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gatorhead 10-24-2012 03:32 PM

I shed some light on this in one of my other posts and I believe it to be true. I have no data to back it up but I can add 2+2 and as my son says it equals 5! The recent pill mill laws were a growing trend, hyped by an "epidemic". Treating physicians can no longer prescribe their known patients with narcotic pain medicines. Instead they have to seek out "PAIN Clinic's" some of which are pill mills, pay the cash get what you want, go to the next one. The one's that nee it cannot get it. The ones who want it get more than they need.

It never was about patient safety. In Florida at least our Governor opposed the pill mill law and was lobbied by those who operate them. Its big bucks. The DEA stepped in and questioned every single doctor about their prescriptions and why they prescribe this to said patient and then ask why that is a better alternative than say, yoga. Finally as of July 1 , 2012 you have to have a certification as a pain doctor to prescribe. You can see where this is a pain in the royal butt for doctors.

The answer to the problem started becoming popular about 8 years ago. Sure they gave them long before that but the epidural/nerve root blocks started becoming the norm and is the ONLY solution at many of the "legit" Pain clinics left here in Florida. Problem is they are cutting corners buying the cheapest drug from where ever they can. There are many cases where a dirty needle was stuck back into the vial to obtain more medicine!Just as there were always injections, there were always complications.

The injection trend is here to stay! There is far more money to be made with it than there ever was writing a script. Most places charge on average between $1500-$1800 per injection and do it up to 3 times in 6 months. They charge for office visits on top of that and have you come in for follow ups inbetween. They could only charge for the office visit prior to these and the whatever kickback they received from the pharmaceutical companies. In addition to this they are not bothered at all by the DEA! So for them it is a free for all, win situation no matter how you look at it.

Injections anyone?

ginnie 10-24-2012 03:38 PM

Hi Gator head
 
You are correct in everything you said. My doctor admitted to being harassed by the DEA on all scripts. Still she did prescribe for me. If you are in my area, she is a physiatrist/pain specialist, Name Dr. Emese Simon on Robinhood lane in Sarasota. Very compassionate doctor! No I don't want the shots, and she won't force them. Take care Gator head. You put the problem in plain english. I think there is going to be trouble over this whole issue. ginnie:hug:

Dubious 10-25-2012 09:20 PM

Quote:

Originally Posted by gatorhead (Post 925483)
I shed some light on this in one of my other posts and I believe it to be true. I have no data to back it up but I can add 2+2 and as my son says it equals 5! The recent pill mill laws were a growing trend, hyped by an "epidemic". Treating physicians can no longer prescribe their known patients with narcotic pain medicines. Instead they have to seek out "PAIN Clinic's" some of which are pill mills, pay the cash get what you want, go to the next one. The one's that nee it cannot get it. The ones who want it get more than they need.

It never was about patient safety. In Florida at least our Governor opposed the pill mill law and was lobbied by those who operate them. Its big bucks. The DEA stepped in and questioned every single doctor about their prescriptions and why they prescribe this to said patient and then ask why that is a better alternative than say, yoga. Finally as of July 1 , 2012 you have to have a certification as a pain doctor to prescribe. You can see where this is a pain in the royal butt for doctors.

The answer to the problem started becoming popular about 8 years ago. Sure they gave them long before that but the epidural/nerve root blocks started becoming the norm and is the ONLY solution at many of the "legit" Pain clinics left here in Florida. Problem is they are cutting corners buying the cheapest drug from where ever they can. There are many cases where a dirty needle was stuck back into the vial to obtain more medicine!Just as there were always injections, there were always complications.

The injection trend is here to stay! There is far more money to be made with it than there ever was writing a script. Most places charge on average between $1500-$1800 per injection and do it up to 3 times in 6 months. They charge for office visits on top of that and have you come in for follow ups inbetween. They could only charge for the office visit prior to these and the whatever kickback they received from the pharmaceutical companies. In addition to this they are not bothered at all by the DEA! So for them it is a free for all, win situation no matter how you look at it.

Injections anyone?

While I feel sad that all of this has led to such an awful outcome, one should not throw the baby out with the bath water!

In over 20 years of clinical practice, I oversaw and sent out numerous patients when indicated for various types of spinal ESI's. They were always done by very reputable PM docs in the area. There were and are a few unscrupulous ones who most referers were aware of, so we just stayed away from them.

In my experience, those whom I sent to one of the "good guys," at best were helped tremendously and at at worst, had no relief. A couple here and there (rare) had temporary complications of an "epidural headache" but they were carefully followed up and resolved within a week or two. On the other hand, the "bad boys" were known for various serious failures and complications. One of the worst ones was a patient who had too many discograms, one of which was septic and because it was work comp, went undiagnosed for 6 months. Not pretty.

So I guess my thought is that one should exhaust all conservative efforts to address their spinal pain issues before progressing to ESI or surgery with the understanding that if you go the latter two routes, you have made a thoughtful and educated decision so that if something goes wrong, while that would not be okay, at least you weighed the risks! ESI's DO help an awful lot of people....unfortunately some will get hurt in the process!

gatorhead 10-25-2012 11:15 PM

Quote:

Originally Posted by Dubious (Post 925974)
While I feel sad that all of this has led to such an awful outcome, one should not throw the baby out with the bath water!

In over 20 years of clinical practice, I oversaw and sent out numerous patients when indicated for various types of spinal ESI's. They were always done by very reputable PM docs in the area. There were and are a few unscrupulous ones who most referers were aware of, so we just stayed away from them.

In my experience, those whom I sent to one of the "good guys," at best were helped tremendously and at at worst, had no relief. A couple here and there (rare) had temporary complications of an "epidural headache" but they were carefully followed up and resolved within a week or two. On the other hand, the "bad boys" were known for various serious failures and complications. One of the worst ones was a patient who had too many discograms, one of which was septic and because it was work comp, went undiagnosed for 6 months. Not pretty.

So I guess my thought is that one should exhaust all conservative efforts to address their spinal pain issues before progressing to ESI or surgery with the understanding that if you go the latter two routes, you have made a thoughtful and educated decision so that if something goes wrong, while that would not be okay, at least you weighed the risks! ESI's DO help an awful lot of people....unfortunately some will get hurt in the process!

I truly do understand they have their place in medical treatment. Where I am now it is all the rage, and all they are looking to do and acting like it is a cure all. Then when you do subside and have them done and they DON'T work for you all the sudden you're the bad guy! The last clinic I was "supposed" to get an injection from told me they didn't have an issue with the batch they were using. 3 people have died this week from that clinic that I decided against the shot(s)

ginnie 10-26-2012 10:13 AM

To dubious
 
What irritates me is when PM says they won't help you anymore unless you DO the shots, and or the surgery. I have had two spinal fusions. Not doing that great below the fusion site. I don't want more surgery, and I don't want more shots. I have had enough. ginnie

mrsD 10-27-2012 07:47 AM

far far worse
 
This is far far worse than I ever expected, or anyone else for that matter!

http://news.yahoo.com/fda-pharmacy-t...--finance.html

Quote:

Staffers at a pharmacy linked to the deadly meningitis outbreak documented dozens of cases of mold and bacteria growing in rooms that were supposed to be sterile, according to federal health inspectors.

In a preliminary report on conditions at the pharmacy, the Food and Drug Administration said Friday that even when the contamination at New England Compounding Center exceeded the company's own safety levels, there is no evidence that staffers investigated or corrected the problem. The FDA uncovered some four dozen reports of potential contamination in company records, stretching back to January this year.

ginnie 10-27-2012 08:17 AM

Yes MrsD
 
Yes, this health scare is one of the worst. and doctors down here want to use the needle because they arn't prescribling pain medcations much...Leaves patients in a terrible position, not to mention physical pain. How will trust ever be re-established? ginnie:hug:

Dr. Smith 10-27-2012 04:43 PM

Quote:

Originally Posted by mrsD (Post 926367)
This is far far worse than I ever expected, or anyone else for that matter!

http://vitals.nbcnews.com/_news/2012...ew-deaths?lite

http://abcnews.go.com/Health/Wellnes...ry?id=17570870

http://www.washingtonpost.com/fdas-a...bc7_video.html

Doc

mrsD 11-01-2012 12:15 AM

More news...

http://news.yahoo.com/mass-firm-tied...173229843.html

It is horrific.
Quote:

In a related story, The Boston Globe reported Wednesday that NECC sent customers a report card touting the cleanliness of its labs, even though internal tests showed widespread contamination.

The Quality Assurance Report Card claimed that during the first half of 2012, there were no instances of contamination exceeding accepted standards on surfaces in "clean rooms," where the company produced sterile injectable medications.

But company records indicate that during that same period, the company's own internal testing showed that 33 surface samples from the clean rooms contained bacteria or mold at levels requiring corrective action. Those results were disclosed in a report released Friday by FDA investigators.


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