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MS Contin ER (Extended release morphine
#31
(06-01-2011, 10:42 PM)Cycler Wrote: I suppose that is too often the case but isn't there always a legal remedy to capricious denials ?

(06-01-2011, 11:10 AM)jayne Wrote: cycler sometimes it isnt a money issue its a ego issue.....adjusters sometimes just like to hold things over our heads cuz they can......it is why so many good Drs wont work with WC any more....its a do what I want you to or you aint getting Kaka issue.....you will settle for nothing just to get out from under them and they know it....

Welcome to the world of Workers Comp.Smile

 
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#32
So which is it ?
Have you exhausted all available legal remedies or that your physician has a financial interest in NOT referring you onward ?

(06-01-2011, 11:44 PM)freebird Wrote:
(06-01-2011, 10:42 PM)Cycler Wrote: I suppose that is too often the case but isn't there always a legal remedy to capricious denials ?

(06-01-2011, 11:10 AM)jayne Wrote: cycler sometimes it isnt a money issue its a ego issue.....adjusters sometimes just like to hold things over our heads cuz they can......it is why so many good Drs wont work with WC any more....its a do what I want you to or you aint getting Kaka issue.....you will settle for nothing just to get out from under them and they know it....

Welcome to the world of Workers Comp.Smile

 
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#33
(06-02-2011, 08:48 AM)Cycler Wrote: So which is it ?
Have you exhausted all available legal remedies or that your physician has a financial interest in NOT referring you onward ?






Some of your answers and words are ambiguous to say the least.
Do you have any major experience in the World of Workers Compensation? I think very little. You have opined on my statements with nothing of value.

Since you actually know 0 about my case or situation , AND you start with the mudslinging.... Not Cool but I really can overlook a donkey. Wink

Remember, 8 years I have been dealing with my injury. I still draw a weekly check and all my medical/prescriptions are paid for. I have a really good Attorney...

IF you want, I will hook you up with our local Sheriff's dept. so you can ask about the Hydrocodone/Vicodin issue in our surrounding area.

You harped on wording but in the end dependency is still "not good" The feeling of needing a drug is really mind blowing.

Have a nice day Cycler. Remember, Googled answer's are not alway's "real world" answers.


 
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#34
Free:
Yes, I have experience with workers comp and no, there is nothing ambiguous in any of my statements that I can see. Example ?
I don't see any slinging of anything, I asked you a simple question that you may or may be able to evaluate but IF you could may lead to a new perspective on your care. For instance, have you found out what Prialt is yet ?
What's more, I have quite a bit of experience in the chronic pain treatment world which forms the basis for my comments.

I read back the entire thread and I see where I went off track oth you Free. I missed you pot where you explained how far you travel to your clinic and where the spine injury is that makes the catheter placement difficult. My apologies. Yes I can see where that might significantly limit your options.

I agree that "feeling" the dependency is not a good but that is simply the price to be paid for the long term use of narcotics to control pain. That feeling has noting to do with addiction as explained elsewhere. glad to hear the switch away from morphine eased your discomfort.

Btw, what I wrote about stool softeners won't be found by any Google search.

Peace
 
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#35
As a Emergency Room RN who holds a masters degree and also holds a certification in Emergency room nursing, I find the directions of some of these threads lately pretty scary.

Unless someone is a pain management specialist. No one should really be trying to convince anyone of not taking narcotic pain meds. They are still the gold standard for treating chronic pain and the chances of addiction are low when used properly and as directed.

You may all argue over schematics, but there is a difference between dependence and addiction. Dependence is a physical reaction but addiction is a mental reaction.

No one should be telling someone about how their pain meds should be administered either. Everyones body is different and everyone resonds to medication differently. Someone may need ot take pills more or less then the recommended dosage.

It's scary that some people on this board feel the need to play educated professional because they read a few articles and have their own person basis to fall back on. I AM an educated professional in this area, and I wouldn't dare tell someone that they should or shouldn't be taking anything that their doctor prescribes because I don't know that person's medical history.

You may not realize that certain meds make some others less effective, so therefore more meds will be needed than the standard prescribing dosage.

Also, to ask someone why they don't get a pump or a SCS is pompous and arrogant. Pumps and SCS are very serious surgeries and also should not be taken lightly. And if that Whether that person is a candidate or not, should be up to them and their physican, not up to a stranger on a WC board. SCS and especially pumps have a whole host of other side effects problems of their own. Having a SCS also does not mean that you don't take pain meds anymore. I tak emore now, then I did before my SCS.

All I am saying is that unless you are a trained professional who IS IN DIRECT patient care with the person who you are regurgitating Internet medicine to , you should not be doing it. It is illegal and immoral at best, dangerous at the worst, to give medical advice to people you know nothing about.

An opinion, is an opinion, I understand that, but some people on here are making a habit of reading internet medicine and acting like they know what the hell they are taking about . I hate to tell you , but you do not.

If you don't like that people take narcotics, then go and get yourself an Md or a Masters degree in nursing like I did , and then you can have a factual and educated way to help people. Not telling everyone who takes narcotics that they are doomed for a life of addiction and crime.

This is just sad.

Ok..I said my peace, I'm going to take my legally prescribed meds ( that I am not addicted to ) and go get some sleep.

Take care everyone and have a safe night.

<gets off of soap box and goes to bed>
 
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#36
welcome Dina to the Forum....I asked her to stay and help us all out since our other nurses have parted ways..you all welcome her to...
........I love cats, I just cant eat a whole one by myself......







 
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#37
Dina,

Welcome and be careful about assumptions and realize that essentially none of the folks here are under the care of a University level Chronic Pain Program and there is a world of difference because of that, financial being not the least of them.

First of all it's semantics. We haven't gotten to the schematics yet.

Secondly, nothing I have posted is my opinion but facts and best practices firmly rooted in the peer reviewed Pain and rehab literature ( citations available on request..<g>)

Thirdly, you are correct in that genetic variation in the expression and activity of the Cytochrome P450 enzymes does alter opiate metabolism rates that may need to be taken into account if analgesic dosing BUT that will not affect intervals in sustained released preparations, only strength, right ?
( i.e one cannot metabolize drug not yet available to the gut )

I am perfectly comfortable recommending against the practices of high does opiate therapy for non-malignant chronic pain outside the hospital setting, useful in some circumstances granted but an experiment gone horribly wrong over the past 15 years since the feds implementation of the Pain: The Fifth Vital Sing program in 1999 that gave any physician carte blanche to prescribe narcotics in a manner never seen before in the USA with predictable results. In the state of Washington alone deaths form accidental prescription drug overdose jumped by 17% immediately thereafter.

You are correct that SCS and pump are major surgeries, so is back surgery and that's how these folks got into this mess in the first place as the peer reviewed spine literature points out. If you care to review it there is currently a full scale battle going on concerning the topic of spine fusion surgery and the less than 30 % success rate, surgeon compensation and kick backs by the device manufacturers, and lack of any scientific validation fusion for discogenic pain and spine DJD absent instability.

On the other hand, the emerging literature on SCS and pain pumps are quite favorable in restoring patient function and reduction of pain to tolerable ( not absent ) levels with subsequent reduction in oral medication needs. Your personal experience is not unusual but has been trending downwards with the newer paddle and programming options coming on market in just the past two years. The current discussion is about re-operating to remove and replace with the newer technologies in cases such as yours which is finding very few takers on the patient side as you might imagine.

Obviously from the above I am not some bumpkin on the corner but have a thorough and wide knowledge in this topic. If you do notice an error in fact in any of my posts please let me know but I'll stick to my position on the matter as reflective of the current medical literature and practices.

Anything I post is verifiable via standard search engines, although knowing something about PubMed helps, and is presented for reference only as to better inform when that information is not readily forthcoming from caregivers and can be useful in having informed discussions with their caregivers should they choose to take it. As you've seen, it's mostly a leave it rather than take it.

sleep well.
 
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#38
Cycler - my problem is that no one here is a doctor and should not give medical advice. Period. You are not a doctor, you read on the Internet and regurgitate what you read as fact. For every thing you read against or for any subject, there is another article that can pulled up to go against it.

It is illegal to dispense medical advice without a license. You are well read, you should know this. Unless you are a doctor, you should not be doing it. You know it. You are more interested in showing people that you are smart - I get it, you can read- but are you an MD who is trained in pain mgmt? No. So you should not give advice on whether someone should follow their doctors orders or not.

I am not going to give in to the arguments, I have better things to do today. I have said my peace. You are going to do what you want, but I wanted to warn others about taking advice from someone who is not a doctor.

Best advice is : check with your physician on the best mode of treatment for you. Do not start or stop any course of treatment without your doctors knowledge.
Don't let anyone make you feel bad for needing medicine for pain.

That's all I have say on this subject.

Have a nice day and enjoy your weekend.



(06-04-2011, 08:33 AM)Cycler Wrote: Dina,

Welcome and be careful about assumptions and realize that essentially none of the folks here are under the care of a University level Chronic Pain Program and there is a world of difference because of that, financial being not the least of them.

First of all it's semantics. We haven't gotten to the schematics yet.

Secondly, nothing I have posted is my opinion but facts and best practices firmly rooted in the peer reviewed Pain and rehab literature ( citations available on request..<g>)

Thirdly, you are correct in that genetic variation in the expression and activity of the Cytochrome P450 enzymes does alter opiate metabolism rates that may need to be taken into account if analgesic dosing BUT that will not affect intervals in sustained released preparations, only strength, right ?
( i.e one cannot metabolize drug not yet available to the gut )

I am perfectly comfortable recommending against the practices of high does opiate therapy for non-malignant chronic pain outside the hospital setting, useful in some circumstances granted but an experiment gone horribly wrong over the past 15 years since the feds implementation of the Pain: The Fifth Vital Sing program in 1999 that gave any physician carte blanche to prescribe narcotics in a manner never seen before in the USA with predictable results. In the state of Washington alone deaths form accidental prescription drug overdose jumped by 17% immediately thereafter.

You are correct that SCS and pump are major surgeries, so is back surgery and that's how these folks got into this mess in the first place as the peer reviewed spine literature points out. If you care to review it there is currently a full scale battle going on concerning the topic of spine fusion surgery and the less than 30 % success rate, surgeon compensation and kick backs by the device manufacturers, and lack of any scientific validation fusion for discogenic pain and spine DJD absent instability.

On the other hand, the emerging literature on SCS and pain pumps are quite favorable in restoring patient function and reduction of pain to tolerable ( not absent ) levels with subsequent reduction in oral medication needs. Your personal experience is not unusual but has been trending downwards with the newer paddle and programming options coming on market in just the past two years. The current discussion is about re-operating to remove and replace with the newer technologies in cases such as yours which is finding very few takers on the patient side as you might imagine.

Obviously from the above I am not some bumpkin on the corner but have a thorough and wide knowledge in this topic. If you do notice an error in fact in any of my posts please let me know but I'll stick to my position on the matter as reflective of the current medical literature and practices.

Anything I post is verifiable via standard search engines, although knowing something about PubMed helps, and is presented for reference only as to better inform when that information is not readily forthcoming from caregivers and can be useful in having informed discussions with their caregivers should they choose to take it. As you've seen, it's mostly a leave it rather than take it.

sleep well.

 
Reply
#39
And that wasnt coppied, I may just be a un educated pill popping addict. But truley who knows more about being addicted...? I believe us users of narcotics tell the real truth, If it wasnt for us, drug studies wouldnt know what to write about for others to copy.
 
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#40
nursedina

Pressing the like button.
 
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