Opioid Medical Complications Long Term Opioid Therapy may be needed of appropriate for your pain management. However in higher doses and in long term, you may develop some medical complications. The following are there complications that you may experience as a result of long-term opioid therapy. Please talk to your doctor if you feel any of the following problems: 1- Neuroendocrine abnormalities and erectile dysfunction You may experience difficulty with erection, lower libido and lower stamina due to lower testosterone level. Please talk to your family doctor or your treating physician if you experience any of these symptoms. 2- Sleep Apnea: Long Term Opioid Therapy can aggravate Central Sleep Apnea meaning it can impair ability to breath at night through sedating the breathing centre of brain. It can also aggravate obstructive sleep apnea. If you snore, wake up tired, get muscle twitches or spasms at night you should speak to your family doctor or treating doctor. Mixing opioids with benzodiazepines or other sedative medications can increase the risk of sleep apnea. Please do not mix opioids with any sedating medication or alcohol. Please inform your doctor of any changes in your medications. 3- Opioid Induced Hyperalgesia (OIH): It maybe difficult to believe that taking pain medications like opioids can have a paradoxical effect and increase the pain. OIH is a paradoxical hyperalgesia (increased in pain sensation) resulting from Long Term Opioid Therapy. It is characterized by pain sensitivity (hyperalgesia: increased pain sensation, and allodynia: perception of pain from a non painful touch message) in the absence of overt opioid withdrawal. It is distinct from tolerance in that pain extends beyond the area of initial complaint. It is also known as opioid neurotoxicity. Please inform your Family Doctor or Treating Doctor if you encounter any of these complications while on Long Term Opioid Therapy. Sleep Apnea can be a life threatening complication and the two other medical complications can impair your quality of life. It is important to inform your doctor if feel any sign of these complications so your doctor can adjust the dose or change your medications.

Chronic PainRemedies


Postpartum depression, like many other mental illnesses, carries with it a stigma. With this stigma there is shame, guilt, fear, anxiety, and anger. As with all mental illnesses, if left untreated the effects can last for a longer period of time, worsen, and become a permanent part of your daily life.

Over the last few years there has been more talk about postpartum depression. The media has brought it in to the light to try and ease the stigma. However until we can change the way society perceives mental health, there will always be those who suffer in silence. I know this. I am one of them.

Approximately 50% to 75% of all new mothers will suffer from something called “Baby Blues”. This is a temporary and often mild feeling of fatigue, feeling overwhelmed, crying either out of sadness or frustration and changes to your sleeping and eating patterns. Given the fact that a newborn has the highest demands, requires immediate attention and has no concept of day or night it is easy to see how the vast majority of new mothers reported feeling the Baby Blues. Most new mothers recover once they get into the swing of life with a new baby. Having a child is a big change and specifically for first time mothers, there are some significant lifestyle changes that will need to be made that can take some getting used to.

Approximately 15% of mothers have reported struggling with Postpartum Depression. It is worth noting that these are only reported cases. Many mothers either don’t recognize the symptoms, or are ashamed to report what they are feeling. I admittedly, am an unreported case. I know firsthand what it is like to carry with you this secret, all the while acting seemingly normal to those around you.

In recent years, new categories have been added to the postpartum umbrella diagnosis, including postpartum anxiety, postpartum post traumatic stress disorder, postpartum obsessive compulsive disorder and postpartum psychosis. Someone who is struggling with postpartum depression can also be dealing with one or more of these diagnoses at the same time.

Postpartum anxiety affects approximately 10% of postpartum women and can be recognized by constant worry and the overwhelming sense of doom. You will often have racing thoughts that you are not able to control, most of which will be negative. You may assume the worse is going to happen without having any real reason to feel that way. You may find it is difficult to focus, sleep and eat. Often, the postpartum woman may be afraid of being left alone with the baby.

Postpartum post traumatic stress disorder affected 1%-6% of women and will often occur after birth following an unplanned or emergency cesarean, a baby who is sick or in the NICU, a difficult labor, a lack of support during labor, or other medical emergencies during delivery. Those who suffer postpartum post traumatic stress disorder will often have nightmares about the scenario or will avoid anyone and anything that reminds them of it. Often, the women will become overprotective of the baby.

Postpartum obsessive compulsive disorder affects 3%-5% of postpartum women. This can be recognized by repeating the same task over and over again in an attempt to cope with anxiety or depression which can include making lists, compulsive cleaning, checking and rechecking actions that you or others have already performed or repeatedly having mental images of yourself or the baby that can be disturbing. Often, the woman will be afraid of being left alone with the baby.

Postpartum psychosis is the most severe form of postpartum depression. It affects approximately 1 in every 1000 pregnancies. The onset is very sudden and usually occurs 2-3 weeks after birth. The symptoms are bizarre and uncharacteristic behavior, suicidal thoughts, delusions and hallucinations, thoughts of hurting the baby, and uncharacteristic hyperactivity.

Postpartum psychosis is considered to be a medical emergency. The person should be seen and treated immediately.

Symptoms of postpartum depression will usually appear shortly after birth. Sometime, mothers begin seeing the signs 3-6 months after birth. When a woman gives birth, her hormones take a sharp dive. This is the cause for the sudden changes in mood, the chronic feeling of fatigue and depression. That, in combination with a lack of sleep, being overwhelmed and feeling anxious about your parenting skills creates the perfect storm for feeling inadequate and depressed.

Mothers who suffer from postpartum depression are often confused about what is happening to them. They are uninformed about postpartum depression. In my case, I remember thinking to myself, “I should be happy. I must be a terrible person.” It is hard to imagine yourself finally holding your child after countless hours spent dreaming about this moment and feeling nothing but self-pity and remorse. But it is real and if left untreated it could escalate to something more severe.

Postpartum depression is not to be confused with Baby Blues. The feeling of depression and anxiety can last for months and even up to one year. Some mother report suffering from severe postpartum depression even 2 years after birth. This can happen if the problem is never addressed or treated. There is however, the possibility that childbirth only amplifies underlying symptoms that have been ignored for some time before, such as anxiety or post traumatic stress disorder.

I myself am no stranger to mental health, which is why I can see it from multiple perspectives. To the new mother who doesn’t feel normal, I have been there. To the woman who is toying with the idea of walking away from it all, I have been there. To the woman quietly sobbing in a dark nursery watching the sun rise and feeling the cold air brush against your ankles, I have been there. You are not alone in this. Reach out for help and understand that it is not you that is the problem. You are not broken. There is a solution. There is no shame in asking for help.

Chronic Pain

If you feel lonely and you believe that you have to face the world alone,then you have a lot to reconsider. Loneliness is the worst enemy of human's mind. For more than a million years we are adapted to live among others and to connect to others. It's imprinted in our DNA to live with others. That has become a part of our way of being. That is why it hurts so much to be or feel alone. But the good news is, YOU ARE NOT ALONE. You can join this or any other community, group of people or any person in your life path to share the weight of your moments with them. The first step is to allow yourself not to be alone. Accepting your value to others and their value to you. Allowing yourself to connect with others. Then you will see that: YOU ARE NOT ALONE!

Mind BodyPatient’s VoiceRemedies

Patient care can be provided by different methods. In some methods the patient is considered as a passive subject of health care. The patient's role is to be the best follower of doctor's orders and has no active role in the circle of care. In an active approach to health care patient is at the center of health care and takes an active role in the circle of care.

There are many steps that patients can take to improve their own health. Everything starts with learning about our conditions and what can be done to help these conditions. Proper nutrition, exercise, proper life style, stress management, sleep hygiene, behavior modification and positive thinking are among a few to name that can help us to improve our conditions much better.

Self management education is built on the foundation of believing ourselves. Self management education is important because it changes our health and life from passive to active. It helps us to gain control over our condition and play a central role in our path to healing.

Chronic PainMind BodyPatient’s VoiceRemedies

Finding Your own happiness is possible by finding your own state of flow. Csikszentmihályi is a Psychologist who describes flow as “being completely involved in an activity for its own sake. Being so absorbed into something you love to do, which is challenging enough, but not too easy or too hard, just for the love of doing it and not for the outcome. To get there, first we need to have some level of honesty with ourselves. There is a calling for something we love to do in all of us, but we get too busy doing what we need to do in order to get what we want to have! There is nothing wrong with trying to make a living. The great loss happens when we forget the actual living in the process of trying to make a living. We go about our daily routines without enthusiasm and we feel exhausted at the end of the day. One day of our daily routine may feel so long at times that we feel it may never end. Bringing enthusiasm back to life is what we need to get into our own state of flow. So consider the following steps: 1- Be Honest with yourself and find your own calling. You are worthy of it, just be honest and have a real look at your own interests. What gives you a kick? 2- Open some time for your own interest and focus on what you love to do. It does not have to be a lot of time out of your schedule, but only you can open this window for you. 3- Don't give into wasting your time on a too simple version of what you like or don't set the bar too unrealistically high. Creating your own balance. 4- Enjoy doing what you love to do for the sake of doing it. 5- Enjoy your new habit: LIVING IN YOUR OWN STATE OF FLOW

Chronic PainMind BodyPatient’s VoiceRemedies

Meditation is very popular practice all around the globe. Meditation is a way to keep your mind fit, the same way a gym trainer would train the body to be fit.

  Meditation is used as an umbrella term. There are many forms of meditation. Just as exercise is an umbrella term, and there are a number of different exercises you can do. It is a group of related activities. You can choose one technique and focus on mastering that, or you can practice multiple until you’ve mastered all forms of mediation.

So how do you go about practicing mediation? And what is the point?

  Many think that the point of meditation is about emptying the mind. This couldn’t be further from the truth. Meditation is about focusing on the Here and Now.

What does that mean?

If you really think about it, many of our thoughts, angers and worries stem from thoughts of the past, and thoughts of the future. Meditation encourages your focus to be on right now, right at this moment. And what is happening right at this moment? You are breathing. Meditation uses a focus on breath because nothing is more current than your lungs filling with air and emptying at that moment. When we meditate, we temporarily let go of the past (which we cannot  change) and the future (which is still unknown) and bask in the present; a place and time that is real and current, and that we often forget to appreciate.

When you can focus on the present, the past seems less significant, and the future is full of endless possibilities. The idea of good things or bad things happening is irrelevant. The understanding is that things happen, and things will always happen. Good or bad is a label we attribute to the situation based on thoughts of the past and our own ideas for the future. This is where our minds often become stuck in a loop.

Our minds are like hamsters on a hamster wheel. They can run all day and all night. But in the end, they aren’t really going anywhere. When our minds are filled with situations and circumstances, things that have been and things that could be, we are running and not really going anywhere. We have no control over most of the things that occupy our minds. And that is why, by using meditation techniques, you can focus on what you do have control over. You can focus on what is relevant. The Here and Now.

The mind is what runs the body. Meditation does not only promote mental health and awareness of yourself and the world around you, it has many physical befits as well. There have been many studies that show the positive effects of meditation on the body and its different systems. For example, meditation combats stress. Stress on its own can affect blood pressure, heart rate, sleep, pain, and anxiety


Meditation promotes:

  • better quality of sleep
  • lower blood pressure
  • improved blood circulation
  • a lower resting heart rate
  • less anxiety
  • slower respiratory rate
Mediation has even been known to be useful in weight loss, smoking cessation, and pain management when used in combination with other treatments.

While there are a number of forms of meditation techniques, they all share in the theme of focus. Any technique you choose will be difficult at first. We have spent our entire lives allowing our minds to run free. Getting your mind to focus without thoughts racing through will take practice and persistence.

Concentration Meditation:

This form of meditation involves focusing on one single point for concentration. This can be your breath, repeating a sound, listening to a repetitive gong etc. The purpose of this form of meditation is that is offers you something to refocus back on when your mind wanders into thoughts. Instead of giving in to the random thoughts crowding your mind, you acknowledge them, and then let them go, going back to your point of focus.

This is usually the easiest way for beginners to start practicing meditation.

Mindful meditation:

This technique is different from focused meditation. It is considered a more advanced form of meditation. Mindful meditation encourages the observation of thoughts rather than a clearing of thoughts. The idea is to see the thoughts that are floating through your mind in a neutral light. You are not judging or engaging the thoughts. You are simply acknowledging that they are there.

This meditation technique offers you a view of your thoughts from above, allowing you to find patterns in what you perceive as good thoughts and bad thoughts. With practice, you will become more aware of your tendency to quickly judge situations as negative, and you will be better able to alter your outlook to see things in a more positive light.

There are many other meditation techniques that you can try once you have mastered the art of focus. There is Tai Chi where you use your body and controlled muscle motions while keeping a relaxed mind. There is also walking meditation for those who are now able to practice Mindful Meditation with ease.

By practicing mediation for just 2 or 3 minutes a day, you can better train your mind and slowly begin to increase the amount of time you are able to meditate.

Chronic Pain


Living with chronic pain is no easy feat. Pain causes many changes, both outside and on the inside of the person facing chronic pain.

When dealing with chronic pain, it is all too easy to slip into making your life centered on the pain. It can become difficult after a long history of dealing with the pain, to see the line between your pain, and the rest of your life. This is where anxiety is born.

Anxiety is a state of constant fear and worry. You can fear the pain, and worry about all aspects of it. You can worry about the triggers, the intensity of current pain and the pain still to come. You can worry about all possible future outcomes in regards to your health, finances, and family without having any bases to do so.  Anxiety can cause you to spend the better part of most days living in the fear of “what if?”

Anxiety is assuming the worst will happen at all times without having any actual reason for thinking this way. Anxiety is extreme worry coupled with fear, caution, and constantly being on alert for danger. Anxiety is a seed. It is planted inside of you, and if left untreated, will grow and branch into all other areas of your life. Anxiety can also evolve, and take on new forms by way of your friends and family, your workplace, your confidence and self esteem. It can be exhausting at times, and lead to a depression.

So how can you treat anxiety that is combined with chronic pain? It isn’t always easy as these two feed of off of each other. Pain causes anxiety. People who suffer with anxiety may have a lower threshold for pain and may be more sensitive to the medications for treating pain. That being said, treatment is very possible.

Nutrition: Those who suffer with chronic pain and anxiety should limit or eliminate caffeine, nicotine and alcohol. These can act as triggers for anxiety and panic attacks.

Sleep: Good quality sleep in the night hours can help with both chronic pain and anxiety disorders. The symptoms of both conditions can often be made worse when you are not getting enough sleep in the night. Practice good sleep hygiene and avoid caffeine late in the day to promote good sleep.

Alternative treatment: Meditation, Yoga, acupuncture and massage have all been known to be helpful in treating anxiety and managing anxiety. Relaxation techniques: This includes progressive and slow muscle relaxation, breathing retraining as well as visual and auditory aids. Relaxation techniques have been shown to help combat and cope with anxiety.

Medications: Some medications are available to treat symptoms of both pain and anxiety in one pill. Speak with your primary care physician to determine which medications and course of treatment best suit you.


Chronic Pain

You can use mypain.ca and #ZENDOSE on @Drkevinrod on twitter as your companion to Mind Body Health. The information on these online resources can be used as a program for achieving better Mental and Physical health. This program is free of charge and is guided by a licensed health professional. You can use the contact us section to get started on this program. Otherwise you can enjoy daily readings of #ZENDOSE on twitter @Drkevinrod, reflect on them and follow up with mypain.ca site as your online resources for learning about Self Help for better mental and physical health. Please scroll down to read more.

Chronic PainMind BodyRemedies

With the new year just around the corner, now might be as good a time as any for chronic pain sufferers to start keeping a pain diary.

Pain is not always easy to talk about. It can often be misunderstood by friends and family. Because the pain is an invisible entity, it can be hard to describe it to someone who does not face your pain on a daily basis. A pain diary is used to create a picture of the pain, making it easier to understand and also helping to uncover useful information that may have otherwise gone unnoticed.

Pain is often described as a number ranging from the least amount of pain, to the worst pain. These numbers are used to create a picture or a map of the pain. A pain diary uses the same concept, giving as much detail to the pain as possible to create a larger, more descriptive picture of the once invisible pain.

A pain diary can help by allowing you to see and understand your pain patterns and triggers. Over time you can observe which medications and therapies offer you the most pain relief. You can also see how your environment around you affects your pain. Changes in season, amount of natural daylight and even stressful situations can all be pain triggers that go unnoticed because of our busy lifestyles. Diet and activity can also be factors affecting your pain. By using a pain diary, you will begin to notice the patterns and triggers that you maybe hadn’t noticed before, allowing you to make changes to better manage your chronic pain.

Another important benefit of keeping a pain diary is that you are better equipped to communicate with your doctor because you have now become an expert in your own pain. You can offer your doctor vital information about your pain that you may not have had before, maximizing your treatment plan and your overall pain management.

Keeping a pain diary does not need to be complicated. These are the key points that should be included in your log:

  • The date and timeline
  • What activities have you been doing since your last diary entry?
  • What were you doing when the pain started?
  • Where exactly on your body did you feel the pain?
  • How often did you feel the pain or for how long did the pain last?
  • How intense was the pain from 1- mild to 10- severe?
  • Did the pain stop you from doing an activity? (walking, cooking, working, sleeping)
  • What medication did you take and at what time? Did they give you any relief?
  • Was there anything else that you did that helped with the pain?
  • What emotions were you dealing with when the pain started? How did you feel after the pain eased?

Use these questions and try to keep your entries as frequent as possible to get the full benefit of a pain diary. With time, you will start to better understand your pain and you will be better equipped to manage it.

Chronic Pain

sleep   Sleep hygiene is the combination of sleep environmental and behavioral practices that you can take part in to help promote a better quality and more restful sleep.

Sleep is a top indicator of your overall health. Poor sleep can have a direct impact on your daytime activities, mental health, alertness and physical health. People who struggle with chronic pain are much more susceptible to poor sleep at night. Pain sufferers are much more likely to list environmental factors as the main contributor to poor sleep. Taking extra care to maintain a sound sleep environment is particularly important for those who suffer with daily pain.

The following are some helpful tips:


Your sleep environment should be consistent from day to day. Where you sleep should be temperature controlled. Your room should be cool, but not cold, to promote restful sleep. The room should be as dark and quiet as possible. An uncomfortable temperature, bright lights and sound can disrupt continuous sleep, leaving you to wake up feeling tired and irritable.

You should choose the most comfortable mattress and pillow that best suits your needs. Bedroom sheets should be light weight, and breathable to prevent overheating while you sleep.


Scheduling your sleep is another form of sleep hygiene. Consistent sleep times will also allow you to adopt sleep routines to ensure quality sleep. Adults require seven to eight hours of sleep per night.

Although daytime naps can be helpful when you have not have good sleep the night before, they can have a negative effect on your sleep the following night.

There is also a benefit in having a consistent wake time in the mornings.


It is important to turn off your work and worries for the day at least 30 minutes before your set bedtime. The bed should be a worry-free zone. Cell phone, laptops and any other electronic device should never be brought into the bed with you.

Bright lights before bed can have a negative effect on your sleep quality, interfering with your body’s own sleep-wake (light-dark) cycle. Cell phones, television screens and tablets should be avoided in bed.

Exercise plays an interesting role in sleep hygiene. While regular exercise is very beneficial to good quality sleep, exercise too close to bedtime can actually have a negative effect on your sleep at night, leaving you unable to fall asleep at a reasonable time.


It is well known that coffee is a stimulant, and drinking coffee before bed may leave you lying in bed at night unable to fall asleep. There are many stimulants out there that are not recommended before bedtime. Coffee, chocolate, many teas, soft drinks and sugary snacks before bedtime can all be detrimental to your sleep at night.

Alcohol and cigarettes before bed will also have an effect on the duration of deep sleep, leading to sleep fragmentation.

Poor sleep has also been linked to increased hunger and consuming larger meals late at night. Eating a large meal too close to your bedtime makes it difficult for your body to metabolize you meal. It is advised that instead of consuming a larger, higher calorie meal late at night, a light snack would be a better choice to promote better sleep.

Chronic Pain