Pamela Visit 2 - Why do I feel worse?

Title:	Pamela Visit 2 - Why do I feel worse?
Topic:	Pain Management
Relevant Terms:	Chronic Fatigue Syndrome, Chronic Pain, Depression, Fibromyalgia, Irritable Bowel Syndrome, Myofascial Pain Syndrome, Pain, Rheumatology, Systemic Lupus Erythematosus, Widespread Pain
Primary Audience:	Primary Care Physicians, Rheumatologists, Neurologists, Pain Physicians, Nurse Practitioners, Physician Assistants, and Psychiatrists
Launch Date:	01-Dec-08
Credits:	1 AMA PRA Category 1 Credit™
Expiration Date:	The accreditation for this activity has expired.

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Learning Objectives

At the conclusion of this educational activity, participants will be able to:

Recognize FMS from other disorders though better understanding of diagnostic criteria.
Apply current clinical practice guidelines to diagnose and treat FMS patients.
Properly identify and address behavioral, psychological, and social factors affecting patients with FMS.
Develop appropriate pharmacological and behavioral treatment interventions tailored to the individual needs of patients with FMS to better manage pain and improve quality of life.
Assess evidence-based effectiveness of procedural modalities such as trigger point injections.
Implement a multi-disciplinary team approach to improve pain management and patient compliance.

Faculty

Course Chair:
Paul J. Christo, MD, MBA
Assistant Professor
Department of Anesthesiology & Critical Care Medicine
Division of Pain Medicine
The Johns Hopkins University School of Medicine
Baltimore, Maryland

Paul J. Christo, MD, MBA

Dr. Christo is a board certified, Harvard-trained anesthesiologist and Hopkins-trained pain medicine specialist. He directs the Multidisciplinary Pain Fellowship Program at The Johns Hopkins Hospital and directed the Pain Treatment Center at Johns Hopkins for 5 years. Dr. Christo is an international lecturer, reviewer for pain journal editorial boards, teacher, and published author in areas relating to pain medicine. He has coordinated several CME (continuing medical education) programs that focus on educating both specialists and generalists on important aspects of pain diagnosis and treatment. He specializes in treating patients with chronic pain: spine pain (low back and neck pain), cancer pain, disc herniations and degenerative disc disease, neuropathic pain (reflex sympathetic dystrophy or complex regional pain syndrome), shingles pain (post herpetic neuralgia), thoracic outlet syndrome, and post surgical pain. Further, Dr. Christo is experienced in performing implantations of pain pumps and spinal cord stimulators for the treatment of unrelenting pain. He has recently been selected as a Mayday Foundation Pain and Society Fellow during which he will engage in media and policy initiatives for the advancement of pain control.

Dr. Christo is recognized in the "Guide to American's Top Physiciains" for Pain Medicine, "America's Top Anesthesiologists: Guide to American's Top Anesthesiologists", and "The Baltimore Magazine, Top Doctors in Pain Medicine/Anesthesiology". He has appeared as a guest on Dr. Mehmet Oz’s Oprah and Friends XM Satellite Radio Show, Voices in the Family Radio Program hosted by Dr. Dan Gottlieb, and Retirement Living Television’s, Healthline, hosted by Dr. Kevin Soden. His credentials in pain medicine include subspecialty certification in Pain Medicine by the American Board of Anesthesiology and board certification by the American Board of Pain Medicine. He has also earned an MBA from the Johns Hopkins Carey Business School focusing on health care management.

Dr. Christo has published on such topics as the procedural elements of pain medicine, post herpetic neuralgia (shingles-related pain), opioid effectiveness in chronic pain, aging and addiction, cancer pain, and complex regional pain syndrome. He is currently investigating novel therapies for the treatment of chronic pain syndromes such as thoracic outlet syndrome, sexual side effects of chronic opioid therapy, pain medication prescription errors, and online educational modules for pain education.

Consultant:
Perry G. Fine, MD
Professor of Anesthesiology
Pain Research Center
School of Medicine
University of Utah
Salt Lake City, Utah

Perry G. Fine, MD

Perry G. Fine, MD, completed medical school in 1981 at the Medical College of Virginia in Richmond. He served an internship in 1982 at the Community Hospital of Sonoma County in Santa Rosa, California, and completed his residency in 1984 at the University of Utah Health Sciences Center in Salt Lake City. In addition, Dr. Fine completed a fellowship in 1985 at the Smythe Pain Clinic of the University of Toronto in Ontario, Canada.

Dr. Fine is a Professor in the Department of Anesthesiology of the School of Medicine at the University of Utah, where he serves on the faculty in the Pain Research Center, and is an attending physician in the Pain Management Center. He teaches the first- and second-year medical school courses in social medicine and the fourth-year medical school course in medical ethics. Currently, he serves on the Board of Directors of the American Academy of Pain Medicine, the Society for Arts in Healthcare, and the American Pain Foundation. Dr. Fine serves as the External Strategic Advisor for Capital Hospice, Washington, DC and is a consultant to the Center for Advanced Illness Coordinated Care, based in Albany, New York, developing and educationally supporting self-sustaining models of prehospice palliative care in community settings, as an integrative component of disease management and advanced illness coordinated care. He is very pleased to have been selected to serve as the Chair of the National Initiative on Pain Control for 2003 to 2008.

Dr. Fine is widely published in the fields of pain management and end-of-life care. He serves on the editorial boards of several peer-reviewed medical journals. As a medical avocation, he has worked as a team physician for the University of Utah football team for the last 18 years and was a medical officer for the 2002 Winter Olympics in Salt Lake City. He is the recipient of the 2007 American Academy of Hospice and Palliative Medicine Distinguished Hospice Physician Award, and the 2008 American Pain Society John and Emma Bonica Public Service Award.

Consultant:
Muhammad B. Yunus, MD
Professor of Medicine
Section of Rheumatology
University of Illinois
College of Medicine at Peoria
Peoria, Illinois

Muhammad B. Yunus, MD

Muhammad B. Yunus, MD, is a Professor of Medicine in the Department of Medicine, Section of Rheumatology at the University of Illinois, College of Medicine in Peoria. He received his medical license from the State of Illinois. Dr. Yunus became a Fellow of the American College of Physicians in 1984, and Founding Fellow of the American Rheumatism Association in 1986.

Dr. Yunus has made the most significant contributions in the area of fibromyalgia syndrome (FMS), a hitherto under-recognized but common rheumatologic disorder. He conceived and carried out a careful controlled study of this syndrome which was published in Seminars in Arthritis and Rheumatism in 1981, demonstrating that fibromyalgia is a recognizable and characteristic disease. This was the first scientific study to characterize the clinical syndrome of fibromyalgia. This paper also provided the first data-based criteria on FMS. The subsequent ACR criteria study greatly benefited from Dr. Yunus’ 1981 criteria. This publication has now been proven to be one of the most significant contributions to the rheumatology literature in terms of its impact on practice, recognition and conceptualization of fibromyalgia syndrome, and stimulation for further research. Since the publication of Dr. Yunus's first study of FMS, results of numerous studies by other investigators have been published, corroborating Dr. Yunus's original findings. Research in fibromyalgia has now achieved a great momentum, resulting in its worldwide recognition as a chronic and disabling rheumatologic disease.

Dr. Yunus is widely recognized nationally and internationally for his research contributions in primary fibromyalgia syndrome, and is regularly invited by medical journals and book editors to write articles, editorials and chapters on this topic. Dr. Yunus was a manuscript reviewer by invitation for several prestigious medical journals including the New England Journal of Medicine, American Journal of Medicine, Arthritis and Rheumatism, Journal of Rheumatology, Annals of Internal Medicine, Journal of Clinical Rheumatology, and others. He is also an Editorial Board member for numerous peer-reviewed journals such as the Journal of Musculoskeletal Pain, and served as a Consulting Editor of Physician Information and Education Resource (PIER), American College of Physicians (ACP).

Dr. Yunus was also a recipient of numerous faculty awards for outstanding teaching. Further, he has provided voluntary help to the Arthritis Foundation, Central Illinois Chapter, and is currently serving as a member of its Board of Directors, as well as the Chairman of its Medical & Scientific Committee. He has appeared in television programs and on local radio shows to discuss arthritis and arthritis-related topics.

PREREQUISITES There are no prerequisites for participation.

ESTIMATED TIME TO COMPLETE ACTIVITY 1 hour of participation.

STATEMENT of NEED Since patients with FMS are now more commonly seen in primary care settings, we have identified a significant need for the education of primary care physicians regarding the proper diagnosis and optimal management of patients with FMS, and specifically, to increase awareness of the needs of patients with FMS, to encourage a more multi-disciplinary approach in managing and treating pain, and to better identify and treat the various subtypes of patients with FMS. Neurologists and rheumatologists currently treating patients with FMS would also benefit from participating and collaborating in more continuing education programs highlighting the more recent advances on the diagnosis and management of the disease.

SPONSORSHIP STATEMENT
Presented by The Johns Hopkins University School of Medicine.

FULL DISCLOSURE POLICY AFFECTING CME ACTIVITIES As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:
- All speakers have indicated that they have not received financial support for consultation, research or evaluation or has a financial interest relevant to their presentation.

Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution which receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

OFF LABEL PRODUCT DISCUSSION No speaker has indicated that their presentation will include information on off-label products.

DISCLAIMER The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

CREDIT DESIGNATION STATEMENT The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ACCREDITATION STATEMENT The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

STATEMENT OF RESPONSIBILITY The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

ACKNOWLEDGEMENT This activity is supported by an educational grant from Pfizer Inc.

INTERNET CME POLICY The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet based program. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine’s CME program. CME collects only the information necessary to provide you with the services that you request.

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Release Date: November 7, 2008
Expiration Date: November 30, 2009

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