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Patients at Pittsburgh hospital can enter opioid-free pain management program

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Patients at Pittsburgh hospital can enter opioid-free pain management program


PITTSBURGH (KDKA) — For the first time in western Pennsylvania and possibly in the nation, patients at a local hospital can choose not to be given opioids before, during and after surgeries.

Inside UPMC Shadyside Hospital, doctors are taking a unique route to managing surgical and post-op pain in some patients to help prevent opioid use disorder.

Dr. Shiv Goel, chief of anesthesiology and perioperative medicine at UPMC Shadyside, said the whole team at the hospital worked to launch its opioid-free pathway in May in response to patient demand. 

“We had been seeing a lot of patients coming into the hospital for surgery asking specifically not to use opioids for their pain management. And so far, there was never any defined pathway that existed that would ensure that a patient who’s making such a request gets that option and that request is honored. For the first time, this gives the power to the patients to choose the type of pain medications they want to take for managing their pain,” Goel said.

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For surgical pain, they use regional anesthesia, nerve blocks, local anesthesia or non-opioid IV medications.

For post-op pain, in addition to meds, patients can also choose from techniques like aromatherapy, acupuncture, hypnosis, music therapy and biomedical devices. The doctors help to address anxiety, which contributes to pain.

“All of that does tie into decreasing how they perceive their pain. If their anxiety goes down, they perceive pain less,” Goel said.

Amy Hartzer had a partial mastectomy for breast cancer last month.

“I’ve heard it’s as bad as dental surgery and people getting hooked on opioids. I thought, yeah, there’s an opioid-free pathway, sign me up,” Hartzer said.

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Hartzer was happy to have control over her pain management, especially because she’s starting chemo in a few weeks. She didn’t want to have more complications.

“I actually had a nerve block, and the doctor explained what that would be like. And I have to be honest, I’m glad I went the opioid-free because had I not and they would have given me opioids, it would have been for no reason. I was never in a lot of pain,” she said.

Patients wear a special bracelet and stickers are added to charts so everyone is on the same page with their pain management plan.

Lead coordinator of the opioid-free pathway at UPMC Shadyside Heather Margonari says patients can opt out at any time. She said 39 patients have enrolled in the pathway in just over two months.

“Some of them do have a family history of addiction, and some of them have addiction use themselves. But there are also a lot of people that have had these opioids in the past and have had bad reactions to them with side effects,” Margonari said.

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They hope this one-of-a-kind approach can prevent people from feeling the pain of opioid use disorder.

“Patients seem to be much happier on the pathway. They’re definitely more alert. And I think they also feel empowered that they’re choosing to do this opioid-free, and their wishes are being followed,” said Margonari.

“That is a problem which has been created by the health profession itself. There was a time when we started calling pain the fifth vital sign. We created unrealistic expectations for our patients. .. I think we owe it to ourselves and our patients and to our country to try to right this wrong, which was being perpetuated on all our patients,” Goel added.

People interested in learning more about this opioid-free pathway can reach out to the team at UPMC Shadyside.

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Pittsburgh’s new 2026 budget is approved, with nearly $30 million in realigned expenses

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Pittsburgh’s new 2026 budget is approved, with nearly  million in realigned expenses






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From ‘Steel City’ to ‘eds and meds’: As Pittsburgh welcomes NFL Draft, it isn’t so easily defined anymore

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From ‘Steel City’ to ‘eds and meds’: As Pittsburgh welcomes NFL Draft, it isn’t so easily defined anymore


When a Pittsburgh sports team appears on national television, it’s a sure bet that one of the commentators will refer to the team’s hometown as “the Steel City” in one way or another.

But even as the Steel Curtain defense was helping propel the Steelers to the first of four Super Bowls in the 1970s, the industry for which it was named was well into decline.

“It’s been nearly 40 years since the nadir of job destruction in the wake of heavy industry,” said Chris Briem, a regional economist at the University of Pittsburgh’s Center for Social and Urban Research. “The peak of those steel jobs was probably in the 1950s, honestly.”

Sportscasters will inevitably use the nickname when the NFL Draft sets up shop in Pittsburgh from April 23-25.

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But if Pittsburgh isn’t “the Steel City” anymore, what is it? What drives the economy and culture at the confluence of the region’s three rivers these days?

It may be tempting to look to the relatively simplified “eds and meds” shorthand of recent years. The region’s universities and health care systems certainly have beefed up their presence across the city’s footprint. But Briem, whose book “Beyond Steel: Pittsburgh and the Economics of Transformation” was released in February, said there is no one industry that has supplanted steel in the region.

And that’s probably a good thing.

A steel-dominated city

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“The book documents that we were a steel-dominated, steel-dependent region for a lot longer than we should’ve been,” Briem said. “I think the nature of us having multiple generations all connected to the steel industry was really infused into the culture.”

As steelmaking went away, civic and business leaders sought something to replace it.

“The short answer is, nothing has really replaced the steel industry, and nothing really will,” Briem said. “The conditions that made this such a dominating place to produce steel won’t be replicated here or anywhere else.”

During the Industrial Revolution and again during World War II, the navigable waterways that formed Pittsburgh’s footprint, and the Pennsylvania Railroad’s former dominion over regional commercial transportation, created the perfect conditions to turn the city into a steelmaking juggernaut.

But that production likely peaked more than a century ago, during the 1920s, Briem said.

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“It was really downhill after that, and it’s mostly accidents of history — the Great Depression, World War II — that extended its importance and made it seem as though it wasn’t in decline.”

The final steel mill within the city limits closed in 1998. Today, steel jobs in Pittsburgh proper are limited to office staff at the U.S. Steel headquarters Downtown, and that is primarily the result of its recent merger with Japan-based Nippon, further illustrating that the one-time American industrial titan has reached the point where it needed a partnership to survive. The only production facilities remaining in the region are in Braddock and Clairton.

Identity

As the Steelers were cementing their legacy as the greatest NFL team of the 1970s, the notion of Pittsburgh as “the Steel City” began to be replaced locally with the “City of Champions” moniker, says Anne Madarasz, chief historian and director of the Western Pennsylvania Sports Museum at the Heinz History Center.

“Out of that evolving dark time when steel was shutting down, you got this sense that while the city’s pride might not be on the front page of the paper, it was there in the sports section,” Madarasz said.

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The advent of “Steelers Nation” — the notion that no matter where you went in America, you could find a few Steeler fans — is directly tied to the death of steel.

“ ‘Steelers Nation’ was really created by the outflow of people from the region as steel was declining and our sports franchises were rising,” Madarasz said.

Michael Glass, director of urban studies at the University of Pittsburgh, said that following the region’s population dropping by several hundred thousand between 1970 and 1990, it is still largely trying to find its identity.

“We had coal, coke, steel, iron, glass, all of this manufacturing stuff,” Glass said. “It was easy for communities to understand their role in creating the region’s wealth — coal miners, steel workers, barge pilots. But after de-industrialization in the ’70s and gut punch after gut punch, we’re still struggling to sort of find a narrative to move us along.”

Glass said “eds and meds” only describes a small piece of the region.

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“It doesn’t describe the kind of economy where you could make a life for yourself the way you could with the good, often union-related jobs you had as part of that broader industrial complex that kept the region going for 150 years,” he said. “If you look out into Fayette County, eds, meds, steel — none of it matters with the level of disinvestment those communities are still fighting against.”

Despite the population decline in the wake of the steel industry, Pittsburgh has grown in many areas.

“When you look at the city today, there’s not just a single answer,” Briem said. “This is a much more diverse economy than it probably has ever been.”

Diversity

The seeds of today’s diversity began growing more than 100 years ago, Madarasz said.

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“Pittsburgh has been able to reinvent itself a few times over history,” she said. “Back in the 1920s and ’30s, the creation of the Mellon Institute took the power of Pittsburgh’s universities and combined them with industry to create this center of innovation for the future. The government invested in nuclear energy through the work of Westinghouse.”

Even the abandoned industrial properties left in the wake of steel’s collapse are seeing a second life in many cases — the former Homestead Works is the site of the Waterfront shopping center, and Hazelwood Green sits atop the former J&L steel property.

Tech companies also have found an upside in some of the region’s former industrial sites.

“AI companies are looking for space to build data centers, and we have old industrial sites they’re finding that are very suitable for that,” Madarasz said.

Glass said some towns have cast a skeptical eye toward such proposals.

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“You see some suspicion in these communities where people are asking, ‘Is this going to be a benefit to me, or is it going to take the water, take the energy, drive my energy costs up and not benefit my kids?’” he said.

Technology of a different kind has taken root primarily through Carnegie Mellon University: robotics.

“Without a doubt, Pittsburgh has the country’s largest concentration and mass of robotics research and start-ups,” said Howie Choset, professor of robotics, biomedical Engineering, electrical and computer engineering at CMU’s Robotics Institute.

He said Pittsburgh’s longstanding, blue-collar work ethic has helped the robotics industry bloom.

“We have this idea that in Pittsburgh, we make things,” Choset said. “We make machines that matter and that work. And I think that has really helped distinguish us from our peers.”

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Choset said that work ethic comes to light in comparing the typical investor or start-up in the Bay Area to one in Pittsburgh.

“In the Bay Area, they try to get as much investment as possible, and they try to get some dominant market, damn the reality,” he said. “Whereas here, we’re more focused on, ‘Let’s solve a problem that generates value.’ And you end up with a lot more companies that last a lot longer as opposed to companies that get a bunch of investment and burn out.”

Bloomfield Robotics, a company that spun off from CMU research labs, partnered with Kubota and last year debuted Flash, a robotic vehicle that can collect data on crop size, monitor plants for disease and send real-time data to farmers in order to maximize crop yields. Gecko Robotics has created robots that not only can inspect military vehicles and ships and collect data, but also make repairs in areas difficult for people to reach.

Choset said part of the legacy of Pittsburgh’s one-time industrial dominance is the hardworking ethos that he felt has attracted thought leaders and investors in tech and robotics.

Madarasz said Pittsburgh has benefited from being a relatively small city with a big-city culture, again, in no small part due to the industrial wealth concentrated in the region by people like Andrew Carnegie, Henry Clay Frick and Richard King Mellon.

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“We have Heinz Hall, the Carnegie museums, Phipps Conservatory, the Hillman library and cancer centers,” she said. “Those are all entities funded by industrial wealth that are now managed by foundations.”

Similar to the 1920s, Madarasz said, Pittsburgh today “benefits in many ways from a combination of academic research fueled by industrial and corporate wealth, with some partnership between industry and government to build the modern economy where health care, life science, robotics and computer engineering are dominant.”

That diversity has made the city much stronger, Briem said.

“We have the medical industry, the financial services industry and a great technology base here, and a lot of it is rooted in the ‘eds and meds’ that you hear people mention,” he said. “I think the big lesson is that the steel industry lasted longer than any one industry will exist in one region ever again. We have some great stories of post-industrial change, but we haven’t done as well spreading that change to the larger steel economy in places like Aliquippa, Clairton, Braddock and to some extent the Alle-Kiski Valley.”

Today, Pittsburgh is a prime driver for the regional economy. The city’s job gains constitute the bulk of all employment growth across Southwestern Pennsylvania over the past 15 years, according to Briem’s research.

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From 2010 through the middle of 2024, more than 75% of the Pittsburgh region’s employment gains have been generated by jobs within the city. Moreover, at the end of 2024, the city’s 2.7% unemployment rate was lower than that of any county in Southwestern Pennsylvania.

“There’s a strong persistence of memory in Pittsburgh,” Briem said. “We’ll never forget the steel industry. But we’ve moved on.”



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Game #22: Tampa Bay Rays vs. Pittsburgh Pirates

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Game #22: Tampa Bay Rays vs. Pittsburgh Pirates


Location: PNC Park, Pittsburgh, PA

Broadcast: KDKA AM/FM, Sportsnet Pittsburgh

The Pittsburgh Pirates are at home today against the Pittsburgh Pirates looking to grab a win against the Tampa Bay Rays.

Please remember our Game Day thread guidelines.

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  • Don’t troll in your comments; create conversation rather than destroying it

  • Remember Bucs Dugout is basically a non-profanity site

  • Out of respect to broadcast partners who have paid to carry the game, no mentions of “alternative” (read: illegal) viewing methods are allowed in our threads

  • The commenting system was updated during the summer. They’re still working on optimizing it for Game Day Threads like ours. If you don’t like clicking “Load More Comments”, remember that the “Z” key can be your friend. It loads up the latest comments automatically.

BD community, this is your thread for today’s game against the Rays. Enjoy!



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