The Price We Pay for Pain

[Guest guest]

Dear Friends in Pain,

This " subject " has been one that continually affects all of us suffering

CIP, those of us too in the healthcare profession(s), and lastly the

government who due to political restraints, misinformation about the safe use of

opioids in CIP and malignant pain, will raise the costs to the extreme in DENIED

treatment of pain.

1. Medical research supports the use of opioids in CIP.

a. Higher quality of life

b. Less LTD (long term disability)

c. Less permanent damage (strictures, muscle loss, etc.)

2. Financial costs.

a. Opioids (long acting) can be purchased for

a song (methadone pennies per month), some

more costly.

b. Costly long acting (Duragesic, Oxycontin, Kadian)

cost LESS in that a higher RTW (return to work)

is evidenced.

c. Suicide is the cheapest form of treatment for WC

and some insurers.

d. Taking a CIPer off pain management increases

the rate of suicide (less cost for insurer but the

family and loved ones cannot be repaid), but

INCREASES the insurable cost of BOGUS

" rehab " facilities which chain CIPers screaming

in pain to wheelchairs, and shorten their lifespan

and brain neurons by HALF at least.

e. The cost for CIPers without pain management is

a price no one should pay; isolation, severe

depression, loss of material assets, self respect

and integrity.

3. Medical profession costs

a. We are losing potential pain specialists due to rulings

such as Dr. Bill has suffered.

b. It has taken years for " us " who are proactive to train

healthcare professionals to " actively " treat CIP and

now " fear " runs rampant as trained POLICE

gestapo, plunge physicians and staff into jails, with

falsified criminal charges.

c. " Addict " as defined by DSM-IV is not a credible

pain client who can become tolerant to some

opioid therapy. UPWARD titration at the onset

of therapy allows a " baseline " to be reached and

tolerance then becomes a slow animal:

i. Acute incidents or changes may require

upward titration or changes.

ii. Deterioration (DDD and other disorders)

may require upward amounts.

iii. Generic drugs are notoriously

ineffective

in opioid therapy; have your physician

write " brand name " and then your insurer

must pay for such.

What can we do to offset the political unrest of managing pain? Today

the very pain specialists of repute are overwhelmed by clients requesting

treatment due to certain professional associations now encouraging the same NOT

TO

PRACTICE pain management due to the potential legal and medical liabilities

inherent in the DEA's witchhunt of providers and patients.

1. Document your pain.

a. Keep a daily pain journal (1 being lowest and 10 the

highest pain).

b. Give your provider a copy whether he/she wants it each

visit.

c. INCLUDE ancillary treatments; PT, massage therapy, hot

baths,

walks, and treatments other than opioids

to show your treatment plan.

2. NEVER share medication with another person.

a. Not only is this illegal it is a felony with opioids.

b. Keep your medications on your person at all time.

c. Take your medication as directed, if you need more then

your

pain records (above) will show this.

3. Bring a significant other to first meetings with pain specialists.

a. This shows viability in your pain.

b. It may give more insight on what is needed.

c. Often exhaustion, lack of sleep, and long periods make

us " forget " keep a list of key aspects of your

pain.

4. Keep a letter stating you are a viable CIPer for the ER if needed.

a. Have your primary write a letter.

b. Many ERs are quick to label (this is medical

malpractice)

a viable CIPer as an " addict " or " drug seeking. "

c. Keep your physician abreast of increased pain so he/she

might adjust medications prn.

5. Know yourself, and be educated.

a. Search the internet for your medications.

b. Keep others living with you aware of adverse affects.

c. Request ADs (antidepressants) for most in CIP suffer a

loss

of Serotonin and other " feel good hormones " the

AD will also " boost " your opioids.

d. Find positive mechanisms daily to be " happy. "

i. Like most in 12 step programs live

" one day at a time. "

ii. Internet support forums; general and also

small groups (such as mine) which help

the isolation of CIP.

I certainly do not intend to spout my " two cents " but these facts and

these interventions could save " you " and your physician hardship. Dr. Bill was

a

physician who practiced pain management in a most progressive manner, he saw

the " ethical and moral need " to even treat " known addicts " in pain. When we

are trained as healthcare professionals we are taught that an addict in pain

deserves treatment. ONE cannot stigmatize an addict it is " malpractice " yes,

and it is held liable in a court of law.

In recent months I have handled more in need of advocacy due to the DEA

witchhunt. In all sincerity I spoke with Dr. Bill via email in 1998 when

injured and living in the Commonwealth; I found him empathetic (empathy cannot

be

taught in medical school it is inherent in one's character), and knowledgeable.

It was a pleasure to converse with this man who truly loves those in CIP and

does not want to see " suffering. " He has been a " hallmark " for those in CIP

and those who advocate for clients who have CIP. I had hoped sincerely he

would not return to practice in the Commonwealth when he won the first round,

for

the Commonwealth of Virginia WAS proactive and like Texas has written

guidelines to promote opioid therapy for those in CIP.

The tide WILL turn against (not for) unless each of us individually takes

responsible for the good treatments allowed and given. Going on the " street "

due to poor management only reinforces that we as a group are " drug seeking

addicts " who are weak in character and without viability. I encourage each of

you in support groups to truly listen to other members who may be driven to

this practice, and open your hearts and minds, share your physicians, do what it

takes to prevent this.

WE cannot prevent the few that get in and FAKE their CIP to well meaning

physicians. But we can remain apart from this and remain solid. Up until a

few years ago PAIN was considered just a symptom TODAY WE HAVE won a major

battle it is a " disorder " in and of itself. These factors, continual research,

continued practice by solid physicians with courage and integrity will allow

this VENOMOUS cycle of witchhunting to end.

I wish each of you here a PFD, and please take these suggestions to

heart. IT IS YOUR LIFE and all of us share this...

Peace and God's blessings,

Hallenbeck~Sikorsky~ BS,RN,UM,QC

Owner-Moderator

" AnGeLsInPain "

" OneVoiceInPain "

Interqual Certified

Published Psychiatric Researcher

Advocate for those in CIP, HIV, Psychologic Pain

" The Lord Will NEVER push us beyond what we can endure. "