Posted on 07/13/2019 5:27:23 AM PDT by GailA
If you don’t mind, what is the diagnosis?
No, I have 7 years of first hand personal experience combined with reading just about everything that was ever published regarding the treatment of chronic pain. Yes, I am an EXPERT who just happens to be a FReeper.
Yes, I am an Expert whose opinion just happens to differ with the official policy of the government. I have been fighting this fight my entire professional life so I am not surprised my fellow freepers don’t see things the way I do but it does sting a little. Yes, I was taught that you really need to go to the lab and see the Rouleaux for yourself before you prescribe for that “Sicle cell Crisis”.
One of Trump’s most amazing accomplishments is exposing the political elites (in both parties) for the frauds they are.
He’s also ripped the cover off of the Deep State and has shown us how biased the courts really are.
Its uncanny the way his presidency and the power of his personality has exposed the forces of liberalism for their hypocrisy, corruption and hatred.
I marvel over it everyday.
oh my word- seriously? You cite a tumor patient as support for the claim chronic pain doesn’t need opioid treatments? That is a basic no brainer operation decision- simple- cost effective- quick- hardly any recovery-
We’re not talking about cases that can be easily corrected with surgeries- we’re talking smashed spines- that are beyond repair- people suffering from nerve conditions that can’t be corrected with surgeries- people that have arthritic pain all over that prevent them from living a full life, and for whom NSAIDS either stop working, or can’t be used anymore due to liver or kidney damage- Many inoperable cancers-
To say that there is not a need for opioids in chronic pain because a book shows that some pain can be reduced or cured for specific issues, and because a chief resident made a false claim- is just disingenuous- there are many cases fro which surgery6 is not an option and chronic pain is a life altering, life debilitating issue, that only opioids can help with- until some other form of medication, non narcotic, comes along and is just as, or more powerful than, opioids
Again- the hysteria over the supposed, falsely claimed ‘addiction rates’ of opioids is a lie- addiction rates are very low- The only epidemic we have is with illegal addicts- not with people with chronic pain going on opioids to be able to function in life with a modicum of dignity and self sufficiency
You and i are going to disagree obviously- but I am going to keep posting the facts- there is no legally prescribed opioid epidemic among folks who use them as prescribed- opioids are not dangerous- there is only a very very slight risk of addiction and or death when they are not abused- and very few who are prescribed them legally abuse them- infact- I posit suicide rates would climb dramatically, and illegal drug use deaths would rise dramatically if medically prescribed opioids are made illegal
[[reading just about everything that was ever published regarding the treatment of chronic pain.]]
I find that hard to believe- when i was easily able to find, within minutes, medical studies that prove addiction rates are very very low with prescribed opioid use- and medical studies that show when opioids are used as directed, result in extremely low death rates- I think you’re trying to sell us all a biased opinion=- not a medically backed fact-
Presumably a patient with a smashed spine would be at least a para if not quadriplegic. If the pain lateralized at all a tractotomy would probably be like a miracle. Just off the top of my head a truly intractable joint pain might be alleviated greatly by a glycerol injection. I can’t recall ever seeing that written up or done, there likely is some reason it isn’t. No question, treating chronic pain requires a toolbox with MANY tools and a lot of creativity. It is an extremely challenging thing. Of course, we can also just prescribe narcotics.
...and I referenced that patient with terminal illness not to support my claims about chronic pain but to demonstrate that even in a terminal illness patients prefer non narcotic outcomes when offered.
Most chronic pain patients have tried the gamut of conservative treatments and failed. Since you like clinical anecdotes so much, I can tell you that at one time I was a spinal cord stim enthusiast. We had studies showing good results at 5 years. About half of the trails were successful and went on to implant. I think we had well over a hundred cases with implants over the years and although they worked ok for a couple of years, they stopped working after that.
Your cousin’s story is tragic. Did he have a psych history? Did you try to get him into an addiction center? Why did he get the opiates in the first place? How long did it take for him to become addicted? Did you, as a medical professional convince him do non-opiate treatments? I am very sorry that you could not help you cousin even though you were very close and had expert knowledge and experience.
Suffering is noble ... as long
as someone else has to do it.
Well, i do understand the concern about drug addicts getting legally prescribed medication, and then overdosing on them- and understand the concern for that issue- but to go after chronic pain sufferers when the evidence shows that there is a very small chance of addiction or death, is unconscionable in my opinion and the opinions of a great many people- pain patients and non pain folks as well-
There are a great many chronic pain health issues for which surgery is simply not an option- and right now- opioids- are the best we have to help these folks be able to function with at least a little bit of dignity in life- otherwise they’d be lying in beds unable to move- in constant chronic pain- wishing they could just die so the pain would stop- That’s not cool-
They deserve every chance they can get to be able to function as best they can by whatever means necessary- and when operations are out of the question, then drugs are the only answer left- and they should not be denied that because of the fact that only a few people ever get addicted when used as directed-
I am passionate about this issue-
He lived in a distant state. None of us even knew he was an addict. The call from the coroner was the first indication anyone had.
In response to “most patients who have tried ‘conservative’ management (whatever that is)” have not been offered the treatments I am talking about because there are almost no surgeons offering them which is my entire point. If patients knew they had non narcotic options almost all would choose them. Certainly, every patient I was involved with who got them preferred them.
If we combined our passions perhaps we could accomplish something.
Read the book. It’s $400 on Amazon. You will realize there are very few chronic pain conditions a Neurosurgeon with 40 years experience at Mass General didn’t encounter. There are also PDF copies available online that might even be free.
I used to put in “spinal cord stimulators”. They were a mess. In some cases they were helpful but not many. It isn’t something I would recommend. They also are not in White’s book and I don’t think that was because he hadn’t heard of them.
Like i said- you and i are gonna disagree- I have pointed out numerous times there are people fro whom surgery is not an option, for whom drugs help somewhat, and you keep pointing to worse case scenarios to make your points- You know full well I wasn’t talking about paraplegics but about those who’s spines are beyond surgical repair- or for patients with other conditions who can’t get surgery because of the risked involved- who have to live with chronic pain for the rest of their lives— but people for who surgery is no longer an option- It’s either drugs, or lay in bed forgotten by all but those that have to take care of them- They don’t deserve that- not when there is help available that allow them to continue life with even the most modest amount of dignity, self respect, and ability-
[[Of course, we can also just prescribe narcotics.]]
We’re not talking about patients that can be cured by other means- again- you are making an ‘it works in some cases, so therefore, it must work in all cases’ argument, when there ARE other means available- We are talking about people who have no other options- they are out of options- surgery, pain management etc are not helping them- can not for various reasons- You don’t restrict their choices to things they can’t get or they aren’t eligible for, simply because a very few people become addicted to the very drugs - That is cruel-
” Yes, I am an Expert whose opinion just happens to differ with the official policy of the government. “
Huh? The current policy of the DOJ is to shut down pain clinics that prescribe opiates for chronic pain. It would appear that you would like that. Handing out 5, 10 and life sentences to pain physicians because they disagree with the indications all of the sudden since that little faggot Sessions got in there.
Now, I’m not saying that there were not abuses. But why can’t that be handled at the State level and not by the federal police state goons. That’s wrong medically and constitutionally. Even if we disagree on policy, we shouldn’t resort to criminalizing our opponents as the fed are doing now for fun and profit.
“He lived in a distant state. None of us even knew he was an addict. The call from the coroner was the first indication anyone had.”
Sad, none of his family knew. I guess that would make it hard for anyone else to know including his doctor.
It was his doctor that prescribed the OxyContin for his chronic low back pain. He and I had this entire conversation a few years ago at a family gathering. I thought he was just interested.
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