Peace for the World

Peace for the World
First democratic leader of Justice the Godfather of the Sri Lankan Tamil Struggle: Honourable Samuel James Veluppillai Chelvanayakam

Saturday, August 5, 2017

Pain Management

by Victor Cherubim-
( August 5, 2017, London, Sri Lanka Guardian) Pain is an unpleasant sensory and emotional experience. Even though the experience of pain varies from one person to another, there are different types of pain. It is one of the body’s most important communication tools. Pain is one way the body tells you something is wrong and needs attention.
Carlo Rovelli said:”Reality is not what it seems”. “Pain stems from an injury to the body’s tissue. The injury can be to bone, soft tissue or organs. The injury to body tissue can come from disease, or it can come from a physical injury such as a cut or a broken bone”. Then there are different types of pain. There is nerve pain, muscle pain, Then there is acute pain and chronic pain.
The binding power of medicine
We visit our Doctor and expect we get cured immediately. There was a time that doctors were like Gods, or thought they were Gods. Medicine half a century ago was neither costly or for that matter considered effective. Since then science has identified over 13,600 different ways our bodies can fail. For each one, if not for most, scientific platforms are being discovered with remedies that can reduce suffering, extend lives and stop the spread of disease.
“We are doctors, not police and we are present in the Mediterranean to save lives”. This was the message given to reporters by Medecins Sans Frontieres (MSF International), Doctors without Borders, an independent, medical, humanitarian organisation, an NGO fighting to rescue “illegal” migrants at sea.
Doctors are becoming increasing aware of their different roles today. Outside Libyan waters doctors are deployed in military vessels to disrupt the smugglers business. They are aware of trafficking in Nigerian girls and women. The job of these doctors is to separate them from their traffickers before they disappear in the world of abuse.
A case in point, one among a few, a very few (not known), of the Search and Rescue vessels, “Vos Prudence” Italian Navy’s Maritime Rescue operations which is fighting a losing battle to contain the 93,417 migrants from all over the world arriving in Italian shores in 2016,bound for “somewhere” to live and work in Europe.
The volume and complexity of world migration, together with the spread of disease has grown exponentially beyond our capacity as individuals or as nations. Our fear is that this knowledge has grown beyond our capacity to assimilate.
The route of administration – making a pill into a patch
As with Traditional Medication delivery methods which was in use in administration over time, such as pills, capsules, liquids, powders, more recently intravenous injection, have now been supplemented. Some of them we are told are often inefficient and can lead to undesirable side effects.
From a pharmaceutical point of view, the pill is the easier form of medication for pain. It offers different ways of control medication –both the dose and the time.
Among the newer methodologies for the administration of medicines to our bodies is the use of transdermal approaches including gels and patches, for the treatment of many of the common ailments, particularly to control acute pain. It is also a common way for smokers to control their nicotine dose. Drugs can affect the liver, a patch avoid it.
Making a pill into a patch is fairly a clever way of creating new patients for pharmaceutical drug platforms, a method of “re-purposing”. Besides, the diffusion of the drug through the patch to your skin into your blood stream is different from an intravenous (IV) injection, which is an instantaneous dose.
Transdermal patches will give a local effect without affecting the whole body unnecessarily. It is a method of delivering medication through the skin, in a non invasive way. A Patch is adhered to a patient’s skin .The patch contains the medication prescribed to the patient. The medication is said to permeate the skin in a controlled fashion. This way attains more steady levels of the drug in the body.
Patches are worn, stuck on to the outer layer of the skin of the necessary body needing attention. It can be kept on for as little as 8 hours to as long as a week, depending on the therapeutic indication. The adhesive on one side of the medicated patch are comfortable without a bandage aid.
As the skin layers absorb the medication via the blood vessels into the blood stream. The blood carries the medication through the circulatory system and through a patient’s body. Pharmacists state that it “bypasses the liver’s metabolic activity” as well as the acidic environment in the gastro-intestinal tract.”
The downside
Patches can cause skin irritation. Alcohol wiped areas absorb the patch differently than an area that is not cleaned in most cases. The Patch or Oral medication cannot be logically transferred from one to the other and expect the same result say pharmacists.
The disadvantage is that you need to change the placement of the patch regularly, perhaps, like what a diabetic would do, to alter the locations of the injections, so that the area does not build up a resistance to medication.
The downside of patches that I experienced when I was prescribed patches by my GP for a severe elbow pain was that it took many hours for the meds to track in and many more hours to get the medication out of the system, when the patch was removed. However, it was good after all in relieving my acute pain.
I hope I am not suggesting that patch meds are the “be-all” for all type of pain.