Word: palmer
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Donors choose to remain unnamed for two main reasons, says Stacy Palmer, editor at The Chronicle of Philanthropy: privacy and security. She adds that "these are also people who regard it as the most pure form of giving." Feeney disclosed his generosity when a 1997 lawsuit threatened to make his finances public. But Healy says part of the decision to go public was also rooted in an industry-wide desire for greater transparency. "There is a lot of concern about conflicts of interest," says Lenkowsky. "Placing an emphasis on accountability means that anonymity is less likely to be encouraged...
...Studies have shown that patients who use a multidisciplinary program do better than patients who take medications only," says Dr. Pamela Palmer, medical director of the pain-management center at the University of California, San Francisco (UCSF). "The anxiety, the depression, the hopelessness that come with chronic pain really all have to be addressed"--as do the loss of mobility, hypersensitivity to touch and other effects that can destroy the quality of life. "It's not as if you can just take an anti-inflammatory drug and all those problems go away." To pain specialists like Palmer, the hand wringing...
...that contributed to the COX-2 fiasco--but pain experts try to carefully match the drug to the type of pain, the patient's risk profile and even his or her personality. "A patient's psychological preference for treating pain can be more important than the amount of medication," Palmer says. She cites the case of an elderly woman with arthritis in her back who preferred taking the oral narcotic Vicodin to using a more potent opioid drug delivered through a patch. "The Vicodin wasn't nearly as powerful as the opioid patch," says Palmer, "yet it gave her more...
...from a psychological perspective: the fear of reinjuring something." Getting the patient to move--or, better yet, exercise--not only restores function and raises spirits, it also prevents the cascade of health problems that stem from paralyzing pain. "If you're lying in bed all day," explains UCSF's Palmer, "you're going to have more problems from a cardiac standpoint, a pulmonary standpoint and a mental-health standpoint...
Although high-profile cases of addiction to OxyContin and other opioid pain-killers have scared off many doctors and patients, such drugs have an important role to play in chronic pain. They are particularly useful, says Palmer, for elderly patients, many of whom can't tolerate the side effects of anti-inflammatories. Younger people develop tolerances to opiates more quickly than the elderly, says Palmer, which means the young wind up needing ever higher doses. That is not a big problem in older patients. "I like to use low-dose opioids in the elderly because there aren't any liver...