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Complex regional pain syndrome (CRPS) is as bad as it sounds — severe, spreading chronic pain with redness, fluctuating skin temperature, and sometimes changes in body hair and nail growth. These issues make it hard for most patients to use their affected arm or leg, the body parts that are most often impacted.
As if that’s not enough, CRPS is not widely known by many doctors and is not well understood, so it is often misdiagnosed and many patients receive the wrong treatments or no treatment at all.
Most cases of CRPS develop after an injury to a limb. Up to 7 percent of children who suffer a traumatic arm or leg injury may develop CRPS shortly afterward. That rate is even higher in adults: about 8 to 10 percent.
The approach to CRPS at Cleveland Clinic has been shaped by Dr. Stanton-Hicks, MD, a consultant in our Department of Pain Management who is one of the world’s leading experts on the condition. He helped establish the Pediatric Pain Rehabilitation Program at Cleveland Clinic’s Shaker Campus, which provides an intensive program for children and adolescents with CRPS. This complements the Chronic Pain Rehabilitation Program, a similar program for adults with CRPS.
It is important to integrate a range of physical, occupational and psychological therapies — such as biofeedback, relaxation techniques and group therapy — on an inpatient and day-care basis over a three-week period. In regards to children, the emphasis is on psychological approaches, for patients and their parents alike, because of the importance of developmental changes in children’s responses to pain.
“Both programs aim to raise patients’ pain threshold and help them manage pain so that it’s not such a big part of their lives,” explains Dr. Stanton-Hicks.
The techniques that patients learn in these programs, sometimes together with well-chosen medications, enable some patients with CRPS to successfully manage their pain and lead active, “normal” lives. Other patients require additional interventions, such as nerve blocks or spinal cord stimulators that modulate pain by delivering electricity to the spine.
About 80 to 85 percent of children and adolescents with CRPS who complete this intensive array of therapies eventually get “almost completely better,” says Dr. Stanton-Hicks. That degree of recovery is unusual in adults, where the aim is more about maintaining function and reducing pain to a level that lets patients keep working and lead a relatively normal life, he explains.
An arc of lips was pursued upward; offered in finespun amiability, malignant rapture. “Just see me as you see fit.” ⠀⠀⠀❑。 @kh_ronos.
@RoxyTall Don't much trust the cops, but Ned Kelly comes across as a malignant narcissist prone to grandiose fantasies of political power.
@ShawnClose15 Just...instincts and I read the pathology report. There are no malignant cells. 🙃 Sorry to go on....
@joshjob42 @ESYudkowsky McNamara had no malice towards Vietnam, but he sure was malignant.
Putin mistakenly thinks it’s 1955 and that media suppression can douse inconvenient information. While he can propagandize from the Kremlin, promising that only he can make Russia safe from an encroaching NATO and the decadent West, he is not the only authority. For almost three decades now, curious Russian people have consumed the international press and learned how manipulative official media can be. Many have traveled to the West, too, and attended college abroad, which has given them the critical perspective that might have been denied to their parents. The internet has provided a window on the world through which Russians can judge their own country. Russia hasn’t become a Western country by any means, but compared to the time before the fall of the wall, it’s become increasingly globalized, both economically and culturally. Putin may be able to pause that integration, but can he reverse it? Doubtful….
Even though Putin now controls Russian media, he can’t prevent inquiring Russians from using VPN accounts to breach the official blockade of news and social media on the internet. According to one source, demand for VPNs in Russia has risen dramatically since the media clampdown, as have downloads of Telegram and Signal, two encrypted messaging apps. A Russian with a computer and an internet connection can be as well informed about the war as any Westerner if they ignore Putin’s don’t-look-up order.
This could change, of course. The man who would bomb a children’s hospital is capable of anything. Putin possesses police-state powers that he could deploy. He could kerosene the Russian internet and set it aflame. He could jam the BBC’s revived shortwave service into Russia. He could try to ban VPNs, but not even China has done that. He could upgrade the monitoring of internet traffic. Or he could expand the “spot checks” of protesters’ smartphones, a tactic used at anti-war rallies in Moscow, in his search for dissidents. He could even hunt down and incarcerate Russians who voice their opposition to the war, sotto voce, in the comments sections of restaurant websites.
Guests sit around the charcoal grill and choose which what they would like eat.
Osaka is known as the culinary center of Japan with its 91 Michelin-starred restaurants and thousands of other places to eat. Osakans are also known to enjoy life through eating and drinking with friends and family and are the most out-going people of any Japanese region.
My moving to Japan has opened my eyes to many different dining experiences, tastes and sensations. I am not a “foodie