greenberg, a nurse from the Brigham & Women’s Hospital, and know that there are so many others that would be really inspired to become proficient in this area.  The other challenge is understanding and communicating to others clear linkages between getting one of the certificates and/or the master’s degree and a specific career enhancement.  There seems to be a certain pioneering element to encouraging students to go for the certificates or the degree as a natural next step in career growth.

What are your hopes and vision for the PREP program?

I hope that PREP grows steadily, both in numbers and in innovative educational initiatives, and sustainably with input from all communities of interest: students and alumni and staff and our steering committee and faculty and leaders in pain issues globally.  I would love to speak with students and alumni and gain their insights on how we can best lead the way in pain research, education and policy.  I welcome calls, 617 636-0815, emails wendy.williams@tufts.edu, or simply stop by my office in the M&V building, Room 142A. I’d love to meet you.

Add comment November 15th, 2010

Do Cortisone Injections Make Pain Worse?

cortisone injectionby Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator

A recent study published by The Lancet (to read the study abstract, click  here ) explores the question of efficacy and safety of corticosteroid injections for tendinopathy, both short-term and long-term. Using a systematic review of randomized control studies, researchers observed that corticosteroid injections reduced pain in the short term compared with other interventions, but this effect was reversed at intermediate and long terms.  

As this research indicates, there is a need for multidisciplinary pain management approaches in the treatment of chronic pain conditions.  What have been your experiences with using corticosteroid injections?

Add comment November 2nd, 2010

Music Prescription for Physical and Emotional Pain

Music and Pain Relief by Nancy Mitchell, MS-PREP

A prescription for music may be a beneficial adjunct to more traditional therapies according to research at Glasgow Caledonian University. Check out this article in Science Daily.

Add comment September 21st, 2010

MS-PREP August 2010 Capstone Presentations

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator

 

August 11, 2010 marked the culmination of intensive research and planning for two candidates for Master’s degrees in the Pain Research, Education and Policy Program at the Tufts University School of Medicine with the presentation of their capstone projects.

Margaretta Elizabeth (Beth) Sangree, a student in the joint program with the New England School of Acupuncture (NESA), presented her capstone project entitled

PREP%20August%202010.jpg

Pictured L-R: Ylisabyth (Libby) Bradshaw, DO, MS, Associate Director of the Pain Research, Education and Policy Program; Margaretta Elizabeth (Beth) Sangree, MS-PREP candidate, Richard Glickman-Simon, MD, Director of the Pain Research, Education and Policy Program; and Sherry Brink, RN, BSN, MS-PREP candidate

“Measures of the Patient-Provider Relationship in Acupuncture Treatments”. Beth highlighted several studies that support the importance of relationship-centered care in effective pain treatment. Future directions will include quanitfiable, replicable, randominzed control studies to continue to document the effect of patient-provider relationship on treatment effectiveness.

Sherry Brink, RN, BSN, presented her capstone project on “Post-Op Pain Management in the Pediatric Patient” with emphasis on bringing best practices of post-op pain managment to underserved, international patient populations. Sherry recounted her experience bringing comprehensive pain management methods to a small rural hospital in the Andes mountains of Peru and her development and integration of a bilingual nursing education module on pain management currently being used by the staff in Peru. Sherry hopes to use her MS-PREP degree to further her international medical mission work by continuing to educate nurses worldwide in effective, compassionate pain management methods.

Congratulations to these two exceptional MS-PREP degree candidates!

Add comment August 23rd, 2010

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