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All posts by Integrated Pain Associates

Abrupt Discontinuation of Opioids Dangerous, FDA Warns

Reports of “serious harm” in patients dependent on opioid painkillers who suddenly stop taking the medication, or rapidly decrease the dose, have prompted a drug safety communication issued today by the US Food and Drug Administration (FDA).

Harms from abruptly stopping opioids or rapidly decreasing the dose include “serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide,” the FDA said.

While the FDA continues to track this “safety concern,” the agency is requiring changes to the prescribing label for these medicines that are intended for use in the outpatient setting. These changes are designed to promote safe tapering or discontinuing of opioids in patients who are physically dependent on the medication.

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Megan Brooks

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Another Lawmaker Overlooks Pain Management in Bill to Fight Opioid Crisis

“Dependence isn’t addiction, and that is continually left out of the discussion and the policies being made,” said disability advocate Maelee Johnson.

Hardly a day goes by when the discussion of opioids and their misuse is not on the front page of local or national newspapers. However, the flipside of the issue, pain management, is barely, if ever, centered in the conversation.

This came up most recently with Republican Sen. Rob Portman of Ohio, who seeks to advance a bill he previously introduced called the Comprehensive Addiction and Recovery Act 2.0, which would, among other things, establish a three-day limit for opioid prescriptions.

This lack of focus on disabled and chronically ill patients has inadvertently pitted doctors against their own patients, who are framed as going down the rabbit hole of dependency following a sprained ankle or routine dental surgery. But this overly simplistic framing erases people with long-term disabilities and chronic health conditions who are struggling to live their lives while being punished for using the best tools we have available to enable their full participation in society.

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 Rebecca Cokley

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Legitimate opioid use for pain management

People across the country who are dealing with serious acute and chronic pain issues are becoming increasingly alarmed and confused about whether their opioid prescriptions will remain available.

If you are someone who’s looking at a major surgery, such as spinal fusion or a total knee replacement and resulting acute pain; are dealing with chronic pain, from conditions such as Crohn’s disease or rheumatoid arthritis; or are in palliative care after battling cancer, you should know there’s a lot of misinformation out there.

Unfortunately, doctors, pharmacists and patients can fall victim to faulty reporting and make decisions based on what they believe are facts but are half-truths instead. That’s why we’re going to set out the current information, so you know — or can find out — where you really stand.

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IPA Imaging Earns ACR Accreditation

Killeen, Texas — IPA Imaging has been awarded a three-year term of accreditation in magnetic resonance imaging (MRI) as the result of a recent review by the American College of Radiology (ACR). MRI is a noninvasive medical test that utilizes magnetic fields to produce anatomical images of internal body parts to help physicians diagnose and treat medical conditions.

The ACR gold seal of accreditation represents the highest level of image quality and patient safety. It is awarded only to facilities meeting ACR Practice Parameters and Technical Standards after a peer-review evaluation by board-certified physicians and medical physicists who are experts in the field. Image quality, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs are assessed. The findings are reported to the ACR Committee on Accreditation, which subsequently provides the practice with a comprehensive report that can be used for continuous practice improvement.

The ACR, founded in 1924, is a professional medical society dedicated to serving patients and society by empowering radiology professionals to advance the practice, science and professions of radiological care. The College serves more than 37,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.

About IPA Imaging

Integrated Pain Associates is wholly committed to delivering care to our community and has been delivering innovative pain management solutions for over a decade. We have taken great measures in order to open up alternative avenues to you as your partner in healthcare. At IPA Imaging we believe that finances should never be a barrier to receiving healthcare and we are committed to providing access to the best quality and affordable diagnostic imaging services for our community.

IPA Imaging offers high quality, on site MRI at a lower, more affordable cost to patients. With high quality images read by the area’s top radiologist(s) and a highly trained staff we honor our commitment to clinical excellence and quality.  We are conveniently located in Killeen and offer same day appointments.

For those with high deductibles or no insurance, we are confident you will find that IPA Imaging is significantly more affordable. Our time-of-service cash pay saves you up to 50% or higher savings compared to other imaging providers.

By using our self-pay option, you get affordable, high-quality imaging services, avoiding the hassle of merely paying down your deductible while paying more out of your pocket.

Save those deductible payments for really big issues, and pay less up front with cash pay. Take advantage of our affordable pricing options. 

Remember, you have a choice of where you go for imaging services.

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Unintended consequences of opioid crackdown

The overdose problem – and a rise in suicides, another byproduct of the drug epidemic — is so pervasive it’s being blamed for a drop in U.S. life expectancy.

The crisis has led to a rush of public health and law enforcement initiatives at all levels of government. The federal government has vowed to cut prescription opioids by a third. More than 30 states have passed some type of legislation aimed at attacking the opioid epidemic.

“Defeating this epidemic will require the commitment of every state, local, and federal agency,” President Donald Trump said in a March speech in New Hampshire. “Failure is not an option. Addiction is not our future. We will liberate our country from this crisis.”

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Walmart tightens its opioid prescription policies

Walmart is making its opioid policy more strict, limiting the duration of such prescriptions and requiring that they be filled electronically.

The company announced on Monday that within 60 days, it will only fill first-time acute opioid prescriptions for seven days or less nationwide, and it will limit the dosage to 50 morphine milligram equivalents, or MMEs, per day. The CDC publishes MME conversion guides to help pharmacists figure out the right dosage for each type of prescribed opioid.

 There are more than 5,300 Walmart (WMT) and Sam’s Club locations in the United States.
The new restrictions follow recommendations from the Centers for Disease Control and Prevention. A CDC study found that people who were prescribed at least one day of opioid therapy had a 6% chance of being addicted a year later — but for those prescribed eight or more days of treatment saw that chance spiked to 13.5%. The CDC also notes that patients who are prescribed higher dosages are more likely to die from an overdose.
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Chronic Pain and Intimacy

Eight Ways to Improve Your Sex Life with Chronic Pain

If you suffer from chronic pain, you may feel that intimacy with your partner isn’t possible or sometimes even desirable. Chronic pain can affect mobility. And fatigue and depression make it hard to get in the mood. Often it’s easier to simply mourn the loss of this part of your relationship. But don’t do that just yet.

You’re not alone:
Sexual desire and functioning are difficult for many people with pain. More than half of the respondents in one study said that pain placed limitations on their sex lives. They reported pain and fatigue as having the biggest effects. According to experts, both men and women with pain commonly experience a downturn in their sex lives.

Roadblocks to desire:
Emotions related to pain and sex are complex. You may feel fear or anxiety for a number of reasons. Pain or reactions to medication may make you question your ability to become aroused, perform sexually, or have an orgasm. Limited mobility or painful joints can prompt feelings of unattractiveness or discomfort about your body. Perhaps a previous attempt to have sex with your partner didn’t go smoothly, and you’re afraid it will happen again. Or you may be dealing with a combination of these obstacles.

Ways to help:
The good news is that you can have a fulfilling sex life with chronic pain. It requires a bit of planning and maybe some new foreplay and positions, but pleasure is possible. You may even experience a break from your discomfort and pain: orgasms release chemicals called endorphins that are natural pain and stress fighters.

To bring more intimacy into your relationship, consider trying a few of the following:

     Take a warm bath:A soothing soak can relieve pain. If you’d like, ask your partner to join you. Sex needn’t follow. Just relaxing together can be a sensual first step to reintroducing intimacy into your relationship.
     Plan for “least-pain” times:Your pain may feel worse at certain times of day. Sex in the morning or afternoon may be better than at nighttime. Set your alarm clock a little earlier, or plan a quiet weekend afternoon with your partner. Also, get to know when your pain medication kicks in. By becoming more aware of when you have the most pain relief, you can time intimacy to when you’re feeling your best.
     Play with positions:Some sexual positions may be more comfortable for people with arthritis. And don’t forget foreplay. Massage, oral sex, and other alternatives to intercourse can help take attention or pressure off of parts of the body that are painful to move or touch.
     Rule out depression:If you feel as if your sex drive has dropped, talk with your healthcare provider about whether you might have depression. Lack of desire can be a symptom.
     Fight fatigue:Keep your energy level up by getting eight hours of sleep, building good nutrition into your diet, and practicing stress-reduction techniques like yoga or meditation.
     Get moving: Regular workouts will help to keep joints more mobile and boost your energy, mood, and positive feelings about your body. Gentle exercises before sex also can improve range of motion.
     Monitor medications: The medications that you take to control pain or other symptoms may affect sexual function. For example, some antidepressants can decrease your ability to experience orgasm. Consult your healthcare provider or pharmacist about possible side-effects.
     Go slowly: Give yourself permission to nurture intimacy at a comfortable speed. Kissing, cuddling, and other gestures of affection will convey love and let your partner know that you value being close.

Source: https://www.painaction.com/eight-ways-improve-sex-life-arthritis-pain/

In addition, the utilization of opioid medications significantly reduce testosterone levels in both men and women which can have a huge impact on sexual desire and performance. Reduced testosterone levels are also associated with decreased muscle mass, increased fat deposition, reduced bone density, and increased pain levels. Eliminating opioids from your medication regimen will help restore more normal sexual desire and function and can actually reduce current pain levels says Dr. Benjamin Lowry.

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TRICARE Insurance

ATTENTION: TRICARE PATIENTS
On January 1, 2018 there were many changes to the Tricare program. These changes include an increase in copays for office visits and outpatient procedures and could impact you. Please read the attached material and visit the Tricare website to learn more. https://tricare.mil/Changes
#knowyourbenefits #insuranceupdate #Tricare #noticetopatients#painstopshere #IPAclinic

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Patient Portal Guide for Patients

Do you ever wish you could just send a message directly to your provider or an IPA staff member?

Well, now you can! IPA has a secure Patient Portal where you can send messages to your provider, request an appointment, pay your bill online, and so much more. The Patient Portal is an easy, convenient way to access your IPA care team without the hassle of calling, leaving a message, and waiting for a response. With the portal, your message goes directly to a member of our team who will begin working on a solution and will have an answer for you, in most cases, the same day.

If you provided your e-mail address when you established care at IPA, you should have received an e-mail with the Patient Portal instructions and your username. If you do not have access to the Patient Portal please call our office at (254)245-9175 and one of our staff members will help you get set up.

Our goal is to provide faster, easier, and more convenient access for our patients.

Please visit the link below to see the Patient Portal User Guide for instructions on how to navigate the Portal.

https://ipaclinic.com/patient-portal/patient-portal-guide/

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DRG Therapy: A Different Approach to Pain Relief

DRG Therapy: A Different Approach to Pain Relief

Dorsal root ganglion (DRG) therapy is a new type of neurostimulation therapy designed to manage difficult-to-treat chronic pain in specific areas of the lower body, such as the foot, knee, hip or groin. If you suffer from this kind of pain, DRG therapy may work where other therapies have not—or may have provided only partial relief.   Benjamin Lowry M.D.  at Integrated Pain Associates is one of the few physicians in the area trained to perform this procedure.

DRG therapy is for patients whose pain is limited to a specific area of the body. The DRG corresponds to specific anatomical locations in the body and relays information, such as pain signals, to the brain.

The Dorsal root ganglion is a nerve cluster that regulates signals and sensations as they travel to the brain. Stimulation of the DRG can modify the pain signals getting through resulting in pain reduction.

The following short video explains what DRG stimulation is and how it works.

https://www.sjm.com/en/professionals/resources-and-reimbursement/video-and-media/nm-overview-of-dorsal-root-ganglion-stimulation

Patients suffering from chronic nerve pain due to the following conditions may be candidates for this procedure:

  • Groin/ Perineal Pain
  • Lower Extremity Pain
  • CRPS
  • Hyperalgesia/ Allodynia
  • Post-surgical Neuropathic Pain
  • Phantom Limb Pain
  • Peripheral Polyneuropathy
  • Intercostal Neuralgia
  • Postherpetic Neuralgia

Studies have shown that DRG Stimulation has a significantly greater efficacy over traditional spinal cord stimulation. In a double-blind study, over 50% of the participants experienced pain relief with an average pain reduction of over 80%.

Please take the time to view this DRG presentation by Benjamin Lowry, MD

Dorsal Root Ganglion Stimulation- For PTs

If you’re suffering from focal lower extremity pain, complex regional pain syndrome, or other forms of painful nerve disorders, then DRG may be very helpful at reducing your pain. Please call us at (254)245-9175 to learn more about how this new pain management technology is changing lives.  Our staff at Integrated Pain Associates looks forward to hearing from you and discussing how neuromodulation may help you.

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