TPC Admin

  • I discovered a new way to eat cucs, thanks to my neighbor. Cut them up in bite size portions and dip in ranch dressing…………YUMMY!! and way too simple.

  • ThumbnailA few weeks back, I was asked to moderate a phone support group for a kindred consumer pain organization. The topic was pacing.

    As I finished the introduction of the how’s and why’s, I listened carefully to the […]

  • Just spent a long weekend with an old friend who turns out to be a chain smoker. My lungs and clothes had a work out just being around her as she smoked in her home, in the car and elsewhere. She did ask if I minded, so I was trying to be gracious as she invited me to her home. Naturally, I say I was fine with it. I did not expect to be living in…[Read more]

  • 16 pounds lost and hit my second stalemate. So frustrating. I hate these as they can make you want to throw your hands ups and give up. I am determined not too!

  • ThumbnailI find this topic of conversation comes up a lot, especially for those who live with pain. Sleep. Will I find a comfortable position? Will I fall asleep tonight? Will I be able to sleep in my bed or will I resort […]

    • For me it is always the fetal position and I have to lay on my left side due to the pain in my back and neck. I don’t change positions in my sleep like some folks are able to do. I can fall to sleep easily but each night it is the same routine. Go to sleep, wake up within 2 hours. Go back to sleep (if it is a good night) and wake up within an hour or so. This goes on all night, sleep a little, wake up for a while, sleep a little, wake up. The really bad nights are the one’s I dread. Those are the nights where the pain does not allow me to sleep longer than a 1/2 hour or so and I lay there wide awake for hours at a time.

    • Me I sleep on my Left side in a pretty tight fetal position. I roll over onto Right side and onto back frequently during the night due to pain that wakes me up. A good night is to fall asleep in one position and wake up 5-6 hours later in same position. that is when I say “thank you God for a good night!” I also deal with restless leg syndrome. Some night no problem, legs are relaxed and allow me to sleep. But other nights about 6 or more nights per month – I can not get them to cooperate…they are moving all night and I find that sleep is not going to happen so that is when I get some good movies out and just vicariously sail off into another life.
      In the past year I have had a real problem with sleep cycle due to changes in pain characteristics and also pain intensity. there were weeks that I had but 2-3 hours sleep per night. But I now have a sleep medication and pain meds that help to make night time something to look forward to and not dread.
      Turning down the lights early in the evening helps with my sleep hygiene. Doing a Gratitude journal before bed is also helpful. and a note pad near the bed helps when my mind starts racing…I sit up get the pad, write everything down that is pouring out of my brain…then I can settle down and sleep. it is on paper…sometimes I read it in the morning but mostly I ignore it.
      My favorite pillow is a contour memory foam pillow. since getting hooked on that about 10 years ago I no longer wake up with neck aches. I could not afford a memory foam mattress so I bought a 3 inch memory foam topper and I love it. Like sleeping in a cloud.
      Noki4, sleepless nights are the pits. Glad I do not have them too frequently.
      And Naps are my favorite thing in all the world. do not get them often but there is nothing like laying down in the middle of the day and catching an hour nap!! My motto…”when all else fails, take a nap”

  • pharmacyI had an interesting conversation the other day with a journalist. No kidding! I spent about 30 minutes on the phone discussing the recent upscheduling of hydrocodone-containing combination products (HCCP). Here are some of the most common of the 65 brand names and generic medicines affected:

    Vicodin, Vicodin ES, Vicodin HP
    Lortab, Lorcet, Lorcet Plus
    Norco
    Zydone
    Vicoprofen
    Hydrocodone and one of the following:

    Aspirin (also called ASA)
    Acetaminophen (also called APAP)
    Ibuprofen

    Cough medicines that contains hydrocodone

    He was concerned as his grandmother has been prescribed one of these preparations for her pain and wanted to understand how the change could affect her. Great grandson, right? I thought so. So, I tried to explain both sides of the issue that have been in play for several years now. He produced a nicely balanced article in my opinion. I do hope that sharing my impressions with him may have contributed. See what you think.

    As I shared this news with my colleagues at TPC, I was reminded that not everyone may be up to date on the changes that have recently occurred. So, if you have not been following the recent turn of events, I will try to summarize it:

    On August 22, 2014, the US Drug Enforcement Administration (DEA) issued its final rule moving hydrocodone-containing combination products (HCCP) from Schedule III to Schedule II under the federal Controlled Substances Act. The DEA’s rule will become effective on October 6, 2014.

    Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, less abuse potential than Schedule I drugs, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous.
    Some examples of other Schedule II drugs are: cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin
    For other Schedules, see DEA Drug Scheduling.

    Those of you who have an old HCCP prescription with remaining refills will likely experience difficulty trying to get them refilled, beginning October 6, 2014.
    A new prescription will be required. Why? Schedule II medications cannot be refilled.

    Pharmacies will be required to deny the request to fill an old prescription even if refills are indicated.
    They should direct you to contact your prescriber if you do not have a new prescription.
    This could cause a delay in your ability to obtain a new prescriptions and having it filled before you run out of medication. Plan ahead. Do not put yourself at risk for the onset of opioid withdrawal by running out.

    Your prescriber will need to use his/her own judgment on whether to require an office visit in order to obtain a new prescription or just pick it up at the front desk; office visits are not required by law, as long as the prescriber is certain that the prescription is being issued for a legitimate medical purpose, in the usual course of professional practice.
    Refills can no longer be called in to the pharmacy either, EXCEPT in emergency situations, as with other Schedule II controlled substances.

    “In an emergency, a practitioner may call-in a prescription for a Schedule II controlled substance by telephone to the pharmacy, and the pharmacist may dispense the prescription provided that the quantity prescribed and dispensed is limited to the amount adequate to treat the patient during the emergency period.
    The prescribing practitioner must provide a written and signed prescription to the pharmacist within seven days. Further, the pharmacist must notify DEA if the prescription is not received.”

    Some pharmacies may be reluctant to accept these emergency prescriptions because of the requirement for a follow-up written prescription. If your prescriber is unable to find a pharmacy to accept a phoned-in emergency prescription for a Schedule II medication, he/she will either need to:

    Arrange for you to be seen by a prescriber in a clinic or emergency room;
    Phone in a prescription for a Schedule III (e.g., codeine + acetaminophen) or Schedule IV (e.g., tramadol) opioid analgesic; or
    Phone in a prescription for a non-controlled pain reliever (e.g., an NSAID).

    For those of you who have been given a HCCP prescription with refills in the past, the DEA does provide an option that a supply can be provided for up to 90 days. Following is the section from the DEA Practitioner’s Manual describing a Schedule II “prescription series”:

    “…[A]n individual practitioner may issue multiple prescriptions authorizing the patient to receive a total of up to a 90-day supply of a schedule II controlled substance provided the following conditions are met:

    Each separate prescription is issued for a legitimate medical purpose by an individual practitioner acting in the usual course of professional practice.
    The individual practitioner provides written instructions on each prescription (other than the first prescription, if the prescribing practitioner intends for that prescription to be filled immediately) indicating the earliest date on which a pharmacy may fill each prescription—this is known as the “Do Not Fill Until” instructions written on a prescription.
    The individual practitioner concludes that providing the patient with multiple prescriptions in this manner does not create an undue risk of diversion or abuse.
    The issuance of multiple prescriptions is permissible under applicable state laws.
    The individual practitioner complies fully with all other applicable requirements under the Controlled Substances Act and Code of Federal Regulations, as well as any additional requirements under state law.”

    Basically, this provision allows a prescriber to issue prescriptions totaling a 90-day supply in a variety of ways: 3 prescriptions each with a 30 day supply; 6 prescriptions each with a 15 day supply; or as many as 90 prescriptions with a one-day supply, if needed.

    The ability to do this has been poorly understood by many prescribers, therefore, not frequently used. It is anticipated that with the need to replace a very large number of HCCP refills (about 26 million per year nationwide), the use of this practice just might become more common.

    [I would be remiss if I did not give a shout out to one of my favorite pain advocates. Thank-you, Bob Twillman of the American Academy for Pain Management, for making this information so easy to share].

    Before closing, I must also share another bit of news that some may have missed. Tramadol (Ultram, Ultracet) was placed in the Schedule IV class by the DEA effective on August 18th, 2014.  It joins the ranks with other medications like: Xanax, Soma, Valium, Ativan, Talwin, Ambien.

    Please let me know if you experience any hurdles with these changes in regulations and lessons learned so others may benefit.

  • ThumbnailA few weeks back, I was talking with a friend who lives with pain. What she told me I had heard before yet it continues to stay on my mind. Her physician prescribed a TENS unit as another way to treat her back […]

  • ThumbnailI remember when I was in grammar school, being asked to write about how I spent my summer vacation. As an adult, I have been remiss and did not plan summer vacations on a regular basis, if at all. This year was […]

  • Wow, how frustrating to hear. I found that water yoga was a powerful experience. The water is warm and getting into the poses were much easier when not working against gravity. The relaxation and breathing at the end (using water noodles) was the best part. Placing one under your neck and armpits with the other under your knees allows you to be…[Read more]

  • Tender, you are an inspiration and a gentle soul. I enjoy chatting with you during the week. I am finding that when I cannot jump online, I miss those chats. Everything seems possible. I hope others will join in the conversation and find the solace that I have found with my new chat friends.

  • Ok, color me frustrated. I gained 2 pounds just from taking the weekend off and spending time with friends whom I have not seen for months. This is just plain WRONG.

  • Thank you Dionetta. I choose wisdom and generosity of spirit which you have shown writing this important message and sharing your thoughtful words.

  • Bravo, Dionetta! Take it slow and allow the weight to melt away. It seems frustrating at times, but each day that your clothes loosen just a little more, is proof that you will reach your goal. I hope to drop at least 40 pounds over the next year. I try not to use that as the daily metric though to avoid becoming disillusioned. I am choosing…[Read more]

  • He doesn’t call me “Brat” for no reason. LOL

  • I wonder if I could sign up a group membership and have my canine crew doggie paddle along side of me. LOL! Great suggestion, Dionetta. I wonder what is working for others. I had good news stepping on the scale this morning–now 12 pounds lighter.

  • My challenge is the reverse, as I have a live-in brother who grapples with psoriatic arthritis. He tends to hibernate at his computer no matter the weather. Now, that it is warmer, I have started walking the dogs […]

  • I have to share a success story. I was traveling with my 81 year old cousin to a family reunion over this past weekend. He has rheumatoid arthritis and becoming less steady on his feet. He also told me that he had pulled his hamstring several times over the recent weeks. However, he insists on walking whenever he can as he fears that one he stops,…[Read more]

  • I also know how hard it can be to start moving and doing things. Especially after 2 surgeries in less than 2 years. The VA has given me several pedometers over the years and I have not found them to work well or last. My fitness pal has an area where I monitor my water intake and that makes it easy to remind myself to drink enough per day. I…[Read more]

  • Load More