Day: 12/17/2014
5/5/2014, Prescription for Disaster
Now, this is what I call journalism:
http://www.newyorker.com/magazine/2014/05/05/prescription-for-disaster
Selected excerpts:
A 1989 article in the New England Journal of Medicine stated, “To allow a patient to experience unbearable pain or suffering is unethical medical practice.”
In a letter of thanks to [Dr.] Schneider, one patient wrote, “I call you the pick-up doctor, why? Because after these other doctors screw your life up from negligence in surgery (like the disc on my back), they do not want to bother with you anymore. So you get referred to Dr. Schneider.”
Pain is inadequately treated, particularly among the poor and the mentally ill, in part because there are lingering doubts about whether such a subjective experience is proportional or “real.”
Although about a hundred million Americans suffer from chronic pain, according to a recent report by the Institute of Medicine, medical schools devote, on average, only nine hours to pain, and only about four thousand physicians are board-certified as pain specialists.
When some patients were discharged, they became belligerent, yelling at the providers, throwing soda cans, or spitting in their faces. The physician assistant Kim Hébert later testified that she called the local police more than twenty times. “Patients threatened to stalk me, patients threatened to cut me up in multiple pieces, patients threatened harm on my family,” she said.
Opioids are unique among medications, because there is no maximum dose. Unlike painkillers such as aspirin or Tylenol, consuming large quantities is unlikely to permanently damage the organs.
The D.E.A. began investigating about six hundred and fifty doctors a year, particularly those at “pill mills”—clinics where doctors sell drugs in exchange for cash, with little regard for the practice of medicine—but the agency’s tactics did little to slow drug abuse. Deaths from opioids have quadrupled in the past ten years.
After Schneider’s arrest, the Sedgwick County Medical Society was overwhelmed by calls from former patients requesting referrals. The society held a meeting to discuss what to do about Schneider’s patients, who complained in letters to him that no one wanted them. Jon Parks, the Wichita pain specialist, said he told the doctors at the meeting, “There has always been a Dr. Schneider in our community.” He said that doctors in the area dealt with chronic pain inappropriately, by administering nerve blocks, one of the few forms of pain treatment that were reimbursed well. “These doctors stick needles in, take their cash, and run,” he said. When the procedures failed, patients were on their own, and ended up in Haysville. He said to the doctors, “No offense, but this is self-wrought.”
George Watson, formerly the chief of staff at Riverside Medical Center, in Wichita, wrote a letter to the Kansas Board of Healing Arts, explaining that Schneider “sees the rejects of medicine that WE won’t see. He sees the people who have had all the surgeries and epidural steroid injections that insurance would buy, before it ran out, AND they still have pain.”
He [Mark Sullivan, a professor of psychiatry at the University of Washington] believes that doctors are inappropriately adopting a “palliative-care mentality” to “relieve the suffering of people who have had very tough lives.”
Yeah, I don’t think these doctors are listening… I’d like this professor to switch places with a pain patient who’s assembling aircraft machinery for a week, then we can sit down and talk about “very tough lives.” Heck, he doesn’t have to work as an aircraft mechanic, he can pick items off of shelves all day at the nearest Amazon warehouse. I wonder how long he would last in over 90 degree heat in a 10-hour shift?
Professor Sullivan thinks pain is mainly about “mentality,” and appears to be very dismissive of the physical part of it. But then, he’s a professor of psychiatry, so I guess he’s a little biased.
Rx drug overdoses linked to doctors; prescriber names to be sent to prosecutors
http://www.pharmaciststeve.com/?p=8147
http://www.wvgazette.com/article/20141214/GZ01/141219687
The committee reviewing overdose deaths plans to send the names of at least 27 doctors to law enforcement agencies and medical licensing boards, state Board of Pharmacy officials confirmed last week. About 20 pharmacies also will face scrutiny for filling the prescriptions.
When these doctors lose their license or stop practicing, and the pharmacies are closed down by the DEA, what will happen to all the legitimate pain patients that were being treated?
From October 2013 through last March, about 150 West Virginians died of drug overdoses, according to the data the panel is now reviewing.
From Wikipedia: The population of West Virginia – 1.854 million (2013)
The panel also identified pharmacists who could face discipline. Their names will be sent to the pharmacy board, but not to law enforcement.
Really? I mean, seriously? C’mon, the list of names that went to law enforcement included everyone, didn’t it?
The panel likely singled out some doctors and pharmacists already being investigated by state and federal authorities, Potters said.
Two doctors, two prosecutors and a pharmacist serve on the panel.
No one on the panel to advocate for patients? No, of course not…
The board identified 176 people who have received pain-pill prescriptions from 13 or more doctors over a year… In September, the panel gave the West Virginia State Police the names of 90 people suspected of soliciting an excessive number of prescriptions for pain pills from multiple doctors.
If you’re a pain patient on opioid therapy, be assured that your name is on a law enforcement list somewhere…
Marijuana addiction?
I received a “like” from 800recoveryhubblog, which appears to be all about drug rehabilitation — a multi-billion-dollar industry. I checked their page on marijuana, and since I don’t agree with just about all it has to say, I won’t be liking anything from this blog.
http://800recoveryhubblog.wordpress.com/category/addictions/marijuana/
What is withdrawal like?
The symptoms are similar in type and severity to those of nicotine withdrawal—irritability, sleeping difficulties, anxiety, and craving—peaking a few days after regular marijuana use has stopped. Withdrawal symptoms can make it hard for someone to stay off marijuana.
I mean, how wrong could this be? Who writes and believes this crap?
Sometimes, when I get weepy…
…I end up laughing at myself, at how silly I’m being. And I think of Truvy from Steel Magnolias:
“Laughter through tears is my favorite emotion.”
This Doctor Believes Your Back Pain Is All In Your Head
http://www.huffingtonpost.com/2014/12/17/healing-back-pain_n_6317310.html
Sarno, a former professor of rehabilitation medicine at the New York University School of Medicine, posits that bodily pain is caused by repressing one’s emotions and by stress, not by physical ailments. According to Sarno, “goodists,” or people who put other’s needs ahead of their own, are the most likely to suffer from chronic pain with emotional underpinnings.
Ah, New York, probably connected to the infamous Dr. Kolodny.
This is a new word for me: goodist. So, now my chronic pain is caused by me putting other’s needs ahead of my own… after all, I’m a woman, and that’s what most women do, right?
“I consider that I practice very conservative, standard medicine,” Sarno says in the film. “My theories may involve the unconscious, but that doesn’t make them any less rigorous.” Still, Sarno’s success remains largely anecdotal and his methods have been largely unrecognized by the mainstream medical community.
Filmmaker: “What he is pointing out is that the vast majority of chronic pain symptoms are the repression of one’s emotions.”
Seriously, people, my pain is not caused by repressed emotions…
But, okay, for Dr. Sarno, I’m going to practice mindfulness for a moment…
Yeah, I’m back, still in pain.
Cuban Cigars About To Become Legal Again
http://www.huffingtonpost.com/2014/12/17/cuban-cigars-legal_n_6341576.html
President John F. Kennedy first made Cuban cigars illegal in the U.S. as part of a broad embargo in 1962 — though not before ordering 1,000 of them for himself. There was a time when the relative few Americans authorized to travel to Cuba could bring back $100 worth of cigars, though that loophole had lately been closed.
Compton Mayor Aja Brown Explains The Difference Between Pulling Over A Black Driver And A White Driver
Ah, it’s nice to see a woman politician doing good things… Too bad she’s against marijuana legalization… Well, nobody’s perfect.
http://www.huffingtonpost.com/2014/12/16/compton-mayor-black-driver-white-driver_n_6317006.html
Under comments:
David Groves · University of Wisconsin–Parkside
9/9/2014, Fort Campbell Intrepid Center opens to treat TBI (Kentucky)
Today, service members, and thousands of others who experience TBI or psychological health conditions have new hope, as the Intrepid Fallen Heroes Fund (IFHF) joined with military leaders at Fort Campbell on Monday to officially dedicate the new $11 million Intrepid Spirit Center set to provide crucial treatment of psychological injuries in returning service members.
This is the third of nine planned Intrepid Spirit Centers nationwide to be completed and opened to treat active duty service members. The first two centers were dedicated last fall at Fort Belvoir, Va. and Camp Lejeune, N.C., and have already provided care for 2,000 service members. Two additional centers are currently under construction at Fort Bragg, N.C. and Fort Hood, Texas.
Brainyquote of the day (and words to live by)
“Love all, trust a few, do wrong to none.” William Shakespeare
Mental vs. physical pain
Under comments:
Realist says: “Pain”, just another crutch for underlying psychiatric disease and addiction problems
BL says: mark maginn, it is evident that Realist has problems that they aren’t aware of, let alone seeking treatment for. Those who suffer from chronic severe pain, know what their physical problems are that cause that pain.
I don’t like it when pain patients blame those that suffer from addiction for the problems we face today. And I don’t like it when those with physical pain look down on those with mental pain, as BL appears to do in this comment.
Pain patients with physical pain that can be “proven” with x-rays, MRIs, and other expensive tests, for some reason think that people who don’t have and/or can’t afford those allegedly objective tests aren’t in pain. You know, because they don’t have “proof.”
Or maybe they think that “mental” pain is “all in your head,” while physical pain is somehow more “real.” It’s funny, because chronic pain usually means suffering from both physical and mental pain, regardless of the underlying medical condition. And, of course, I’m of the opinion that pain begins and ends in the brain, so it’s actually all “mental” anyway.
Everyone knows there is no such thing as objective proof of pain. Pain cannot be measured by current technology, and even if it could, I’m not sure our perception of pain is something that can even be measured.
All Things Chronic 