https://www.facebook.com/nolanscully/photos/a.1650631771858020/1866071863647342/?type=3

Two months. Two months since I’ve held you in my arms, heard how much you loved me, kissed those sweetie “pie” lips. Two months since we’ve snuggled. Two months of pure absolute Hell.

I’ve wanted for a long time to write a little about Nolan’s last days. His last few days shined with how amazing my son is. How beautiful he is. How he was made of nothing but pure love. This may be long, but bear with me, it’s agony unlike any other.

When I brought Nolan to the hospital for the last time, I knew there was something else wrong other than just a lingering case of C-DIFF. I just knew, and strange enough, I think he did too. He hadn’t eaten or drank anything in days and was continually vomiting.

On February 1st we were sat down with his ENTIRE team. When his Oncologist spoke, I saw the pure pain in her eyes. She had always been honest with us and fought along side of us the whole time, but his updated CT scan showed large tumors that grew compressing his bronchial tubes and heart within four weeks of his open chest surgery. The Mestatic Alveolar Rhabdomyosarcoma was spreading like wild fire. She explained at this time she didn’t feel his Cancer was treatable as it had become resistant to all treatment options we had tried and the plan would be to keep him comfortable as he was deteriorating rapidly.

After a while, I composed myself and went into Nolan’s room. He was sitting in “Mommy’s Red Chair” watching YouTube on his Tablet. I sat down with him and put my head up against his and had the following conversation:

Me: Poot, it hurts to breathe doesn’t it?
Nolan: Weeeelll…. yeah.
Me: You’re in a lot of pain aren’t you baby?
Nolan: (looking down) Yeah.
Me: Poot, this Cancer stuff sucks. You don’t have to fight anymore.
Nolan: (Pure Happiness) I DONT??!! But I will for you Mommy!!
Me: No Poot!! Is that what you have been doing?? Fighting for Mommy??
Nolan: Well DUH!!
Me: Nolan Ray, what is Mommy’s job?
Nolan: To keep me SAFE! (With a big grin)
Me: Honey … I can’t do that anymore here. The only way I can keep you safe is in Heaven. (My heart shattering)
Nolan: Sooooo I’ll just go to Heaven and play until you get there! You’ll come right?
Me: Absolutely!! You can’t get rid of Mommy that easy!!
Nolan: Thank you Mommy!!! I’ll go play with Hunter and Brylee and Henry!!

The next day he was resting, as he slept most of the days after. We had Hospice on board, all his IV medications, even his DNR signed. (I cannot explain to you what signing an Emergency Responder “Do Not Resuscitate” order for your angelic son feels like. ) When he woke up we had the van packed and I had his shoes in my hand to take him home for the evening. We just wanted ONE more night together. But as he woke, he gently put his hand on mine and said “Mommy, it’s ok. Let’s just stay here ok?” My 4 year old Hero was trying to make sure things were easy for me….

So in between sleeping for the next 36 hours, we played, watched YouTube, shot Nerf Gun after Nerf Gun and smiled as many times as we could. An hour or so before he passed he even filled out a “Will”! We laid in bed together and he sketched out how he wanted his funeral, picked his pall bearers, what he wanted people to wear, wrote down what he was leaving each of us, and even wrote down what he wanted to be remembered as… which of course was a Policeman 👮🏻

About 9:00pm we were watching YouTube in bed (Peppa Pig actually) and I asked Nolan if I could get in the shower, as I was not allowed to leave him and Mommy had to be touching him at all times. He said “Ummmm ok Mommy. Have Uncle Chris come sit with me and I’ll turn this way so I can see you”. I stood at the bathroom door, turned to him and said “Keep looking right here Poot, I’ll be out in two seconds”. He smiled at me. I shut the bathroom door. They said the moment the bathroom door clicked he shut his eyes and went into a deep sleep, beginning the end of life passing.

When I opened the bathroom door, his Team was surrounding his bed and every head turned and looked at me with tears in their eyes. They said “Ruth, he’s in a deep sleep. He can’t feel anything”. His respirations were extremely labored, his right lung had collapsed and his oxygen dropped.

I ran and jumped into bed with him and put my hand on the right side of his face. Then a miracle that I will never forget happened….

My angel took a breath, opened his eyes, smiled at me and said “I Love You Mommy”, turned his head towards me and at 11:54 pm Sgt. Rollin Nolan Scully passed away as I was singing “You are My Sunshine” in his ear.

He woke up out of a coma to say he loved me with a smile on his face! My son died a Hero. He brought Communities together, different occupations, made a difference in people’s lives all around the world. He was a warrior who died with dignity and love to the last second.

All Nolan ever wanted to do was to serve and protect others, he did just that all the way up to his last breath and continues to do so every day. He loved his family fiercely and everyone of his “friends”!

I look at everything he accomplished in 4 short years and can only think of what he could’ve accomplished with a longer life. But sadly because of Childhood Cancer (Rhabdomyosarcoma to be specific), the world and our family will miss out on someone so full of love, who just wanted to protect and serve. We HAVE to do better with funding, research, treatment options. Below is a picture that seemed to grab everyone’s attention because my son was terrified to leave my side, even as I showered.

Now I’m the one terrified to shower. With nothing but an empty shower rug now where once a beautiful perfect little boy laid waiting for his Mommy. See less
— feeling heartbroken with Jeanette Atkins and 2 others
.

Filed under: General Problems | 2 Comments »

any healthcare professional – worth their salt – would not  recommend getting  a flu shot in this time of year,  But the vast majority of these employee chain Pharmacists are just doing as they are told – in fact – most chain pharmacists have QUOTAS of getting/giving SO MANY VACCINATIONS EVERY DAY… I guess things have changed, it use to be any vendor that gives a “rebate/discount” for anyone covered by Medicare/Medicaid or any federal health program to cause those health programs to incur an expense is/was considered a illegal kickback.

I have heard of some chains – in the past  – who have pushed flu shots this early in the year, were “pushing” for a second or “booster” flu shots in Nov, Dec & Jan because the pt’s antibodies by the end of the year after getting a flu shot this early in the year are waning and may not be high enough to protect a pt from catching the flu after the first of the year when the flu starts to ramp up. I guess is a good way for the chain pharmacies to “double dip” by encouraging early flu shots and then recommending a second/booster flu shot when the real flu season gets here because the pt’s antibody blood level is “too low’ to be effective, when it is needed the most.  Besides, most insurances pay 100% for flu shots – so the pts may not object to getting a second flu shot, since they don’t have any out of pocket costs.

In this article ..it is stated …  A recent spike in flu cases in the Southern Hemisphere is being regarded as a warning sign that flu activity in the U.S. The southern hemisphere is – seasonally – 6 months ahead of us… it is like early Feb in “down under” right now.

Personally, we don’t get our annual flu shot until the last week in Sept and/or the first two weeks of Oct. It takes about two weeks for the flu vaccine to “ramp up” to effective blood levels and typically peak flu season is at the end of the year or the first of the next year.

Flu shots now available at Walgreens and you can get a cash reward for getting one

https://www.pennlive.com/life/2022/08/flu-shots-now-available-at-walgreens-and-you-can-get-a-cash-reward-for-getting-one.html

Walgreens said it is now offering flu shots for anyone 3 and older and it is offering cash rewards for getting any vaccination.

According to Walgreens, reports indicate, “A recent spike in flu cases in the Southern Hemisphere is being regarded as a warning sign that flu activity in the U.S. could reach pre-pandemic levels during the 2022-2023 flu season. Australia is nearing the end of its worst flu season in five years, according to a report from the country’s Department of Health and Aged Care.”

Walgreen is offering a $5 Walgreens Cash reward August through December and a $10 Walgreens Cash reward in September to myWalgreens members that receive any vaccination at Walgreens. Customers must be a myWalgreens member to get the rewards.

“Getting vaccinated is the best way to protect ourselves and those around us from flu and other vaccine preventable illnesses,” said Dr. Anita Patel, PharmD, vice president, pharmacy services development, Walgreens. “To help save families a trip, Walgreens pharmacists are co-administering flu shots and other recommended vaccines during a single visit.”

Appointments are encouraged. Customers can make an appointment online or by using the Walgreens app.

Vaccinations available in addition to flu include COVID-19, shingles, pneumonia, whooping cough, meningitis, measles, tetanus, typhoid and polio.

Flu shots also are available at Rite Aid and CVS.

Filed under: General Problems | Leave a Comment »

ENGLISH, Ind. — Kenny Marshall and his family are very lucky he is alive after a recent hit-and-run.

https://www.whas11.com/article/news/local/indiana/kenny-marshall-hit-and-run-victim-english-indiana-crawford-county/417-b697d104-7ed8-4372-b89e-4c20c92971ee

Once an active grandfather to his one and seven-year-old grandchildren, the 66-year-old is now left stuck after a driver struck him while riding his bike near State Route 237 and Church Road.

While Marshall said he does not remember much of it at all, police told him the suspect was driving at high speeds, dragging his bike several yards with it following the impact.

“When my mom first called me, she said, ‘it’s your dad.’ And that’s all it took. Just a lot of unnecessary panic,” his daughter said.

Marshall’s wife, Robin, who is a 911 dispatch operator, was also the one who took the call the morning her husband was hit.

“Uh, I mean we’ve been together 50 years and I thought – I thought, I can’t do it without him,” she said.
Credit: The Marshall Family
Some of the injuries Kenny Marshall suffered following a hit-and-run in English, Indiana.

Marshall said he has lacerations on the back of his head, held together with 13 staples. His arm was also hit and bruised along with an area of his chest and his back.

The injuries may be healing, but the side effects that came in the wake of the crash – constant migraines, loss of balance and memory loss have not subsided. Marshall said he is in constant pain.

His family knows that he will recover but, in the meantime, they are hoping whomever is responsible will turn themselves in to police.

The Crawford County Sheriff’s Office is investigating the incident.

If you have any information, you are asked to call the, at (812) 338-2802.

►Contact reporter Connor Steffen at csteffen@whas11.com or on Facebook, Twitter or Instagram.

►Make it easy to keep up-to-date with more stories like this. Download the WHAS11 News app now. For Apple or Android users.

Have a news tip? Email assign@whas11.com, visit our Facebook page or Twitter feed.

Filed under: General Problems | Leave a Comment »

Posting for a mom on another page as she’s having issues with Optum. Please provide her with suggestions in the comments.

“Easton gets home infusions EVERY week. Every week for over 2 years now, we’ve had the same nurse come in and provide care for my baby and infuse his life saving enzyme replacement medication. Life saving. Without this medication he would not be here!!!

Monday of last week we got a call from his nurse that Optum (the pharmacy that provides the meds, supplies, and nurse) has decided that basically since they don’t get enough “business” from enzyme replacements (well duh, because Pompe is a freaking RARE DISEASE), they will no longer be doing Enzyme Replacement Therapy.

What does that mean? We’ve got to find a new pharmacy with a new nurse and pray to God that they know what they’re doing when it comes to a drug like Lumizyme, which has a black box warning. But whatever. That’s fine. I don’t want a company taking care of my kid that’s only looking for dollar signs anyway. However, we will wholeheartedly miss his nurse. Easton has built a bond with her like no other and I’m so sad for him and us.

Now what really, really makes me angry is that these people are obviously so greedy that they have not had the decency to let us know any of this. Had Easton’s nurse not been kind enough to tell us, we still would not know and this is all taking place September 6th! I have not gotten a phone call, email, nothing. Nothing but crickets from Optum. And again, this is something he needs every week, at the very least, every other week to be able to function. I don’t even want to think about the detrimentals that would follow him going a long time without this medication.

Please say some prayers for us as we navigate through all of this along with many others that are in the same boat as us. I have seen posts from parents that are finding out about this in different ways. Optum has not told any of us anything, like none of it is important and our children’s well being isn’t at stake.”

just so that everyone is clear, OPTUM is a PBM and a mail order pharmacy and is owned by United Health – the same UNITED HEALTH that is endorsed by AARP.  The above text from the web is a pretty bad example, but it is appears to be clear where Optum’s agenda is…. THEY DON’T GET ENOUGH BUSINESS… not that they are NOT MAKING A PROFIT and/or LOSING MONEY…

Another example that HEALTH CARE IS NOTHING MORE …NOTHING LESS THAN A FOR PROFIT BUSINESS

Filed under: General Problems | 1 Comment »

From an award-winning journalist, an explosive narrative investigation of the generic drug boom that reveals fraud and life-threatening dangers on a global scale—The Jungle for pharmaceuticals

Many have hailed the widespread use of generic drugs as one of the most important public-health developments of the twenty-first century. Today, almost 90 percent of our pharmaceutical market is comprised of generics, the majority of which are manufactured overseas. We have been reassured by our doctors, our pharmacists and our regulators that generic drugs are identical to their brand-name counterparts, just less expensive. But is this really true?

Katherine Eban’s Bottle of Lies exposes the deceit behind generic-drug manufacturing—and the attendant risks for global health. Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects.

The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings?

A decade-long investigation with international sweep, high-stakes brinkmanship and big money at its core, Bottle of Lies reveals how the world’s greatest public-health innovation has become one of its most astonishing swindles.

Filed under: General Problems | 10 Comments »

CVS could look to regional buys as it plans primary care acquisitions

https://www.healthcaredive.com/news/cvs-primary-care-acquisition-q2-regional/628805/

Executives of the health giant teased a potential acquisition during a Q2 earnings call as buys in primary care heat up. Who could it nab?

As it aims to compete with peers and strengthen its primary care network, CVS Health signaled it would use acquisitions to expand its primary care network and could use smaller, regional buys over larger ones to make its healthcare footprint more vertical.

The healthcare giant, while building up its virtual care network, MinuteClinics and retail presence, has lagged behind its competitors in the primary care arena as companies like Walgreens, Amazon and Walmart have made significant inroads into primary care with multibillion-dollar partnerships and deals.

That could change this year. Executives teased a potential acquisition during the company’s second-quarter earnings call on Wednesday, with CVS CEO Karen Lynch saying that the company would take its next steps into primary care by the end of the year.

“We can’t be in … primary care without M&A. We’ve been very clear about that,” Lynch said.

Primary care has exploded with regional players as private equity has focused on the primary care space, transforming the least-paying medical specialty into a market flush with cash. From 2010 to 2020 alone, researchers at NEJM, in an analysis of PitchBook data, found that total capital raised in the primary care space increased from $15 million to $3.83 billion, and that deals involving private investor backing shot up from two to 46. And, in the first half of 2021, primary care deals totaled $8.4 billion.

“There’s a huge footprint of players that we’re not even aware of at the national scale,” said Matthew Bates, managing director and physician enterprise service line lead at Kaufman Hall. “If I was going to place a bet, I would place a bet on a series of roll-ups.”

Multiple regional acquisitions or partnerships would solve a scaling problem with primary care network companies. Bates pointed toward One Medical, which Amazon announced it would acquire for $3.9 billion. One Medical has a presence in fewer than half the states in the country. The acquisition has a big price tag, and Amazon will have to pay even more to scale the company given its modest footprint. For example, Walgreens invested $5.2 billion into VillageMD to scale its primary care practices, Bates noted. 

Regional buys would also capitalize on existing care relationships in established markets without the company having to funnel additional cash to penetrate new markets. And, if it wanted, CVS could use its large healthcare tech stack — like its virtual primary care service — to quickly scale regional models.

CVS senior vice president of business development and investor relations, Larry McGrath, opened the possibility of multiple acquisitions during the company’s earnings call, adding that there was “no one and done asset” in the space to grow their primary care network.

“We’ve been very active in evaluating a wide range of assets in and around the care delivery space,” McGrath said. “And what I would reiterate is that our priority areas remain primary care.”

A regional acquisition, or multiple, would open up new acquisition targets to CVS given that few national primary care targets remain that have not publicly exited or been acquired. Companies that have exited with a public debut include Oak Street Health, which went public in 2020 and P3 Health Partners, which went public via a merger with a special purpose acquisition company.

“There is no national player that’s in all 50 states and is a natural target,” Bates said.

Filed under: General Problems | Leave a Comment »

Aat

Filed under: General Problems | Leave a Comment »

Opioid Prescribing Is Down, Yet Alternative Pain Treatments Remain Underused

https://www.practicalpainmanagement.com/news/opioid-prescribing-is-down-yet-alternative-pain-treatments-remain-underused

New study confirms reduction in opioid prescribing for cancer pain and non-cancer pain but, surprisingly, no matching increase in opioid alternatives. So how is chronic pain being treated?

New study confirms reduction in opioid prescribing for cancer pain and non-cancer pain but, surprisingly, no matching increase in opioid alternatives. So how is chronic pain being treated?

Since the CDC issued its practice guideline on prescribing opioids for chronic pain in 2016, professional organizations, payers, and many physicians have been moving away from opioids and looking toward other, often multidisciplinary, treatments to manage pain, including cancer-related pain.

According to a brand new study, opioid prescribing is indeed down – however, opioids do not seem to have been replaced with other therapies. The research, published August 10 in PLoS ONE, was led by Sachini Bandara, PhD, and Emma McGinty, PhD, of Johns Hopkins Bloomberg School of Health, and Mark Bicket, MD, PhD, of the University of Michigan.

When the CDC released its initial guidelines on opioid prescribing for chronic pain, the recommendations were largely in line with guidance from professional organizations calling for physicians to write fewer prescriptions for opioids and to instead use non-opioid drugs and non-pharmacological therapies as first-line treatments, explained Dr. Bandara, assistant professor and drug policy researcher at Johns Hopkins and first author on the study.

At the time, she noted, physicians as well as pain-advocacy communities warned that reduced opioid prescribing could have a negative impact on patients with chronic non-cancer pain if their pain was not properly managed with non-opioid therapies. The aim of the present study, wrote Dr. Bandara and team, was to find out whether opioid prescribing was actually decreasing and if non-opioid treatments were increasing correspondingly.

Previous reports have demonstrated a decrease in opioid prescribing overall between 2010 and 2020, but individuals with cancer and palliative, end-of-life-care were specifically excluded from the CDC recommendations on opioid use for pain. Dr. Bandara’s team looked at data from between 2012 and 2019, focused on opioid prescribing for pain in people with and without cancer, and found that the number of privately insured adults who were prescribed opioids for pain (both cancer pain and chronic non-cancer pain, or CNCP) declined during that period.¹

So while their report aligns with prior data, what is new is that opioid alternative use has not increased, begging the question: are individuals living with chronic pain getting the pain relief they need?

Using the IBM Marketscan Research Databases from 2012 to 2019, which include insurance claims and encounters for between 26 million and 53 million individuals covered by private insurance companies Bandara et al identified individuals who were diagnosed during that period with cancer pain or non-cancer pain, including low-back pain, neuropathic pain, headaches, and arthritis.

Their records analysis showed that the number of people who received an opioid prescription declined from 49.7% to 30.5% for those with chronic non-cancer pain and from 86% to 78.7% for those with cancer pain. In addition, of those who did receive opioid prescriptions, fewer received extremely high doses or more than one week’s supply of the medication.

Meanwhile, non-opioid prescriptions remained steady (from 66.7% to 66.4%) for people with non-cancer pain and increased slightly (from 74.4% to 78.8%) for those with cancer pain. “We see opioid prescribing going down, while non-opioid prescribing is not increasing to fill that gap,” said Dr. Bandara.

Non-pharmacological therapies (eg, interventional procedures, physical therapy and exercise, mental health care) do not appear to be filling the gap either. A secondary analysis of the data, which looked at a subset of the sample of patients with CNCP, found that substitution of non-pharmacological therapies in place of opioid therapy in patients with CNCP was 3.5% in 2019, essentially unchanged from 2013, when it was 3.4%.

Mark Bailey, DO, PhD, was not surprised by these findings. “We’ve known this for a long time,” he said, pointing out that the trend of prescribing fewer opioids has been underway since about 2012. Dr. Bailey, director of the neurology pain division at University of Alabama at Birmingham School of Medicine, said his perception is that people with cancer are not getting less pain medicine, but he does note that oncologists seem to be less willing to write prescriptions for pain. “I’ve definitely seen this, because they’re sending me their dying patients to take care of their opioids for them.”

Dr. Bailey also pointed out that, while there is an abundance of data showing that doctors are prescribing fewer opioids, overdose deaths are still rising dramatically, suggesting that people (whether they are under care or not) may be just “changing the drug of choice from prescription drugs to street fentanyl.”

He added, “I think the take-home message is that prescribing less medicine has not curbed the overdose death rate; it has skyrocketed. But it’s not the drugs that we prescribe anymore. All the hoops and laws and regulations and guidelines that we put on ourselves have not fixed the problem they were designed to fix.”

And those efforts have created other problems. Jeffrey Bettinger, PharmD, clinical pharmacist and specialist in pain management at Saratoga Hospital Medical Group, pointed out that he is now seeing patients with non-cancer chronic pain and palliative care needs as well as cancer-related pain who are no longer able to get the same pain relief they got with opioids.

In this special series, Dr. Bettinger and Reed J. Yaras, DO, analyze the CDC opioid prescribing guideline revisions, including patient populations with and without cancer, which are expected to be released later this year.

Filed under: General Problems | Leave a Comment »

My story of how state medical boards can end careers and the Ruan Court decision

https://youtu.be/yy2rj82fABU

Because I choose to treat pain refugees who were refused pain care by 10+ doctors, I came up as an overprescriber, which scared the North Carolina Medical Board. (see future youtube video on overprescribing). The only doctors send to prison or had their licenses taken are doctors treating pain, no others

Filed under: General Problems | 1 Comment »

Extending the list to others in the field of pain advocacy and research

Professors and Doctors, and Medical Researchers (Please distribute this redacted version w/o names)

This is an email to my doctor who is wanting to taper me off all opioids because he thinks I have Opioid Induced Hyperalgesia, so sorry for the not introducing the topic part.  If you feel like sharing my sitation with another others or first want more data, I can provide what I have.  I agree one thing – I should not be having 9/10 pain on 50 ug/hr of fentanyl and 10 mg Percocets TID, but it is what it is.  The question is -what is the cause and thus the right treatment?  Would a spinal cord simulator at L4 or wherever the knee nerves emerge, solve all 4 root causes?  Or would opioid rotation be your first choice to hit all possibilities?  Share with anyone you like, for my life is on the line and I welcome all the help I can get.  I hereby for HIPAA purposes in good mind and faith submit this to anyone you like.

No luck with RF ablation.  I’m going out of my mind due to pain.  During periods of decent analgesia, I have found 4 possible reasons for my predicament, and I have no clue which is right and if any treatment modality would help 2 or more or what testing might narrow it down.

1. Opioid Induced Hyperalgesia – After long term opioid use, a person becomes more sensitive to less painful signals.  The problem with this is that my pain is specific to the very targeted area of my knee medial meniscus. Improves with dose reduction.
2. Opioid Tolerance – loss of analgesic efficacy over exposure to an opioid.  Apparently this can happen to any opioid at any dose, and improves with dose escalation.
3. Maladaptive neuroplasticity – the spinal cord “learns” a repeated pain signal sent over and over again.
4. Central sensitization – the spinal cord becomes amplified much like maladaptive neuroplasticity.

I don’t know much about neuroscience, far less than you do, but it so it aeems that treatment needs to first figure out the right answer to 1-4 above, because for example 1) and 2) both suggest different dose strategies, though apparently opioid rotation treats both.  I found one decent paper on hyperalgesia, but I have only scratched the surface. Do you know how to tell these apart?  Here is what I know about each.

In January 2022, when swapped out Oxycontin for Fentanyl, for months my pain scores fell from7-9 to less than half or around 4-5.  When my dose was increased for the trial of 4 percocets, the pain was a bit easier to manage, and at 3.5 its been a bit harder to manage, and at 3 even harder.  When I say harder to manage, I mean its harder to catch pain at a 7 from going to a 9.5 with less medicine.  While these changes are small as a percent of my dose, the though dose-equivalent MME switch from Oxycontin to Fentanyl both at 120 MME did give me a stronger opioid, and pain fell hard, just as you would expect with opioid tolerance.

OIH was new to me.  I’ve asked professors, and I get mixed feedback.  Some think it isn’t a real phenomena and said it was mostly due to intrathecal morphine pump users who when their doses were reduced, their pain improved.

Dr. C, the interventional pain guy who did my RF ablation, came up with number 3 on the list.  He said over time, the nervous system becomes highly efficient at transmitting a pain signal over and over, but the rotation to fentanyl, even this was true, fixed the problem.

The fourth one came from Dr. B, but I found it in the literature.  He said my specific type of spinal cord damage predisposed me to central sensitization, which he called “wind up phenomena” which I also found papers on.

I’m not being a whinny patient who wants more and more opioids.  Yes the 4 Perocet was a band aide over the real problem.  But which of the 4 reasons behind my severe knee pain escapes me, but I’m no MD.  Dr. B did warn me about central sensitization long ago, and Dr.C pointed to number 3 on the list.  In fact, since the swap to fentanyl worked for 3 if that is the culprit, opioid rotation should work for 1, 2 and 3.  I deeply regret getting into this mess, and wish I never asked about my knees, but even Dr. J didn’t want to do a knee replacement before November 2021, and that is when I went to the head of orthopedics, Dr. R, who did my hip replacement in 1998 and got me in the clinical trial for the ceramic/ceramic hip, reportedly one of the top joint docs worldwide, and he told me no to knee replacement, so to check on his opinion I went to another medical univerisy orthopedics, who told me the same thing.  They said I’d have just as much pain after surgery as before surgery, and that knees are not replaced due to pain, but due to mechanical issues like knees locking up or other such phenomena.

Filed under: General Problems | 2 Comments »