Filed under: General Problems | 2 Comments »
Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.
A report from Human Rights Watch accuses Tennessee of regulating opioids to the point of depriving patients in pain
Posted on December 22, 2018 by Pharmaciststeve
Human Rights Watch Accuses Tennessee Of Over-Regulating Pain Management
A report from Human Rights Watch accuses Tennessee of regulating opioids to the point of depriving patients in pain. Along with Washington State, the analysis focuses on Tennessee because of its new prescribing regulations, which are considered some of the strictest in the nation.
In its 109-page report, Human Rights Watch interviewed patients who were involuntarily weaned off of high-doses of powerful painkillers. Tennessee’s new law doesn’t directly impact so-called chronic pain patients, but it seems to have had a chilling effect. Several tell the advocacy organization that their doctors feel pressure to lower everyone’s dosages.
Gail Gray of Celina, Tennessee, tells HRW that her primary care physician cut her pain medication nearly in half but still felt like he could get in trouble. So Gray was forced to a clinic an hour away, which she worries might be a “pill mill” since they only take cash.
“I’m not comfortable with this. I feel like he [my primary care doctor] has pushed me into doing something that’s not right, and I don’t want to break the law,” she said.
More: Tennessee Doctors In Training Mode As Nation’s Tightest Opioid Restrictions Take Effect
HRW also interviewed clinicians, like a nurse practitioner from Vanderbilt’s hematology department who tells of her difficulty with insurance companies denying heavy prescriptions for a sickle cell patient.
A doctor in Knoxville describes how a new state law requiring physicians to try alternatives before turning to opioids has resulted in risky decisions. At times, he’s recommended surgery as a first course of action, just to avoid flack from regulators.
“It’s really against everything I was trained to do, but it’s the will of the legislators and regulators,” Dr. Joe Browder said.
The state did not respond to the study, which was funded by the U.S. Cancer Pain Relief Committee, a nonprofit with ties to pain management and the pharmaceutical industry. But Human Rights Watch says its top recommendation is for states to just limit the unintended consequences of cracking down on opioid prescribing.
Filed under: General Problems | 3 Comments »
7 y/o DIES: doc claimed symptoms …”were all in his head”
Posted on December 22, 2018 by Pharmaciststeve
‘Widespread and dangerous’: Facing medical uncertainty, some doctors tell patients it’s all in their heads
https://www.cnn.com/2018/12/21/health/medical-uncertainty-diagnosis-afm/index.html VIDEO ON LINK
When 7-year-old Bailey Sheehan arrived at a hospital in Oregon partially paralyzed, a doctor said the girl was faking her symptoms to get her parents’ attention because she was jealous of her new baby sister.
But that doctor was proved wrong when an MRI showed that the girl had acute flaccid myelitis or AFM, a polio-like disease that’s struck hundreds of children since 2014.
Erin Olivera, mother of a child with AFM and founder of a private Facebook page for parents of 400 children with the disease, says Bailey’s experience is hardly unique. She estimates that based on postings by parents, as many as 1 in 10 children were told that the paralysis was all in their heads when they first sought medical care.
Experts who study the art and science of diagnosis say the problem goes beyond this one rare disease. They say that in general, when presented with a puzzling disease, physicians too often leap to a diagnosis of a psychiatric problem.
“Mental disorders become the default position to deal with medical uncertainty,” said Dr. Allen Frances, former chair of psychiatry at the Duke University School of Medicine. “It’s widespread, and it’s dangerous.”
Dr. Mark Graber, president emeritus of the Society to Improve Diagnosis in Medicine, added, “It’s a tendency that physicians have when they can’t find a physical cause.
“It’s bad. It’s very bad.”
Bailey’s story
Bailey was a healthy little girl until October 28, 2014, when she suddenly couldn’t move her neck or her right shoulder or leg.
A rehabilitation expert at a children’s hospital said Bailey wasn’t really paralyzed, according to her mother, Mikell Sheehan.
The doctor said the paralysis was an emotional reaction to her sister’s birth four months earlier. He diagnosed Bailey with a mental condition called conversion disorder.
Sheehan told the doctor off.
Bailey Sheehan was diagnosed with AFM after her mother disagreed with an initial diagnosis.
“I said, ‘You’ve been with my child for 15 minutes, and you think it’s psychological? Get out of my face,’ ” she remembered.
Sheehan said the doctor hinted that she was unstable.
“He said, you know, ‘moms with new babies don’t get enough sleep,’ ” she said.
Bailey’s regular pediatrician, who’d known the girl since birth, disagreed with the diagnosis and pushed for further testing. That’s when the MRI showed that she had AFM.
Armed with the correct diagnosis, Bailey received treatment for AFM, including extensive physical therapy, and four years later is walking again.
“We were lucky that her pediatrician was such an advocate for us, but I don’t know if everyone’s that lucky,” Sheehan said.
Sheehan says she understands why doctors didn’t immediately think of AFM for her daughter, because the disease was not well-known four years ago. But there are several other causes of paralysis in children, and she wonders why her daughter didn’t get a full round of testing for those.
Dr. Benjamin Greenberg, a neurologist who’s seen cases of AFM across the country, said that even this year, when AFM has made headlines nationally, parents have told him that doctors have missed the disease and suggested that their children were faking their paralysis.
“The stories I can tell are maddening and saddening,” said Greenberg, associate professor of neurology at UT Southwestern Medical Center.
Four years later, Sheehan says, she still feels the scars from her daughter’s misdiagnosis.
“You feel violated and wrongly accused,” she said.
The dangers of false certainty
Though there’s no data indicating how frequently doctors misdiagnose physical conditions as psychiatric ones, experts in the field of diagnosis say they see it all too often.
It typically starts when a patient has a perplexing illness and doctors feel a need to come up with a diagnosis.
“Doctors are uncomfortable with not having answers,” Frances said.
The consequences can be “catastrophic,” he said, because a misdiagnosis can lead to a patient receiving treatment for a disease they don’t have and missing out on treatment for the disease they do have.
“False certainty is much more dangerous than uncertainty,” he said.
The American Medical Association and the American College of Emergency Physicians declined requests for comment.
Get CNN Health’s weekly newsletter
Graber, who is also professor emeritus of medicine at the Stony Brook University in New York, said part of the problem is that medical students are taught that physical symptoms sometimes have a psychological basis. That’s true, he said, but doctors need to thoroughly test for physical problems before defaulting to a psychiatric diagnosis.
“Physicians have an obligation to do a thorough workup before turning to a psychological explanation,” he said. “When a doctor can’t find a cause, that’s a great time to get a second opinion or consult with a specialist.”
Frances added that it’s OK for a doctor to simply say “I don’t know.”
“Doctors need to learn to embrace medical uncertainty,” he said.
Filed under: General Problems | 5 Comments »
OREGON | PAIN REFUGEES, POLICY, & A PRESCRIPTION FOR HARM
Posted on December 21, 2018 by Pharmaciststeve
https://youtu.be/dMZxmMwHeqU
Hello Everyone! PLEASE SUBSCRIBE! LET’S BE FRIENDS, FOLLOW ME EVERYWHERE MY LOVES: INSTAGRAM: http://www.instagram.com/cayleecresta TWITTER: http://www.twitter.com/cayleecresta YOUNOW: cayleecresta PATREON: https://www.patreon.com/cayleecresta & SEND ME LETTERS! PO BOX 234 Wilmington, MA 01887 For business inquiries: caylee.cresta@gmail.com Hello Everyone, Welcome to today’s video. I hope you’ll take the time to watch this documentary on the opioid policy currently being proposed in the state of Oregon. Pain patients face the potential for a severe loss of life & functionality if this proposal goes through. Regardless of overwhelming testimony, patient comment, and expert opinion, they continue to uphold the course of the policy. This is a story that truly needs to be seen to be believed, it is a story of dangerous ideology & the harm that can result when a policy is influenced by belief rather than data. As of now, Oregon patients continue to receive zero support from media outlets & have been forced to fight this battle alone. Please share as far & as wide as you are able so that we may protect the pain patients living today in fear. For more information please contact Oregon Pain Action Group on Facebook at www.facebook.com.group/oregonpainactiongroup/ Email Amara at oregonpainactiongroup@gmail.com Or amara4advocate@gmail.com Featured Article Links: https://www.foxnews.com/health/as-opi… https://thehill.com/opinion/healthcar… https://www.politico.com/story/2018/0… https://www.statnews.com/2018/12/06/o… https://www.washingtonpost.com/nation… https://www.huffingtonpost.com/entry/…
Filed under: General Problems | 6 Comments »
CVS Pharmacy tech with cerebral palsy sues CVS, claims discrimination
Posted on December 21, 2018 by Pharmaciststeve
Pharmacy tech with cerebral palsy sues CVS, claims discrimination
http://longisland.news12.com/story/39679576/pharmacy-tech-with-cerebral-palsy-sues-cvs-claims-discrimination VIDEO ON LINK
ISLIP TERRACE – A pharmacy technician with cerebral palsy is suing CVS, claiming discrimination.
Dana Paladino, of Islip Terrace, says CVS discriminated against her because of her disability. Paladino, who has cerebral palsy, says she’s worked at the CVS in Islip Terrace for 15 years and earned stellar reviews. But Paladino says she’s being pushed out by a new manager who allegedly told her she’s a “burden” to the company because of her physical limitations.
Paladino is now taking CVS to court with charges of discrimination against the pharmacy giant.
In the federal lawsuit, Paladino claims her physical limitations were never an issue until May 2017, when CVS hired a new manager who told her, “Either you’re going to quit, or I’m going to get you fired.”
Paladino says another manager told her months later that she was a “burden to the company and a burden to the store.”
The lawsuit claims Paladino’s managers cut her work hours, putting her at risk of losing her health benefits. Her attorney, Justin Marino, says the ordeal has been traumatic for her.
Disability advocate Douglas King says the actions of CVS’ managers clearly violated the American With Disabilities Act.
CVS issued a statement saying: “We dispute the allegations in the complaint filed by our employee, Ms. Paladino. Since the beginning of her employment at CVS, we have provided her with accommodations and we continue to do so.”
Paladino’s lawsuit seeks unspecified damages, but she says there’s more to her court battle than money — she says she wants to make sure the same thing doesn’t happen to anyone else in her position.
Filed under: General Problems | Leave a Comment »
FAKE NEWS: Paolo Antonio Argenzio Passed away on Monday December 10th 2018, from a self inflicted gunshot wound because of untreated pain
Posted on December 21, 2018 by Pharmaciststeve
Paolo Antonio Argenzio
https://everloved.com/life-of/paolo-argenzio/obituary/
Paolo’s obituary
Paolo Antonio Argenzio,
Passed away on Monday December 10th 2018, from a self inflicted gunshot wound. In 1999 Paolo graduated Boston University with a masters degree in Financial Management and would make use of until June of 2018. Having suffered a spinal injury after being struck by a drunk driver in October of 2014, Paolo endured chronic pain which increased after a failed back surgery in January of 2018.
Once his doctors without prior notice stopped prescribing Paolo pain medications, he would become bedridden and feel a burden to his family. Without finding alternative treatment for his pain, Paolo could no longer endure his suffering and in his final communication to his wife Teodara expressed his love for his family and wishes they remember him during his best days.
Paolo leaves behind a wife Teodara, three children Catherine, Edward and Mariana. His two siblings Angelo and Salvatore, nieces Liliana, Giselle, nephews Alberto and Ignacio.
Filed under: General Problems | 24 Comments »
The overwhelming source of the problem is cheap but powerful drugs coming in from Mexico by way of China
Posted on December 20, 2018 by Pharmaciststeve
Immigration: The Hidden Driver of the Opioid Epidemic
More than 900 Americans died every week from opioid-related overdoses in 2017. Every American community, big or small, has experienced the epidemic’s merciless, corrosive advance across our cities and towns. It is human tragedy, a family tragedy, and a national crisis.
The issue is complicated by the fact that tens of thousands of Americans need prescription pain medications for legitimate medical reasons. Pharmaceutical companies have been innovative in creating potent opioid based medicines and they were, and remain, rewarded with successful sales.
Some patients, however, abuse legitimate drugs, lie to treating physicians, and illegally sell otherwise lawful drugs. But the real problem is not from frazzled doctors, bad patients or bad medicine. The overwhelming source of the problem is cheap but powerful drugs coming in from Mexico by way of China.
There is another core contributor to the problem that isn’t as widely known: the river of illegal aliens surging across our porous borders. As former LA Times reporter Sam Quinones’ award-winning book, Dreamland: The True Story of America’s Opioid Epidemic recounts, just as standards for the prescription of oxycodone and other painkillers were being tightened, a group of largely illegal Mexican immigrants from Xalisco, in the Mexican state of Nayarit, pioneered a new model of heroin distribution. It was in essence Uber for drug dealers, involving small franchises, with a nonviolent approach, carrying small amounts of drugs directly to addicts in their homes and neighborhoods, using a customer-first mentality and lots and lots of delivery drivers.
From Dreamland, “The delivery drivers did tours of six months and then left. If they were arrested they were deported, not prosecuted, because they never carried large amounts of dope.” With hundreds of new illegal aliens from the state entering the country every day, the police could arrest as many street-level dealers as they liked. As a DEA agent tells Quinones in another part of the book, “We arrest drivers all the time and they send new ones up from Mexico. They never go away.” There would always be new dealers, and the model could continue. An essential part of the process was the dealers returning home, where their ill-gotten gains provided them with status in their rural, poor homeland.
Another law enforcement officer recounts to Quinones, “Their system is a simply thing, reall, and relies on cheap, illegal Mexican labor, just the way that any fast-food joint does.” That flow of dealers is the linchpin of the Nayarit model, which has since spread nationwide. Illegal immigration is the lynchpin of the flow of dealers. Stop illegal immigration, and you stop the flow.
The biggest contributor to illegal immigration are the loopholes in our laws, and our lack of southern border infrastructure. The Center for Immigration Studies has estimated that in the last two years, because of loopholes, more than 250,000 illegal aliens have been caught at the border and released. If even one-tenth of one percent of those illegal aliens are drug dealers, the Border Patrol will have actually caught 600 traffickers and released them to wreak their havoc in our communities.
There is also, of course, the fact that a porous border allows drugs to flow across the border, but people are much easier to interdict than fentanyl. That is why we must also deliver on the president’s border wall–providing $5 billion in unrestricted funding this year, immediately. The funding bill is the last train leaving the station, to stop the flow of drugs and the illegal aliens that bring them from pouring into our communities. Nancy Pelosi will ensure when she takes over as Speaker of the House that nothing will be done.
More than 49,000 Americans died last year from heroin and opioid related overdoses. If open-borders liberal Democrats or weak-kneed establishment Republicans stop us from fixing the problem by closing the loopholes and building the wall, they will be accomplices to the next 49,000 deaths as much as the drug dealers of Xalisco.
Filed under: General Problems | 2 Comments »
Vietnam Vet only gets enough pain meds to be able to leave his house 2-3 TIMES A YEAR
Posted on December 20, 2018 by Pharmaciststeve
Filed under: General Problems | 3 Comments »
He got out of his truck, sat down on top of his military records and took his own life with a rifle
Posted on December 19, 2018 by Pharmaciststeve
A Retired Marine Colonel Took His Life At A Florida VA. He’s The 5th Vet To Do So Since 2013
https://taskandpurpose.com/florida-va-veteran-suicide
ST. PETERSBURG — On Dec. 10, retired Marine Col. Jim Turner put on his dress uniform and medals and drove to the Bay Pines Department of Veterans Affairs complex. He got out of his truck, sat down on top of his military records and took his own life with a rifle.
Aside from leaving behind grieving family and friends, Turner, 55, of Belleair Bluffs, left behind a suicide note that blasted the VA for what he said was its failure to help him.
“I bet if you look at the 22 suicides a day you will see VA screwed up in 90%,” wrote Turner, who was well-known and well-respected in military circles. “I did 20+ years, had PTSD and still had to pay over $1,000 a month health care.”
Turner’s death marked the fifth time since 2013 that a veteran has taken his life at Bay Pines. There were more suicides there during those five years than at the rest of the VA hospitals in the state combined. There were none at the James A. Haley VA Medical Center in Tampa.
It’s unclear how many other veterans killed themselves during that period at VA facilities around the nation. The government’s second-largest bureaucracy declined a federal Freedom of Information Act request by the Tampa Bay Times for that information last year. In an email Friday afternoon, VA spokeswoman Susan Carter said the agency only started collecting the information a month after the denial.
From October 2017, to November 2018, there have been 19 suicide deaths at VA facilities around the United States, Carter said. The vast majority of veteran suicides are off campus and 70 percent of those who take their lives hadn’t sought treatment from the VA, according to VA statistics.
As for why it keeps happening at Bay Pines, officials there say they don’t have an answer.
***
Long before he became a statistic — one of 20 veterans who die by suicide every day — James Flynn Turner IV was a young man from a wealthy Baltimore family who joined the Marine Corps and reveled in his service to the nation.
“My brother’s identity was being a Marine,” said Jon Turner.
Jim Turner flew F-18s and then became an infantry officer, taking part in the invasion of Iraq in 2003. He later served in Afghanistan and spent a decade working at U.S. Central Command at MacDill Air Force Base.
He left “an enduring legacy of professionalism, commitment and superior leadership which served as a guiding force for all service members whose lives he touched,” said Edward Dorman III, a recently retired Army major general who worked with Turner at Central Command for a decade. “That’s a life worth emulating.”
When Turner retired, he lost his identity and began to struggle, his younger brother said.
Those problems exacerbated some of the mental health issues Turner was experiencing from his time in the Marines, said his ex-wife, and led to the dissolution of their 27-year marriage,
“He came home seemingly fine,” said Jennifer Turner. “It was a couple of years later that he just got more aggressive.”
It was never anything physical, she said. “He just got agitated very easily. He had nightmares, where he would wake up screaming military stuff.”
The problems reached a crescendo as Turner was retiring in 2015, his ex-wife said.
The couple decided to separate. In January 2016, while Jennifer Turner was out of town, Turner grew angry at his son and chased him out of the house with a gun. Pinellas County Sheriff’s deputies responded and detained him under the state’s Baker Act.
***
Jennifer Turner believes her ex-husband may have taken his life because he was refused treatment at Bay Pines. Both she and Jon Turner say it was quite possible he became frustrated with having to wait and left without being helped.
The VA did not comment, citing privacy concerns.
Others who lost a loved one to suicide at Bay Pines have different theories on why they chose to end their lives there.
Vietnam War Navy veteran Jerry Reid, 67, may have driven to the VA to take his own life on Feb. 7, 2013, because he lived alone and didn’t want to have his body found weeks or months later, said his friend, Bob Marcus.
Joseph Jorden, 57, a medically retired Army Green Beret, likely took his life at Bay Pines on March 17, 2017, not because of poor treatment, but because he felt safe there, said his brother, Mark Jorden.
But Gerhard Reitmann, 66, who served with the Marines in Vietnam and later as a guard for President Richard Nixon at Camp David, “felt like the VA wasn’t really taking care of him” when he ended his life at Bay Pines on Aug. 25, 2015, said his brother, Stephan Reitmann. To get one’s truck fixed, you can check this link right here now to get help finding the right spare parts.
The mother of Esteban Rosario, 24, who ended his life at Bay Pines on May 8, 2013, could not be reached for comment.
***
Regardless of why he took his own life, Turner left behind family and friends, many of whom gathered for a memorial service Friday afternoon in Largo, still struggling with the aftermath.
“Both of his heartbroken children are currently in school and they have lost their main means of financial support,” his sister-in-law, Katie Turner, wrote on a GoFundme site set up to help them “In lieu of flowers, the family has humbly requested donations for the children’s continued educational expenses. “
If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24/7 across the United States. Call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press “1” to reach the Veterans Crisis Line.
Filed under: General Problems | 8 Comments »
The VA cut my pain meds cold turkey after over 25 years. I now buy heroin on the street
Posted on December 19, 2018 by Pharmaciststeve
Paul Wayman, a 69-year-old veteran, wrote: “The VA cut my pain meds cold turkey after over 25 years. I now buy heroin on the street.”
“You need to talk with veterans. My friend has more metal and screws in him than a robot, but no more pain meds. Suicide is the only light at the end of the battlefield,” Wayman said. “I used to do a lot of volunteer work, loved doing it with my wife. Now I get high so I can walk.”
“All we’re asking is some relief. And some quality of life,” he said. “Ending life now is not on bucket list. I do think about it all the time.”
Wayman is among the hundreds who reached out to Fox News through emails and messages on social media, following the publication of a three-part series on the nation’s struggle to address its crippling opioid crisis, caused mainly by illegal drugs, and the unintended victims – chronic pain sufferers who have relied on prescribed opioids for relief – left in its wake.
Filed under: General Problems | 15 Comments »
Physicians, NPs, PAs, pharmacists, PLEASE HELP! Take the 2-minute CLINICIAN OPIOID TAPER SURVEY AT https://lnkd.in/epVRiYY … Share with other prescribing clinicians!!!