Sunday, November 8, 2009

This sounds interesting for those of you like me


“Epidemic” of under-treatment affects more than 70 million Americans suffering from persistent back pain, headaches, joint pain; disproportionately affects minorities and low income

WASHINGTON, DC (November 4, 2009)-- Warning that patients shouldn’t assume their doctor has enough knowledge to treat their pain, a national panel of experts today called on medical schools to train doctors and nurses on the basics of pain care, reform the nation’s reimbursement system, and address pain as a public health crisis. The group insists that without health reforms and better training to diagnose and treat pain properly, people with untreated pain may face a lifetime of pain as a chronic illness – which could lead to job loss, depression and in some cases, even suicide.

“Doctors, who don’t lack for compassion or medical skills, often offer only limited treatments to patients disabled by chronic pain,” said Lonnie Zeltzer, M.D., co-chair of the panel, and the director of the Pediatric Pain Program at the University of California, Los Angeles. “With little or no specific training in pain management, and working in systems that make it much easier to treat common conditions like high blood pressure than a complex problem like pain, doctors may intend to help but leave most patients under-assessed and under-treated. Minorities, children and women often faced the highest risk of under-treatment.”

The panel, convened by the New York City-based Mayday Fund, included anesthesiologists, neurologists, primary care doctors, pediatricians, emergency physicians, nurses, psychologists, pharmacists and patient advocates (the full Committee is included below). After a conference in Washington D.C. and deliberations that lasted over several months, the panel’s report, A Call to Revolutionize Chronic Pain Care in America: An Opportunity in Health Care Reform, says pain is a huge public health problem. They developed several recommendations for government agencies, Congress and the medical community to address.

The report and recommendations have been endorsed by more than 30 organizations, including the American Academy of Family Physicians, American Academy of Pediatrics, The Joint Commission, American Nurses Association, American College of Emergency Physicians, and the American Academy of Neurology (the list of current signatories is below).

“As we get closer to the possibility of health care reform, the frontlines of medicine - adult and pediatric primary care - could face enormous strains from millions of new patients seeking care for pain,” says Russell K. Portenoy, M.D., panel co-chair and the chairman of Pain Medicine and Palliative Care at the Beth Israel Medical Center in New York. “Primary care is the first stop for people in pain, and both the training received by clinicians and the system of care should facilitate best practices in pain care, but this is not the way it is.”

The Mayday Fund Special Committee on Pain and the Practice of Medicine writes that chronic pain should be reframed as a chronic illness since “the burden of chronic pain is greater than that of diabetes, heart disease and cancer combined.” People in chronic pain have longer hospital stays, and many duplicative tests and unproven treatments—all of which drive up the nation’s health care spending, the panel said.

Chronic pain costs the nation more than $100 billion a year in lost productivity and direct medical costs, the report says. “This is a wasteful system,” Portenoy adds. “Major reforms in the health care system are needed if we want to improve the quality and cost effectiveness of care for chronic illnesses, and pain is as much a chronic illness as diabetes and heart disease.” Although the impact of pain on patients and on society is among the most serious of public health concerns, chronic pain has been largely left out of the current national debate on health reform, the panel writes.

According to the report, about “one-third of people in pain report that their pain is disabling and has a high impact on their ability to function in daily life. Research suggests that the high cost of under-treated pain includes lost productivity. Pain is the second-leading cause of medically-related work absenteeism, resulting in more than 50 million lost workdays.”

The authors pay particular attention to the numerous studies that suggest low-income populations, minorities, women and children are more likely to be under-treated for pain or not receive pain care at all. If doctors do not recognize chronic pain as a serious illness, or as serious as others, or they perceive that pain complaints cannot, or should not, be treated, persistent pain results. In some cases, such as pain in young children and adults with dementia, patients may not report their pain, and under-assessment drives under-treatment.

“The tragedy of this system is that it leaves many people suffering from unrelenting pain,” says Zeltzer. “Pain that goes untreated may permanently change the body’s nervous system and may lead to pain that can be managed but never goes away.”

Federal policymakers have recognized the impact pain has on individuals and the health care system and have included provisions of the National Pain Care Policy Act 2009 (NPCPA) in health reform proposals. That bill calls for an Institute of Medicine Conference on Pain; increased funding for the National Institutes of Health to collaborate across institutes to find more effective treatments for pain and to better understand the biology of pain; a grant program to improve health professionals’ understanding of and ability to assess and treat pain; and better public education so that consumers understand the danger of letting pain go untreated.

“Remarkably, less than one percent of the NIH budget was devoted to pain in 2008,” Zeltzer said. “This amount is not commensurate with a public health problem of this magnitude.”

In addition to medical school reforms and expanded funding for pain management training programs, the panel cited specific measures that would ease this public health crisis. Among them:

•Health care providers, insurers and government agencies should eliminate disparities in access to pain care related to race, gender, age and socioeconomic status. All Americans in pain, including low-income Americans, should be offered timely and effective treatment for their pain.

•Government, health care payors and providers should develop coordinated health information technology (IT) systems to track pain disorders and treatments. Computerized IT systems can boost physicians’ knowledge about the best treatment for pain by providing them with best practice information quickly.

•The Department of Health and Human Services should reform payment to eliminate the current incentives that drive pain care toward procedures or unproven treatments. Primary care doctors should be reimbursed for the time it takes to provide comprehensive pain care to patients who are disabled by chronic pain—a system that can cost a little more up front, but often reduces the cost of treating pain over the long haul.

•The Surgeon General should mount a public education campaign to inform the public about the risks associated with under-treated pain. Consumers should understand that if they wait too long to treat acute pain they run the risk of developing a chronic syndrome, one that’s costly to treat and potentially disabling.

“Reducing the burden of uncontrolled chronic pain is a societal necessity, a medical challenge and an economic requirement,” the panel says.

The Mayday Fund is a New York City-based private philanthropy dedicated to alleviating the incidence, degree and consequences of human physical pain. The Mayday Fund does not lobby or retain individuals or organizations to lobby. The panel participants are listed below. To obtain a copy of the report please visit This article is the pain of the mayday Fund.

Saturday, September 12, 2009

Sometimes I feel like pulling my hair out

I will explain my title shortly, but first I would like to thank everyone for their comments. I had planned on giving up on my blog. I have been at this for almost 25 years, calling and writing congressman and senators, join other organizations. You name it I have done it. Of course like everyone else I am getting older, the pain is getting worse along with other problems, so after the post in February, I said to hell with it.

Then the comments and e-mails started coming from everywhere, so it gave me the courage to start making entries again. I know it will be through tears at times and anger at others, I will try again. For that I have you to thank, so I will continue as long as I can.

As for as the title, Sometimes I feel like pulling my hair out . We have now gone to 78,000,000 million people like you and I, living in CHRONIC PAIN . Are we any closer to getting help? HELL NO. If anything we are further away than ever. We all know the situation with the medical community. Most of them have opiodphobia which in itself is a mental illness.

A couple of months ago my primary care DR. that helps me, looked at me and said, you don't look right. I replied that I didn't know what he was talking about. He said that my eyes had bags under them. I replied that I didn't get much sleep the night before. He then said, have you been drinking? I said drinking, I don't even drink. I reminded him that I told him that I didn't drink on my first visit to him. He said would you be willing to take a drug test. By this time I was getting mad and I said Dr. knock yourself out. Take all the tests you want to any time you want to, because you want find anything with the exception of what is supposed to be there. So he sent me down for the test and sure enough he found nothing. The next visit he apologized. But that is the way I live, from visit to visit and I am sure most of the rest of you do also. I don't know about the rest of you but I am so tired of living like that.

Wouldn't it be nice if we got half the amount of good publicity as the drug dealers do bad. I don't know why the news media has to make everything about us so negative, but they have succeeded scaring most of the Dr's. in the nation to death. If that wasn't bad enough the average person feels the same way. I JUST WONDER IF THE THOUGHT EVER CROSSES THEIR MIND THAT THEY COULD BE THE NEXT PERSON TO BE IN CHRONIC PAIN. Even my own family has made statements about me getting addicted to opioids.
I was talking to my sister a couple of weeks ago and she is a registered nurse. She said what you need to do is get off of those old narcotics and starting some exercise and you will feel better. There was dead silence on the phone for a while. She asked me if I was still there. I know smoke must have been coming from my ears.
I said yes but I cannot believe that you would make a remark that STUPID. I said, how many times have I told you that I can't even get out of the bed most days without taking pain medicine. I cannot believe this country has been brain washed to be so cruel to poor people in unbearable pain but they do.

Well I have to go. I am to angry to write any more.

Monday, February 16, 2009

My life: Unrelenting Pain and Fear

Everyone in chronic pain can relate to the part about "unrelenting Pain", no matter what is causing it. The same thing day in and day out. It doesn't stop for birthdays or any other day for that matter. Some of us are in pain as a result of a fall, a auto accident or some disease like fibrormyalagia. It really doesn't matter, its all pain. Its hard to believe that a country as advanced as the USA Can have 78 million people that live this way but its true. the Suicide rate is 4-5 times higher than other people and lets face it, there is probably not a single one of us that haven't thought of taking our lives at on time or the other. I certainly have.

Every day I read about some new pain drug coming on the market to fight pain. I ask myself why, because you can't find a doctor to prescribe it to you. What is going on in this country right now with the way chronic pain people are treated is a damn disgrace. I have someone that is helping me now but as always its not enough but it does help. He is my primary care physician.

FEAR the other word I talked about is something we all live with. Fear of what you may ask? Fear that if you have not found a pain doctor, that you never will find one. The other side of it is you have looked and looked and finally found someone to help you, but what would you do if something happened to the doctor you now have, or if he told you he didn't want to help you any more. I live in fear of my doctor saying he is going to stop helping me. I have no idea where I would turn. It took me a year of practically begging but then one day I asked my wife if she would go with me. My wife talked to him for quiet a while and that was the key. He agreed to help me. (That is a tip by the way). Another, tip is always go well dressed and have your spouse do the same. My wife always goes with me on every visit.

I still live in fear and dread every time I have to call for a refill. Such is the life of the chronic pain person