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Dr. Carolina Issa

Dr. Carolina IssaDr. Carolina Issa

Director of Clinical Operations

Dr. Carolina Issa joined Nevada Comprehensive Pain Center in 2015, as the Director of Clinical Operations. Originally trained as a medical doctor and clinical researcher, she brings significant operational experience to the Executive Team. While practicing medicine, she led numerous healthcare programs, from underserved areas of rural Colombia, to health promotion programs in the United Arab Emirates.
She had the opportunity to work for the Pulmonary Department at the University of Texas Health Science Center at San Antonio and at the Veterans Administration Hospital in pulmonary research.

In her role, she ensures operational efficiencies, quality care delivery, and service excellence for all practice locations. She leads efforts to improve quality outcomes and clinic operations in a way that contributes to an enhanced experience for staff and patients.

What You Should Know About Fibromyalgia

Even though we can’t always see the pain, it’s important to spread awareness about the effects of fibromyalgia–both on a personal and national level. When you suffer from fibromyalgia, it’s easy to suffer in silence. Fibromyalgia is often called an invisible illness because there are few outward symptoms. Worse, the condition itself is little understood. While medical professionals now have developed guidelines to help them diagnose somebody with fibromyalgia, since we currently don’t understand exactly what causes it, it can be difficult to treat effectively.

Who suffers from fibromyalgia?

Approximately 100 million people in the U.S. suffer from chronic pain, with women disproportionately affected by it as compared to men. According to an article on The Wall Street Journal, the “prevalence of any chronic pain condition was 45% among women, versus 31% among men.”

Unfortunately, women suffer more from fibromyalgia than men. Approximately 75-90% of all people with fibromyalgia are women. They are 1.6% more likely than men to have it. Over 12 million people in the U.S. suffer from fibromyalgia and its cost–from missed day of work, lost productivity, and medical costs–may be as high as $14 billion every year.

Moreso, since this is a difficult condition both to diagnose and treat, the health care costs for somebody with fibromyalgia can be three times greater than individuals with other pain conditions, often due to the time and energy needed for diagnosis.

Women are also more likely to suffer from irritable bowel syndrome, migraines, neuropathic pain, and osteoarthritis. Women have also been shown to be more sensitive to pain, with lower pain thresholds and tolerances.

What is fibromyalgia?

Fibromyalgia is difficult to classify, because there are no identifiable causes of the disorder. It is characterized by widespread and chronic pain along with:

  • Sleep issues
  • Weakness
  • Fatigue
  • Cognitive problems
  • Depression

According to the American College of Rheumatology’s guidelines, fibromyalgia is diagnosed when a patient has:

  • A history of widespread bodily pain that has lasted for more than three months
  • Pain that is located in all four quadrants of the body
  • Pain in 11 out of 18 tender points on the body where muscles attach to joints, such as the shoulder blades or knees
  • Clinical symptoms that include fatigue, stiffness, depression, anxiety, tenderness, and sleep issues

How can you treat fibromyalgia? 

Once a person has a diagnosis, there are some treatment methods that can help. Often, a team of medical professionals will orchestrate treatment plans aimed at improving the overall quality of life of the person with fibromyalgia.

These fibromyalgia treatment plans often include the use of:

  • Medications, such non-steroidal anti-inflammatory drugs and anti-depressants
  • Physical therapy
  • Exercise
  • Chiropractic care
  • Alternative practices, such as yoga and biofeedback
  • Interventional procedures 

Fibromyalgia doesn’t have to be invisible. By making a point to discuss your pain with your doctor and those around you, you can begin to spread awareness about this difficult condition. Contact us today for more help with your pain.

How To Take Care Of Yourself As A Caregiver

As we talked about recently, caregivers face their own unique health challenges. Chronic pain caregivers, help is available to keep you healthy while caring for your loved ones. Here are some ways caregivers can take care of themselves.

1. Get connected

Several organizations, national and local, are devoted to caregivers and helping them with their needs. Organizations offer training, ways to take care of yourself, and can give you a feeling of connectedness when you’re feeling down.

Caregiver.org hosts an online support group and educational webinars and a video archive focusing on topics such as bathing techniques to avoid injury. Caregiver Action Network also offers a repository of information designed to make life easier.

Locally, there is a list of caregiver support groups in Nevada, provided by Caregiver.com, a magazine covering issues of concern to the caregiver community.

2. Ask for help

If you try to do everything yourself, you’ll need help too before you know it. Asking a friend or family member to step in for a day so you can catch a movie or spend some time alone helps to keep your spirits high. If you don’t have any friends or family available to cover for you, consider respite care.

Respite care allows caregivers to take a break of several hours or longer to catch up on chores, exercise, or enjoy much-needed alone time. Costs for respite care vary, but are sometimes available on a sliding scale.

3. Take care of your health

Exercise for 30 minutes, four days each week at minimum, recommends the American Academy of Family Physicians (AAFP). Exercising reduces stress, improves sleep quality, and supports health. Restful sleep is an important part of health. If caregiving demands make it difficult to sleep through the night, AAFP recommends napping when your loved one does.

Eating a balanced diet is also key, and healthy meals can be eaten with the person managing chronic pain. Keeping on top of physical exams and routine check-ups is also important to stay healthy and catch any health issues early.

4. Stay organized

Keep all doctors’ notes in a file and keep detailed records, including people you talk with on the phone regarding health care, researchers recommend. List keeping and knowing where to find information and needed items helps cut down on stress and makes you feel more in control.

What impacts has caregiving for a chronic pain patient had on your life? How do you manage? Do you need additional help? Contact our team at NVCPC today!

Caregivers Face Real Health Risks: Here’s What You Should Know

Helping the 100 million people living with chronic pain are an estimated 42.1 million caregivers, who in their supportive efforts are themselves at risk for injury leading to chronic pain, according to researchers at Ohio State University’s (OSU) Center for Clinical and Translational Science. Here’s what you should know.

What are caregiver health risks? 

The research from Ohio State University adds onto a body of knowledge that already shows caregivers are less likely to care for themselves by eating nutritional food and exercising, according to FamilyDoctor.org, the website of the American Academy of Family Physicians (AAFP).

The stress of being a caregiver can lead to increased risks for cancer, diabetes, anxiety disorders, and heart disease. When stress levels rise and time constraints grow, self-care can take a back seat to caring for a loved one. Fortunately, by making time for exercising and healthy eating, caregivers can avoid much of the health risks they face.

The impact of chronic pain is frequently discussed from the perspective of those experiencing it, couched in terms of diminished life satisfaction, lost job time, and increased medical bills. But OSU researchers interviewed 46 caregivers and found the true impact of chronic pain is much more far-reaching.

Increased rates of pain 

Chronic pain affects everybody—caregivers are at risk for becoming patients themselves, researchers discover. Nearly all the caregivers studied—94%—experienced some form of musculoskeletal pain during the study, researchers found. The lower back was the most common area of complaint, affecting 76% of people. Knees, shoulders, and wrists each affected 43% of study participants.

At highest risk for becoming part of the chronic pain statistics are the 14 million “high-burden” caregivers, defined as those spending at least 21 hours per week supporting those living with chronic pain. High-burden caregivers’ efforts frequently leave them with nagging shoulder, knee, or back pain. The helpers become patients. Ohio State occupational therapist Amy Darragh says:

“Almost all of the caregivers who participated in our study said they experience significant musculoskeletal discomfort related to caregiving activities, and that this discomfort can interfere with their ability to provide care, work, and participate in life activities.”

Increased risk of injury

In the study, 78% of caregivers said the pain prevented them from providing assistance. 66% said it affected their quality of life. Chronic pain caregivers find repetitive tasks leave them open to injury. This can result in diminished capacity to provide care and enjoy their lives.

Depending on the severity of chronic pain people experience, they may need help with anything from walking to dressing in the morning. Caregivers don’t have training for these tasks. This leaves them at risk for injury if done repetitively with improper form.

Tasks identified by caregivers as most difficult included transferring chronic pain patients from one place to another, bathing, helping them use the bathroom, walking up or down stairs, or rising from falls. When not performed with the proper technique, these tasks may lead to back or joint strain, according to the study.

Researchers tell the story of 67-year-old Margie, who helps her husband eat meals and navigate into or out of bed. She also pushes his wheelchair along the access ramp connected to their home. As a result, her back, shoulder, and knee continually bother her. This leaves both Margie and her husband unable to care for each other. Darragh adds:

“Interestingly, professional caregivers report similar experiences, but they have access to both training and technology that help them reduce their risk of injury.”

Conversely, informally appointed caregivers lack access to this crucial support, leaving them open to injury. Researchers hope to continue researching the specific activities that most commonly lead to injury and then identify ways to help caregivers avoid pain.

If you’re a caregiver, what challenges do you face? If you need additional support for managing yours or a loved one’s pain condition, contact us today.

What Is Stress, And Are You Suffering From It?

We talk a lot about stress in our culture. Many people are feeling the effects of stress-related illnesses. Our jobs and even our families can cause stress in our lives. But stress sounds like such a nebulous concept. What is stress for one person is not at all for another. Here’s how you can figure out if you’re suffering from stress.

What is stress?

So what exactly is stress and how does it impact our bodies? What is the real cause?

Anything that makes us feel overwhelmed, out of control, or that things are too much to deal with can be considered stress. Not all stress is bad. As humans we are programmed to feel stress as it makes us take action. This is how our ancestors survived before civilization. It is how we can work harder to pass a difficult exam or survive a hypothetical zombie apocalypse. However, when stress becomes an enormous burden, it can have opposite results. It can cause us to shut down, turn off, and tune out.

Stress is caused by stressors. These are the individual actions, events, or stimulus that causes a “fight-or-flight” reaction. The term stress specifically refers to the feeling we get when we are faced with an overly difficult challenge that we feel we can’t handle. Our experience with stress is coded into our DNA.

Symptoms of stress

When you are under stress you may feel the following things:

  • Increased blood pressure
  • Rapid breathing
  • Slow digestion
  • Fast pulse
  • Lower immune response
  • Tense muscles
  • Insomnia
  • Increased pain sensitivity and levels

Obviously, as chronic pain patients, it is extremely important that we learn how to control our response to stress. Stressful situations are going to happen, but how we react to them is what really matters. It could even reduce our pain in the future. The American Heart Association offers these suggestions:

  • Practice positive self-talk
  • Try out emergency stress stoppers
  • Find pleasure
  • Make time for daily relaxation

What causes you the most stress in your life and how do you handle it? If you need help managing your pain, contact us today!

Take Small Steps For Big Changes In 2019

It’s that time of year again: time to come up with a New Year’s resolution. Setting a goal can be a great way to make positive changes in your life. However, actually carrying out those goals once the daily grind has stripped away your motivation is an entirely different story. By looking at what science has to say about goals, habits and happiness though, you can give yourself an edge when it comes to following through on your resolutions.

Break your big resolution into smaller goals and habits

Let’s say you want to be healthier this year. That’s a great resolution, but it’s very broad and a little overwhelming. Research has shown that pursuing concrete goals is a much more effective way to increase happiness than encouraging abstract goals. For instance, you might have more success with a goal such as losing five pounds, rather than something as broad as simply being healthier.

An article at Stanford News explains:

“The reason is that when you pursue concretely framed goals, your expectations of success are more likely to be met in reality. On the other hand, broad and abstract goals may bring about happiness’ dark side — unrealistic expectations.”

With a concrete goal, you know when you’ve successfully met it, and you can celebrate. With an abstract goal, it can be difficult to judge when you’ve accomplished your goal.

Additionally, clinically depressed people tend to have more abstract or generalized goals, while non-depressed people often have clearly-defined, concrete goals. Because generalized or abstract goals are more difficult to visualize and realize, personal motivation can be negatively affected. According to a study conducted by researchers at the University of Liverpool, this may maintain or exacerbate depression.

Change your habits to 
support your goals

Habits are the result of associative learning. When you’re learning a response, you engage the part of your brain that supports working memory and the intentional mind. This helps you make a decision that takes your intentions into account. If you continually make that same decision in the same context, a shift takes place. You engage the part of the brain that supports cue response associations without retaining information about the goal or outcome.

Eventually, your decision-making will dwindle. Your brain will begin to associate the cue with the response. This means that when you’re presented with the cue for a habit, you do what you always do without considering why. Habits can function almost outside awareness.

This does not, however, mean that habits can’t be changed. Disrupt your old habit, insert a new behavior and repeat it until it becomes a new habit. For example, to disrupt a junk food problem, stop buying it or put it in a new, harder-to-reach spot in the kitchen. Have a different, healthier snack or action to stave off the mid-afternoon munchies. It might take a while for it to become routine, since forming a new habit can take anywhere from 15 to 254 repetitions, but eventually it will become just as ingrained as your old, bad habit.

Achieve your goals in 2019

One of the biggest ways to help yourself is to make realistic goals. Even breaking your resolution into smaller goals won’t help if it’s nearly impossible, like paying off all of your debts or losing a hundred pounds in a year. Set a goal that you can actually meet. When you’ve met or surpassed it, congratulate yourself on a job well done and set another goal.

What are your New Year’s resolutions for 2019?  

Adding Last-Minute Holiday Cheer To Your Season

It’s the very last minute, and in all of the gift-buying, gift-wrapping, teacher-gifting, and holiday dropping-in, you realize that your own home is, well, less than festive. Never fear. There are a few last minute touches you can add to make your home and your holiday merry and bright.

Candles

There is something about a house filled with candles that makes everything brighter. More than just light, candles bring a warm relaxing glow to each room. Select candles that have a natural holiday scent such as pine or cinnamon and engage all of your senses. You can also use LED battery-operated candles if fire is a concern.

Fire

In a similar vein, if you have a fireplace, use it. Even if you use a fire starter log or simply turn on the gas, a fireplace epitomizes a warm holiday feeling and sets a holiday tone.

Family traditions

Adding a new family tradition to the holidays is easy: pick one, and get it going. Many families start off the holiday season by popping popcorn, making hot chocolate, and watching a holiday movie. Classics like It’s a Wonderful Life are always good, as are more recent movies like Elf and A Christmas Story. You can use this as a weekly family wind-down on Friday nights, or bring a frantic weekend to a close with Sunday night movies in pajamas.

Fresh greens

Did you forget to decorate your home? Are you allergic to tinsel or any other type of artificial cheer? Visit your local Christmas tree lot and ask them for some of their trimmed greenery. Twine it around banisters, use it as a runner down the center of your table, or place it on a mantel or hearth. You can include pinecones in your décor, adding a few drops of cinnamon essential oil to bring more fragrance to your home.

Fragrance on lights

A drop of essential oil on the light bulbs in your house will quickly fill each room with holiday fragrance. Refresh as necessary, but just one drop at a time. This only works on traditional bulbs that get warm.

Bake cookies

Grab the kids and bake some cookies, for Santa, the neighbors, or yourselves. Try a festive cookie recipe, or give candy-making a try. Or be adventurous and try tto host a cookie swap (and then renew your gym membership!).

Make a gingerbread house

You can buy a kit from your local grocery store, or follow the steps here for a DIY-gingerbread house. Other ideas include making mini gingerbread villages with graham crackers.

Reflect

The holidays can be a difficult time for a number of reasons. Maybe you have lost someone close to you, or you or a loved one are fighting a chronic illness. Maybe you are just tired from so much activity or pressure to be constantly feeling joyful.

Take a moment on your own to relax, recline, and reflect. It doesn’t need to be much: a cup of tea, a quiet, comfortable chair, a journal, and you. Write down what you are grateful for and make plans for the coming year. Look forward and back at the same time, and be restful in the present. This brief time-out may be just what you need to rejuvenate your spirit and mind.

Sing and dance

Do you have a colossal collection of carols? An overflow of holiday standards on vinyl? Play your holiday music and sing along. Get up and dance. Take lots of pictures.

Make an elaborate breakfast

Food instantly connects family, and who doesn’t love to eat a leisurely breakfast late in the morning? Now that we are so busy with activities and appointments and homework later in the day, breakfast might be the perfect place for a family meal. Make overnight French toast and serve it with fruit, yogurt, breakfast meat (vegetarian options, too!), and plenty of coffee and juice. Ban all electronics and start your day together.

Volunteer

Giving is good for your health. Study after study shows tangible health benefits to giving, either as a volunteer or with money or material goods. Take a moment when you feel way to busy to do one more thing, and try one of the following easy donations:

  • Give food: Pick up some extra food at the store during your weekly shopping trip and take it to a local food pantry. Many stores have bins to collect food and will take it for you! Food pantries need not only canned goods and things like dry pasta, peanut butter, and tuna, but they also need toiletries, diapers, feminine hygiene products, and socks. Give what you can. It all adds up.
  • Give blood: Blood banks experience critical blood shortages during the holidays. One pint of donated blood can help up to three separate people. Donating blood takes about an hour (even though the actual donation only takes about ten minutes).

Pay it forward

This is a quick and easy way to make someone else’s day bright with no extra effort. When you buy a coffee or food at drive-thru, or even in person, pay for the person behind you. If you want to do it for more than one person, buy a gift card in a set amount (say, $25) and tell the cashier to use it until it is gone on the people who come through after you. This is a selfless act of kindness that could very well change someone’s entire day.

When the holidays make you more “Bah, humbug,” than “Ho, Ho, Ho!” how do you turn yourself around? Consider your last-minute secrets to holiday cheer.

Pain Management Clinic Las Vegas North

Nevada Comprehensive Pain Center Las Vegas, North Location

COMING SOON!

1610 E. Lake Mead
North Las Vegas, NV
89030

 

Pain Management Clinic in Las Vegas North Map

James A. Boesiger, DMSc, PA-C, CPE

James Boesiger DMSc, PA-C, CPE. has been practicing medicine for over 30 years and has a passion for pain and headache management. After graduation from Lake Erie College PA program, he completed his Master’s degree in sport medicine graduating from the United States Sports Academy, with honors. He spent about 20 years working in emergency medicine throughout Central and South Florida and during this time he was also an Assistant Professor at Nova Southeastern University’s PA program. While on faculty there, he was “Teacher of the Year” two years in a row with another “outstanding teacher” award his final year there. He has also been an instructor at Barry University and guest lecturer at Touro University in Las Vegas, lecturing in pain management and other medical topics.

In 2005, James became interested in pain management and moved to the Las Vegas Valley to begin a new chapter in his long career. Through the American Society of Pain Educators (ASPE), he became one of Nevada’s first “Certified Pain Educators” (CPE) in 2006, and was credentialed as a “Credentialed Pain Practitioner” by the American Academy of Pain Management in 2007. Furthering his education in headache medicine, he passed a board exam to earn a “Certificate of Added Qualification” (CAQ), in 2016 through the National Headache Foundation. PA Boesiger is well known for his lecturing and teaching qualities and has given talks/speaker programs from locations throughout the United States from Hawaii to Manhattan. He has been a speaker and or consultant for over a dozen pharmaceutical products and has served on Pain Advisory Boards for companies such as DepoMed, Daiichi Sankyo, and Bioventus and was invited to address the entire Collegium Pharmaceutical sales force at their national meeting in Phoenix Arizona.

Mr. Boesiger is well versed in pain medicine and headache management but also has significant experience in such conditions as fibromyalgia syndrome and integrative medicine. Demonstrating his passion for life-long learning, he completed his Doctorate of Medical Science (DMSc) from Lynchburg College, Virginia in 2018. As part of his Doctoral degree, his research project and scholarly paper was on “Stigmatization of People in Chronic Pain” which reveals his unique perspective and understanding of those who suffer from chronic pain conditions.  PA Boesiger frequently includes famous quotes from philosophers, theologians and bioethicists in his talks but his favorite quote is from Elaine Scarry in her book, The Body in Pain. She writes, “To have pain is to have certainty, to hear of someone else’s pain is to have doubt.”

Allison Zieglmeier, FNP-C

Allison Zieglmeier, FNP-C, was born in Ohio but raised in Southern California. Her family history is well rooted in the healthcare industry. Her grandmother, great aunts, and great uncles were all medical providers avidly serving their community during the time of segregation. Her father is a practicing physician of over 50 years who also served 21 years in the U. S. Air Force. Her mother is a homemaker who has volunteered at many institutions that provided services to the underserved population. Her parents instilled in her the importance of gaining an education and serving the community with the emphasis of providing for those who do not have adequate access to healthcare services. Throughout her younger years, volunteering at her father’s clinics and assisting her mother with volunteering in the community, her interest in healthcare grew.

Allison graduated from Nevada State College with a Bachelor of Science in Nursing degree. She practiced as a Registered Nurse specializing in pain management with hospice and palliative care for over 10 years. Her dedication and hard work were recognized by the March of Dimes in 2008 where she was presented the March of Dimes Nurse of the Year award for Hospice Nursing, Home Health, and Palliative Care. With the passion to be able to provide a higher level of care, she furthered her education and graduated from National University with a Master of Science in Nursing degree, specializing in Family Nurse Practitioner. Allison also graduated from Fisk University with a Bachelor of Arts in English because of her love of reading and writing. During her free time, she likes to read and write non-fiction, fiction, and poetry, travel, exercise, and spend time with her family and friends.

Allison is a member of the American Academy of Nurse Practitioners, Nevada Advanced Practice Nurses Association, American Pain Society, and Sigma Theta Tau International Honors Society of Nursing.