20 January 2009

Tonight's House M.D.

----I can't put posts below the fold with blogger so please stop reading if you haven't seen it----

So, I cringed just slightly when I saw that tonight's episode of House M.D. involved a patient with undiagnosable chronic pain. I know it's just a TV show. But my nerdiness won't allow me to avoid comment....

And, as per usual, at least in the way they were described, the partial theories of what his affliction might be were rather dodgy. But whatever. Here's my nerdy question: wouldn't the symptoms have been alleviated earlier in treatment?

The final diagnosis was some weird form of epilepsy that 'rewired the pain neurons of certain areas of the brain'. But nowadays several anticonvulsants (at least atypical anticonvulsants) like Neurotin, Lamictal, and friends,are commonly used relatively early in treating all sorts of chronic pain.

And, in many cases, treatment for chronic (or severe acute) pain includes benzodiazapenes like Lorazepam, which also have anticonvulsant properties.

Finally, if they had really suspected that the problem was opiate-blowback, wouldn't House's team have used at least some of the above in tandem with the Naloxone to alleviate the suckiness of flushing the opiates from the patient's system?

Okay. I know. Just a TV show. Back to regularly scheduled programming...