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All Posts in Category: IPA

Benzodiazepines might be a ‘hidden element’ of the US’ overdose epidemic

Benzodiazepines might be a ‘hidden element’ of the US’ overdose epidemic — and doctor visits for prescriptions are increasing

(CNN)Doctors have been increasingly prescribing benzodiazepines, also known as “benzos,” in recent years. Looking at data from 2014 to 2016, new research found this class of central nervous system depressants was prescribed at about 65.9 million office-based doctor visits. That’s a rate of 27 annual visits per 100 adults.

The research, which analyzed data from the National Ambulatory Medical Care Survey, was published on Friday by the US Centers for Disease Control and Prevention.
Benzodiazepines such as alprazolam, diazepam and lorazepam can be helpful when taken on a short-term basis. Doctors often prescribe them to relieve acute anxiety, agitation or to help someone sleep. Taken over the long term, they can become addictive. In older adults, the drugs have been shown to increase the risk of falls, cloud judgment and impair memory. There is an increased risk of hospitalization and death for people who take benzos, particularly if they are taken with an opioid.
Despite the risks, among the doctor visits at which benzodiazepines were prescribed, approximately one-third involved an overlapping opioid prescription at a rate of 10 annual visits per 100 adults from 2014 to 2016. That prescription combination increased from 0.5% of doctor visits in 2003 to 2% in 2015.

Updated 10:02 AM ET, Mon January 20, 2020

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IPA Building New Ambulatory Surgery Center on Ridgemont Drive

A group of physicians specializing in pain management is renovating part of a building on Ridgemont Drive to open a 7,400-square-foot ambulatory surgery center.

Integrated Pain Associates’ outpatient facility at 4351 Ridgemont Drive will have 10 pre-op bays, three surgery rooms and 10 post-op bays. The facility previously was home to Dr. Dan Munton’s Texas Sport and Spine, which IPA bought effective July 1 after Dr. Munton retired.

The Forge Training Facility continues to operate at the north side of the building that originally was home to Circuit City. D1 Sports previously was located in the building.

The surgery center cost is $3 million and is expected to open in July, IPA marketing representative Lydia Bailey said.

Central Texas roots

Dr. Scott Irvine started IPA in Killeen in 2007 with his wife. Since then, the group has grown to nine board-certified pain anesthesiologists serving more than 38,000 patients with practices also in Temple and Waco.

“We do all the most contemporary procedures,” Irvine said. “So, when they come, it’s not just one thing, or one dimensional. It’s multiple dimensions, and I think that is what’s been most exciting for these folks.”

IPA expanded into Abilene in September 2018 with the acquisition of Abilene Spine and Joint operated by Drs. Edward Brandecker and Roberta Kalafut at 1888 Antilley Road.

IPA is moving the Antilley Road surgery center to the new center on Ridgemont Drive, Irvine said.

“In the context of contemporary medicine and meeting all the new criteria associated with surgery centers, it does not pass. It passes now, because it’s grandfathered it, just like so many older things are, but that’s why we’re moving it,” Irvine said.

The new surgery center will be brighter, roomier and more streamlined for the benefit of patients and staff, he said.

Welcomed move

The expansion into Abilene has been positive, Irvine said.

“What we’ve found is the people are just spectacular. The people are just wonderful,” Irvine said about the doctors’ expansion into Abilene.

Two IPA physicians are based in Abilene: Dr. Scott Campbell and Dr. Jerry Tarver.

“One of our requirements on these sorts of things is we don’t want to be viewed as sort of sharks coming to town,” Irvine said. “We hire people and put them in your town. They live there. We have two physicians who actually live and go to church in town. They’re part of the city.”

Irvine and other IPA physicians at Central Texas locations rotate through the practice to assist, Irvine said.

“You have to kind of think about it in terms of you would sort of think about a franchise,” Irvine said. “We’re taking a successful patient management model, we keep everybody educated and contemporary and then we say, ‘OK, let’s open this up and you guys can run this as your place.’ And, that’s what’s happening,” Irvine said.

Interventional procedures are used to address pain at the nerves instead of solely using narcotics, including opioid medications. Such minimally invasive procedures as a dorsal collar stimulator or implanted decompression spinal devices can reduce pain by 50 to 70 percent, Irvine said.

“We can then reduce your narcotic dosing by that amount and then reduce the exposure to the risks associated with opioids,” he said.

What else is in the works (or not yet) for Abilene

Following are updates on other commercial projects in the city, based on city permitting information:

► 3550-3558 S. Clack St. – A site plan for a new retail shell for multiple tenants has been submitted to the city for review, said Tim Littlejohn, building official with the city of Abilene. The lot is just north of Cheddar’s.

► 3650 S. Clack St. – The lot where a Burger King recently was razed after sustaining major storm damage has been cleared. Plans have been filed for a new Burger King building.

► Inca Trio Fire Services  – A new company building is being built at 1009 Martin St.

► ALDI’s – No word from the company on a timeline for plans announced late last year to locate a store next to Kohl’s. The city also does not have permitting applications on file for the company, Littlejohn said.

► Torchy’s Tacos – The Austin-based regional restaurant and bar has listed on its website three job postings for an Abilene location: assistant manager, kitchen manager and managing partner. The company has not submitted permitting requests with the city, Littlejohn said.

► Panera Bread – Although long-rumored that the restaurant is coming to Abilene, no plans are on file with the city for the business, Littlejohn said.

► Tea2Go is opening a second location at 1152 E.N. 10th St. on Oct. 5. 

By , Abilene Reporter-News

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Join us this Pain Awareness Month

Integrated Pain Associates joins the global health care community in recognizing September as Pain Awareness Month.  This international campaign was first established in 2001 to create greater understanding that pain is a serious public health issue. Pain Awareness Month is dedicated to helping people with chronic, acute and cancer pain lead better lives. The movement is supported by health care providers and facilities, research universities and foundations, pharmacists, community and advocacy groups, government agencies, legislators, and the media.

September is Pain Awareness Month

Integrated Pain Associates supports Pain Awareness Month at each of its Texas pain care centers in Killeen, Waco, Temple and Abilene. Some of the goals of this worldwide public awareness campaign include:

·         – Promote awareness of pain as a serious and complex public health issue

·         – Increase awareness of the different types of pain conditions & disorders

·         – Educate patients about available pain treatment & management resources

·         – Provide informational toolkits to nurses and pharmacists

·         – Work with lawmakers to shape responsible pain treatment policies

Learn more about Pain Awareness Month:  https://uspainawarenessmonth.com/

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Purdue Pharma to pay $270 million to settle historic Oklahoma opioid lawsuit

(CNN)Purdue Pharma has agreed to pay $270 million to settle a historic lawsuit brought by the Oklahoma attorney general, who accused the OxyContin maker of aggressively marketing the opioid painkiller and fueling a drug epidemic that left thousands dead in the state.

The settlement comes after Purdue fought the attorney general in court, seeking to delay the start of the trial, which is scheduled for May 28.
“It is a new day in Oklahoma, and for the nation, in our battle against addiction and the opioid epidemic,” Attorney General Mike Hunter said Tuesday in Tulsa.
Hunter said that $102.5 million of the settlement would be used to help establish a national addiction treatment and research center at Oklahoma State University, with additional payments of $15 million each year for the next five years beginning in 2020. The company will also provide $20 million of addiction treatment and opioid rescue medications to the center over the same five-year time frame.
A remaining $12.5 million from the settlement will be used directly to help cities and counties with the opioid crisis.

READ FULL STORY HERE

Updated 5:30 PM ET, Tue March 26, 2019

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Obesity Shown to Affect SCS Pain Outcomes

A study from the Cleveland Clinic reported a 20% better pain response to spinal cord stimulation therapy among patients categorized as underweight/normal than morbidly obese.

Investigators used self-reported data from 181 patients treated with spinal cord stimulation (SCS) implants to determine the relationship between body mass index (BMI) and pain relief (Spine J 2019;[3]:476-486). Categorized into four groups, the researchers found a 2% reduction in efficacy for every BMI unit.

The investigators measured pain on an 11-point numerical rating scale before and at six and 12 months after SCS implantation. Using multivariable regression analysis and adjusting for confounding factors such as opioid utilization, they found an inverse relationship between post-SCS outcomes and BMI.

“It could be that being overweight is associated with other degenerative conditions, such as osteoarthritis, that can exacerbate pain in ways that are not amenable to SCS treatment, or that other medical conditions that are more common in people with higher BMI lead to a loss of pain relief over time,” said Joshua M. Rosenow, MD, FAANS, FACS, the director of functional neurosurgery and epilepsy surgery at Northwestern Medicine, in Chicago.

Full Story Read Here: https://www.painmedicinenews.com/Primary-Care/Article/05-19/Obesity-Shown-to-Affect-SCS-Pain-Outcomes/54895

 

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Study Shows Smoking Reduces Efficacy of SCS

San Francisco—Researchers at the Cleveland Clinic Foundation have uncovered yet another detrimental effect of smoking. Their retrospective analysis concluded that among pain patients implanted with a spinal cord stimulator, current smokers demonstrated significantly higher pain scores and opioid use than their counterparts who had smoked or never smoked.

“Spinal cord stimulation [SCS] is a great treatment option for patients with chronic spinal pain,” said Youssef Saweris, MD, a pain management fellow at the Cleveland-based institution. “Yet while spinal cord stimulation provides many patients with relief, we occasionally encounter failures.

“One of the common associations with chronic pain is with smoking,” Dr. Saweris continued. “In fact, the prevalence of smoking among adult patients with chronic pain is quite high, and it keeps increasing.”

Full Story, Read Here:  https://www.painmedicinenews.com/Interventional/Article/05-19/Study-Shows-Smoking-Reduces-Efficacy-of-SCS/54896

 

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May is Mental Health Awareness Month

May is Mental Health Awareness Month

“Chronic pain, anxiety and depression are all directly related, equally important and have to be addressed.  Chronic pain will never be under control without treating the anxiety and depression.   A multimodal approach is always best when treating both physical and mental health.  There are many different professionals who can help with depression to include psychiatrists, psychologists, counselors and social workers.   Patients should talk to the healthcare professional that they feel most comfortable with.

Individuals who take proactive steps toward managing their pain often find relief.  However, fighting chronic pain can be complicated by the debilitating effects of depression, pain, and anxiety.  But, there is hope and we encourage anyone suffering to reach out for help.”

  • Kristian Delgado, MD

Chronic Pain and Mental Health

Chronic pain affects every aspect of your life, including your mental health. Sometimes patients are so focused on alleviating their physical aches that they neglect to address the psychological effects of their chronic pain.

Ignoring the toll chronic pain has on the mind can be a major mistake. Your mental state can exacerbate your physical pain, making it even more difficult to manage.

In a 2006 study, 77% of people who suffered from chronic pain reported feeling depressed. Over 85% of chronic pain patients said that they had difficulty sleeping.

Let’s discuss some common psychological effects of chronic pain, and how to cope:


Depression

You can’t sleep, you can’t socialize, you can’t work — of course you would feel down. However, some people who endure chronic pain also experience major depressive disorder: symptoms include persistent feelings of sadness, loss of interest, inability to concentrate, sleep disturbances, appetite changes, self-isolation, low self-worth, and more.

Long-term pain can trigger a depressive episode, even for individuals who have never before been diagnosed with depression before. The insomnia caused by chronic pain (more on that below) wreaks havoc on your moods and prompts you to nap frequently instead of engaging with others. Pain issues also cause you to withdraw from activities, thus isolating yourself from your loved ones. Depression is shockingly common among individuals suffering from chronic pain.

 

Insomnia

While a symptom of many mental and physical disorders, insomnia is also a separate diagnosis in its own right. You need quality sleep to function. Even though getting a good night’s sleep is sometimes inconvenient and often difficult in today’s hectic world, adults still require seven to nine hours of sleep every night.

Chronic pain makes sleeping difficult. This can be due in part to the pain itself, as well as any medication side effects you may need to cope with the pain. Insomnia adversely impacts every aspect of your life: concentration, digestion, memory, fitness, relationships, etc. Worse, insomnia can exacerbate psychological disorders like depression or anxiety.

 

Anxiety

You worry, and most of your worries are connected to your chronic pain: you worry about why you’re in pain, how you’ll pay your bills, when you’ll see your doctor, if you’ll keep your job. Your pain keeps you up at night, and you find yourself obsessing over what-if scenarios. You become fearful, wondering if the pain will ever go away or if it is actually a symptom of another serious illness.

People sometimes even second guess themselves, wondering if they are overreacting or if their pain is psychosomatic. For all these reasons and more, chronic pain can cause anxiety and even panic attacks.


Fatigue

Fatigue is different from simply being tired. Feeling tired can be fixed by resting; feeling fatigued can’t be relieved by resting and if anything, resting might worsen the feeling. Walking around the block feels like running a marathon. You are so focused on appearing “normal” that you mentally exhaust yourself.

Studies indicate that arthritis can physically increase fatigue; the body fights the inflammation by releasing chemicals, which can in turn cause fatigue.

 

Guilt

Feelings of guilt may stem from everyday occurrences, such as being unable to play with your toddler, or work for more than a few hours a day. While not a disorder by itself, feelings of guilt can overwhelm a person.

Chronic pain prevents you from participating in activities that most people take for granted like socializing, working and exercising. You might feel angry at yourself and blame yourself for no longer being able to engage with the world. Guilt is one of the most insidious mental side effects of chronic pain.


Tips for Coping with the Mental Effects of Chronic Pain

Educate yourself about your condition to reduce fear of the unknown.

Practice meditation.

Exercise (only as much as you are able, and with your pain medicine clinician’s permission!)

Consider seeing a mental health counselor for talk therapy.

Some people might need medication to treat insomnia, depression, or anxiety.

Practice mindfulness: focus on the here and now.

Do not fall into self-medication! Using substances might temporarily alleviate physical or emotional pain, but this is never a good long-term solution.

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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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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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