Correspondent: Thomas Sachy, MD, MSc
Although I practice child, adolescent, adult, and forensic neuropsychiatry, the majority of my clinical practice is in the field of pain management, and I am a strong supporter of using opioids for the treatment of chronic noncancer pain. I have come to this position after approximately 11 years of face-to-face patient interaction, along with ongoing intensive review of the medical and scientific literature dealing with opioids, and the other forms of analgesic medication, as well as the neuroscience behind chronic pain disorders.
For several years now, and especially over the past several months, there has been an ongoing barrage of news media attention focusing on the fact that overdose deaths due to prescription opioids have reached “dangerous” or “alarming” levels of epidemic proportions. In response to these statistics has come an almost mob-like crusade to track down and punish incompetent, unethical, “pill mill” physicians and their practices, which is justified and one would think this could be easily attainable. Inexplicably, these objectives do not seem to be that easy to accomplish. Why?
At the same time, there also seems to be a push to punish and/or eliminate the pain physician who by some mysterious standard is considered to be over-prescribing pain medications, and/or prescribing medications in “extraordinary” or inconceivable combinations. Of course, these assertions fly in the face of science, and the experiences of the untold myriad of patients who literally have new, functional lives, less troubled by the specter of chronic debilitating pain. These patients still have pain and they always will suffer from it; however, with the right combination of medications — including and especially opioid medications — they once more can experience lives that contain a modicum of tranquility.
As stated above, I am a neuropsychiatrist. I am certain that I see great medical benefits bestowed upon the vast majority of my patients with chronic pain who are prescribed opioid analgesics. They and their families tell me that this is so, and I believe with an objective eye that I see the benefits as well.
But, as a neuropsychiatrist I have to consider what certain others might think of these assertions or observations. They might conclude that I am…
…just a clever, greedy "pill mill" doctor,
…good hearted, but somewhat delusional or a “sucker,”
…ill-informed at best or completely ignorant at worst regarding pain management in general, or
…simply a fool who should be “laying low” instead of putting his license and livelihood at risk.
So, I am either a Fool or a Good, Bad, or Ugly Pain Physician — or some combination thereof. Meanwhile, what will follow in this series are my personal experiences and opinions regarding the anti-opioid medication hysteria that is gripping this nation, and a rational defense of long-term opioids which, if not diverted or abused, are an absolute medical necessity, if not a medical miracle, in an inflexible world that predisposes humans to chronic pain disorders and other related neuropsychiatric diseases.
———————————
About the Author: Thomas Sachy has Bachelor’s Degrees in electrical engineering and in general studies, and graduate degrees in medicine [MD] and biology [MSc]. His post-graduate medical training was in psychiatry, forensic psychiatry, and behavioral neurology. Dr. Sachy practices in the state of Georgia and has completed numerous ongoing continuing medical education activities in the field of pain management and the neurosciences, and has been featured on national TV on several occasions. He is a Diplomate of the American Board of Psychiatry and Neurology.
Proviso: All observations, opinions, advice, or facts expressed above are those of the guest author, and do not necessarily reflect the positions of Pain Treatment Topics, our staff and advisors, or our educational supporters.
Posts
22 comments:
Dr. Sachy hit the bullseye with his introduction to his series on pain management. Instead of legislating pain management physicians who are providing controlled relief for chronic sufferers, be it from cancer or other medical conditions, toughen up the laws on the abusers, the street sellers, and the ones who make it difficult for those who do need these miracle drugs in order to resume a quality life. One in pain does not get "high", they get relief.
The above comment raises an important point. There ARE laws against diversion and illicit sale of opioids; even against giving a friend or relative some of one's opioid prescription. The laws are not being enforced. It's like the seat-belt laws -- until people started getting costly fines, many just ignored them. It's unfortunate but true that, until people start getting their hands slapped, many won't do the "right thing" when it comes to opioid safety.
Thank you for writing an article that supports the thousands of chronic pain patients. There are so many stories about the negatives of opioids that those truly suffering go under-represented. There are many of us living and battling chronic, debilitating pain every day.
I don't see how it does pain sufferers any good to crack down on "abusers." The war on drugs has many destructive consequences. The victimization of pain sufferers is just one of them.
There are many innocent casualties including doctors and patients in this misdirected "war on drugs" that has been displaced into the "war on pain sufferers and their treatment"! We all suffer because of the misrepresentation of pain treatment as "drug dealing". The fact is that medical attention to the true nature of chronic pain and its suffering is diverted away from where it is so desperately needed. Unfortunately that kind of diversion is rewarded rather than criminalized, whereas the criminal diverters are given lighter or no sentence when they further misrepresent themselves as "addicts"! Strange world we live in.
It is also true that no one even looks at the physical and psychologic harm that comes to appropriately treated chronic pain sufferers when action of the DEA and state regualators result in abrupt cessation of treatment. The consequences for the suddenly undertreated and often untreated chronic pain is in fact nothing short of physical and psychological abuse.
My recent experience with a local pain center attached to a nationally recognized hospital is that even pain medicine specialists seem to be backing away from opiates. In the examine room were flyers trumpeting how psychology treats pain (which it most certainly does, but rarely alone). After discussing my meds, medical history and a brief exam -- with little regard shown for my pain diary and current multi-disciplinary pain management plan -- was told morphine was my "real problem." Rather than replace it with another medication, I was supposed to "learn to manage" my pain (as opposed to the managing in which I was already engaged, apparently). She recommended a book (to add to my existing shelf of similar books and CDs).
I left shocked. I appreciate it's difficult to generalize for an entire field based on one encounter or even one clinic (as it is also difficult for readers to judge without the entire context of my case), but I left that clinic with a strong sense that pain medicine was shifting in the direction of privileging psychologically-based treatment (which, again, I think is indeed a strong adjunct therapy) to the detriment of patient care (certainly to my care!).
As for enforcing existing drug laws, well, sure. But a big problem is the lack of good treatment programs for addicts without insurance -- not to mention access to pain treatment for patients without insurance. And with the increase in restrictions on opiates (the county health system in my area is adopting an opiate pain management policy almost identical to Washington State's), I fear that under and un-treated patients will resort to obtaining opiates from dealers and diverters. Where do existing drug laws leave us then?
Thank you "anonymous," immediately above, for your excellent comments. These say a lot about what the problems are for persons with pain these days. We're eagerly awaiting Dr. Sachy's next installment in this series and we'll point out your comments to him. -- SBL
Like the Armies of Good Intentioned, anti-drug soldies out there intent on stopping the abuse of opoid pain medications, I, too, at one time thought that people who relied on "Drugs" to get through their day were just "White-Collar Junkies", using whatever excuses they could get a physician to believe. Right up until I bacame one of those aflicted. And until recently, my doctor was willing to trust what I told him and work with me to keep my chronic pain in check. He believed me when I told him whether a specific treatment modality was effective and I'd trust him and follow his dosing schedule and instructions to the letter. But lately, he and his fellow practioners have changed their willingness to do what they know to be right and adequate. Simply stated: they're running scared. He has cut my daily dose down to less than a third of what it once was, less than a third of what has been working, not because he wants to, or because he thinks it's the right thing to do, but because he's under pressure from those "Do Gooder Soldiers". "Either you cut down or we cut your license." Why? Why doesn't the DEA attack the true problem, the abusers, rather than those that honestly Need the medication? Why? Because it's Easier. It's easier to go after the doctors and the patients than it is to pursue the true problem. It's easier to attack the physician/patient side of the equation than it is to go after the criminal side. The former is open, they're in plain sight, and they're honest. They operate in the daylight. They're easy to find and they're easy to confront. To go after the latter takes effort. They Hide in the shadows. And when they're pushed, they push back, hard That's Tough! And it can get Dangerous. They have to actually get Out of the Office and into the Field, where it's dirty and nasty and hazardous. That's no fun.
Until the "Controlling Authorities" are willing to face the truth and are willing to go after the Real cause of the problem, those of us that suffer with chronic pain are going to continue to be the ones to Pay the price, every second of every day, of every week of every month of every year. Until They are unwillingly thrust into this "Hell on Earth", be it the result of an accident, or a disease, or just bad luck, they will Never Truely Understand what it is they are doing to their fellow human beings. Until they've been there, they'll just continue to vacuum their conciences "the easy way out."
To anonymous above: after 18 years living in pain--I now have full body RSD--I believe our govt. officials do know the truth about the absurdity of trying to curb drug-abuse related ills by interfering with the doctor-patient relationship of the pain sufferer. They have many reasons for pretending not to know. The missing link is the millions of misinformed taxpayers who are letting them get away with this cruelty. Out of all the research, personal stories, etc. I have amassed the most life changing was a comment posted by Anonymous in Pain-Topics in response to "Severe Chronic Pain is a Killer-Study Finds" on 4/8/10.
I quote: "...I DO UNDERSTAND why people don't want to believe the claims of those of us who live with chronic pain (though such unbelief has caused me more suffering even than the terrible pain of my disease). I actually believe it is a natural protective mechanism - I've experienced it myself. You look at someone whose life has gone to hell in a handbasket, who has lost everything they cherished, whose life NEVER gets any better, only worse, and you NEED to believe that they had a hand in bringing this on themselves, or in perpetuating it, or you need to believe they are exaggerating, maybe even making it up. Because if all of that misery can befall a totally innocent person...... well, it would stand to reason then that .... that it could happen to ME! THAT is the thought that is intolerable. THAT is a possibility that most people cannot admit, that they cannot allow to be true, for it would shatter the illusion that life is predictable, that one can count on being rewarded for one's labors and one's vigilence. For those whose lives are comfortable, who have been richly blessed, that illusion probably is what keeps them going, gets them out of bed in the morning. I have to admit, it was lovely while it lasted."
It is this mental weakness & cowardice in not questioning these comfortable mental defences on the part of our fellow citizens whose families have not YET been struck by chronic pain that are allowing this horror to continue and escalate to a point where I fear that it may be too late. Do the math, if nothing else, people. The overdoses newspapers desperate to survive are citing do NOT statistically add up to epidemics.
By tomorrow, it COULD be you, your spouse or your children, living in torturous pain. Do not be duped into thinking it could not happen to you! Vote & deal w/ your legislature accordingly.
Continuing on the subject in my post above, where are the medical providers, the scientific, academic and research community, the pharmaceutical industry...these supposedly powerful lobbies...when we as your most weakened, tormented and helpless patients need you the most? Why are you not helping us? Where is the massive professional outcry against this invasion into the doctor-patient relationship? This is one of the forums I trust. Can some of you esteemed experts answer this question, or at least address my legitimate anguish in some manner, before I die a hopefully early death? Even that will not be a comfort as 3 out of my 3 children have inherited the family autoimmune curse; 2 have lupus (my oldest son gave his kidney to my brother with lupus before he was diagnosed with it himself), and my daughter at 21, with 2 toddlers, has lupus with kidney and stomach involvement. My youngest son at age 17 has R/A of the C0 and C1 vertebrae causing nerve pain across the left side of his head. So even death will not bring peace when I envision the worsening situation in the years to come for my children if someone doesn't stand up against this madness.
Answers, anyone? This is truly a humble, heart-wrenching quest for knowlege; even wisdom, not meant to put anyone on the spot. Usually no one answers me but Dr. Leavitt, whom I genuinely thank. But he cannot speak for the whole forum.
I would be interested to hear if you have prescribed along with the opiods low dose naltrexone or naloxone. The research suggests that very low doses can help reduce developmenat of tolerance to opioids AND make them more effective.
If not one of you professional healers, academics, researchers or pharmaceutical experts will chance to even speculate why there is no massive outcry from your lobbies to protect your most vulnerable patients, even on an a forum where it can be done anonymously if desired, then I am no longer surprised that there is no public attempt to help us. Instead I am deeply saddened, ashamed of the educated and privileged in the US, and terrified.
What is this menace that has silenced you? Is it the DEA or something larger? Is it the possibility of losing your practice and reputation on trumped up charges as has happened to some of your own of late? Say your patient with opiates as part of their treatment plain was in car wreck and died. No matter that the accident itself could have killed the person, or their fragile state of health from years of living with chronic pain, or even the alcohol or cocaine that they mixed with your prescription. Their death will be added to your "murder count" with other similar flawed cases until your whole community is convinced you are some kind of white collar cartel before you even set foot in a court room. I get it. But if I get it, so can other Americans, if educated. Fight back for us. Fight back for your colleagues. And you may even be unknowingly be fighting back for yourself if you are unlucky enough to develop CRPS, or Lou Gerig's or the host of other horribly painful conditions that can befall a man, woman or child. Don't count on the medical community to treat you any better because you used to be one of them, because they won't. You'll be labelled as the same sorry, drug-seeking, weak, worthless and pain-in-the-neck "patient" that the rest of us are.
I'm tired of reading so-called research with a promising title that concludes with there is not enough research with "non-cancer" pain patients to come to a conclusion.
I'm tired of legislature wasting our public time and money naming this or that day after a disease. Excuse me, it may look like everybody's busy doing something, but exactly what is the bottom line result? Whose pain got lowered? Whose functioning improved? Whose pain got CURED?
I'm tired of laws that diverted millions of dollars from research to enact, that will simply inconvenience the true addict for a while until they figure out something else to self-destruct with, while the pain patient must swim through mud to meet the ever-increasing demands of the regulations, be undertreated, or lose treatment altogether.
I've run out of time, my nervous system is probably battered out of all hope of repair. But it's not too late for my children. Please UNITE and help us. Regain your power and the respect in society that you DESERVE.
Russell B,
I want to applaud the comments made by the good doctor here. What started out as Chronic Back Pain from a Failed Spinal Fusion of L4, L5, S1 has now spread throughout my body with so many secondary medical conditions that they have directly related to 33 years of suffering debilitating,excruciating pain. As a matter of fact I was just discharged from the hospital 3 days ago for Pneumonia in both lungs, blood count that should have been above 20 something to 10. Adrenal Insufficiency, chronic anemia, copd, my brain is like mush compared to what it was only 10 years ago.
I have had so many doctors through the years to tell me a little pain never hurt anyone, well guess what good doctors a little pain if left uncontrolled turns in to a big chronic pain that may become uncontrollable.
I could go on and on about my health issues but I think you know my point. I really feel now that my pain will never be below a 4-5 for the rest of my life. I have a very high rate of metabolizing medications combine that with a high tolerance and the DEA sticking their nose in my business I will never be able to get a high enough dose to really control my pain. To be honest with you all we are doing now is putting out fires.
To all of you who suffer from this terrible DISEASE I pray you find the help you so desperately need.
Sincerely,
Russell B
I have to point out the one reason that this does not have a bigger outcry by the patients, is that many pain patients are "living with" their abusive non-treatment(i.e. getting minimal opiods to help them "live" a few days a month).
Why are they not part of the outcry? Because they signed the abusive controlling "Opiod Agreement" and fear that they will lose their entire life, by exposing their name, risking being dropped by their doctor.
If they then look for another doctor, they are "doctor shopping"
Imagine if one were found to be breaking the law-i.e "doctor shopping", to find treatment for diabetes, or "doctor shopping" to find a GI who met their needs. Would they be persecuted? No, they would be looking for a second opinion, or looking for a Caring Doctor. Why is it only "Doctor Shopping" when it is for pain relief?
I digress, but my point is, we will never have the Proper Patient Outcry, because the pain patient risks their treatment by doing so! The Cancer Patient gets more care, the Diabetic gets more care, when they outcry...the pain patient gets cut-off!
The pain patient NEEDS you DOCTORS to stand up taller and higher to get the DEA out of Medicine and get PAIN TREATMENT in the hands of those who UNDERSTAND PAIN TREATMENT!
Thank you, "Husband of a 14 year pain patient" for your call-out of the health care community.
It always gives me such encouragement to see a family member advocating for pain patients. You all can make a difference for us! As you know, we are sometimes just too weak to fight. But when I see family members who are willing to speak the truth, in addition to the burden of care and support of their loved one, it gives me a glimmer of hope. You all have such a thankless job, caring for us. If pain patients are misunderstood, their loved ones are even more in the shadows...the ones who stay and don't abandon us. I am praying for you to stay strong for your wife, please take time out for yourself--somehow, someway--to spend time with male friends or do a hobby. No one can carry the burden you do alone. And that's what happens far too often.
Again, thank you for your words and also for the 14 years of example of what a real man is. Chronic pain is definitely not for wimps, whether you are the patient or the caregiver!
Thanks Linda, but I am not the one in pain, and it is no burden....the one in pain has the burden, I only have to watch and try to help and pray.......
Where can we go from here? I love this web-site and the contributors, but how can we turn this into a real help for those in Chronic Intractable Pain? I have already secured a web domain(www.chronicpainawreness.org), but I do not know where to start, I need doctors who will stand up and be advocates for the REAL pharmaceutical treatment of pain, not this so called opiod agreement BS that the pain patient is forced to live with to merely exist!
I saw a t-shirt the other day the said...... "Let's trade... you have a chronic painful disease....and I'll have a bunch of stupid opinions"
To the authors of this web site, how do we take this to the next level? I just stumbled on your site this weekend and read all of your pages with excitement............what can we do? Lets GET THIS OUT OF A FEEL GOOD FORUM, into HELPING THE PAIN PATIENT! I ASK WHAT CAN WE REALLY DO TO AFFECT CHANGE???? Comments? Suggestions? Or just another month of articles? My wife's time is running short and she is at the ripe age of 42....... Thanks again for all you do, but let's take this to the next level!
Thank you "Husband..." above for your comments -- I applaud your fighting spirit. Love the t-shirt slogan. There are patient advocacy groups already in action that could use your support: the American Chronic Pain Association(www.theACPA.org) and the American Pain Foundation (www.painfoundation.org) are two. Contact them... today! --SBL
Thank you Linda and everyone else that posted above.
Unlike many diseases or syndromes, chronic pain patients have to fight not just their disease/condition, but we also have to fight the court of public opinion and the fear and ignorance that goes along with treatment. And like most, I'm sure, I just don't have it in me to fight. Some days it's all I can do to feed the dog,(and I mean that literally, unfortunately) much less take on advocacy work. We need pain physicians and researchers to speak out for us. LOUDLY and CONSTANTLY. Instead of abstracts and articles in professional journals, this information should be put in press releases, Sent to major news outlets. Yelled from rooftops. Anything to get the word out that opioids, as part of a multimodal plan, are safe if used as directed.
It's shocking that so many doctors as well as the general public are uninformed about opioid therapy. It's amazing to me that pain isn't even addressed in most medical schools. And it's downright horrific that the DEA gets to decide who is deserving, who is over-prescribing, and who shall go to jail for unknowingly treating an addict. But then our society treats addiction as criminal instead of physiological, no matter the behavior of the addict.
I applaud Dr. Leavitt. I've been reading this blog for a few years, and have always found logic and sanity in his articles. But, we as patients need more than a few sane doctors blogging about the problems and issues. We need another Siobhan Reynolds. Actually we need another few thousand of her type...persons who will fight for us tooth and nail because we simply can't do it ourselves.
It's sad to admit, but on occasion I have wished for cancer. Truely wished. Simply because then I could feel confident in getting the treatment that might make me somewhat more comfortable. And it disgusts me to admit such thoughts...but when all you can concentrate on is the pain, you get a bit morbid.
Nothing is a panacea, but pain medications at least allow for a modicum of relief. With medication and meditation, I think many undeserved patients could have a better life.
Yet, I have had people tell me that no one but those a week from death with terminal cancer should have OxyContin. It's a shame that we as a society allow for comfort of the dying,but applaud the suffering of the living.
I echo Linda's outcry....Who is finally going to put a stop to the DEA's rampant terrorism of pain patients and pain management doctors? When will it end?
As I've done many times before, I urge patients like Samantha (above) and all others to support advocacy organizations. The American Chronic Pain Assoc. (theACPA.org), the American Pain Foundation (painfoundation.org), and U.S. Pain Foundation (uspainfoundation.org) all need your help. If you cannot actively participate, they also need your financial contributions to stay alive and do their good work. -- SBL
I know the above is sincere Dr. Leavitt, and I have immense respect for your work here. I admire the balance and objectivity you display in your posts, and I have been helped with the information that is here in my own struggle to manage the pain. Those you mention are fantastic organizations that do work hard to make life easier for those of us in pain.
But, at the risk of sounding like a person that sees only problems... that advice of donations sadly brings us to yet another crux for many with CP that is untreated or under-treated.
Pain that doesn't wait til after 5 o'clock and weekends leading to unemployment. Denials of disability, followed by waiting and appeals and lawyers. The bills from the visit with the latest "ologist" stacking up on the counter-top. Prescriptions that cost as much as your mortgage. Still, I hold out hope that enough of us can manage to send off the occasional letter or check and someday the tide will turn to reason.
I did support a Pain Advocacy Group financially; Pain Relief Network (PRN) started by Siobhan Reynolds (I'm still grieving her death from a plane accident in Dec of 2011) & her husband Sean Greenwood who had intractable pain. Sean left our work years ago due to a stroke caused from being unable to find a doctor to treat his 24-hour severe pain when his physician was arrested (& later acquitted--but long after Sean had died). I gave up soda, coffee, tea & drank water so that money went to PRN. The group saved my life, allowing me to live to see 2 grandchildren born, 2 kids graduate from school, 1 daughter married and hopefully now to see a son marry a woman I love like a daughter already. At the time I was ready to commit suicide, even having all of the dumbed-down materials & placating Polly-anna resources of the American Pain Society website. I felt like I was going crazy, that I was the only one who couldn't rise above this monstrous & exhausting pain in my body with a few Advil or Tylenol, some light stretching & walking & a good old fashioned positive attitude. Getting educated on PRN about the gravity of my situation was comforting in that I found I wasn't crazy; medical science HAD PROVEN that my body and mind were degenerating. It also steeled my wool to live & fight along w/ the small core of brave people who were not shutting up about the abuse being waged against defenseless pain patients, as well as any doctor compassionate enough to treat them with scientifically proven opiate therapy. I'd like to know which state or federal courts or agencies have been challenged on behalf of we HUMAN BEINGS in pain by either of the groups Dr. Leavitt mentioned. I could be wrong, but I only know of their advocacy through efforts like "10,000 Voices of Pain", etc. The decision makers have heard our stories; THEY DON'T CARE. I remember such an articulate wheelchair bound woman's testimony at a REMS hearing, caringly addressing another contributor, a woman whose son had lied to a doctor about his pain, crushed the resulting long acting formula narcotic to take all at once, mixed it with alcohol & cocaine, & thereby overdosed. I was touched how she lovingly explained to this mother that as sad as the results of addiction are (this wasn't this kid's 1st go-round), torturing millions of us like she in her wheelchair, who need this medicine to be able to function and have some quality of life, would not bring back her son. Neither would adding more hoops for the pain community to jump through change her son's behavior one bit, he KNEW what he was doing was dangerous--lack of education or labelling was NOT the problem. How could you hear this and not "get it" no matter how stupid of a bureaucrat you are? Anyway, PRN was shut down when we came to the aid of a pain doctor arrested for doing his job too well (relieving pain), & were too much of a threat for the DEA. An obstruction of justice charge was filed, & we were beggared by fines for refusing to give up basic constitutional rights. The case made it all the way to the Supreme Court where it is now sealed, something that is only legal in matters of national security. And now Siobhan is dead. Think about this as you go to your pain clinics in the months to come & your docs start to cut your doses...even as the reduced functionality sends you back to your darkened bedroom to serve out your life sentence. Are we going to get out our canes and walkers and storm the Pentagon? Funny thought but come on? What is the national security threat? What is really going on here?
With all due respect Dr. Leavitt. The Pain patient lives in fear. How can one get involved in the associations you are recommending, when they are the very associations that label a Pain Patient as a drug seeker, if they don’t sign the one sided Opiod agreements, and are threatened with non-treatment if they have an emergency and receive pain medication from another LICENSED physician. Most Pain patients are undertreated and accept what they can get, if only to have a week of life every month. My point - The pain patient has to keep their anonymity to avoid persecution from their pain management doctor and practice. Wouldn’t you agree the main reason a pain patient seeks Opiods is because they are looking for relief? But when they tell their doctor that, they get looks, stares and labels. I guarantee you if I stood up in front of one of the organizations you recommend, and state my name and my wife’s name, that she would be booted right out of her doctors practice, because she would be labeled a trouble-maker or problem patient. I am not sure if you know it or not, but most doctors don’t like to be challenged in the way they practice medicine. You might further say, if that is the case she should seek another practice….. But wouldn’t that be “Doctor Shopping” and around and around we go…. Most Intractable Pain patients are put through pain and humiliation and threats of non-treatment, all by the so called pain management institutions in this country. The only way for this issue to be resolved is for the Doctors to take action on behalf of these patients, and start a REAL Intractable Pain Management Organization, that eliminates all of the fear and brings medical sense to those seeking real treatment, with the right to be treated by physicians who will “do no harm.” I would be more than happy to speak with you and your colleagues to understand how this can start, as it is becoming too late in the game for my wife. But that could only be with one condition, that one doctor would stand up and guarantee her continued treatment, regardless of her actions to support the pain patients in this country. Not to be Judgmental, but I doubt I would find a doctor who would guarantee they would treat my wife, with the treatment her pain deserves, while we help fight the fight. The Challenge- if you want to stand up and be the one, or if you know one who would, by all means let us know and we would start this today.
Post a Comment