Thursday, March 22, 2018

Guest Post from Jordan Fersel, author of When Bad Backs Happen to Good People

Title: When Bad Backs Happen to Good People
Author: Jordan S. Fersel, MD
Publisher: iUniverse
Genre: Medical
Format: Ebook

Chronic back and neck pain is a thorny issue that plagues millions living in today’s modern world and has the power to take over a person’s life—not just physically, but also psychologically, emotionally, and physiologically. The good news is that there are effective ways of dealing with chronic pain that allows patients to return to a productive life without undergoing unnecessary surgery. Dr. Jordan Fersel is a board-certified pain specialist who relies on his diverse professional experience to distinguish the differences between acute and chronic pain, scrutinize the accuracy of an MRI scan to diagnose pain, examine the architecture of the spine, explain nerve injuries, differentiate between the various types of arthritis, and offer potential treatment options. Through included case studies and illustrations, pain sufferers will learn there is hope for managing pain through proper diagnosis and a treatment plan tailored to treat individual needs. It’s Not All in Your Head shares guidance from a trusted physician that explores chronic back and neck pain, its sources, and the many treatment options available.


In her passionate and compassionate article of 11/15/17, "The Death of Pain Management" ,Janice Reynolds, a retired pain management nurse, places her finger with precision on the pulse of what ails the field of pain management. It does not seem at this point that the opioid crisis is the direct resultof doctors over-prescribing narcotics, most doctors I know are afraid to prescribe pain killers for the fear of being sanctioned, fined, or having
their medical license revoked.

When a patient comes to a doctor, it is common that acute pain is the primary complaint. We are used to trying to identify and treat the cause of pain, which in many cases is an indicator of something more serious, but not always. There is a triage system in each physician's mind as to the seriousness of the message of pain. While sometimes we may over-react, but in my mind, the best physicians ask themselves, "what is the worst thing 
that this pain can indicate" and act accordingly. We all know the old adage, prepare for the worst, but hope for the best, and with regard to acute pain that is a 'best practice' in medicine.
But what about the patient that has sustained a work or motor vehicle related injury, has arthritis or any autoimmune disease or chronic infection who complains of long-standing pain that does not go away and that has not responded to conventional medical treatments and interventions?

I can tell you that traditionally, it has been difficult to find a physician willing to treat these chronic pain patients. The reason for this is that these patients do not fit into traditional Western medical models of cause and effect, stimulus and response. There may still be pain despite reducing a fracture, and there might still be severe
back pain following an injury with normal MRI results. And there may even be patients will horrible looking spines on MRI who complain of no pain. And patients have the right to complain when there is severe pain. And physicians or government officials or politicians, or DEA agents are not able to feel this type of pain unless they are unfortunate enough to become chronic pain sufferers themselves. And there is no reliable way for the physician to differentiate between those who have real chronic pain and those who fake it in order to gain access to narcotics, except possibly by examining their behavior. 

So let's say the doctor refuses to believe that the patient has chronic pain. Two options exist for the patient. Find another physician, perhaps more sympathetic than the first. 
But the new doctor may not really understand what is causing the pain either, it's just that he believes the patient when he says it hurts and it doesn't go away. And if you can't find a doctor to prescribe you pain medicine, you may come to believe that it is all in your head, or more likely, attempt to purchase painkillers on the street, because they are out there...

What happens to chronic pain patients that self-medicate? Well, they may just feel better, but more likely they will use too much of the narcotics, and this will result in all types of complications from constipation to physical and psychological dependence, to respiratory depression and death. This group is taking dangerous medications with no medical oversight.  And that group of self-medicators is growing larger by the day because physicians are simply not willing to lose their hard earned licenses to help a chronic pain patient in need of relief. At least not when there is a tsunami of law enforcement, government officials and even other doctors waiting outside the office door so that they can free society of the 'offensive' pain medication prescriber. And more and more patients then seek relief on the streets, where dangerous and potent impurities such as Fentanyl may be mixed in to the narcotics causing overdose and death.

The reason this article by Janice Reynolds is so powerful is because she recognizes that the challenge here is not only the over-prescribing of opioids. No, patients overdosing is the result of the real crisis not it's cause. If you don't define a problem properly, you will never solve it. What is the real problem we should seek to resolve? What is the war that needs to be waged if  the War on Drugs is not the right war? Simply put, what we have all been missing, but what Janice Reynolds understands, is that it is the War on Chronic Pain that needs to be waged. And how is this war to be waged?
  • Better understandings of the mechanisms of chronic pain. What are the patterns and concepts that will support the often contradictory facts that the physician is confronted with? Can we develop simple models of why chronic pain is occurring based on our knowledge of physiology, anatomy, radiology and pharmacology and in the future, molecular medicine? Can clinical research deliver the answers or will basic research or some combination of the two? How can we deal with placebo effects and lack of randomization in our search for answers? Will we ever be able to objectively measure pain as 'outsiders' relative to the pain sufferer? How much of suffering from pain is related to the psychological state, and what is the relationship between the two?
  • Once we have some answers, (and they can even come by trial and error or observation and become 'best practices') some understanding of mechanisms that fit with our understanding of neuroscience and medicine, we can try evidence-based therapies. It is clear that narcotics produce some effect in terms of pain processing in the brain, because otherwise they would not be in such great demand by pain sufferers. Can marijuana produce similar benefits without the side effects? The jury is still out on that one, but I suspect the benefits will be limited. Can we find other treatments that will effectively treat chronic pain by decreasing inflammation in the body and enhancing the body's ability to heal itself. I think the field of Regenerative Medicine may hold some crucial answers.
  • Once we have some useful solutions that provide real relief, then education becomes the key. Every physician needs to have a working knowledge of how chronic pain works. Who will teach this to medical students and doctors and how much time will be spent on becoming proficient in the understanding of chronic pain?
  • There will always be an element of society that is attracted to the psychological effects of medications that alter the central nervous system. These individuals are not the same as chronic pain patients! Hopefully, with better measurements and models of chronic pain these two groups will become differentiated. Right now they both seek the same medications, but for different reasons, and that is fuel that is powering the opioid crisis. It is not only the province of law enforcement or government to distinguish between the two, but hopefully for all our benefits, law enforcement will work together with physicians to identify the individuals that help fuel this crisis.
In my book, When Bad Backs Happen to Good People, I have started to open the discussion of some of the mechanisms of chronic pain so that we will begin to find useful solutions in the near future.

J. Fersel, M.D.

Jordan Fersel, MD, is a board-certified, pain-management fellowship-trained physician who earned a BA in biology from Queens College and an MD degree from Mount Sinai School of Medicine. He has been director of Pain Management Services at Trinitas Medical Center Oncology Unit for several years. Dr. Fersel and his wife, Esty, divide their time between Philadelphia and West Orange, New Jersey. 

Monday, March 19
Guest blogging at Inkslinger's Opus

Wednesday, March 21
Interviewed at Review From Here

Thursday, March 22
Guest blogging at The Literary Nook

Monday, March 26
Book reviewed at The Dark Phantom

Tuesday, March 27
Guest blogging at Bent Over Bookwords

Wednesday, March 28
 Book reviewed at A Title Wave

Thursday, March 29
Guest blogging at As the Page Turns

Monday, April 2
Book reviewed at I'm Shelf-ish

Wednesday, April 4
Book reviewed at Splashes of Joy

Thursday, April 5
Interviewed at The Writer's Life

Friday, April 6
Guest blogging at All Inclusive Retort

Monday, April 9
Book reviewed at Voodoo Princess

Tuesday, April 10
Guest blogging at Queen of All She Reads

Thursday, April 12
Book reviewed at A Book Lover

Friday, April 13
Book reviewed at Room With Books Reviews

Wednesday, March 21, 2018

Featured Book: When a Stranger Karen S. Bell

WHEN A STRANGER COMES by Karen S. Bell, Thriller, 224 pp., $12.00 (Paperback) $2.99 (Kindle edition)

Author: Karen S. Bell
Publisher: KSB Press
Pages: 222
Genre: Thriller

Achieving what you crave can also bring the terrifying fear of losing it. For Alexa Wainwright, this truth has become her nightmare. Born Gladys Lipschitz, the daughter of an unwed Soviet-era Jewish immigrant, her debut novel, A Foregone Conclusion, soared to number one on the bestseller’s list and became an international sensation. The accompanying fame and riches were beyond her expectations. Unfortunately, her subsequent work has yet to achieve the same reception by critics and readers. Yes, they have sold well based on her name recognition, but she dreads the possibility of becoming a mid-list author forgotten and ignored. She vows to do whatever it takes to attain the heady ego-stroking success of her debut. But is she really?

Witnessing an out-of-the-blue lightning bolt whose giant tendrils spread over the blue sky and city streets below her loft window, Alexa doesn’t realize just how this vow will be tested as she’s magically transported to an alternate reality. In this universe, the characters from her books are given the breath of life and she meets publisher, King Blakemore, who just might be the Devil himself. At first, she shrugs off her doubts about this peculiar publisher and very lucrative book deal offer because the temptation of riches and refound fame is too strong. But all too soon, Alexa realizes she’s trapped in an underworld of evil from which she desperately wants to escape. For starters, she finds herself in an iron-clad book contract that changes its wording whenever she thinks of a loophole. Desperate to get her life back, she devises schemes to untether herself from this hellish existence. She’s also aided by the forces for good who attempt to help her. However, King Blakemore is cleverer and more powerful than she can begin to understand. Playfully, he decides to give Alexa a second chance to save herself from eternity with him and to be free. He offers her the prospect of a rewrite, as most authors do as part of the writing process. Given this chance, will Alexa make the same choices and the same mistakes again?

Alexa, as the MC, is relatable, likable, and vulnerable with a keen sense of humor. Her world is very small because writing is her life and so she is an easy target for entrapment. Her pact with the Devil is an allegory for the evil lurking in our midst. The social decay of modern society with its excessive greed, the ignorance of our political leaders, and our indifference toward the survival of all species from the effects of climate change, among other environmental pressures, are perhaps brought forth by the darkest forces of human nature.

When A Stranger Comes is available at Amazon.

Order Your Copy!

When she opened her eyes, it had taken Jodie a moment to realize she was lying on the living room floor. Automatically checking her wristwatch that now had a cracked plastic face, she saw that she had been unconscious for about 20 minutes. She was alone. That was good. There was blood all around her. That was not good. It had been difficult to get up and walk, but she needed to see the damage and tend to her wounds. Shuffling over to the front door, she engaged the deadbolt just in case he decided to come back. Usually, after one of these brutal fights, he stayed away for several hours getting so drunk that his rage turned into remorse.
            She turned on the bright florescent lights and looked in the bathroom mirror. What she saw was so shocking that she stared at her image in disbelief. Her left eye was swollen shut and the surrounding skin was dark purple. Her bruised and battered lips were swollen, cracked, and caked in blood. Two teeth were missing right in front giving her face the frightening hint of the homeless beggars she saw sleeping in the alleyways and picking through garbage. It hurt to keep her pummeled mouth open but her broken nose made breathing difficult. The metallic taste of blood oozing on her tongue and dripping down her throat made her gag. Her chafed skin, where his fists pounded on her chest and neck, was achy and throbbing. Gaping sores, almost to the bone on her arms and legs, were from where he kicked her with his heavy work boots after he knocked her down. Their exposure to the air or where they contacted her torn clothing stung as if touched by a hot poker. Ugly, chilling mementos of his snarling, wild-eyed mania as he bashed her again and again.
            With shaky hands, she turned on the water and noticed her swollen black and blue knuckles most likely from when she punched him hard in his face. She moistened a hand towel and carefully brought it to her eyes. The warm compress felt good and she stood like that for several minutes until a wave of nausea hit her. She grabbed for the sink feeling dizzy and broke out in a cold sweat. You fucking bastard, I hope I punctured your eye and scratched all the skin off your face! For a split second the horror of that fight gripped her again and she swallowed hard, her bloody saliva choking her. Trying to take deep breaths was excruciating, so she took quick shallow puffs of air in an effort to calm herself, but her heart was racing and pounding like a drumbeat in her chest. Focusing on her wounds, she tried to regain her composure as she gingerly washed the blood off her face and body but kept dropping the wet towel in the sink.
            And then the doorbell rang.
            She froze, as a spontaneous paralyzing fear shot through her. Quickly, she turned off the water silencing any noise. Maybe whoever was there would go away if they thought she wasn’t home. No one can see me like this. Then the banging started and for one frightening second she thought he had come back, angry that she bolted the door. “I know you’re in there.” It was Kerry, her next door neighbor. She hadn’t realized she was holding her breath until she started breathing again. “Are you okay?” Kerry yelled. “I almost called the police. Open the door and let me in. You might need to go to the hospital. Jodie? …Jodie?” Then she got annoyed. “Suit yourself.” And the yelling, banging, and doorbell ringing stopped.
            Waiting a few minutes until she thought it was safe, Jodie came out of the bathroom and sat on her bed. She looked at her packed suitcase, the empty threat that had started this most recent vicious confrontation. No more. Now she was certain. She had to leave. To get out of there. Right now. He used his fists on her…again. He had kicked her...hard. Next time he might kill her. Beaten to death. Another homicide in this godforsaken white trash part of town. Why am I so stupid? Why have I stayed with this guy? I thought we had something, a future. Said he was so sorry the last time. Said he loved me. Said he’d never hurt me again. Lying scumbag!
             She left without so much as a goodbye note. Why would he care anyway? The prick. But before she walked out, her wounds opening anew, her blood dripping on everything, and her hands trembling, she poured the remaining whiskey in the 2-liter bottle on the crappy sofa. Her rampage gaining momentum, she bashed the flat-screen-52-inch-TV with the empty bottle knocking it off its stand, causing it to crack in several places. Nearly passing out again, she managed to smash all five bottles of his precious booze on the cheap linoleum floor. Shattered glass flew everywhere making the whole room a minefield for bare feet. Good! I hope he comes home in the dark and walks on this in the morning.
            Her frenzy in full froth, she wobbled into the kitchen. Every dish crashed to the floor. Wine glasses. Crash. The pretty porcelain candlesticks they bought at the fair. Crash. Holding on to the kitchen counter to gain some strength before she grabbed her suitcase still on the bed, she found scissors in one of the drawers. Stumbling over to his closet and then his dresser, she cut up his shirts and pullovers, scissored the pant legs off his jeans, and clogged their bathroom toilet with his underwear. As an afterthought, she slashed the mattress, gouged the feathers from the comforter, cut the foam in the pillows into wedges. With a final relish, and gathering up all her remaining might and power, she slammed his laptop against the wall.
            Then she hobbled as fast as she could. Threw her suitcase out the door and onto the pavement, it being too awkward to carry in her condition while negotiating the few stairs. Luckily, her car was parked close. Easing herself into the driver’s seat, her lacerations making her wince, she stepped on the gas and left town, calming down only slightly when the trailer park was out of range of her rear view mirror. She did not speed. She did not want to get pulled over looking like someone’s punching bag. At least she could see okay out of her good eye. Driving carefully, she took the highway heading north. Anywhere but here. Any town but this. Another ending, another lonely drive to nowhere…and then a sliver of hope. Always that sliver of hope. A new beginning. A fresh start. I’ll figure things out. Be smarter. And finally get it right. Yeah, this time, I’ll get it right. Find a decent guy with a good job. Find a guy who doesn’t drink. Find the life I’ve always wanted.

When a Stranger Comes…is Ms. Bell’s third novel. Her debut, Walking with Elephants, was initially published by a small publisher who went out of business. Subsequently, she took over as an indie publisher. It went on to win the Awesome Indies Seal of Excellence and was a top-five finalist in the Kindle Book Review’s 2012 contest for the best indie books. Sunspots, her second novel, was awarded the Seal of Approval for good writing. She holds a Master of Science in Mass Communication and for 15 years, she was an editor/copyeditor for a “Big Four” public accounting firm. Ms. Bell was also technical editor for an accounting industry magazine.
Here are some reviews of her previous work published in the Florida Times Union:




Monday, March 5, 2018

Book Blast: Sgawwrath by Sarah Kennedy - Win a $25 Gift Card

Title: Sgarrwrath
Author: Sarah Kennedy
Publisher: XlibrisUS
Genre: Fantasy
Format: Ebook

The Flame is the most mysterious and powerful entity in the universe. Even the Guardians, in whose hearts Flame burns, who breathe and wield its power, have never seen its Source nor harnessed its full potential. They are content to serve the Light. Arawn is not like the others. He is young, untested, and he seeks more power though a prophecy reveals the predominance of the Flame belongs to another. Arawn is easy prey for Sgarrwrath who lures him into Darkness to corrupt Arawnís Flame to his will. His brotherís, three powerful, incorruptible Guardians refuse to abandon hope. They journey into Darkness, how far will they go to save him?

I have always loved to write stories and was blessed with wonderful parents who still encourage me to follow my dreams. To hone my craft, I have taken courses through the Institute of Childrenís Literature and Long Ridge Writerís Group. In 2005, I was published in Angels on Earth, and in 2011, I published my debut novel, Sgarrwrath, Prequel to the Prophecy of Hope, which recently received an Honorary Mention in the Halloween Book Festival Competition of October 2013. Today, I live quietly in a small town with my three rambunctious cats.   



Terms & Conditions:
  • By entering the giveaway, you are confirming you are at least 18 years old.
  • One winner will be chosen via Rafflecopter to receive one $25 Gift Certificate to the e-retailer of your choice
  • This giveaway begins February 26 and ends on March 9.
  • Winners will be contacted via email on March 10.
  • Winner has 48 hours to reply.
Good luck everyone! 


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