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petmom1 replied to the topic Beating the Nicotine Urge in the forum Wellness Issues 10 years, 2 months ago
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]
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petmom1 replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 2 months ago
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!
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Micke Brown, BSN, RN wrote a new post 10 years, 2 months ago
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Dionetta Hudzinski wrote a new post 10 years, 3 months ago
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Now, how do we stop this discrimination?
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Micke, as frustrating as it is we need to continue to stand up and shout. This past 4 months I have received 4 calls (3 in the past 2 weeks) from people in pain in WA state who need help finding resources. They find me through the Seattle times article…they write to Elin and then she refers to me. we are now banding together to approach the Seattle times to see if they will do a follow up to the pain rules 4 years later to see where we are. Some state officials are proud of the fact that prescriptions are decreasing and also they are denying more applications for prescriptive authority saying they are concerned for the safety of the general public. Just saw they refused to grant an extension and broadening of prescriptive authority to Naturopaths. reason: we can not increase the providers who are prescribing controlled medications if we want to stem the prescribing of opioids in WA state. WHAT??? Same old BS.
It is frustrating when I read the reports of MD’s and Nurses who are abusing drugs and losing their licenses in WA state. Every month I get the report…and it sickens me to see the numbers. How do we fight this? Education…REAL education!! get some pain patients on a panel and do a dog and pony show.
The Moms of kids who have died of overdoses get to do it…why can’t we??? Put a REAL face on it.
Frustrating for me as right now I am dealing with my own pain as well. Thought I really understood chronic pain until Sept 2013 when my life went upside down and sideways. Post viral seronegative arthritis.Received the official diagnosis today. My hands and wrists are the worst so typing is now a real chore. No rheumatologist in this part of the state so I will have to go to Seattle. I am finding that resources for people in pain are scarcer than ever. Pain clinics are so overwhelmed it takes an act of congress to get an appointment in less than 6 months if they will see you at all.
There are some very compassionate physician out there but they are far and few inbetween. I am lucky I have a team that is very patient centered and concerned about how the pain is affecting my life. They listen, They give me just about anything I ask for. The meds are carefully prescribed each month with careful follow up. I even got a flare up plan written in my chart. they all know me from my days as the pain management nurse at the hospital. In those days they dreaded seeing me…they’d say oh no here she comes…how are our patient’s doing? or they’d call me and ask me to come do that thing that I do. (i.e. help their patients get relief from the pain using multimodal techniques) I am still know affectionately as the Pain Lady by many.
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Dionetta this is an outstanding blog. People living with pain are not only held to higher standards but there are many healthcare providers and folks in the general public who judge us all to be addicts. They do not take the time to learn about pain and/or refuse to believe that we must utilize pain medications to help us to have some normalcy in our lives and quality of life.
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Noki4, thank you. Glad you thought it was worth reading. I can not tell you how upset I was as I tried to advocate for this guy and I felt like I was doing what I do when I encounter biased people who think anyone in pain is lazy and not worthy of pain relief.
I want to be around when (God forbid) they are smitten with chronic pain…or even acute pain that is not relieved. I want to say…see what did I tell you…can you understand NOW!! but actually when I WAS faced with that very situation I could not not do what I do for anyone in pain…I worked diligently for several hours to get the pain under control without judgement, without an attitude, without poking fingers. I just did my job as compassionately as I could. The next day I had the conversation as he (an ortho Doc who just had major – very painful surgery) sat in bed and said to me “I was never so glad to see you in all my life” I told him to NEVER forget this. of course he did some time down the road AND I, true to my nature reminded him of his ordeal in the recovery room when he was ashen colored, white knuckling it, and asking- no begging for relief.
He who thought that 2 tylenol after a hip or knee replacement what sufficient for “most” people. “I fixed the problem so they should have less pain” ARE YOU KIDDING ME? Let me take a saw and saw off your joint…then take a hammer and chisel to implant the new hip or knee joint. Let me see if this hurts???
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It has moved beyond discrimination and into legislation in West Virginia. West Virginia has passed laws to reclassify drug schedules of federally scheduled drugs into different classes. Tramadol, a non-narcotic has been moved into the same class as Oxycotin. Today, I was told that Hydrocodone was reschedule as well. This means I will have to get a new prescription every month in stead of every three months. I now have to pay for 12 doctor visits instead of 4. It’s egregious and excessive as well as a financial burden. I will also have random calls to report the amount of medication in my prescription bottles. The only way to fight against this abuse is legally in West Virginia. It will be nearly impossible to repeal.
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Nickopedia, the situation that you mention is not unique to West Virginia. That was a decision that came from the FDA and it is a national law/rule now for ALL states. Is it fair? NO. Did it make getting your medications harder if not down right difficult to impossible? YES.
So what are we to do? Whining helps no one. Taking action does! Write to your legislators both state and federal. Tell them your story. encourage others to tell their stories. Help someone else tell their story. Keep telling the story until someone listens. Flood their offices with weekly letters, phone calls, emails actually work the best as Snail mail scares them and we sure do not want to scare them.
keep track of times that you are told untruths about prescriptions. dates, times, who. Keep track of conversations you have had with others in similar situations…again dates and names and contact info. It will come in handy to back up your story.
Where one person in pain is discriminated against there are more than a 1000 more who have not spoken up, who remain silent; who may be scared to speak up for fear of retaliation even greater than their present situation. But I ask what could be worse than being in pain and then being singled out for discrimination, care that is less than quality or effective.
team with others in your town…do a meetup… talk to others; spread the word. write a letter to the editor.
make comments on all negative media…let them know the truth. -
Nick – see blog https://paincommunity.org/old-pain-medications-new-rules/
It explains what happened.
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Micke Brown, BSN, RN wrote a new post 10 years, 3 months ago
I 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)
IbuprofenCough 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.
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Micke Brown, BSN, RN wrote a new post 10 years, 4 months ago
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Micke Brown, BSN, RN wrote a new post 10 years, 4 months ago
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tndrft001 replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 5 months ago
I gave up on weighing myself and only do it when I’m in for my checkups. I go more by the feel of my clothes. If my waist band starts feeling like they’re pinching me, I know it’s time to start watching my portion sizes again. 😀
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Dionetta Hudzinski commented on the post, The Words You Choose Make a Difference 10 years, 5 months ago
Thank you Petmom!!!
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Dionetta Hudzinski replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 5 months ago
Oh no Petmom…:( but did you have a good time? was it worth it? do not get discouraged. You can do one of 2 things…sit and analyze the weekend and what you might have done differently to stay on track and still have fun…or you could just chalk it up to a good time and start over today with a renewed sense of determination.
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Dionetta Hudzinski replied to the topic Water therapy in the forum Treatment Options for Pain 10 years, 5 months ago
Petmom…I am with you on that. Water is one of the best vehicles for exercise, relaxation etc. Love the feeling of weightlessness. AND I think this is one of the many therapies we need to work on getting more available to people in pain. it is a relatively cheap therapy when you look at the cost of others that do not work as well.
Where would…[Read more] -
petmom1 replied to the topic Water therapy in the forum Treatment Options for Pain 10 years, 5 months ago
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]
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petmom1 replied to the topic Introduction- in the forum Welcome to The Pain Community 10 years, 5 months ago
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.
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petmom1 replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 5 months ago
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.
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petmom1 commented on the post, The Words You Choose Make a Difference 10 years, 5 months ago
Thank you Dionetta. I choose wisdom and generosity of spirit which you have shown writing this important message and sharing your thoughtful words.
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Dionetta Hudzinski wrote a new post 10 years, 5 months ago
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Dionetta Hudzinski replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 5 months ago
That is so true. It took years to get here -to this point in time. It certainly did not happen overnight. Sometimes it seems that way when we actually “wake up” to the fact of our present circumstances. And as much as we would like to turn back the clock and weigh what we did 10 or 20 or 30 years ago; it it just is not going to happen…[Read more]
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tndrft001 replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 5 months ago
Something my doctor told me a long while back, about losing weight, has always stuck with me and I find, for myself, it helps and that is to remember it took awhile to gain the weight, so it will take awhile to lose it.
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Dionetta Hudzinski replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 5 months ago
Thanks Petmom, I try not to focus on the number…rather focus on how I feel and when others make comments Like -WOW you look like you are losing wt! I say thank you I feel better. And I only weigh in monthly at my clinic appts. (I do not own a scale) Funny I have been to the clinic more in the past 6 months that I have been in the past 6+…[Read more]
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petmom1 replied to the topic Painiac Shuffle, Move & More in the forum Wellness Issues 10 years, 5 months ago
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]
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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”