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Thread: Pain Control. Just curious..

  1. #81
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    Quote Originally Posted by Mrs Parker View Post
    I've been debating posting this article, but I think it's important.

    Trigger/Content Warning- discussion of suicide as it relates to chronic pain, forced tapers, etc.

    Normally, I'd cut and paste the content, but because of the sensitive nature of the article, I'm not going to.
    If you would like to read it, it's here:
    https://medium.com/@ThomasKlineMD/op...s-c68c79ecf84d

    The headline is: #OpioidCrisis Pain Related SUICIDES associated with forced tapers
    May 30, 2018 More PAIN RELATED SUICIDES added associated with opioid pain medication reductions and discontinuations as recommended by the CDC and by Andrew Kolodny, M.D. and his “Physicians for Responsible Opiate Prescribing” (PROP)
    -Thomas Kline, MD, PhD
    @Mrs Parker...whooo...that is tough reading. I see myself in a number of stories because many of my medical issues are dismissed as 'not that significant' but given how many problems I have and how long they've gone on, I am positive that there is no alternative to effective dosing of opioids which did turn my life around.

    I guess I'm lucky(?) that I'm doing my own tapering, in my own sweet time but I just cannot stand the office visits to review what doesn't change, the urine tests that prove over and over that I'm using what I'm prescribed, the unhelpful ER people when I neeed to go in for unrelated problems, and the constant threat of being turned over to a pain clinic. Now I know some - @snowy - have decent luck at pain clinics but the only ones that I'd consider are more than an hour away. For some that may sound good enough but it's just more than I can handle. I have no life with all of the other medical appointments that to add more in wouldn't be adding to the quality of my life. I will be first in line when the damn MJ stores finally get allowed to open (July 1st...yeah legal except they weren't given licenses!)

    And I just read a story about 2 towns in the state, Lowell and Lawrence got surprised by a big jump in HIV from sharing needles, many in the homeless community who don't have medical access. Also one of the town's was mentioned as having its own fentynal factory pumping out so much that it was cheaper than anything out there.
    Helpful jaders Rated helpful
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    Pain Control. Just curious..
  3. #82
    Quote Originally Posted by Bawston View Post
    @Mrs Parker...whooo...that is tough reading. I see myself in a number of stories because many of my medical issues are dismissed as 'not that significant' but given how many problems I have and how long they've gone on, I am positive that there is no alternative to effective dosing of opioids which did turn my life around.

    I guess I'm lucky(?) that I'm doing my own tapering, in my own sweet time but I just cannot stand the office visits to review what doesn't change, the urine tests that prove over and over that I'm using what I'm prescribed, the unhelpful ER people when I neeed to go in for unrelated problems, and the constant threat of being turned over to a pain clinic. Now I know some - @snowy - have decent luck at pain clinics but the only ones that I'd consider are more than an hour away. For some that may sound good enough but it's just more than I can handle. I have no life with all of the other medical appointments that to add more in wouldn't be adding to the quality of my life. I will be first in line when the damn MJ stores finally get allowed to open (July 1st...yeah legal except they weren't given licenses!)

    And I just read a story about 2 towns in the state, Lowell and Lawrence got surprised by a big jump in HIV from sharing needles, many in the homeless community who don't have medical access. Also one of the town's was mentioned as having its own fentynal factory pumping out so much that it was cheaper than anything out there.
    I see myself in those stories too. As I read through the list of lives lost and their circumstances, I just sat here
    and sobbed. I know without one shred of doubt that if I didn't have my son to care for, I'd be on that list.
    That's a hard thing to admit 'out loud', but it's true. I think many of us know that place of exhaustion,
    vilification, desperation, isolation, and bone-crushing pain that can lead to a choice like that.

    I too live with the threat of, "Well, if you don't like tapering, we'll send you over to the pain clinic."
    The pain clinics here are not well regarded and local pharmacists are at best reluctant to fill Rx's
    from them (and, at worst, are real pr_cks about it....) They are known for pushing expensive shots,
    no matter what your situation is, require frequent mri's, (who has the cash for that?!?) require frequent random
    pill counts, and make you sign contracts that say you can't be treated by anyone else for any reason.

    I've signed away enough freedoms as it is, I really don't want to lose the last shreds of control I have over
    my life and my body.

    I dread visits to my rheumatologist for fear of what she'll cut next and by how much and she's fairly
    kind about it at least. I feel so awful for people who've been yanked off their meds with no warning,
    no taper, no nothing. Ok, I think I'm done ranting... for now. Thanks for listening.
    Helpful Keith K Stone, snowy, trish5959 Rated helpful
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    Nolite te bastardes carborundorum, b_tches!

  4. #83
    ::Sigh...::

    http://m.arkansasonline.com/news/201...I5EpdM.twitter

    Efforts to curb the nation's opioid epidemic have led some pharmacies, such as those at Walmart and Sam's Club, to enact new policies limiting the dosage and supply of the medications dispensed to some patients, despite what the doctors prescribed.

    Pharmacists and others in the prescription drug supply chain say they are just doing their part to end a crisis that led to the deaths of 32,000 people in the United States in 2017 and sent countless more to hospitals and treatment centers.

    Physician groups and patient advocates are concerned about Walmart's opioid policy that limits the dosage and supply of the prescription drugs pharmacists can dispense. They say management of a patient's pain should be handled by doctors, not pharmacists.

    As part of a multipronged approach to address opioid overuse and abuse, Bentonville-based Walmart said in early May that its pharmacies would begin limiting first-time opioid prescriptions to a seven-day supply or less, depending on applicable state laws. Introduced at all Walmart and Sam's Club pharmacies over a 60-day period, the policy also restricts the daily maximum dosage patients can receive to the equivalent of 50 morphine milligrams.

    CVS Health, the nation's largest pharmacy chain, implemented a similar policy in February. Medicare and Medicaid also are changing their coverage limits for opioids prescribed for acute pain. In addition, 32 states to date have adopted laws limiting the supply and dosage of the drugs that can be prescribed and dispensed. Most exempt patients have cancer or are receiving end-of-life or palliative care.

    Walmart and Sam's Club operate 4,473 pharmacies in the U.S., according to a June market research report. According to Sam's Club's corporate website, it operates 566 pharmacy locations nationwide. CVS has 9,207 stores.



    In an emailed response, a Walmart spokesman said the company adopted the new policy and dispensing limits because "the health and safety of our patients is a critical priority."

    The spokesman said the seven-day initial fill policy for those with acute pain aligns with U.S. Centers for Disease Control and Prevention recommendations made in a March 2016 report. That research found the group most vulnerable to addiction to opioids is those in acute pain, often from recent injury or surgery, and taking pain medication for the first time.

    Patients with chronic pain or refilling prescriptions are less likely to become addicted. Taking an initial acute prescription for longer than seven days increases the risk of addiction, according to the CDC, and the risk of overdose rises at dosages higher than 50 morphine milligram equivalents.

    The Walmart spokesman said that the company understands there may be instances where the need to manage a patient's pain outweighs the risk of addiction or overdose. "We will continue to empower our pharmacists to work with their patient's prescribers and use their professional judgment (to the extent they can within the confines on an applicable law) in those cases."

    The American Pharmacists Association supports these policies in their emphasis on the pharmacist's role. On its website, it states that while any effort to address prescription drug abuse must balance patient needs with the need to prevent abuse, "pharmacists' knowledge, accessibility and expertise puts them in a unique position to help combat this epidemic."

    A spokesman for the association pointed out a section of its policy supporting "recognition of pharmacists as the healthcare providers who must exercise professional judgment in the assessment of a patient's conditions to fulfill corresponding responsibility for the use of controlled substances and other medications with the potential for misuse, abuse and/or diversion."

    DOCTORS WEIGH IN

    The American Medical Association has taken a number of steps to combat the opioid crisis. One of these is the formation of an opioid task force. This group encourages doctors to take continuing medical education or other courses on opioid prescribing, pain management, addiction and other related topics.

    Dr. Patrice Harris, chairman of the American Medical Association's opioid task force and the association's president-elect, said physicians are writing fewer prescriptions for opioids, and that drugs such as heroin and illegally obtained fentanyl now account for the most deaths and overdoses. She has said the association has concerns about laws and pharmacy policies that regulate how doctors treat pain. Association members believe those decisions should be made by doctors based on a patient's needs.

    The association supports other measures such as prescribing non-opioid medications when possible or alternative treatments like physical therapy when appropriate; using state prescription drug monitoring programs; providing comprehensive treatment for substance abuse disorders; co-prescribing naloxone to patients at risk of overdosing; and encouraging safe storage and disposal of opioids and all medications.

    WHO'S TO BLAME

    More than 200 lawsuits have been filed nationwide by cities and counties seeking reimbursement for the costs of handling opioid-related deaths, emergency services and substance abuse treatment. The law firms of Crueger Dickinson LLC and Simmons Hanly Conroy represent the plaintiffs in most of these lawsuits, all of which claim pharmaceutical manufacturers deceptively marketed the drugs. The suits also claim prescription drug distributors and pharmacies failed to maintain effective controls over their distribution.

    The Healthcare Distribution Alliance, the national trade association representing pharmaceutical distributors, takes issue with being characterized as part of the problem.

    Responding to a recent court filing, alliance Senior Vice President John Parker said in an email: "The misuse and abuse of prescription opioids is a complex health challenge that requires a collaborative and systemic response that engages all stakeholders. Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated.

    "Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation," Parker said.

    Like the other stakeholders striving to curb the opioid crisis, the distributors recognize the need to work collaboratively to attack the problem from all fronts.

    In February, the alliance joined other groups representing the pharmaceutical industry to form a national education and awareness initiative called Allied Against Opioid Abuse. The collaborative effort aims "to engage providers, pharmacists, and the public in education about the rights, risks and responsibilities associated with prescription opioids," according to a news release announcing the initiative.

    "We all have a role to play in developing and advancing meaningful and responsible solutions to address the serious and complex issues raised by the opioid abuse epidemic," said John Gray, alliance president and chief executive officer.
    Nolite te bastardes carborundorum, b_tches!

  5. @Mrs Parker, i've read that in a number of cities the admins are refusing to stock narcan because they feel they are "wasting" the money on addicts, especially those who need it more than once. they'd rather people die than pay for narcan and an ambulance ride. unbelievable.

    and i would wager those ods are not from prescription drugs either. but here in bizarro world we pretend that docs kill the patients, not illegal heroin and fentanyl. alternative facts kill.
    Helpful LeeAnn, Squelix Rated helpful

  6. #85
    Quote Originally Posted by notcharlotte View Post
    @Mrs Parker, i've read that in a number of cities the admins are refusing to stock narcan because they feel they are "wasting" the money on addicts, especially those who need it more than once. they'd rather people die than pay for narcan and an ambulance ride. unbelievable.

    and i would wager those ods are not from prescription drugs either. but here in bizarro world we pretend that docs kill the patients, not illegal heroin and fentanyl. alternative facts kill.
    Nolite te bastardes carborundorum, b_tches!

  7. #86
    @notcharlotte "bizarro world," made me laugh. You got that absolutely correct.
    @Mrs Parker Thank you for the article.

    Great posting gals. M
    Last edited by Mecha; 2 Weeks Ago at 03:58 PM.
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    Quote Originally Posted by Bawston View Post
    @Mrs Parker...whooo...that is tough reading. I see myself in a number of stories because many of my medical issues are dismissed as 'not that significant' but given how many problems I have and how long they've gone on, I am positive that there is no alternative to effective dosing of opioids which did turn my life around.

    I guess I'm lucky(?) that I'm doing my own tapering, in my own sweet time but I just cannot stand the office visits to review what doesn't change, the urine tests that prove over and over that I'm using what I'm prescribed, the unhelpful ER people when I neeed to go in for unrelated problems, and the constant threat of being turned over to a pain clinic. Now I know some - @snowy - have decent luck at pain clinics but the only ones that I'd consider are more than an hour away. For some that may sound good enough but it's just more than I can handle. I have no life with all of the other medical appointments that to add more in wouldn't be adding to the quality of my life. I will be first in line when the damn MJ stores finally get allowed to open (July 1st...yeah legal except they weren't given licenses!)

    And I just read a story about 2 towns in the state, Lowell and Lawrence got surprised by a big jump in HIV from sharing needles, many in the homeless community who don't have medical access. Also one of the town's was mentioned as having its own fentynal factory pumping out so much that it was cheaper than anything out there.
    I stopped going to pain clinics. It felt like they thought I was hiding something. They asked about me using PKs. I told them what my GP gives me (actually it's enough for a small bird that stubbed his toe). They asked if I ever purchased anything from anywhere else. Adjusting my halo, I said, "Oh no, I would never do anything like that!" I wish I could've been honest and said "Yeah! Ever heard of PR?? It's a forum for people to purchase meds! We have no choice when we can't get what we need from doctors! So how do ya like that!??
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    @ Mrs Parker...first, I'd like to thank you for mentioning Dr Kline. I had not heard of him but started reading his articles and found this regarding palliative care which I'm pretty sure most of us fall under AND which would seem to exempt us from these idiotic laws created by non medical people:

    When we read the CDC Guideline and found on line one: “This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.” Palliative care has always been the standard of practice for patients suffering from painful diseases having no cure.
    This CDC Guideline, line one, protected our long-term pain or palliative care patients and also protects us as practitioners. We can use FDA approved titration dosing methodology to whatever it takes, no “cutoffs”.

    There is the perception, magnified by single case reports, of addiction occurring in just about anyone. If this were the case with all the opioids being prescribed there should be far more cases of addiction than there are. The government reports 2 million cases of opioid use disorder (SUD), a newly created category of people who “used their prescription opiate in a way other than prescribed” hoping everyone would believe this is the same as opiate addiction, which it is not. The fear and concern it caused?—?worked.
    Even if the SUD figure were not inflated by a factor of 200% two million OUDs claimed by household survy divided by the US population of 320 million gives a rate of 6 addictions per 1000 people, fairly rare. There has been a fixed occurrence rate of addiction over time going back to the 1920s, ruling out environmental factors such as availability of opiate pain medicine. No one can become addicted if they have a history of opiate use without addiction. 994 people of 1000 population will never become addicted.
    We wanted to share this paper with you, our fellow medical practitioners, to encourage all primary care providers to offer palliative care in their practices for patients suffering from intractable pain of any origin. The evolution of palliative care, CDC exemptions, and reimbursement will be explained. Finally, guidance will be given on how physicians and practitioners can easily start offering palliative care without restrictions on pain medication dosage ethically practice on patients with less fear of retribution, and to be reimbursed for the extra time in caring for people with long term illness.

    “If we know that pain and suffering can be alleviated, and we do nothing about it, then we ourselves become the tormentors.”?—?Primo Levi

    Palliative care allows more comprehensive and humane treatment as it is exempted from opioid dosage restrictions set by CDC and many states over the past two years. Primary care doctors and practitioners can avoid restrictions if their patients qualify for palliative care. (1)
    Pain care becomes palliative care when three criteria are met:
    - The underlying disease has no cure.
    - There is a likelihood that the disease may shorten lifespan.
    - Symptomatic treatment has a high probability of improving the quality of life.

    EVOLUTION/DEFINITIONS OF PALLIATIVE CARE: WHAT IT IS AND WHAT IT IS NOT

    Palliative care is not new. The concept was created by Balfour Mount, a Canadian-trained physician serving as visiting professor at the first hospice, St. Christopher’s Hospice in London. In 1973, he established a palliative care program at Royal Victoria Hospital in Montreal, the first palliative care program to be integrated in an academic teaching hospital. (2) Palliative care has evolved in scope since that time.

    DOSAGE RESTRICTIONS WAIVED BY CDC AND MOST STATES
    The palliative care exemption in the CDC restrictions regarding the prescribing of opioid pain medicine gives providers the freedom to do what is proper to manage pain. As mentioned the CDC Guideline page one, line one: exempts palliative care from the rest of the “Guideline”. Nothing in the “Guideline” that follows applies to the palliative care patient you have in your office.

    Most states provide palliative care exemptions as well. Palliative care is for all prognosis levels, diagnoses, and ages groups. The only qualifications are unavailability of a cure and persistent symptoms. It can be CHF with shortness of breath, COPD with intractable coughing, or a person with lupus, arachnoiditis, or advanced arthritis where cure is impossible and treatment focuses on symptoms of pain interfering with the enjoyment of life. It is no different than certifying one of your patients’ needs cardiac care or comprehensive diabetic care. Only licenced personnel can establish or unestablish diagnoses: “palliative care status” (PCS), a new term as well, is a
    By the same token, people without licenses cannot try to ignore or remove Palliative Care Status (PCS) once in place. Pharmacists, insurance executives, or other doctors not involved with the primary care cannot interfer with the PCS diagnoisis or try to ignore it. It is law in most states and for the Veternes adminstration. Once the PCS is determined, CDC, VA, and state restrictions for opioid prescribing are bypassed. If palliative care is not mentioned in the law, regulation, or guidelines, then the PCS does not apply.
    Last edited by Bawston; 2 Weeks Ago at 04:35 PM.
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    Quote Originally Posted by snowy View Post
    I stopped going to pain clinics. It felt like they thought I was hiding something. They asked about me using PKs. I told them what my GP gives me (actually it's enough for a small bird that stubbed his toe). They asked if I ever purchased anything from anywhere else. Adjusting my halo, I said, "Oh no, I would never do anything like that!" I wish I could've been honest and said "Yeah! Ever heard of PR?? It's a forum for people to purchase meds! We have no choice when we can't get what we need from doctors! So how do ya like that!??
    @snowy... I'm picturing you saying "oh no!" And doing big eyes while putting a hand over your heart. Isn't it sort of like signing those pain contracts where you promise to not get meds from anywhere else and only go to one pharmacy? If you're going to do it, signing their silly contracts surely isn't going to stop anyone.

    I thought you were going to a pain clinic after reading about those calls for you to run in for a pill count.
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    Quote Originally Posted by Bawston View Post
    @snowy... I'm picturing you saying "oh no!" And doing big eyes while putting a hand over your heart. Isn't it sort of like signing those pain contracts where you promise to not get meds from anywhere else and only go to one pharmacy? If you're going to do it, signing their silly contracts surely isn't going to stop anyone.

    I thought you were going to a pain clinic after reading about those calls for you to run in for a pill count.
    No that's the clinic where my GP is. The clinic's policy is apparently to treat pain patients like the scum of the earth. Something new just happened today:I received a letter from them in the mail, wanting me to sign a paper to allow my medical records be given out without my permission. WHAT? No way will I sign that!! What is this world coming to?
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    Quote Originally Posted by snowy View Post
    No that's the clinic where my GP is. The clinic's policy is apparently to treat pain patients like the scum of the earth. Something new just happened today:I received a letter from them in the mail, wanting me to sign a paper to allow my medical records be given out without my permission. WHAT? No way will I sign that!! What is this world coming to?
    @snowy...what the what? Why would they even think that was acceptable or that anyone would approve that? I would be suspicious though thatbtheyd just go ahead and do it and wonder if rather than just ignoring it, if it makes sense to specifically write on it "no, you DO NOT have my permission and if my HIPPA rights are violated I will pursue this". Just seems kind of sketchy since they already can ignore your HIPPA rights in certain cases so who else would they be giving it to?

    I always wonder sometimes if you ignore things like this they go to the default of " patient didn't respond so we assumed she was in agreement with our request".

    I think we really have wandered into bizarro world.
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  13. Quote Originally Posted by Bawston View Post
    @ Mrs Parker...first, I'd like to thank you for mentioning Dr Kline. I had not heard of him but started reading his articles and found this regarding palliative care which I'm pretty sure most of us fall under AND which would seem to exempt us from these idiotic laws created by non medical people:

    When we read the CDC Guideline and found on line one: “This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.” Palliative care has always been the standard of practice for patients suffering from painful diseases having no cure.
    This CDC Guideline, line one, protected our long-term pain or palliative care patients and also protects us as practitioners. We can use FDA approved titration dosing methodology to whatever it takes, no “cutoffs”.

    There is the perception, magnified by single case reports, of addiction occurring in just about anyone. If this were the case with all the opioids being prescribed there should be far more cases of addiction than there are. The government reports 2 million cases of opioid use disorder (SUD), a newly created category of people who “used their prescription opiate in a way other than prescribed” hoping everyone would believe this is the same as opiate addiction, which it is not. The fear and concern it caused?—?worked.
    Even if the SUD figure were not inflated by a factor of 200% two million OUDs claimed by household survy divided by the US population of 320 million gives a rate of 6 addictions per 1000 people, fairly rare. There has been a fixed occurrence rate of addiction over time going back to the 1920s, ruling out environmental factors such as availability of opiate pain medicine. No one can become addicted if they have a history of opiate use without addiction. 994 people of 1000 population will never become addicted.
    We wanted to share this paper with you, our fellow medical practitioners, to encourage all primary care providers to offer palliative care in their practices for patients suffering from intractable pain of any origin. The evolution of palliative care, CDC exemptions, and reimbursement will be explained. Finally, guidance will be given on how physicians and practitioners can easily start offering palliative care without restrictions on pain medication dosage ethically practice on patients with less fear of retribution, and to be reimbursed for the extra time in caring for people with long term illness.

    “If we know that pain and suffering can be alleviated, and we do nothing about it, then we ourselves become the tormentors.”?—?Primo Levi

    Palliative care allows more comprehensive and humane treatment as it is exempted from opioid dosage restrictions set by CDC and many states over the past two years. Primary care doctors and practitioners can avoid restrictions if their patients qualify for palliative care. (1)
    Pain care becomes palliative care when three criteria are met:
    - The underlying disease has no cure.
    - There is a likelihood that the disease may shorten lifespan.
    - Symptomatic treatment has a high probability of improving the quality of life.

    EVOLUTION/DEFINITIONS OF PALLIATIVE CARE: WHAT IT IS AND WHAT IT IS NOT

    Palliative care is not new. The concept was created by Balfour Mount, a Canadian-trained physician serving as visiting professor at the first hospice, St. Christopher’s Hospice in London. In 1973, he established a palliative care program at Royal Victoria Hospital in Montreal, the first palliative care program to be integrated in an academic teaching hospital. (2) Palliative care has evolved in scope since that time.

    DOSAGE RESTRICTIONS WAIVED BY CDC AND MOST STATES
    The palliative care exemption in the CDC restrictions regarding the prescribing of opioid pain medicine gives providers the freedom to do what is proper to manage pain. As mentioned the CDC Guideline page one, line one: exempts palliative care from the rest of the “Guideline”. Nothing in the “Guideline” that follows applies to the palliative care patient you have in your office.

    Most states provide palliative care exemptions as well. Palliative care is for all prognosis levels, diagnoses, and ages groups. The only qualifications are unavailability of a cure and persistent symptoms. It can be CHF with shortness of breath, COPD with intractable coughing, or a person with lupus, arachnoiditis, or advanced arthritis where cure is impossible and treatment focuses on symptoms of pain interfering with the enjoyment of life. It is no different than certifying one of your patients’ needs cardiac care or comprehensive diabetic care. Only licenced personnel can establish or unestablish diagnoses: “palliative care status” (PCS), a new term as well, is a
    By the same token, people without licenses cannot try to ignore or remove Palliative Care Status (PCS) once in place. Pharmacists, insurance executives, or other doctors not involved with the primary care cannot interfer with the PCS diagnoisis or try to ignore it. It is law in most states and for the Veternes adminstration. Once the PCS is determined, CDC, VA, and state restrictions for opioid prescribing are bypassed. If palliative care is not mentioned in the law, regulation, or guidelines, then the PCS does not apply.
    Bawston, this is fascinating! It had never occurred to me that we are palilative patients. I didn't think there were any new ideas under the
    sun when it comes to us (besides the bad ideas which seem to come nonstop,) but this makes so much sense! I'm going to have a poke
    around online and see what I can find out about it. If I, or if anyone else, finds info about it, let's be sure and share it. This could
    make all the difference in the world!
    Nolite te bastardes carborundorum, b_tches!

  14. @Mrs Parker, i believe most docs confuse palliative care with hospice care or would quibble over the definition of a serious illness. the docs never seem to consider the quality of life of patients. it seems to me that if the difference between a patient's lying in bed all day or out doing things is a few pks a day, the answer should be obvious. they never consider the whole patient and their families, which is the goal of palliative care.

    am i wrong? are there palliative care practices? if so, that would be really cool. all i see online for pm in my area are practices touting yoga and acupuncture, and i'd rather spend my money on things i know that work.

  15. #94
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    @Mrs Parker, @notcharlotte...that info is part of a longer one related to palliative care on Dr. Thomas Kline's website. He also has a copy of a palliative care document that doctors can download to verify the diagnosis and previous treatments. What makes perfect sense is that all chronic conditions should fall under palliative care since chronic means there is no chance of recovery but given proper medication, at least chronic patients could have an improved quality of life whereas end of life or hospice care is considered a short term thing.

    He also even posted an article for doctor's about how they can rightly bill so thatbthe extra time managing a chronic patient is worthwhile and we don't have to get rushed through in 15 minutes.

    You might read more of his articles:

    https://medium.com/@ThomasKlineMD
    Helpful Gullible, Mrs Parker, trish5959 Rated helpful

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    Quote Originally Posted by notcharlotte View Post
    @Mrs Parker, i believe most docs confuse palliative care with hospice care or would quibble over the definition of a serious illness. the docs never seem to consider the quality of life of patients. it seems to me that if the difference between a patient's lying in bed all day or out doing things is a few pks a day, the answer should be obvious. they never consider the whole patient and their families, which is the goal of palliative care.

    am i wrong? are there palliative care practices? if so, that would be really cool. all i see online for pm in my area are practices touting yoga and acupuncture, and i'd rather spend my money on things i know that work.
    @notcharlotte...you got me thinking about this and please don't be offended because I have no idea how old you are but I'm wondering if a geriatric specialist might likely have experience with palliative care. In my area I'm surprised at how many primary care doctors specialize or have listed their interests as geriatric care. They're not all geriatric specialists who only take geriatric patients.

    It's possible that some realized that the baby boom bubble was coming and they'd need more medical help as they aged.
    Helpful notcharlotte, Mrs Parker Rated helpful

  17. @Bawston, i'm edging into geriatric territory and i've seen that dr. kline does treat geriatric as well as pediatric. i actually live close enough to visit him, if he takes my insurance of course. first i am waiting to see the results of an endometrial biopsy the other day. it was really traumatic and i haven't gotten over it. the only one i can talk to is my son, who probably prefers not to hear about mom's nether regions.

    being old sucks.
    Likes Mrs Parker, Bawston, trish5959 liked this post

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    Quote Originally Posted by notcharlotte View Post
    @Bawston, i'm edging into geriatric territory and i've seen that dr. kline does treat geriatric as well as pediatric. i actually live close enough to visit him, if he takes my insurance of course. first i am waiting to see the results of an endometrial biopsy the other day. it was really traumatic and i haven't gotten over it. the only one i can talk to is my son, who probably prefers not to hear about mom's nether regions.

    being old sucks.
    @notcharlotte...as they say, getting old is not for weaklings. I'm so sorry to hear about your biopsy. I've had a number of biopsies...all but one was just fine and it's best to know early as possible which can make all the difference in the world. I'm always impressed though with how strong pain patients actually are. I'm not sure if I'm just imagining it or if I'm reading too many stories but it just seems like some people get more nails thrown in the road in front of them. Maybe that's why we're tough.

    I'll be sending positive thoughts your way.
    Helpful trish5959 Rated helpful
    Likes notcharlotte liked this post

  19. #98
    Quote Originally Posted by Mrs Parker View Post
    I see myself in those stories too. As I read through the list of lives lost and their circumstances, I just sat here
    and sobbed. I know without one shred of doubt that if I didn't have my son to care for, I'd be on that list.
    That's a hard thing to admit 'out loud', but it's true. I think many of us know that place of exhaustion,
    vilification, desperation, isolation, and bone-crushing pain that can lead to a choice like that.

    I too live with the threat of, "Well, if you don't like tapering, we'll send you over to the pain clinic."
    The pain clinics here are not well regarded and local pharmacists are at best reluctant to fill Rx's
    from them (and, at worst, are real pr_cks about it....) They are known for pushing expensive shots,
    no matter what your situation is, require frequent mri's, (who has the cash for that?!?) require frequent random
    pill counts, and make you sign contracts that say you can't be treated by anyone else for any reason.

    I've signed away enough freedoms as it is, I really don't want to lose the last shreds of control I have over
    my life and my body.

    I dread visits to my rheumatologist for fear of what she'll cut next and by how much and she's fairly
    kind about it at least. I feel so awful for people who've been yanked off their meds with no warning,
    no taper, no nothing. Ok, I think I'm done ranting... for now. Thanks for listening.
    Thanks for the link and your posts. What really interests me (and there are many points that do) is how your relationship with your son makes your life worth living. How having someone who cares for you and who you care for can make all the difference. It's why I started a new thread about relationships, for better or worse, as I see them as being of major importance.
    Helpful Squelix Rated helpful

  20. #99
    Quote Originally Posted by Bawston View Post
    @Mrs Parker, @notcharlotte...that info is part of a longer one related to palliative care on Dr. Thomas Kline's website. He also has a copy of a palliative care document that doctors can download to verify the diagnosis and previous treatments. What makes perfect sense is that all chronic conditions should fall under palliative care since chronic means there is no chance of recovery but given proper medication, at least chronic patients could have an improved quality of life whereas end of life or hospice care is considered a short term thing.

    He also even posted an article for doctor's about how they can rightly bill so thatbthe extra time managing a chronic patient is worthwhile and we don't have to get rushed through in 15 minutes.

    You might read more of his articles:

    https://medium.com/@ThomasKlineMD
    Palliative care was the only way I got to keep my mother at home, in reasonable comfort for some years, and in her own bed rather than in hospital when she died. The palliative care nurses were nothing less than angels and I believe they, rather than the GP are the ones who know exactly what the patient requires. A good working relationship between the GP and the nurses was essential as often the GP can refuse the medications the nurses believe their patients require.
    Wishing everyone here get's the help they need.
    Palliative care is very often misunderstood and underused.
    Helpful Keith K Stone, notcharlotte Rated helpful
    Likes jaders, Bawston liked this post

  21. I have had chronic pain for many, many years and over the past few years the docs who were rx'ing me small amounts of pain meds and benzos retired. I have had to get new docs and although they are aware of all of my issues that involve pain, none of them have offered me relief and I am afraid to look like a drug seeker.....sigh....

    And that is why I am forced to find alternate ways of getting relief. If I didn't have "help", I couldn't work. I really couldn't do much of anything which leads my mind down dark places.

    I haven't read every post here but I suspect many CP peeps can relate to my experience.
    Helpful trish5959 Rated helpful
    Likes Bawston, Stevo1 liked this post

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