Perception and facts are not necessarily the same thing ?

mtmolehill1This showed up in a closed chronic pain website.. There is a old saying “..what you perceive .. is what you believe …”  Have we become so jaded… that we work off of personal perception(s)… and refuse to investigate – and believe – the FACTS ?

My mother started having back and knee problems in her 30s. She had been a social worker and teacher all of her adult life.

At the onset of her severe problems, my parents owned a lucrative preschool/daycare center, after a cerebral aneurysm forced my dad to retire from his chemical engineering career.

By her mid-forties, my mom was completely disabled, and retired from work permanently.

We made the move from Southern California to Illinois when my mom was in her 50s, shortly after my husband and I were married.

My parents settled in a tiny, rural town where the nearest doctor was, at least, 20 minutes from home.

Nonetheless, they quickly found a kind, caring, general practitioner, in a major city, 35 miles away. He referred my mom to a pain doctor in the same city.

At that time, when she was no longer able to get relief from over-the-counter pain medicine, her doctor mercifully prescribed her three 7.5mg Hydrocodone pills daily.

Although they were originally prescribed by her new pain doctor, who also gave her a few successful lumbar-injections, her GP was happy to maintain the monthly-medication, given my mother’s severe arthritic conditions.

The medicine made such a difference in my mom’s life. She was able to thoroughly enjoy playing with the grandkids, walking with my dad, shopping, as well as so many other day-to-day activities which were previously out of reach.

In short, she regained some of the missing quality of her life.

Then, we lost my wonderful father to pancreatic cancer.

Following my dad’s passing, my mom made a fateful decision to find new doctors much closer to her area. She has always hated driving long distances by herself, and, without my dad at the wheel, she found the 35 miles prohibitive.

She settled for one of the very few GPs, in a nearby town. He, in turn, referred her to a local pain doctor, “Dr. X. “

Doctor X performed several epidural injections for my mother. One or two, out of the several shots, gave my mother additional relief.

While Dr. X continued to schedule more injections for her, he also continued to prescribe her life-saving pain medication.

Then, prior to her last injection with Dr. X, he told my mother, “If THIS injection doesn’t work, there is nothing else I can do for you, and you might as well not come back!”

My mom was, understandably, devastated since the shots had, in the past, given her a bit of comfort, no matter how fleeting.

After this last encounter with the lovely Dr. X, her GP took over her pain medication prescription, filling it every month, for several years.

One day, about a year ago, a completely-preventable event occurred that, we believe, is the cause of my mother’s declining health.

She called the pharmacy, (CVS), as she always did, on the 29th day for all of her refills, including her Hydrocodone.

From here, we are not exactly sure what happened, or who, at CVS, caused the disaster, but their actions ruined my poor mother’s life.

It started when she got the call from CVS.

The pharmacy-technician told my mother, “I just got off the phone with your doctor and he will not allow us to fill your Hydrocodone.”

A bit confused, my mother asked, “Why not?”

The tech continued, “Well, according to Dr. X’s office, you are no longer a patient there.”

Doctor X.

My mom had not seen the grumpy old pain doctor in over two years.

At first, my mother laughed off the error, and patiently explained to the young tech that her GP was her primary doctor now, and had been for years, and that he, and he alone, filled ALL of her prescriptions.

She hung up the phone, thinking she solved the problem, and that CVS would call the appropriate doctor.

But, then, the phone calls started.

The first person to call her was Dr. X’s nurse.

Although my mom was surprised to hear from her, she always liked his nurse, despite his own terrible bed-side-manner.

“What are you trying to pull?,” the woman demanded of my then-71-year-old mother.

My mom, of course, was quite confused.

The nurse continued by accusing my mother of giving Dr. X’s name to the pharmacy, in an attempt to have her pain medicine filled by multiple doctors, at the same time.

Of course, my mom was flabbergasted. She explained the pharmacy’s mistake to the woman, and apologized profusely, even though it wasn’t my mother’s error.

Then, the nurse from her GP’s office called my mom, nearly immediately after she hung up from Dr. X’s nurse.

Her GP had, by now, finally received the request from CVS. They had also received a call from Dr. X’s nurse.

Together, the two nurses had obviously discussed my mother’s underhanded attempt to fill her medicine twice, and the second nurse tore into my sweet mother in much the same way as the first.

By now, my mom was in shock. Could something like this ACTUALLY be happening?

The final blow that day came from the pharmacist at CVS.

He had heard about the debacle, and called to inform my mother that CVS can only fill this “type” of prescription from one doctor.

After trying to explain to him that she only had ONE doctor, the pharmacist finally filled my mom’s medicine.

The next day, she picked up all of her medicine, and was very aware of the suspicious glances from the pharmacy staff.

When she arrived home, she had an urgent phone-message from her GP’s office, stating that the doctor wanted to see her as soon as possible.

My mother went in for an office visit the following day.

At the appointment, the nurse asked her, “Exactly what ARE you doing with all those pills?!?”

My mom, still in shock, and still not fully understanding the gravity of the situation, told her plainly, “Well, I’m TAKING them.”

The nurse, who was obviously not happy with my mom’s answer, continued, “Well, we JUST gave you the same amount of pills only a month ago! Where did THOSE go?!?”

My poor, innocent mom, said, “Well, I took those too.”

When the doctor arrived, he very-shortly told my mom that he was switching her to Tramadol, and that he would, never again, prescribe Hydrocodone to her.

My mom left the office without protesting, assuming that, if the first medicine worked so well and, essentially, allowed her a comfortable semblance of her pre-arthritic life, then this new, doctor-recommended “Tramadol” would certainly do the same.

Nothing was further from the truth.

In the following months, my mother began to suffer terribly.

All of the old aches and pains, that were, for 15 years, held at bay, came back to crush her.

She couldn’t walk. She couldn’t shop, spend time with friends, do any housework, or even travel the two-hours to visit my family or my brother’s family.

She brought out her old cane that she had used only sparingly during recent years.

But, most importantly, she couldn’t sleep. She was suddenly only able to achieve about three hours each night, because the pain was excruciating.

Over the past year, my mother has begged her GP to prescribe her a better medication.

It turns out that Tramadol gives her severe migraines, and a stomach ache. In addition to her arthritis, my mom has diverticulitis, and colon polyps. Any unusual change to her medications typically causes tummy troubles.

In general, they make her feel dizzy and fuzzy, as though she were drunk. I have the same reaction to this medication, so it might be an inherited allergy.

Also, the Tramadol barely touches her pain, so she takes it sparingly.

Time and time again, she has discussed these issues with her doctor.

When she asks for the Hydrocodone, his only reply is, “No. I’m not going to give you that.”

At some point in the past year, since her pain has been so severe, her GP referred her to a rheumatologist.

Her GP even threw her a small bone once by saying, “When you get to the rheumatologist, HE will give you a more appropriate pain-reliever. “

But, the specialist ALSO refused, stating, “No. Sorry. Your GP will have to prescribe that to you.”

My mom does nothing but suffer. She cries all the time, and has given up nearly everything in her life that she used to enjoy.

She is now forced to rely heavily on Ibuprofen, a medication that upsets her stomach terribly, even more than the Tramadol.

A few months back, my mom was given the name of an excellent pain doctor, who is a bit further away than her current doctors.

However, according friends in her area, who suffer with similar conditions to hers, this doctor is always willing to prescribe anything and everything to help his chronic-pain patients.

My mom changed her insurance company, and waited until January to get the chance to visit this new, highly-recommended doctor.

After all, a lot of her friends go to this doctor, and have successfully started regimens that include every pain-relieving medication on the market.

Some of them take the Hydrocodone, but in MUCH larger doses than my mother EVER did, while others get relief from Oxycontin, Morphine, various patches, and even implanted-pain-pumps.

For months, she waited patiently for the chance to see this famously-understanding doctor.

When her first appointment approached, the new doctor’s office requested a number of records, including notes from her GP, and a pharmacy-generated list of her medications.

While she did not see her doctor’s notes, she hand-carried the medication list.

There, on the list, dated about a year ago, in large, bold typing, are the words, “NARCOTIC ALERT! SEE NOTES!”

We can only imagine what that hand-written notes say.

So, needless to say, this wonderful, helpful doctor promptly informed my mother, at their first meeting, “No. I’m not going to change your medicines, but I want you to know you can take up to 10 Ibuprofen daily.”

My mother is lost.

It is important to note that no one, in our family, has EVER had a substance-abuse problem.

Not one of us has ever even been a drinker. No one even has wine at dinner!

My mother was, for many years, a social worker. She worked, often, with troubled-teens who battled various addictions.

My mom looks like Mrs. Santa Claus, dresses like a congresswoman, and speaks like a Harvard professor.

There is NO way ANYONE could EVER peg her to be a drug-abuser.

Except, the pharmacy-technician, who was 20-years-old, and facing a certain-scolding from her pharmacist, made a critical error that is, quite literally, costing my mother her life.

I hope the young lady got a nice Christmas bonus for catching the addict.

The way my mother has been treated this past year borders on elder-abuse.

My mom should be enjoying her 70s, running here and there, and spending time with family and friends.

Instead, she’s writhing in pain, worried about whether or not she can even get up to go to the bathroom.

If her pain wasn’t so well-known controlled before, I would think, maybe, this is just the natural progression of the disease. But, if that were the case, she would not have spiralled down-hill immediately following the removal of her medication.

At the very least, some doctor, somewhere, during the course of the last year, should have weaned her slowly away from her previous medicine.

It is nothing short of a crime against a sweet, elderly woman, who never committed a wrong deed in her entire life. And, I want justice for my mother, and for every other victim in this “war” against drugs!

DEA ruling affecting cough medicine demand

http://www.wnct.com/story/27787152/dea-ruling-affecting-cough-medicine-demand
NEW BERN, N.C. – On October 6, 2014, right at the beginning of cold and flu season, the Drug Enforcement Agency changed the popular cough medicine ingredient, hydrocodone, from a schedule III controlled substance as part of the Controlled Substance Act.

The ruling is having an impact on how people can receive cough medicine this year.

The ruling also changes how drug stores, like Bynum’s, can order supplies. “It causes us to have limits on what we can order,” said Bridgers. “It is available at the wholesaler, but after we sell a certain percentage, we’re not allowed to purchase any more.”

Bridgers said Bynum has had enough supply to give to his customers, but he is also warning them to be safe. He said because the drug is now more difficult to get, he is afraid more people will be trying to steal it the same way they do oxycodone.

SIX die everyday from overdosing on the drug – ALCOHOL !

Alcohol Poisoning Kills 6 Americans a Day, a Federal Report Finds

http://mobile.nytimes.com/2015/01/07/health/alcohol-poisoning-kills-6-americans-a-day-federal-report-finds.html?_r=1&referrer

Six Americans die from alcohol poisoning daily on average, and mortality rates are highest among middle-aged men, federal health authorities reported on Tuesday.

The report is the first in a decade by the Centers for Disease Control and Prevention to tally alcohol poisonings for the entire American population. Most previous analyses looked at certain groups, in particular young people.

The C.D.C. described death from alcohol poisoning as “a bigger problem than previously thought,” but said it was impossible to tell whether the death rate had risen because researchers had changed how they track the data in recent years.

Apparently hasn’t reached  EPIDEMIC LEVELS yet…

CVS had employees sign mandatory mediation contract because ?

Former pharmacist files class action against CVS for overtime pay

http://pennrecord.com/news/15399-former-pharmacist-files-class-action-against-cvs-for-overtime-pay

PHILADELPHIA – More than 1,000 pharmacists are owed unpaid overtime wages from CVSone of the top pharmacy retail stores in the United States, according to a federal class action suit filed last week at the U.S. District Court for the Eastern District of Pennsylvania.

According to the complaint, Baugh worked as an hourly paid Subordinate Pharmacist from October 2011 to October 2012. During that time, Baugh would clock in for shifts at several different local stores as a floater, filling in for sick or absent pharmacists on an as-needed basis.

The claim says that Baugh would speak to a CVS scheduler on the phone and receive the work assignment for the coming week, including locations, days and times. The floaters had the opportunity to choose overtime shifts immediately available, pick up hours as the week progressed or be forced to work an overtime shift if another employee failed to show up.

Baugh estimates that hourly paid pharmacists would work an average between 40 to 50 hours a week and personally logged between 100 and 130 hours in a two-week pay period. According to the claim, Baugh earned an hourly rate of $58.93 for the entire shifts and claims he should have earned $88.40 per overtime hour.

The eligible members of the federal and state class group are defined as subordinate or floater pharmacists who worked overtime hours for CVS during the October 2011 and October 2012 period. The claim estimates more than 1,000 potential plaintiffs would be eligible under the federal complaints, and several hundred from the 406 CVS stores located in Pennsylvania would qualify for the state class.

Why do alcoholics turn to alcohol and nicotine addicts turns to tobacco ?

Why painkiller addicts turn to heroin

http://wwlp.com/2015/01/05/why-painkiller-addicts-turn-to-heroin/

(CNN) — The face of heroin abuse in America is changing.

Back in the 1960s, heroin users were usually young men, who started using around an average age of 16. They were most likely from low-income neighborhoods, and when they turned to opiates, heroin was their first choice.

Now, more than 50 years later, a study from JAMA paints a very different picture.

Today’s typical heroin addict starts using at 23, is more likely to live in the affluent suburbs and was likely unwittingly led to heroin through painkillers prescribed by his or her doctor.

While heroin is illicit and opioid pills such as oxycontin are FDA-approved, each is derived from the poppy plant. Their chemical structures are highly similar and they bind to the same group of receptors in the brain. (A few opioids, like fentanyl, are totally synthetic but designed to bind with those same receptors).

 

In any case, the various drugs produce the same result: an increase in pain tolerance and a sense of euphoria, along with drowsiness, occasional nausea and, at higher doses, a slowing of the user’s breathing.

All these drugs trigger “tolerance” — the need to take higher doses for the same effect — and a craving for the drug in its absence.

It is precisely because there are so many similarities that pain pill addicts frequently turn to heroin when pills are no longer available to them.

Save the addicts – spare no expense – don’t worry pain never killed anyone ?

 1/5/15 – Lawsuit claims doctors shouldn’t have let patient die [Chicago Tribune]

http://www.pharmacychoice.com/News/article.cfm?Article_ID=1310541

Jan. 05A lawsuit alleges that doctors at a north suburban hospital wrongly cut off lifesaving care to a 22-year-old man who had overdosed on heroin.

The suit, filed in Chicago federal court last month, claims medical personnel at Advocate Condell Medical Center in Libertyville inappropriately removed Randall Bianchi from a ventilator and allowed him to die in December 2012. The suit accuses the doctors of administering medical treatment designed to protect Bianchi’s organs for donation when they should have been working to save his life.

Bianchi’s mother, Lydia Cassaro of Florida, brought the lawsuit, alleging the doctors disregarded her desire for her son to be kept alive. Instead, doctors consulted with Bianchi’s father and discontinued life support before the Grayslake man died, according to the lawsuit.

“The patient should have been given an opportunity to survive and to heal,” said Devon Jacob, the Pennsylvania lawyer who filed the suit.

Defendants include the hospital and numerous doctors and nurses, among others. Hospital spokeswoman Kathleen Troher declined to comment on the suit’s claims, noting that the litigation is pending. She said the hospital is taking the matter “very seriously.”

“Our top priority is providing the safest and highest quality of care for our patients and their families,” Troher wrote in an email.

While doctors consulted with his father, who was at the hospital, they disregarded his mother’s requests that they use all medical means necessary to save his life, the suit alleges. She was in Florida as her son was dying, the suit states.

Bianchi’s driver’s license indicated a desire to donate his organs, according to the lawsuit, and his medical care focused on maintaining his organs. Bianchi had no health insurance, the suit states.

Home of the free, home of the brave and innocent until proven guilty.

Muncie pain doctor arrested by federal agents, charged with 8 felony counts

http://fox59.com/2015/01/06/muncie-pain-doctor-arrested-by-federal-agents-charged-with-8-felony-counts/

FORT WAYNE, Ind. (Jan. 6, 2015)– A Muncie pain doctor accused of dangerous prescribing practices was arrested Tuesday in Fort Wayne by Drug Enforcement Administration (DEA) agents.

Doctor William Hedrick‘s nurse practitioner, Gay Gunderson-Watson, was also arrested.

Hedrick faces eight total felony counts of forgery, Medicaid fraud and reckless prescribing. Gunderson-Watson faces 6 preliminary counts of forgery.

Hedrick operated the Centers for Pain relief in Muncie, and in October, the clinic was raided by federal agents.

The doctor is under investigation for fraud, forgery, dangerous prescribing and violating his probation.  The state has identified eight former patients of Hedrick’s who have died of overdoses.

 

 

We have no concerns about collateral damage ?

5000 pts tossed “into the street” without any alternative care available…

Recently a number of big corporate retailers have had their database of credit cards from customers hacked..  If we applied the same/similar laws as we do to doctors who get conned .. shouldn’t we be arresting and indicting the people in the IT dept that allowed it too happen ?

Of course, if Dr Hedrick and his staff had been given the capability to validate driver’s licenses against the state’s BMV’s database to verify who was requesting care and swiping that driver’s license would automatically generate a INSPECT report – Indiana’s Prescription Monitor Program. So that diversion or doc/pharmacy shopping could be detected. BUT… in Indiana the BMV has stated that such would be an invasion of privacy and the state AG has stood by that decision.

It is as if the system… prefers not to use 21st century technology and existing databases to help fight this war on drugs and continues to use 20th century methodologies …. that continues to fail and allow the war on drugs to continue. Is this intentional… or .. just lack of understanding the problem and failure to recognize a more efficient way.

wonder how they are going to put a negative spin on this ?

coloradopot

More of our judicial system being “a nanny “?

Legal battle rages over whether to force 17-year-old cancer patient to have chemo

http://www.whas11.com/story/news/local/2015/01/05/chemo-battle-17-year-old-legal/21314815/

Cassandra was diagnosed with Hodgkin’s lymphoma in September, but decided she didn’t want to complete the prescribed treatment, according to a court summary. Her mother supported this decision, but the Department of Children and Families stepped in and ordered her mother to comply with the doctor’s treatment recommendation.

“It’s really for all the reasons you might imagine,” said Taylor, adding that he couldn’t go into more detail.

Although chemotherapy is a drug that destroys cancer cells, its side effects include hair loss, nausea, pain and fertility changes, according to the National Cancer Institute.

Cassandra underwent two chemotherapy treatments in November and then ran away from home and refused to continue treatments, according to the court summary.

A court hearing ensued in which Cassandra’s doctors testified, and she was removed from her mother’s home and placed in state custody so that the state could make medical decisions for her.

She has been has been living at Connecticut Children’s Medical Center and forced to undergo chemotherapy for about three weeks.

The Hartford Courant reported that Cassandra has an 80 to 85 percent chance of surviving her cancer if she continues with her chemotherapy.

The state Department of Children and Families issued the following statement:

“When experts — such as the several physicians involved in this case — tell us with certainty that a child will die as a result of leaving a decision up to a parent, then the Department has a responsibility to take action. Even if the decision might result in criticism, we have an obligation to protect the life of the child when there is consensus among the medical experts that action is required. Much of the improvements in Connecticut’s child welfare system have come from working with families voluntarily to realize solutions to family challenges. Unfortunately that can’t happen in every situation, especially when the life of a child is at stake.”

“No one is disputing that it’s very serious,” Taylor said. He said there’s “a good chance” Cassandra could survive her cancer with treatment, and “there’s a good chance she could die if she doesn’t. None of us disagree about that.”

I wonder if this person or someone her age… committed a serious crime.. if they would be tried as an ADULT ?

Is this the other shoe dropping ?

As Docs Face Big Cuts In Medicaid Pay, Patients May Pay the Price

Millions of poor Americans may find it harder to find doctors.

http://www.medpagetoday.com/PublicHealthPolicy/Medicaid/49367?xid=nl_mpt_DHE_2015-01-05&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=ST&eun=g578717d0r&

Andy Pasternak, a family doctor in Reno, Nev., has seen more than 100 new Medicaid patients this year after the state expanded the insurance program under the Affordable Care Act.

But he won’t be taking any new ones after Dec. 31. That’s when the law’s 2-year pay raise for primary care doctors like him who see Medicaid patients expires, resulting in fee reductions of 43% on average across the country, according to the nonpartisan Urban Institute.

“I don’t want to do this,” Pasternak said about his refusal to see more Medicaid patients next year. But when the temporary pay raise goes away, he and other Nevada doctors will see their fees drop from $75 on average to less than $50 for routine office visits.

“We will lose money when they come to the office,” he said.