Pain Management :benefits included no longer witnessing the patient suffering, a diminished caregiver burden on spouse

Hip and knee replacements bolster marriages, study finds

https://www.foxnews.com/health/hip-and-knee-replacements-bolster-marriages-study-finds

Orthopedic surgeons are well aware that joint replacement surgeries can reduce patients’ pain and emotional distress, however a recent study explored how hip and knee replacements can improve marriages, too.

“It started with a thank you note,” Dr. Michael Tanzer, lead author and orthopedic surgeon at McGill University Health Center in Montréal, Québec, said in a press release. “My patient’s wife wrote to tell me how delighted she was to have her husband’s quality of life back because of the dramatic effect it had on her own life and their marriage. This one gesture of gratitude made me think about the impact of joint replacement surgery in a way I had taken for granted.”

The impact of joint replacement surgery can extend far beyond an improvement in pain and mobility, one study recently noted. (iStock)

The study noted how spouses of such patients often assume the role of caregiver. Research has demonstrated how spouses report reduced marital satisfaction, higher rates of depression and a lower quality of life.

Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage that cushions the ends of bones wears down over time, according to the Mayo Clinic. In severe joint damage, hips and knees are most often replaced to relieve pain and improve mobility.

Hips and knees see the most replacements to alleviate severe joint damage, experts say. (iStock)

Tanzer said the team conducted a pilot study to evaluate spouses’ perception of patients’ pain and disability before and after total hip or knee replacement.

The study’s sample of 33 couples, who were on average 68 years old, revealed that the spouses rated the patients’ pain levels “significantly” higher, both before and after surgery, as opposed to what the patients reported.

Patients said the most significant effect from surgery was their improved mobility. Other benefits included resuming leisure and sporting activities, an improvement in pain and improvement in social and family lives.

Meanwhile, spouses had different priorities.

Most of them said the largest advantage post-surgery was the ability to carry on with social and leisure activities with their partner. Other benefits included no longer witnessing the patient suffering, a diminished caregiver burden and a sense of independence to resume their normal life, among other advantages.

“As an orthopedic surgeon, it’s important to consider the well-being of your patient’s spouse and know that they too are likely experiencing the burdens of living with a functional disability,” Tanzer said.

“The emotional and social impact as well as the physical challenges can be many and by continuing to research and bring more resources to the clinical setting, we can help both orthopedic surgeons and patients create a better quality of life from diagnosis through to treatment.”

In the study, couples had been married for an average of 36.5 years. To participate in the study, subjects had to have been living with a spouse for at least five years before the surgery. The patients lived with an osteoarthritis diagnosis for an average of seven years, with an average wait time of 8.7 months to receive an operation.

The study was released as part of the American Academy of Orthopedic Surgeons’ Virtual Education Experience called “Marital Relationship and Quality of Life in Couples Following Joint Replacement Surgery.”

Detroit Healthcare Fraud unit has revealed that it aggressively charges healthcare practices on the basis of statistics rather than actual patient care

19 Detroit Healthcare Professionals Indicted for Unlawful Prescribing

https://www.healthcaredefenseblog.com/post/19-detroit-healthcare-professionals-indicted-for-unlawful-prescribing

The United States Attorney for the Eastern District of Michigan indicted nineteen healthcare professionals today, June 11, 2020. See Indictment Below.

United States v. Rankinpdf

The indictment alleges that between September 2017 and June 2020 the Defendants engaged in a scheme involving the unlawful distribution of opioids. The indictment alleges that the conspiracy was between medical clinics, rehab centers and pharmacies involving nearly two million controlled substances of a value of over $41 million. The Indictment alleges over forty-four independent violations of 21 U.S.C. 841(a) and it also alleges that the nineteen defendants engaged in a conspiracy to violate 21 U.S.C. 846 – controlled substance conspiracy. The indictment was issued by Detroit’s Healthcare Fraud Unit and will be prosecuted by Brandy McMillion and Mitra Jafary-Hariri, two federal prosecutors in that division. The Detroit Healthcare Fraud Unit is very experienced at prosecuting healthcare fraud and opioid trafficking cases.

All defendants are innocent until proven guilty and prior experience with the Detroit Healthcare Fraud unit has revealed that it aggressively charges healthcare practices on the basis of statistics rather than actual patient care. This practice is a new tactic by the DOJ and can lead to charging errors and unnecessary government scrutiny.

In order to convict health professional for unlawful distribution of controlled substances (sometimes referred to as running a pill mill) the Government must prove that the physicians prescribed controlled substances for “other than a legitimate medical purpose and outside the course of professional practice”. This is a very difficult standard to meet. The Government must show that prescriptions were not for pain but rather in order to achieve some other unlawful purpose.

To Learn More About the Standard See Our Resources Page Here

To Learn More About the History of the Controlled Substance Act Click Here

Defense of unlawful distribution charges requires a focused defense that highlights the patient care provided to each individual patient and knowledge of Federal Drug Laws, CDC Guidelines for Prescribing, and the standards of practice for pain management (ASIPP, ASAM, etc.). As this case progresses, there are sure to be a significant number of Michigan pain patients separated from their provider. Often, prosecutors and the DEA fail to consider this fact because they believe that all prescriptions issued in such a practice are unlawful.

To Learn More About Government Prosecution Tricks Click Here

Before agreeing to any plea to unlawful distribution, a physician must consult with an experienced healthcare defense attorney who understands the law, medicine, and applicable standards. If you are a provider facing Government scrutiny read this before considering a plea of guilty.

The case is pending before Judge Bernard Friedman and Magistrate David R. Grand. More updates to follow.

Ronald W. Chapman II@RonChapmanAtty is a healthcare defense attorney and specializes in representing physicians and other health professional in government investigations and indictments related to the practice of medicine. He speaks nationally on the topic and has appeared in national publications. He obtains frequent victories for his clients facing government scrutiny.

In reading the court papers the actual total of oral doses was 1,951,148 and out of the 19 charged – 6 had the legal right to prescribe.   The actual time frame involved is ab 34 months ( Sept 2017 – June 2020).

According to this.. it would appear that no pt records were reviewed, no pts had any in person physical exam.. this is a statistical conclusion of guilty. The charges were determined by a GRAND JURY.. and it is claimed that our GRAND JURY system is so designed that if a prosecutor wanted to get a “ham sandwich” charged… it would be quite possible.  As I understand our GRAND JURY system.. only the prosecutor presents “the facts” to the GRAND JURY from which the final conclusion/charges are reached.

The law suit only mentions the strengths of Oxycodone 30 mg and Oxymorphone 40 mg… the first is available as a IR & ER in that strength and the latter is only available as a ER.

So these 6 prescribers collectively – on average – prescribed 57,387 doses/month over the 34 month period.

Meaning that – on average – each prescriber wrote for 9,654 doses/month

Using dosing averages that would represent best practices and standard of care for chronic pain pts..  each prescriber would have 46 pts/month

Looking at 5 day work week.. each prescriber – on average – would be writing prescriptions for abt 9 pts/day.

The typical prescriber will see upwards of 30 pts in any given day.  So these numbers would suggest that LESS THAN 1/3 of the pt office visit would result in a opiate Rx written.  This doesn’t seem to describe what is typically described as what is a “pill mill”

These conclusions are based on averages and what information that was provided in the lawsuit… which there is a link to the *.pdf on the above link to the original article.

 

Pain-Warriors – the movie -to be released May 25th – pre-order now from Amazon

Pain-Warriors – the movie -to be released May 25th – pre-order now from Amazon

Dear friends ,

We DID it ! Pain Warriors is officially released , and available for viewing worldwide . A big thank you for everyone’s belief in us .

We need your support , at this crucial time of programming Pain Warriors across North America and beyond , while the film is fresh out of the door.

Our reviews on IMDb are up to 17 ! From my direct community outreach efforts , the past 2 weeks .

Good reviews , Lots of them , are what make us noticed and desirable to Media, cable TV and Netflix , etc.

Please , if you, your spouse, family member or friend has viewed our film and you are not in the tail credits , leave a review NOW on the IMDb site link below. Time is of the essence.

We are in our peak selling time to broadcasters.

Thanks so much, Tina Petrova
May the force be with us ! Team Pain Warriors.

Here is the direct link below to the IMDb review page .

https://www.imdb.com/title/tt8438478/reviews

www.tinapetrova.com

Are COPS getting a little KARMA ?

https://i.ytimg.com/vi/Uhcoo8JlQu4/maxresdefault.jpg

those in our legal system seems to be getting some of their “own medicine” … there is data after data that shows that <1% of those prescribed opiates for chronic pain will become addicted. 

How the media and “black lives matters” have turned on ALL POLICE FORCES… and now they are claiming that <1% of cops are “bad apples”, but it seems that few are buying that fact/argument.

Now the marches and protests are entering their third week.

I haven’t heard anything about holding US Marshals, FBI, DEA, and SWAT to a higher standard and reducing the budgets of these parts of our judicial system as being suggested as to what should happen to other police groups.

Perhaps the community of subjective diseases should take notice… particularly of the numbers that have been marching in the streets and how many days – in a row -they have been marching and so far what has been accomplished.. a lot of talk ?  Chicago recently had the most shooting in a single day in over 60 yrs.

And those in the community wonders why having a few dozen people show up for a protest and nothing happens …. and they wonder why ?

The Rapp Report

Welcome to The Rapp Report Chronic Pain Crusade blog. Here I will post podcast episodes, general information, statistics, and news on the opioid crisis and the negative effects it has on the chronic pain community. Our goal is to spread the information around to as many people as possible in order to educate and inform and hopefully enact positive change so that CPP’s can resume getting the treatment they so desperately need.
Feel free to share your own stories or articles. If you want your story told in the podcast, just let either myself or my beautiful wife, Dana Rapp know! Be sure to subscribe to the podcast at https://therappreportpodcast.podbean.com/
If you are an Apple user, please leave a rating and review on Apple Podcasts so others can find us!
You can reach us by email at therappreport.podcast@gmail.com
The rules are simple:
  1. Be polite. Be respectful. We’re in this fight together!
Thank you all for joining in this great crusade!

 

People Rarely Die After Using Opioids Prescribed for Them

People Rarely Die After Using Opioids Prescribed for Them

https://reason.com/2020/01/23/people-rarely-die-after-using-opioids-prescribed-for-them/

Although prescription pain medication is commonly blamed for the “opioid epidemic,” such drugs play a small and shrinking role in deaths involving this category of psychoactive substances. A recent study of opioid-related deaths in Massachusetts underlines this crucial point, finding that prescription analgesics were detected without heroin or fentanyl in less than 17 percent of cases. Furthermore, just 1 percent of decedents had prescriptions for the opioids that showed up in toxicology tests.

Alexander Walley, an associate professor of medicine at Boston University, and five other researchers looked at nearly 3,000 opioid-related deaths with complete toxicology reports from 2013 through 2015. “In Massachusetts, prescribed opioids do not appear to be the major proximal cause of opioid-related overdose deaths,” Walley et al. write in Public Health Reports. “Prescription opioids were detected in postmortem toxicology reports of fewer than half of the decedents; when opioids were prescribed at the time of death, they were commonly not detected in postmortem toxicology reports….The major proximal contributors to opioid-related overdose deaths in Massachusetts during the study period were illicitly made fentanyl and heroin.”

Since the researchers considered only active prescriptions, it’s possible that other decedents had been prescribed pain medication at some point in the past. It’s also possible that some of them were introduced to opioids through medical care and became addicted to them, later switching to the illicit drugs they took before their deaths. But that pattern does not appear to be very common.

A 2007 study reported in The American Journal of Psychiatry found that 78 percent of OxyContin users seeking addiction treatment reported that they had never been prescribed the drug for any medical reason. Other studies have found that only a small minority of people treated for pain, ranging from something like 1 percent of post-surgical patients to less than 8 percent of chronic pain patients, become addicted to their medication. A 2015 study of opioid-related deaths in North Carolina found just 478 fatalities among 2.2 million residents who were prescribed opioids in 2010, an annual rate of 0.022 percent.

That unusual scenario nevertheless figures prominently in discussions of opioid abuse and in criticism of pharmaceutical companies accused of causing the problem by exaggerating the benefits and minimizing the risks of their products. The focus on pain pill prescriptions is clearly disproportionate given their actual role in opioid-related deaths. It has led to policies that deprive bona fide patients of the medication they need while pushing nonmedical users toward black-market substitutes, which are far more dangerous because their potency is unpredictable.

Dr. Thomas Kline, MD, PhD: Medical Myths Revealed: Pharmacies MUST be better

almost weekly we are hearing more stories of pharmacists using one of 40 excuses that twitter is giving us. pharmacists have a duty and a right to interfere with prescriptive instructions and stop any prescription for cause, AKA not out of their own prejudge and fears. the courts have ruled that pharmacists can not refuse to fill because of moral beliefs. And that needs to include any phone reasons not based on a reason that finding Broadway covers picking out pain medicines to sabotage. This is raw discrimination and depriving somebody of needed prescription drugs is more than cruel.

Dr Mark promoting MJ in MT for various health issues

pained lives matter

Scientists retract study that found antimalarial drugs dangerous for coronavirus patients

Scientists retract study that found antimalarial drugs dangerous for coronavirus patients

https://www.foxbusiness.com/markets/scientists-retract-study-that-found-antimalarial-drugs-dangerous-for-coronavirus-patients

Three authors of a large study that last month found antimalarials provided no benefit to treating Covid-19 infections, while increasing the risk of heart problems and death, retracted their findings.

The authors said in a statement Thursday provided by The Lancet, the medical journal that published the study on May 22, that they decided to issue the retraction after Surgisphere Corp., the private company that provided the research data, refused to share the full, detailed data set as part of a review after outside researchers raised concerns.

“We always aspire to perform our research in accordance with the highest ethical and professional guidelines,” said the authors, Mandeep Mehra, Frank Ruschitzka and Amit Patel. “We can never forget the responsibility we have as researchers to scrupulously ensure that we rely on data sources that adhere to our high standards. Based on this development, we can no longer vouch for the veracity of the primary data sources.”

The authors also said they apologized for “any embarrassment or inconvenience that this may have caused.”

The Lancet said in a statement that it “takes issues of scientific integrity extremely seriously, and there are many outstanding questions about Surgisphere and the data that were allegedly included in this study.”

The peer-reviewed study analyzed medical records of 96,000 patients hospitalized across six continents with confirmed coronavirus cases from Dec. 20 to April 14. Of the total, 15,000 patients were treated with the malaria drugs alone or in combination with an antibiotic.

Its findings indicated the antimalaria drugs, which many doctors have used to treat Covid-19 patients, didn’t help and might even hurt patients.

Following the study, the World Health Organization paused enrolling patients in clinical trials testing hydroxychloroquine, although this week the organization said it resumed the trials.

More than 100 researchers have raised questions about the data behind the study and about Surgisphere, which had supplied it.

Surgisphere said it has petabytes of data from more than 100 million patients, culled from some 1,200 hospitals and institutions on six continents. Yet many researchers and some hospitals said they had never heard of Surgisphere.

The founder of Surgisphere, Dr. Sapan Desai, was the other author on the paper. Dr. Desai couldn’t be reached for comment.