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» LymeNet Flash » Questions and Discussion » Medical Questions » How do LLMDS treat pain?

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Author Topic: How do LLMDS treat pain?
merrygirl
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I made contatc with a LLMD! Woo hoo! I sent him my labs and waiting to hear back. I am so happy. I wanted to know how do LLMDS treat pain or how they feel about pain meds?

I had another question but I cant remember what it is! LOL

Thanks Melissa

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Aniek
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It varies with each LLMD. Some provide very good treatment and others under-treat. I know some LLMDs will not prescribe any opiods because they believe it weakens the immune system. Since pain itself weakens the immune system, I disagree with that theory.

I got my pain under control by working with a really good pain specialist. These are pretty hard to find and it took months. My LLMD eventually took over the prescriptions.

--------------------
"When there is pain, there are no words." - Toni Morrison

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notkrazybrian
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Yes she is right some due some dont, some rx anxiety meds some dont it just depends, you could try to find a person on here whos goign to the same llmd you are going to see, and see if he does anything for pain.
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MommaK
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Our llmd has a sign in his office that states that he does not prescribe narcotics. I never asked why. Maybe I will get the courage to ask next time.

He did tell us from the beginning that he would treat the lyme, but not be our PCP. We should continue to go to our internal medicine doctor who had tested for lyme initially.

It was our Int Med dr who referred us (my daughter) to a headache specialists, and then we were referred to a pain management clinic.

I think you would want to go to someone who specializes in pain if that is a big complaint of yours! The headache specialists was our 4th neurologist! He's awesome!

The pain management clinic is new to us. So far had one cervical medial branch block and going back for another one on the other side along with occipital nerve blocks.

Good luck! Keep asking for pain meds or referrals! It is hard to improve when you are in severe pain!

MommaK

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Visual Afterimage Man
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One of the nice side effects of an anti-depressant (SSRI) is that it can provide mild pain relief.
Family doc prescribes it for fibromyalgia patients.
I WAS on Lexipro for 7 months and wasn't in much pain.
Last month I stopped Lexipro and noticed muscle pain and stiffness.

--------------------
26 months of treatment. And counting.......

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merrygirl
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Well I have a cobinet of narcotics. Every time I take one I think to myself, "I hope I dont become addicted". I gave birth with no pain meds, so I am pretty tolerant, but the last few weeks have been bad. I know this is why they make pain meds, I just get nervous about taking them and then possibly not having them for when I really need it you know. I dont even know if that makes sense.


like My back is in agony and I take Piroxicam (NSAID) in the am. I took Tylenol earlier and it has done nothing for the pain and fever. But it is about as much pain as I can tolerate.

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Aniek
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Melissa,

Narcotics are not as addictive as people think when you take them for actual pain. When you take them for pain, you don't get the euphoric high because they are actually relieving pain.

If you take narcotics regularly, you do get physically dependant. But there is nothing really wrong with that. It just means your body needs a larger dose to have the same effect on the pain.

Many doctors don't understand this distinction. In fact, many doctors have been scared into not prescribing narcotics, because of misinformation and criminal investigations of doctors supposedly overprescribing narcotics.

If you have pain and need the medication, take it. Your body has enough stress. But try to find a doctor who can work with you to find the best prescription and other treatment. Usually, pain treatment is more than prescribing pain meds. Physical therapy and finding the right exercise is crucial.

--------------------
"When there is pain, there are no words." - Toni Morrison

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CaliforniaLyme
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Many Lyme docs are cautious about pain meds because they have been prosecuted for "over-prescribing" pain meds-

Santee's Dr. Yang: Saint or sinner?
She treats the poor but may lose license


By Anne Krueger
STAFF WRITER


April 2, 2005


SANTEE - Standing in the cramped waiting area of her medical office,
Dr. Therese Yang clasped hands with a patient while Linda Vipond, the
mother of another patient, offered her prayer.


RONI GALGANO / Union-Tribune
Dr. Therese Yang (second from left) took a break in her Santee office
for a moment of prayer and inspiration with staff and patients. With
her were medical assistant Jessica Gallagher (left), patient Barbara
Coultas (standing) and Linda Vipond (sitting, right).


"Lord, thank you so much for the healing hands of Dr. Yang," Vipond
said.


Many of Yang's patients, a lot of them uninsured or underinsured, are
highly devoted to the 44-year-old physician. Some call her the Mother
Teresa of East County for her willingness to treat the chronically ill
and those who can't afford to pay.


The Medical Board of California has another description of Yang.


In a complaint filed last July, Yang is accused of being incompetent
and grossly negligent in prescribing potentially addictive drugs such
as OxyContin to mentally troubled patients.


A hearing is scheduled for August in which Yang faces the loss of her
medical license.


Yang is vowing to fight the medical board charges, saying she's facing
scrutiny because she cares for patients other doctors don't want to
treat.


"I'm guilty of love," she said.


RONI GALGANO / Union-Tribune
Patient Angel Vipond (left) consulted with Dr. Therese Yang in Santee.
Vipond praises the doctor, but the state's medical board alleges she is
negligent.


Yang, who has run her family practice in Santee since 1997, has never
taken a salary. Finding the money to keep the practice going is a
perpetual problem.


Patients pay what they can, depending on their insurance coverage and
financial situation.


She moved from a 5,000-square-foot office on Mission Gorge Road to an
800-square-foot office in the same complex because she couldn't afford
the rent for the larger space.


She relies on grants to help pay expenses, most notably $355,000 she
has received from the Grossmont Healthcare District over the past seven
years. She has just two full-time employees and one part-time employee
to help run her practice.


Yang said it's all worth it to fulfill a mission she has felt since she
read about Florence Nightingale when she was 10 years old.


"In San Diego, there's plenty of doctors to take care of the people who
are insured," she said. "I could help the people who weren't getting
care, so I felt I had to do that."


Yang often spends up to an hour at a time with a patient - good
medicine, but bad business for a medical practice, she said.


One of her patients is 31-year-old Angel Vipond, who with her mother
makes a two-hour drive each month from her Morena Valley home to see
Yang.


Advertisement


Vipond suffers from Lyme disease, a tick-borne illness that she said
causes her migraines and continual pain.


Linda Vipond said Yang was the only doctor in Southern California
willing to treat her daughter.


"I love her, love her, love her," Linda Vipond said of Yang. "She's
honestly been a lifesaver."


Yang recently met with Angel Vipond in a tiny examining room, then
wrote prescriptions refilling Vipond's OxyContin and other medications.
She and Vipond hugged at the end of the examination.


Later, Yang confirmed that Angel Vipond was "A.V." - one of five
patients named only by their initials in the medical board complaint.


The complaint alleges that Yang excessively prescribed controlled
substances to Vipond, described as an "extremely troubled young woman
with a severe psychiatric illness."


The board contended that Yang failed to maintain adequate medical
records and conducted superficial physical exams before writing
prescriptions for drugs that Angel Vipond didn't need.


Angel Vipond staunchly defended Yang, her physician since December
2000.


"She is really getting knocked on," Vipond said. "That is really,
really wrong."


Yang said four other doctors diagnosed Angel Vipond with Lyme disease.
Yang said the medical experts who examined the records of Vipond and
other patients didn't have all the information they need to draw a
proper conclusion.


"I'm not surprised they were looking at our stuff," Yang said of the
medical board investigators. "I am surprised they were unhappy."


Yang said that, unlike a typical family practice, many of her patients
have chronic illnesses and also have psychiatric problems.


She said patients who are prescribed controlled drugs are carefully
monitored and must show that the drug is making an improvement in their
lives.


The goal
"Our goal wasn't to give them the narcotics," she said. "Our goal was
to make them functional in society."
The medical board allegations say that some patients got worse after
being prescribed drugs by Yang.


The medical board said one patient was prescribed five to 10 times the
typical dose of OxyContin, although he was diagnosed as suffering from
a drug dependency.


Another patient taking OxyContin cut his wrists while he was in Yang's
waiting area. Yang said the suicide attempt was a cry for help, and the
patient has dramatically improved. Again, the medical board provided
only initials in their complaint.


Despite the charges, Yang continues to receive support from community
leaders.


Gloria Chadwick, president of the Grossmont Healthcare District board,
said she was aware that Yang faced allegations but didn't know the
details.


"I truly believe everybody is innocent until proven otherwise,"
Chadwick said. "She's got a very good heart. She's very beloved by the
community that she works with. We've only heard positive things."


Sandy Pugliese, president of the Santee Chamber of Commerce and
community relations manager at Sharp-Grossmont Hospital, said Yang is a
valuable asset for the East County.


"She feels this is a calling," Pugliese said. "She has a heart of
gold."


Yang graduated from the University of Michigan medical school in 1984,
and practiced in Arizona before coming to San Diego County in December
1988 to work at the Mountain Empire Health Center, a clinic that serves
the backcountry.


Own practice
In 1994, she began working at the newly opened Lakeside Community
Clinic until she started her own practice three years later.
Yang said she can afford to work without a salary because her husband,
Peter Yang, is a radiologist at Sharp-Grossmont Hospital who makes
enough to support her and their four children.


Even though Yang isn't paid, keeping the medical office open costs
about $200 an hour, she said. Yang has been sharing the office with a
semiretired doctor, James Kenaga, to help pay expenses.


The office waiting area contains only a few beat-up chairs crammed
together. Next to the waiting area is one of three examining rooms,
where a sliding partition does little to muffle conversation between
Yang and a patient.


Medical files fill up the shelves lining almost every wall. Yang's desk
is in a room little larger than a closet, where drugs and supplies are
stored.


The office setting is humble, but Yang's patients don't care. Some have
joined together to try to raise money to help Yang run her office and
fight the medical board.


Georgianna Hemington, who travels from her Las Vegas home to be treated
for Lyme disease by Yang, is outraged by the medical board accusations.


"Her principal concern over what's pending with the medical board is
not what would happen to her," Hemington said. "It's for her patients
and the uninsured. That speaks a lot for her."


Yang said it will cost her as much as $140,000 to fight the medical
board accusations. But she said the battle will be worth it if she can
keep helping those who have no place else to go.


"The biggest difference is we genuinely care," Yang said. "We want to
keep the heart in medicine."

--------------------
There is no wealth but life.
-John Ruskin

All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer

Posts: 5639 | From Aptos CA USA | Registered: Apr 2005  |  IP: Logged | Report this post to a Moderator
Tori
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quote:
Originally posted by Aniek:
Melissa,

Narcotics are not as addictive as people think when you take them for actual pain. When you take them for pain, you don't get the euphoric high because they are actually relieving pain.

If you take narcotics regularly, you do get physically dependant. But there is nothing really wrong with that. It just means your body needs a larger dose to have the same effect on the pain.

Many doctors don't understand this distinction. In fact, many doctors have been scared into not prescribing narcotics, because of misinformation and criminal investigations of doctors supposedly overprescribing narcotics.

If you have pain and need the medication, take it. Your body has enough stress. But try to find a doctor who can work with you to find the best prescription and other treatment. Usually, pain treatment is more than prescribing pain meds. Physical therapy and finding the right exercise is crucial.

Aniek is ABSOLUTELY right!!!!!! There are studies that confirm this.

Fantastic post!
[bow] [bow] [bow]

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merrygirl
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Did dr. Yang lose her license? That is so sad.

I do understand better now.

I was in a lot of pain last night from my back. I ended up taking narcotics, but 2 hours later the pain was almost gone. I felt like a new person. I didn't feel high, or messed up, I didnt have severe pain. That is what it is for.

Thanks guys!

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CaliforniaLyme
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She is still treating thank goodness- a great doc and a great human being!!

--------------------
There is no wealth but life.
-John Ruskin

All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer

Posts: 5639 | From Aptos CA USA | Registered: Apr 2005  |  IP: Logged | Report this post to a Moderator
   

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