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These after-the-fact discounts, called rebates, have come under harsh criticism and are blamed for helping to push up the list price of drugs, which consumers are increasingly responsible for paying. Trump's Move On Drug Rebates Good But May Not Lower Prices, Experts Say The proposed rule would no longer shield the middlemen, known as pharmacy benefit managers, from federal anti-kickback laws if they keep part of the rebates they obtain from drugmakers.
The three biggest middlemen — CVS Caremark, OptumRx and ExpressScripts — control more than 70 percent of the market, and they push makers of brand-name drugs to provide rebates in exchange for special access to their customers.
Every two years, hundreds of scientists enter a global competition. No one knows how to solve the problem. Even the winners only chip away at it. But a solution could streamline the way scientists create new medicines and fight disease. Lawmakers in both Utah and Idaho are moving quickly to add restrictions to the voter-approved Medicaid expansion. Medicaid news comes out of Florida, as well. The reaction from Idaho and Utah lawmakers could chill other potential Medicaid expansion ballot referendums planned for in Florida and other states, said Jamila Michener, an assistant professor of government at Cornell University.
Groups Mount Medicaid Expansion Ballot Campaign In Florida A mix of national and local health care groups, energized by the approval of Medicaid expansion ballot initiatives in three conservative states in November, have been collecting signatures for weeks to support a voter referendum that could cover an additional , low-income Florida adults.
For now, however, the groups aren't saying much publicly about the effort. From hefty tax credits to savings accounts for every infant, the Democrats are going beyond what previous candidates have promised when attempting to tackle wealth inequality in the country. Critics argue that any kind of cash-assistance in addition to the current safety-net programs that exist would discourage people from finding jobs.
Meanwhile, "Medicare for All" has become a highly politicized term, but what does it really mean? Democratic Presidential Hopefuls Amplify Income Inequality Message Several prominent Democrats are pressing for redistributing wealth to low-income families in a bid to make income inequality a defining term of the presidential elections.
Democrats often seek to raise taxes on the wealthy or increase spending on programs that touch low-income households, such as education, health care or housing. The latest effort is more far-reaching and aims to move supplemental cash directly into the hands of low-income Americans. What That Means Americans say they want better health care. How that will happen is still up in the air. Enter Medicare for All, a term that increasingly is being used by health-care advocates, politicians and aspiring presidential candidates.
The concept is the latest iteration of a complex discussion about medicine that goes back decades. To come up with something better than the Affordable Care Act when it comes to giving more individuals access to care and reducing what they pay, while putting fewer burdens on medical industry. From State Battles Against Opioids: Doctors Warned Over Prescribing; Minn. Governor Wants New Legislation.
Feds Warn Wisconsin Providers About Prescriptions Federal prosecutors have warned Wisconsin doctors, physician assistants and nurse practitioners that they have been prescribing more painkillers than their peers.
Bills have already been introduced in both chambers of the state Legislature and one proposal in the House cleared its first committee hearing last week. Walz reiterated his support for the proposals Tuesday after a conference call with undisclosed drug company executives. But the soaring client numbers have the clinic's neighbors pushing back over the crowds of people and cars at the facility.
The bipartisan bill, sponsored by Democratic state Representative Renny Cushing and cosponsored by 11 others in the House and Senate, would legalize, tax, and regulate pot sales. Currently, possession of marijuana up to three-quarters of an ounce is decriminalized.
Accused Doc's Wife Among Nurses Named In Wrongful-Death Suit A wrongful-death lawsuit against an Ohio doctor accused of ordering potentially fatal doses of pain medication for hospital patients alleges a nurse now married to him administered one of the excessive doses he ordered in It's among the growing list of at least a dozen cases brought since the Columbus-area Mount Carmel Health System found intensive care doctor William Husel ordered potentially fatal doses for at least 28 patients over several years, mostly at Mount Carmel West hospital.
News on hospitals comes out of California and Ohio, also. Texas Hospital Giants Cancel Plans To Merge Two Texas hospital giants called off their planned merger Tuesday, the latest combination to get scuttled in the rapidly-consolidating sector. Executives touted the benefits and efficiencies that would come from the combination.
Our goal is to create a model for integrated, consumer-centric, cost-effective care, and I am confident in Memorial Hermann's ability to accelerate and achieve this effort. Updated Lawsuit Says Former Mount Carmel Doctor's Wife Administered Fatal Dose An updated lawsuit in the death of a woman given an excessive dose of pain medication at Mount Carmel West hospital indicates that the nurse who administered the medication later became the third wife of the doctor who ordered it. Meanwhile in Texas, the state's efforts to stop Medicaid funding for Planned Parenthood will be heard by the full 5th U.
Circuit Court of Appeals. And the Texas attorney general petitions a federal judge to eliminate health law protections for transgender citizens and women seeking abortions. Mississippi Considers Abortion Ban After Fetal Heartbeat Mississippi lawmakers are considering what could become one of the strictest abortion laws in the country.
Bills that passed legislative committees Tuesday would ban abortion once a fetal heartbeat is detected, as early as six weeks into a pregnancy. Phil Bryant has said he will sign either House Bill or Senate Bill , which are moving to the full House and Senate for more work.
Supporters and opponents anticipate a court fight. Circuit Court of Appeals will reconsider whether Texas can eliminate Planned Parenthood from the state Medicaid program. The New Orleans-based court's decision Monday comes after a three-judge panel of the court lifted a February preliminary injunction that prevented the state from eliminating Planned Parenthood from the program.
The latest outbreak of measles started in an anti-vaccination hotspot where only 78 percent of the kindergarten through high school population had gotten their shots. Measles Outbreak Now An Emergency In Washington State Measles, declared eliminated as a major public health threat in the United States almost 20 years ago, has re-emerged this winter in the Pacific Northwest and other states where parents have relatively broad leeway over whether to vaccinate their children.
Seventy-nine cases of measles have been reported by the Centers for Disease Control and Prevention since the start of this year. Fifty cases of the highly contagious disease were in Washington State. There were no new confirmed cases of measles Tuesday -- the first time in weeks. However, there are 11 people who display symptoms of measles and are awaiting the results of blood work to confirm the diagnosis.
A growing awareness of the dangers of "religious perfectionism'' is behind the practices some therapists and pastors use to treat post-traumatic stress disorder-type symptoms, including anxiety, self doubt and feelings of social inadequacy.
Other news on public health looks at hazardous chemical reports; over-exercise dangers; Alexa patient care and children's bedtime screen use, as well. Under his direction, the church has taken a lead in confronting an issue that few other religious institutions have tackled: More than 1, industrial chemical accidents take place every year. The biggest include the explosions that killed 15 people at a fertilizer plant in West, Tex.
What The Heart Tells Us Many middle-aged marathon runners and other endurance athletes are familiar with concerns from their loved ones — and occasionally their physicians — that they might be exercising too much and straining or harming their hearts.
It finds that middle-aged men who work out often and vigorously do tend to develop worrisome plaques in their cardiac arteries.
But those men also are less likely than more sedentary people to die prematurely from a heart attack or other cause. New Voices At The Bedside: Hospitals began using voice assistants to allow patients to order lunch, check medication regimens, and get on-demand medical advice at home. But these devices, manufactured by Amazon, Google, Apple, Microsoft, and others are now making deeper inroads into patient care.
Hospitals are exploring new uses in intensive care units and surgical recovery rooms, and contemplating a future in which Alexa, or another voice avatar, becomes a virtual member of the medical team — monitoring doctor-patient interactions, suggesting treatment approaches, or even alerting caregivers to voice changes that could be an early warning of a health emergency. British researchers studied 6, children, average age 12, who reported their use of screens — mobile phone, tablet, e-reader, computer, portable media player, television or game console — during the hour before bedtime.
They also filled out a well-validated item questionnaire measuring worries and stresses, social functioning and other determinants of quality-of-life. The crackdown began in January and has only affected a handful of restaurants. The department is following guidelines issued in December from the U. Food and Drug Administration. Texas Offers Mediation For Surprise Medical Bills In Texas, a growing number of patients are turning to a little-known state mediation program to deal with unexpected hospital bills.
The bills in question often arrive in patients' mailboxes with shocking balances that run into the tens or even hundreds of thousands of dollars. When patients, through no fault of their own, are treated outside their insurers' network of hospitals, the result can be a surprise bill. Other times, insurers won't agree to pay what the hospital charges, and the patient is on the hook for the balance.
Hawaii Bill Aims To Ban Cigarettes For People Younger Than Lawmakers in Hawaii have proposed legislation that would begin phasing out cigarettes in the state, banning them altogether within the next several years.
At least, for people younger than The bipartisan bill, H. Cynthia Thielen R , one of the sponsors of the bill, said Tuesday afternoon in a phone interview with The Washington Post.
The arraignment hearing was year-old Nathan Sutherland's first public court appearance since Phoenix police announced they matched his DNA to the child born to a year-old female patient at Hacienda HealthCare last month. Doug Ducey called for aninvestigation into patient care, financial fraud and sexual-harassment claims at Hacienda HealthCare, which operates the Phoenix facility where an incapacitated patient was raped and gave birth.
The nonprofit company is also in trouble with two state agencies for not hiring an independent third-party manager as they ordered — an issue Ducey mentions in the letter he sent to Arizona Attorney General Mark Brnovich on Tuesday. Seeing Rise In Cases Of Hepatitis A, Often Linked To Homelessness And Drug Use New Hampshire may be experiencing the start of an outbreak of hepatitis A, a highly contagious liver infection caused by a virus that is often passed on objects, food or drinks contaminated by an infected person.
The virus can survive for months on surfaces. The state Division of Public Health Services says that over the past three months, 13 people have been diagnosed with acute hepatitis A infections, including 7 in January, compared to an average 1 to 10 people annually over the past five years. The lawsuit, filed in federal court in Atlanta, is the latest chapter in the dispute over the exchange contract between Anthem and WellStar.
They outlined a plan for fixing the issue Tuesday Feb. Vape Pen Explodes In Face: Brown stopped at a store selling vaporizer smoking pens outside Fort Worth on Jan. He sat alone in the parked car, put his lips to a pen, and soon after, an explosion sent shards of metal into his face and neck, said Alice Brown, his grandmother.
But that substantial number came as no surprise to the investigators involved. Cristal Glangchai, the CEO for a nonprofit, hit a rock riding her scooter, landing her on the pavement just blocks from home. Ex-Tennessee Nurse Accused Of Fatal Drug Swap Error Indicted A former hospital nurse in Tennessee has been indicted on accusations that she accidentally gave a drug used in executions to a patient who then died.
News outlets cite a statement from the Tennessee Bureau of Investigation saying year-old Radonda Leanne Vaught was indicted Friday on reckless homicide and impaired adult abuse charges.
The statement says the former Vanderbilt University Medical Center nurse's actions were responsible for the death of year-old Charlene Murphey. Now They're Flipping The Script. Drugmakers Blame Middlemen For Price Hikes Under pressure over rising drug prices, pharmaceutical companies are pushing a new defense: For years, drugmakers justified price increases by saying they needed to fund research and development of their products.
But lately they have flipped the script. Various reasons were offered, including the arrival of generic versions of its blockbuster Lyrica and foreign exchange rates. But the loss of the ability to boost earnings through annual price increases, which has benefitted drug companies for years, was an undeniable factor. Pfizer shares are down 2. I feel I should say this.
You have just made more judgments about so many people than anyone I have read about on the web. Negative karma just produces more negative Karma. Leave this hospital and start again. Change your attitude and how you view other humans. I can tell by the sentence structure that it is difficult for you to get your point across and have had troubles for a while.
Just keep good faith. Also, for all of the pain sufferers please know that your pain is not your fault nor do you deserve it. I say this having a year ago lost my mother to lung cancer and as an LPN I had to cut back the hours I worked to ensure she was cared for.
She never smoked or drank and to watch her over many months go through a great deal of fear and pain where she was always a strong woman made me angry and sad.
My mom snapped at me as I tried to care for her and later, in tears, she apologized and wanted me to know she loved me. I found this site looking for hope that the doctors who DO have a lot of power in America have some heart and courage and kindness. I also wish the pain sufferers all the best. Remember, you are important and for every bad egg their is someone else trying to right that wrong. Peace to each of you. I am sick of ppl with no REAL pain having meds thrown at them while ppl with true pain are forced to suffer.
I had most of 2 vertebra removed. It never would have happened if the dr. Now I have pain the is excusiating. I am expected to deal with it on 2 10mg methadone a day. Drug addict are good liars. I am in pain. I feel the dr. What is wrong with Dr. There has got to be an answer to this problem. You say the Dr assumed you were a liar. Did you ask him if that is what he thought?
Part of the problem is with you. Change how you view the world and be clear about what you want and things will change. Jake Awake, just shut up and go to bed. Hmm… do you need a better attitude? A good friend of mine help lost her son to suicide because of his chronic, unrelenting pain from of serious spinal injury. He had several surgeries, each one less successful than the last, until he could no longer bear the pain.
He was barely I lost a cousin several years ago who chose a shotgun over daily back pain. Chronic pain is demoralizing, depressing, and saps the will to live right out of you. People have always abused drugs and always will. Instead of punishing those who legitimately need them, maybe we should come up with a better system to treat those who abuse them.
There was a well known doctor who has since died who was an oncologist. He treated their pain appropriately. I have that plus a bunch of other medical problems.
I also developed severe fibromyalgia. I have been on same dose of meds for 2 yrs. I am very careful. No more trips,eating out, etc. Do MDs realky think this is how I choose to live? Have you tried a sacral nerve stimulator or intrathecal pump? What about heparin instillations? What are you doing to treat more than the pain? My wife has dealt with it since her first pregnancy 15 years ago. She was on disability for many of that.
You need to be proactive with the doctors. Start with a urologist that does the interstim by medtronic. You also need to watch your diet.
Acidic foods and beverages, and alcohol are hard on your bladder when your lining is inflamed or absent. You also should find a pain doctor. She used to be on 4 different narcotics every day, now she just takes norco percocet was changed because of the drug seekers when needed.
With her interstim and intrathecal medication pump, she came off disability and has worked the last 5 years. They already KNOW they are murdering us. They do not care, and they pretend a mistake was made when any complaint arises. False sympathy and then they keep doing evil to others deliberately for their own benefit.
The higher the chain of command you hit the less godlike they are. Talking will get you nothing but false sympathy and a knife in your back as soon as you turn it. Alternatively, learning to block, lure and break them, is just as effective, if not more so. Begin creating restated laws releasing control back to the general public in terms of drug purchase, production, education and use, social stigma on a massive scale to abusive docs and Gov.
When was it that Pharaoh was so disheartened he let go his slaves? And another person mind reading. How do you know what they know? You need to ask people what it is they are thinking. You need to ask people what it is they do and do not know. We can only guess what people are thinking.
Way to go Betty! Obama care cut my insurance down to where I cannot get my infusions anymore for either issue. I have Rheumatoid Arthritis, lupus, Behcets disease and multiple other arthritis in my spine etc. I am going through severe withdrawal symptoms because of the DEA and people who abuse medications that I need but they are investigating my doctor trumping up charges, I pray anyways, he had a sheriff working at the front desk. I had a stroke at 16 and went downhill from there, before that was female problems that a Gym actually told my mom I was making it up, imagining it because of child hood trauma.
Come to fine out I had polycystic ovarian disease, endometriosis, and a cyst that ruptured at 14 and almost killed me. Those are the worse of my many problems, the problems that introduced me to opiates. Had I had any idea whatsoever that I was walking straight into hell, I would have declined each and every prescription.
Prescriptions were now only another source, out of many sources I had found along the way. My fear of withdrawals drove me to all those moral compromises, and withdrawal itself lead to the most desperate and pathetic of times, many many times over.
My life no belonged to me, I had no control. I literally had no choice, as the withdrawals are so unbearable that I would rather die then to ever go through them again. I escaped, and now I am free. This is way longer than I had intended! I have been through Hell due to this system. Mark my words that I will make a difference for others that are suffering at the hands of this System. Even in the judicial system you are innicent until proven guilty.
Something has Got to Give here. Pls advice as to how I can fight this and stay strong while I do it. This is my life right now. My doc prescribes me nothing at all. I shake and moan all day and especially all night.
I sound and feel like I am insane. You obviously have never suffered from chronic pain……I have exhausted ALL of the repetitive stuff you wrote! After four years opiates are the only thing that works in acquiring some quality of life! These pills work for me also. I have tried to change them but the pain comes back. I mix the patches with two other meds. I can understand why some doctors are hesitant to trust me, but to completely write me off, before even seeing me, is what really bothers me.
I have over 10 years of medical records and drug tests to monitor my system levels of whatever opiate they have me on, that prove I am NOT an addict and take my meds responsibly. We really need to find some middle ground in all this! There is no difference between people with pain and street addicts.
It is sad that the healthcare system in this country is incomplete. Everyone is quick to hand out pills verses treating or teaching pain management. Pill addiction is different because its a brain disease. Talk to your pharmasist read the info in your script.
In some cases pill addition leads to heroin addiction. Take responsibility quit acting like a middle schooler smoking pot for first time. You obviously know nothing about those who need meds foe pain etc. All medications have risks and side effects. They want people off addictive drugs and give them meds that work like taking candy. I dont drink by the way. There has got to be balance and not a knee jerk reaction to everyone who asks or requests meds for pain.
Dear God I pray that I one day am in a position to knock people like this ignorant, clueless person spouting obvious nonsense about taking responsibility and stop acting like pot smoking middle school off their smug pedestals. Diagnosed with Avascular Necrosis both hips at age 34 as a perfectly healthy person with no history of trauma, issues or history related to the disease. Left hip replaced healed fine. Ten years later right hip replaced after signs of symptoms.
From onset of pain to now, three full years after replacement, pain is worse. Too much to write but the way I have been treated???? I have had one replaced already so been through the whole procedure, pain meds, physical therapy, etc. Not an addictive person here. Chronic pain does ore than demoralize and depress you…it kills your strength, your will, your being a human, and you then understand drug addicts have it BETTER than you in the United States of America.
I was suicidal and before I took my life I got on the web and found an Avascular Necrosis support group which saved my life that night. Stick your finger on a flame and keep it there. I wanted to know why I was still in pain. But I was treated like I wanted drugs and no doctor ever so much as gave me any type of nerve test, test for infection, absolutely ZERO just co-pays and monthly bills.
My story is a mild case compared to many out there and I am one determined sister heated and on fire to do something about this starting in my home town of Los Angeles. Nothing ever gets done with things like this until it hits a celebrity like Michael J. I was 10 minutes from taking my life over this and no way is this ok for as many go through it. Screw the ignorant pathetic commenters who all change their tune when they go through what we have if they survive.
You are so right. Addicts recieve often times repeated, free, treatment and even housing. Along if course with drugs to help them through pain and agony of detox, and relapse. I would not abolish the system,even with its flaws because better something than nothing Yet we, as you said so elequently, get no respite ever, ever, ever, ever….. Your comments are inspiring.
Chronic pain truly tests your soul to its core.. I believe that there is always a silver lining. Chronic pain has made me a strong, compassionate and patient individual. I truly know myself inside and out; like you said the mind has no choice but to transcend the body to survive, and when you reach for the light in those darkest of places you know you have the strength to deal with whatever life can throw at you.
I pity people who make such comments, ignorance and arrogance are worse vices than any drug known to humans. Yes, this group is very informative and supportive. Comments like yours have no place here. You speak of middle schoolers and then leave an uneducated and childish response. You speak of studies yet list no references, I suspect because you are just regurgitating general knowledge to people who already know about addiction.
We know because the only way we can live our lives to any degree of comfort are with drugs that are highly addictive and we have to be so careful. If you truly know anything about what you are talking about, I should not have to tell you that there is a difference between drug dependence and drug abuse. Clearly the people here do not fall in to the latter category, we are dependnet on the drug because we are using it for what it is intended. None of us would choose to pay that much money long term, or endure the side effects of taking such meds long term if the other options we had tried had worked.
However Idk why I even try to explain; I would never wish such a thing on anyone, but statistically you or someone you love will be affected in some way by chronic pain due to illness, and or injury. I have a feeling your ideals will not hold up so well then. Excuse me, a pain patient who never smoked pot as a teen, nor did drugs. Why not say, Whatever and get it very with. Do you also preach taking your meds on time as prescribed or no? I note you said: This is stupid behaviour. It is not working out!
Why are you suffering like this? Complain or find another Dr. Hi Doc, your long glib suggestions of a variety of treatment modalities to try, is an insult to patients suffering from severe, chronic daily pain. I am a medical doctor; I am no longer able to work; I have among other conditions severe spinal stenosis, prolapses in the cervical spine, lumbar spine, two subdural-bleeding in the brain from falling ; I am wheelchair bound; stay awake at night with severe pain; been shot in the chest and leg; have accelerated osteo-arthritis, brittle bone disease and pituitary infarct; what infuriates me is when I ask my Physician for pain prescription and he says: Doctors are morons if they treat genuine pain sufferers with the same paint brush as recreational drug abusers.
I am not a recreational drug abuser: I am in PAIN. For those Doctors who do not have the compassion regarding pain, let me remind you about the Oath that we both took: I curse every medical practitioner who makes a joke out of a patients suffering and insults a person in genuine pain; I hope your kids suffer from non-ending pain and you look on in misery knowing that you cannot do anything for them.
Dr Ahmed Adam, South Africa. I am very sorry for your pain. I have no children by choice So unlikely that my children will suffer non-ending pain I chose not to have children so I could care for others. Keep up the good work and may all that is good for you come to you in great abundance, best regards, Dr Adam, South Africa. I completely agree with every single statement you made.
I feel as though that ought to be emblazoned in bold on every single text book, chanted as an incantation at least daily all throughout medical school, and stamped on every official piece of documentation from all medical boards because it is just that important.
You come across as an astute, compassionate physician, which unfortunately seems to be a minority these days. Every time a statistic is quoted which states that there have been so many prescription related drug overdose deaths, the second half of the equation is never publicized. There is never any information shared on how many patients take their own lives because they have had their medications reduced or withheld.
And the stories like Leila happen very often all across the country and have been happening for many years. First I agree with Ahmed Adam exactly and thanks Dr.
Wible for the contact and support here. If taken appropriately opioids work in the long term for me over 18 years while working full-time and make life tolerable. The data posted to sites such as the CDC and a current negative Consumer Reports article are complete nonsense and easy to rebut — too easy actually.
The data is seriously flawed, easily refuted, and totally biased toward a negative outcome. Needless to say things in our area are getting worse not better and I really empathize with anyone in this situation. Hopefully more to say later. Adam First Id like to say that I never post on these forums at all but I felt compelled to after reading your post.
I have multiple Sclerosis, multi-level ddd, spinal stenosis, fibromyalgia, carpal tunnel syndrome, bulging and herniated discs with tears, tibial tendonitis in both legs, have went paralyzed 3 times, once from the neck down for about 24 hours in January or , then in June of my left arm for 5 months and when that got better in February of my right arm went paralyzed for about 6 weeks.
I went into the ER one night back in April of in excruciating pain and it was a pain I had never had before. He did not care and sent me out of there knowing how painful shingles is, I was in a fetal position crying in pain like I have not done since giving natural birth.
Sorry for the long post and the. Is a new phone. And I am so sorry for you. And what you are going through. Also my husband reminded me that he also sent me home with a blood pressure of over Trika, I too have been mistreated too many times to count. Endometriosis, ovarian cysts, bad gallbladder, unknown internal bleeding where I would vomit blood and need transfusions.. I was put in pain management after about 10 er visits and no one could find out what was wrong with me. Well after trying surgery after surgery things got worse in a few cases.
After a lapor I had worse pain than when u went in. Wound up in the er over and over and the drs would not treat my pain.. Turned out the surgeon while closing me up entrapped a major nerve. So finally had that removed with another surgery. The Dr still discharged new after not going to the bathroom once in 2 days. I went right down to the er after I was discharged.
That er Dr just said I wanted iv pain meds and nothing was wrong with me. So as they were shoving me out the doors my labs came back showing my kidneys were shutting down..
Yup I had a perpherated bladder. And no one believed me till it was almost too late. Than the same with my gallbladder. Than finally after 6 months if dealing with the bad gallbladder my husband convinced a Dr to take it out. By that time it was grey and infected.. Than shortly aft er that surgery I started vomiting blood everyday…no answers for a year. I was hospitalized for 4 months needing blood transfusions weekly, unknown number of endoscopies, transferred to 3 hospitals with no answers.
So I had a sitter for a week. Finally I was down to 80lbs and had gotten 3 staf infections from the picc lines so my husband was going take me out bc no one was doing anything for me. Best day of my life. It was the most severe rare case of HHT he had ever seen. So I was put on the correct meds and got better.
But to this day the HHT caused most of my organs to bleed so I had a full hysterectomy too. But there are a few who still just refuse to control my pain..
Seratonin syndrone, throat closed and more bleeding. And still those few drs knowing everything I have been thru is legit still believe I am just addicted to them. So I now take my struggles and experiences and help others. Your life should be lived to the fullest! It took me traveling all around the states to find my drs. I probably saw plus drs. And to be honest not even a quarter of them truly listened to me. So keep searching friends. Good luck and many prayers!
Oh and I did try every possible thing before pain meds. But now having a great Dr he explained everything so much more clearly for me to understand the meds. Pretty much every pain doctor in this country requires their patients to sign a contract that they will not get meds from any other doctor. Did you call your doctor?
I am so sorry Doctor for you. I agree with you about the other diseases and the other issue is the cost. Why does it cost 2. I love my country. We have some issues I would like to see dealt with before I check out of here to make what I have gone through mean something more to me than meaningless, mind-numbing agony, depression and torture.
I feel for you!! Every adult has pain and you have trust sometime the patient just knows what will work in his own body. I have Fibromyalgia along with thousands of others who struggle every day for a pain free day. All the thing you suggested ,we are doing to get a hours worth of freedom from our pain. There is a big problem with pain clinics making addicts of people because they give too much and want it taken every few hours every day.
I have been seeing a pain doctor for 7 years and we have an honor system. He gives me 10 hydromophone 2mg a month and I show him 2 or 3 of them when I got back. I take it when I need it most. I know this method will not work with every one , but it will with some. Most people with fibromyalgia die by their own hand because the pain becomes too much. I believe the medical field needs to do more to understand the mind set of the patient.
We are not all looking for a pill, we just want relief. Turmeric work good for me with the every day pain. I have Chronic Primary Erythromelalgia on b other hands, both feet. Tha t s a start of a list. Severed tendons, scar tissue. Was in 3 fires, hit by 4 cars, went o very a bridge in one. Have, because of the irresponsible Doctors I meet monthly. Any thoughts other than statistics and things that do not apply to me?
Geuss especially at my habits, shame perhaps. Tool so often used to treat pain…. I read your ideas. Mine are Long Acting Opiates are good medication. Like a gun is good at killing.
You have nine cats in your home. You and your husband smoke and you notice the cats are developing breathing problems and then one is diagnosed with and dies of lung cancer. What would you do now to make your home a healthier place?
The other day I read an article in USA Today discussing the fact that married couples lived longer healthier lives than single individuals their age. What led me to write this is not any problem or disagreement with the results of marriage but the conclusion the doctor reporting it came up with: They are healthier because they have someone who cares about them telling them what to do.
Yes, my wife tells me to drive carefully and I do because I love her but once I walk out the door how I drive, what I eat, exercise and more are not because she is watching me and instructing me.
Married men also have a lower incidence of lung cancer than single men who smoke the same amount. Women with malignant melanomas of same site and stage as a comparable male group had better survival statistics than the men. The conclusion by the doctor blew my mind. Estrogen and progesterone must be protecting the women.
What do we conclude now based upon all these closed minded medical conclusions that do not relate to people but attempt to be scientific?
Our conclusion based upon their wisdom: If estrogen and progesterone was the reason women with melanomas had a better survival rate than men then sleeping with estrogen and progesterone must be what is protecting men who smoke from lung cancer and heart attacks.
And the reason living with dogs increased survival statistics must be related to the fact that when their owners did unhealthy things like eating fatty foods and not exercising they growled and threatened to bite them. I hope you are smiling because I am kidding and it is not because of mechanical causes that these statistics are revealed. When the instructions to take care of yourself come from someone you know loves you it can and does make a difference, because they are not criticizing you they are educating you, but first we need to feel loved and cared for and about before we take their words seriously.
Relationships are what it is about. Men are human doings while women are human beings. I am constantly trying to get the men to become aware of the importance of relationships with pets and people and life and women to see that they need to relate to themselves also and not just live a role, such as Momma, which leads to their demise when the kids leave home. So develop a relationship with yourself and work with your new self and love and care for that new self as if you were your own child too.
So when the kids leave home there will still be reasons to survive for the wage earner and mother. In a sense it is about hormones because our internal chemistry is altered by our relationships. Growing up with love is a major factor in health.
Not because your parents are telling you what to do every day but because their words are hypnotic and they remain within you and when they are therapeutic also you are constantly hearing them in your subconscious, as well as, conscious mind and making healthy choices.
Self-love coming from being loved leads to self-care and a healthy life. The effect of a lack of relationships is not understood by many doctors but is by the poets and song writers. I have mentioned W. Childless women get it and men when they retire.
Now to get to the question I began this column with. What do you think the woman who wrote about her experience and her husband did? And what would you and your husband do when you realize you are killing your cats due to your smoking in the house? This story comes from a full page letter to Cat Fancy Magazine, written several years ago, detailing the emotional impact the death of her cat had on the couple. Here is their solution: We love our cats more than the convenience of smoking indoors.
We are not killing our cats anymore. We hope you are not killing yours. So the relationship is therapeutic but how about getting to know yourself and having a relationship you can enjoy with yourself.
When you do you will find you are never lonely, even when alone. Not to mention that there is also another level of relationship that is always there to support you when it is a healthy relationship and not about guilt but related in a therapeutic way to your spiritual connections and faith. What I have learned and what all health care practitioners and people in general need to know is what Jung had to say and psychology knows.
There is an unconscious psychic reality which demonstrably influences consciousness and its contents. All this is known, but no practical conclusions have been drawn from it. As we have become more empowered over nature the mind has become more prominent and the head dominates. But we must remember there is a unity of psyche and soma within us and they must both be paid attention to.
So we and our health care practitioners must treat both our intellect and our experience; our psyche and soma. Our duplex must be accepted and acknowledged as part of what we are living. The seat of faith is not consciousness but spontaneous religious experience. When you have a relationship with God it keeps you from dissolving away in the crowd. What struck me is how few men and doctors are aware of this and make it part of their lives and professions.
When you ask men to draw a picture of themselves many just draw their head. Yes, some women are thinkers and draw a large head too attached to their body.
When medical students are asked to draw themselves working as doctors the majority draw themselves sitting behind a desk with a diploma on the wall behind them. That is why I started to write this article. So folks wake up to your multiple personalities and that your mind, body and spirit are all within the unified creation which you are. In a sense you are like the planet earth with many components, residents and environmental factors which all have an effect on the health and wellness of the entire planet.
Just like global warming cannot be treated in a simplistic one solution way because every part of the body earth is showing symptoms of the change so our bodies manifest what changes are going on within our duplex make up and unconscious mind. Pay attention to what lies within you and respond to it so you live your healthiest life and develop relationships which enhance your life and give it meaning.
Happiness is not in strength, or wealth, or power, or all three. It lies within ourselves. If your main issue driving the smoking habit is anxiety then treat that first. A good therapist or even a meditation program can help. Vipassana centers often offer a free 7-day silent retreat. Pamela, I know of far too many people who have experienced pain and have been receiving inadequate treatment for it.
This is a tiny minority. Only once have I ever had drugs stolen from me, decades ago, and very few pills were taken.
I have learned to take precautions since then. Even those in dire poverty with kids to feed understand that to sell drugs to someone means that stranger could be harmed by those drugs. Most people are morally together enough not to go the drug dealer route. In this way, people are brushed aside.
Do these doctors have any conscience at all? I had no idea so many patients were diverting prescription drugs. I try to err on the side of trusting what patients say — even though I have been lied to, manipulated, and even had prescriptions forged.
Still I want to wake up every day and believe that I am sitting next to a patient who really does want a long-term relationship with a family doctor built on trust and respect. I do have priorities. Prescribing chronic opioids to patients with difficult-to-verify diagnoses increases my risk of all of those problems I hope to avoid. Do you really think that there is so much more pain today than there was 30 years ago when opioid prescribing rates were very low?
I do think that many doctors hand out opioids like candy, and this is contributing to the addiction, diversion and overdose deaths. I realize that doctors have a broad range of opinions regarding opioids from chronic, non-malignant pain. I happen to be one who feels that opioids are rarely appropriate in this situation, despite the aggressive lobbying by Purdue Pharma and others during the 90s.
This is a very good point made by Dr. I, as a pharmacy professional, can completely sympathize with everything this doctor is saying. I can also see things from the perspective of a Chronic, Non-Cancer Pain patient, too.
I promise you, this is not the case, and we are not all addicts! I used to take Neurontin gabapentin and Zanaflex tizanadine and the combination of these, helped for a few years. However, I was switched to Lyrica pregabalin when it first came out, and had to switch back to Neurontin when I had lost insurance and could no longer afford the Lyrica.
The following years resulted in doctors swapping back and forth between Neurontin and Lyrica, based on preference and my ability to afford the medications, but for the last 4 years, I have not been able to take either, due to me becoming chemically sensitive to this class of medications, to include having an extremely severe reaction to Topamax topiramate. The ER doc wrote me off as a drug addict before ever meeting me, and discharged me with only a referral to a drug treatment program.
This was one of the biggest insults the medical community has ever given me. This is not the only medication that I have grown sensitive to. I have become sensitive to almost everything I am given, and in most cases, the side effect are far worse or I have some of the worst, rare or almost unheard of side effects of the given medication. I have also had the problem of running into doctors that see the medications I take, and automatically reserve themselves to not wanting to actually give me a diagnosis.
I have had rhuematologists say I have textbook presentations of either Rheumatoid or Psoriatic Arthritis, or Systemic Lupus. Yet with all the documentation of these, I can get no doctor to take me seriously or give me a confirmation. My point is, if anything else worked for me, I would gladly NOT take the opiates!
I wish there was a magic drug that would work that was not an opiate. Opiates are all the work for me. NSAID make me vomit blood, steriods make me hurt worse in the long run. I can still fell where the needle went in me with the steriods and that was 10 yrs ago.
Until then give me pain meds please! WTF Nothing is said that we could not get our prescriptions filled that we have been taking for some time while at the same time doing random urine testing!
Over the bridge i go. I found a good doctor but have often found that doctors would trivialize my physical problems. They would give me a medication for depression or anxiety and basically leave me to deal with the physical problem. It is not only opiates that patients get dependent on. In my many many years living with traumatic brain injury I have seen many many other patients and many doctors who readily prescribe or take psychiatric meds for symptoms of brain injuries.
We are often treated as if we are mentally ill, which in fact we can become when our needs are ignored and we are not able to care for ourselves. Advocacy is difficult to find and there is not enough rehabilitation for us. Bottomline, people know 4 types of answers to there pain problems: I use clinical reasoning and acumen to assess every pain encounter.
I even rx some kumbayh methods. I hear you Leslie. And TBI like many other issues is impossible to handle in a minute office visit. My doctor friend says it is worse than drive-through medicine. Sometimes it feels like vending-machine medicine. I have not worked in an emergency room and I can only imagine what happens there.
No happy dancing bunnies. They come to my office. I do think that good patients who follow the rules are clueless about the real problems in the ED. I do not doubt you for a minute Renaldo. Sorry, Doctor, but you just made my head explode! They ask me how long I have taken morphine but no one ever asks me about the 10 years in which my doctor and I tried every conceivable drug and treatment OTHER than morphine. Dependence does not equal addiction.
I face ugly discrimination and bias on a daily basis because of a drug I need. What no one considers is that morphine is just one part in my daily routine to control my pain. They do not see that morphine was my absolute last resort. Prior to introducing morphine into my regimen, I could not walk unassisted and I frequently needed a wheelchair.
Yet, because I take this one drug, I am branded a threat, a nuisance, a time-waster, etc. I was a highly paid, well-respected intelligence analyst and top cybersecurity advisor for our government. I always dress nicely. I always address the medical professionals with respect. All these doctors and nurses would have to do is call my doctor or pharmacist.
I have overheard medical staff whispering about my doctor and they further spread their nastiness by implying that my doctor must be a Candy Man.
Every guideline says I must be treated with respect and that my request for help should be given all consideration. Perform a complete pain assessment and review the recent analgesic history. Pseudoaddiction improves with the provision of adequate analgesia, including opioids. In contrast, associated with a substance abuse disorder will not change.
I am so sorry this has happened to you Sonder. If doctors had more time and energy to truly care for their patients, we could avert these misunderstandings. We all absolutely need a trusted doctor who can oversee our treatments and make certain patients are not suffering needlessly. Unfortunately, as my next blog indicates, many doctors are at a breaking point with despair, depression, and suicide: For many, it is hard not to become jaded.
The good news is many physicians are breaking away from abusive employers, contracts, working conditions and choosing to start ideal medical clinics so they can really be doctors again. You do know all we ever wanted to do was help people. You have gone above and beyond what most people do and the fact that you are educating yourself is impressive. Maybe the professionals, doctors and pharmacists, who disrespect you should walk in your shoes to see what your quality of life is without that medication.
I see that this post was written several months ago — but am hoping you might see this anyway. I want to say a million thanks to you for this. I am having a really bad week dealing with my chronic pain issues — — I am 48 years old and have been dealing with chronic pain issues since I was 17, at which time I was diagnosed with Chronic Interstitial Cystitis. I have been very depressed lately as I have felt like I am also treated like an addict much of the time when I do seek pain medication.
I have 30 years worth of stories to tell — detailing every treatment I have tried -and feel my history is completely dismissed and that I am disrespected so often — and especially by pharmacists , ER physicians and nurses. I have never abused any of my pain medication in any way yet feel as if that is how I am viewed as doing.
To be honest, the treatment I have received by these so called professionals has caused my depression to worsen much more than the actual disease and pain itself. These last few weeks in particular have been hard as I have had to make several ER visits due to kidney stones — I have passed one, had one surgically removed and am getting ready to have a third surgery next week. Anyway — as I am being treated by a pain clinic for my IC — each time I have gone to the er for kidney stone pain I was sent home.
No diagnostics were done to determine what was going on. They just assumed I was drug seeking after hearing my history and sent me home on three different occasions … I finally went to a different ER — they diagnosed the stones — referred me to a urologist who did my surgery and is getting ready to do another as I said , one stone I passed on my own. Anyway — this was just one in a very long line of stories- same song different verse. It has affected my self esteem and made me feel so worthless.
At one time during the last few weeks — I had taken a prescription for an opiate to the pharmacy — it was stronger and the frequency increased above what I normally take as it was temporary and was going to be used until I could get my stone surgically removed.
I just drove away and took it elsewhere — and cried for hours. And I am not a crier normally. Anyway — I will stop my blubbering now. I feel so bad for you and for all the others on this thread who suffer from any type of chronic pain — and who have to deal with being treated with such a lack of respect.
I am sending out prayers , positive thoughts and much love to everyone. And thank you Sonder Twyful for sharing your story … And for all others on this thread who have taken time to share their stories. Oh, and PS … those of us who truly experience chronic pain know that we will never, ever, ever be free of pain.
I was told this was to protect the patient in case a new physician attempted to change things. While marijuana is legal,chronic pain pts are being treated less than dogs. I had part of my nose and lip cut out and soft tissue in between removed. I was sent home without any pain killers. I jammed my arm into my rotator cuff, and I was sent home without any pain-killer, etc. I ask for one 10 mg codeine to get me through the first night, and they call me a dope addict.
I miss the s, where they gave me codeine. I have to sit up slowly. I have to turn my head slowly. Hang onto a wall or person when I try to walk.
And not be able to suck anything from a straw, because part of that muscle was cut out? Pain management is an area where the collapse of personal medicine becomes most evident. I would expect that it would be hard to fool a long-term physician, and most patients would be ashamed of themselves. Today, in most practices, 3 years is a lifer. Chronic pain, like depression, often causes a systemic impediment of many routine activities, and impairs the patient in ways that are not always obvious. I find that drug-seekers talk about drugs, and people with chronic pain talk about pain.
We set goals not measured in degree of pain alleviation, but restoration of function. Those with chronic pain KNOW that it cannot be taken away, but it can be minimized in significance.
As medicine becomes dehumanized, the type of suffering which is most exquisitely felt by humans becomes trivialized. If you are not human, you do not have a right to claim human problems. Suck it up, says the system.
Sufferers are merely discards waiting to be processed. Are we proud of this? I like the way you ask for a solution. By asking everyone maybe someone will have a good idea.
The only idea I have is to redirect addicts to a special clinic where well trained therapists can tell the difference between a drug addict and a patient in dire need of pain medication. Another idea is to have a webs site database where patients with a true need to use opiates are registered after going through some kind of evaluation. Then in the emergency room if they are already registered they can be given pain meds. We do have a drug monitoring program where pharmacists and other medical providers can check to see if a patient is getting multiple narcs from multiple docs doctor shopping drug seekers and that does help.
So please explain to me why i still have my prescription for my fentanyl patch in my purse and can find no pharmacist that will fill it! I am too embarrassed to tell you how many times and for how long I have gone without my medications since the first of the year!
I am working on an exit plan! It is bad enough to suffer from pain but when you have a doctor that gives you a prescription and pharmacists playing god …. Please explain for my children deserve that much! Pam, For me, it takes time, relationship, an ability to trust my own gut, and an acceptance that all humans are capable of all behavior given the right circumstances.
The most important of these for me is still time, intentionally designing my practice to allow time to hear out the source of the pain; time to explain the options and their responsibilities including an up front conversion how we can establish trust; time to assess response and adjust. The astounding increase in all prescribing is inversely proportional to the shrinking amount of time the system allows prescribers to spend with their patients.
Unfortunately, the easiest way to satisfy those needs in the typical 7. The associated personal, financial, and spiritual costs are crippling, no matter what drug we are talking about. Docs, especially primary care docs, I gotta tell ya … hold the line. Reclaim your time with your patients. Give up cursing the system and find a way. The sky is always falling. We did it with my bricks and mortar practice by starting very small without debt, with an exam table and computer. We intentionally watch our overhead like hawks, so that catering to the overhead does not drive our clinical decisions.
Overhead, like debt, limits us all and turns our patients into a means to an end instead of our soul-enriching mission. Stop running to catch up. If you stay with insurance companies as your primary payers , never outsource your billing. But most importantly, link arms with your patients.
Tell them you need them, because you do! Primary care docs get out of bed because relationship matters to us. Keep going back to the patient-doctor relationship as the source of your work-life strength and joy and make your decisions accordingly.
The world would definitely be a better place. There should be more medical professionals that feel this way. Allergic reaction or just over stressed at work but they came on fast so it scared me. The ER doc kept asking what drugs I took. I had taken NO drugs! Benadryl finally stopped the hives. It was after my stoke. The doctors did 3 different drug screens. I was furious that they did them without asking and then charged me for them. So it was odd to me that 20 years ago and then again 2 years ago someone would look at me and think drug user.
I think the crux of the current opiate problem is that very few doctors have actually received the appropriate level of education on the subject, but they still accept people with chronic pain as patients. These type of patients are tough to treat and they require a lot of time and attention from the doctor. The doctors who accept such patients, who are not aware of this fact, soon become overwhelmed with the required work. Those doctors are very quick to blame the patient and are too quick to label a difficult case as an addict.
Even though that doctor is not a pain specialist, his word will be accepted as if he were an expert — simply because he is a doctor. While I sympathize with doctors who have to deal with this dilemma, guidelines DO exist, but few doctors or nurses follow them. First of all, if the patient says he is experiencing more pain than he can handle and that he needs a higher dose, he has a right to be believed. Secondly, do another physically examination of the patient. You should always check for changes in physical condition.
What else could be wrong? If his opioid addiction risks are low, why would he lie?
Why Doctors Treat Patients as Drug Addicts
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