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What should you know about pain killers after surgery?

Recovering from major surgery is an active process that typically takes 6 weeks. Surgical pain is normal and expected, but the pain experience may be different for individuals. Since pain can interfere with your ability to participate in activities to prevent complications (coughing, deep breathing, walking), treating pain is critically important for a successful surgical recovery. Many patients are afraid to take prescription narcotics or “pain killers” because they do not want to become “addicted.” However, untreated pain can lead to the development of permanent pain pathways to the brain, which can delay your recovery and possibly even result in chronic pain.

Narcotic use varies among individuals and there is a big difference between drug dependence and addiction. Dependence is when the body has become accustomed to the medication. This can occur anywhere from a couple of days to a couple of weeks after you start taking pain killers regularly, like after surgery. Addiction, however, generally implies that the medication or substance is interfering with your life in some way. You can become dependent on pain killers during your surgical recovery, but with medical management of your withdrawal from these medications, you will avoid addiction. It is important to use your prescription pain killers as directed to avoid overuse. On the other hand, you do not want to avoid using pain killers when you need them to remain comfortable and active. Stopping your pain killers “cold turkey” can be dangerous and it may cause considerable discomfort. The surgical team will work with you to develop a plan to wean you off your pain killers gradually and safely, at a time when you are ready.

The universal goal is to taper as quickly as your physical, mental and emotional status allows. Since there is ....

Why is it hard to swallow?

Many people suffer from difficulty swallowing (dysphagia) acutely or chronically. Difficulty with swallowing may be a result of a problem anywhere from the lips to the stomach. It may be identified by weight loss, coughing or choking when eating, delayed cough or regurgitation, or outright obstruction. This is more likely to be an issue after a stroke or in elderly and frail individuals. In the inpatient population, symptoms suggesting some level of dysphagia may be as high as 34%. So what do you do if you feel like your swallow isn’t quite right?

High blood pressure in the doctor’s office

“I don’t get it! Everytime I come to your office my blood pressure is high. It’s never like that anywhere else!”

“White Coat Hypertension” is very common and affects many people, even those who feel at ease with their physician. But whether your blood pressure is low or high at the doctor’s office, if you’ve been told you might have hypertension, you are likely to find yourself at home, or in a grocery or drug store with your arm in a cuff trying to figure out if your blood pressure is reasonable. A key to successful self-measurement is knowing the proper technique.

The big studies of blood pressure in the population upon which we base all our definitions of normal and high values were careful to take their measurements in a standardized way. The patient should avoid coffee, tea, nicotine, and other stimulants for at least 30 minutes prior to the test. She should sit quietly for a full 10 minutes reading or softly conversing before measurement. Even reaching across the table to pull the BP cuff near is to be avoided. (Get the machinery next to you when you first sit down.) Use an upper arm cuff. Forearm and finger devices are not reliable. Feet should be flat on the floor, clothing comfortable, and a bare arm may be needed for some machines. Two or three measurements a few minutes apart may be averaged.

A few caveats to mention: if one arm is higher than the other, you have to go by the higher side. Humans have a natural ‘diurnal’ variation, with most of us having a little higher blood pressure in the morning compared with later in the day. Blood pressure rises with physical and mental exertion and takes some time to come down, so don’t expect a resting value if you’ve not been at rest for 10 minutes or more.

Blood pressure is dynamic and always changing. The majority of values should be in a good range; your physician can help you determine if your numbers are in the range you need for optimal health.

Croup: coughs that go bark in the night

Croup is a common childhood illness that can be very frightening to a parent or child. It often starts with the symptoms of a mild cold, such as a runny nose, or sore throat. The child goes to bed as usual and then wakes suddenly in the middle of the night with a barking cough. Often they gasp in between the coughs and make a high-pitched noise called stridor when they breathe in.

Thankfully, croup is rarely dangerous. Most children can be treated at home. But it can be a scary illness for both the parent and the child.

It is important to know how to treat croup at home and when to seek help from your doctor or the emergency room....

Caring for your child's cast

Kids of all generations from all walks of life have one thing in common and that is the love of play and imagination. Play structures, a couch turned to a fort, or their sworn innate ability to fly can take a sour turn. As much as we would like to wrap our little Spider Mans, Incredible Hulks and Wonder Women in bubble wrap, unfortunately life’s little incidences are inevitable.

If ever the time comes where your Super Hero suffers from an injury and needs a cast, it is time to put on your Super Parent costume.

Here are some helpful tips on cast care for the Super Parent:

  • Bathing: Absolutely no showers. We ask parents to give kids a bath instead, keeping the casted limb outside of the tub. In addition, we suggest wrapping the cast with a towel and covering with a newspaper bag or bread bag and closing it off with a rubber band at the top for added protection.
  • Itching: The golden rule of having a cast is DO NOT STICK ANYTHING IN THE CAST! Scratching an itch with an object can cause the skin to break underneath the cast, leaving room for infection. If your child has itching, tapping on the outside of the cast or using a hair dryer set on cool can help.
  • If a cast...

Tips for getting the most out of your inhalers

“Darn! My inhaler is out and I am going to have to call today, a Sunday, to get a refill…”

Spring is here! And that means asthma season is back, and with the nicer weather, pollen counts are high. Flowers are wonderful and the trees beautiful, but if you are like me, some of those plants have your number. The beautiful smells come with itchy eyes, sneezes, and for some, a serious amount of wheezing.

Patients are reaching for their inhalers more often, and sometimes getting into serious respiratory trouble, especially if their medication is running short. Inhalers are expensive, too, and so using them optimally is both financially and healthfully important.

Fortunately, a couple of tricks can really help maximize an asthma spray’s value.

The medication comes out fast and hard when you squeeze the canister, and it can be difficult to time your breath to inhale the dose well, plus with the energy of the release being so high, a lot of misted drug can zoom right out of your mouth. The trick is to use a ‘spacer’, and the simplest is a rolled up piece of paper, to about a one inch diameter. Tuck the sprayer in the far end, wrap your lips around the outside of the other end, and take your leisure squeezing and breathing! The tube holds the mist in place for a few seconds, letting you better coordinate your inhalation and improve substantially the amount of drug you get to where it is needed.

The second tip is to use a steroid inhaler daily if you need your rescue inhaler more than a few times a week. The rescue inhaler will become less effective the more you use it if you don’t directly treat the inflammation of the allergic response in your bronchial tubes with a low dose of cortisone type medication. The dose of the latter is small and will not cause harm to the rest of your system if used according to directions, but it will keep your rescue medication most beneficial!

Two years in the life of the Swedish blog

For those of you who don't know, today is the official two year anniversary of the Swedish blog - this means Swedish has been blogging several times a week for two full years!

What have we been blogging about this year?

Who's been blogging?

We've had people from across Swedish blogging (more than 100 the last time we checked), including:

  • Surgeons

  • Nurses

  • Family Medicine and Primary Care Physicians

  • Dietitians

  • Educators

  • (And many others!)

Why are we blogging?

We started the blog as a way to connect with you (our community), whether you're a current patient, a past patient, a future patient…or just someone who stumbled across our site looking for health information. We believe our role is to be a resource of information, both online and off. Blogging gives us an easy way to keep you up to date, informed, and engaged on a number of health topics

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