Saturday, July 26, 2014

THE PHARMACISTS PARADOX






The more I read,
the angrier I get.


When did a pharmacist get the power to override or even question a doctors choice of medications? 

The ones at Walgreen's do.

All it takes is an 80 million dollar fine for violating the rules on dispensing controlled substances and now a Walgreen's pharmacist can call your doctor and question him/her on your diagnosis and if prescribing a controlled substance is actually what they should be prescribing.

Oh, also, they can question how long you need to be on it.

According to an article in "The National Pain Report,"  there are red flags that can prompt a call to your doctor and, possibly, your prescription being denied. Some of those red flags I can understand. If you're seeking an excessive amount of pills or a multiple doctors prescribing the medication it makes sense that the pharmacist could exercise some caution. When you're on the prescribed medication more than six months, well, that isn't a flag. Chronic pain sufferers are just that. Chronic. What about cancer patients?

Don't even get me started.
Walgreen's calls it their "Good Faith Dispensing Policy" checklist. 
Here are some of the points the pharmacist is to go over with the physician.

  • the diagnosis
  • expected length of treatment
  • use of alternative or lesser medications for pain control
  • the regimen is within the standard of care
  • date of last pain assessment
I understand abuse and addiction. I've seen what it can do to lives. I think pharmacists have a duty to be observant and cautious. Doctor shopping for pills, filling prescriptions early tend to signal there is a problem. Not always but, in most cases, I would agree that using caution is prudent. Having said that I think it's absolutely ridiculous for Walgreen's to have the ability to override a physician. I wouldn't fill a prescription at Walgreen's anymore. I have nothing to hide but when they start questioning chronic pain, I draw the line. When I need my prescriptions filled it isn't for fun. A few days or weeks without them mean I'm in a great deal of pain.  

Pain that a couple of Tylenol won't touch.

Oh, another little tidbit..........

If you go to Walgreen's and your prescription is denied?

That denial is entered into your profile.

It's seen by all of the Walgreen's Pharmacies (more than 8300).

It also notifies the DEA that your prescription has been denied and they must justify the reason.

However, if YOU want to know why????

Good luck.



I can't be sure but click here for the link to a possible copy of the checklist.



Thursday, July 17, 2014

WORD OF THE DAY: INFOGRAPHIC....PASS IT ON









I got an email
Asking me to share this.
Wait until you see it.....


CLICK HERE FOR THE SITE



Fibromyalgia
Source: MBA-Healthcare-Management.com




I'm actually pretty impressed with myself.

I even played around with the code so it would fit.

Ok....enough patting on the back.

Thanks to Skylar Jameyson....

This is an amazing infographic and a huge help to many!









Tuesday, July 15, 2014

THE BESTFIT PROTOCOL COURTESY OF TONIX PHARMECEUTICALS








It was a surprise.
And it was better than I expected.


I got approached by a woman named Laura Colontrelle-Radocaj of Dian Griesel, Int'l. She asked if I'd be open speaking with Dr. Lederman who is the CEO of Tonix Pharmaceuticals. I was aware of the clinical trial that was taking place and had written about it previously so I was thrilled that I had been given this opportunity.

I believe there are subgroups of Fibromyalgia. I also think that is why Lyrica, Savella and Cymbalta (which are all FDA approved treatment for Fibromyalgia) don't work for everyone. For me, Lyrica was worse than the Fibromyalgia. I gained weight, death for me, and my thoughts went to a very dark place. I can't take it. There aren't a lot medications out there that are approved so something new on the horizon was good news. When I heard about the clinical trial, I was hoping I could be a part of it. 

What is it? 

In a nutshell Tonix Pharmaceuticals is using cyclobenzaprine in new doses and formulations for treatment of Fibromyalgia and Post-Traumatic-Stress Disorder (PTSD) which are chronic central nervous system disorders.

So what did I do?
I missed the first call.

In my defense, we didn't make it clear what time zone we were using. So after apologizing over and over again we finally settled on 9:00 Las Vegas time. I felt like SUCH an idiot but it worked out and the call came.

What a wonderful conversation! I expected a few moments. After all, this man is extremely busy so when he kept answering questions and offering information I was floored. We actually spoke for 45 minutes. 

At first I wondered why Fibromyalgia and PTSD? To me, they were on opposite ends of the spectrum until Dr. Lederman gently reminded me how many cases of Fibromyalgia start with trauma. 

Mine included.

I found it interesting that these two disorders could be related. PTSD, however, deals with the trauma and the lack of sleep in nightmares. Fibromyalgia has non-refreshing sleep but the trauma doesn't usually have the nightmare outlet. 

Another thing I found interesting was when I asked him about alpha wave intrusion. The new term for alpha waves is cyclic alternating pattern (CAP), type A2 and type A3. It seems that we all have alpha waves but with Fibromyalgia we have too many alpha waves and they are too frequent. This is what interrupts our sleep. 

I also asked about the use of Flexeril. Cyclobenzaprine (Flexeril) is an FDA approved drug that treats the muscle spasms that is associated with musculoskeletal conditions. Pain managers use it quite frequently but it's difficult to take because it makes you groggy and sleepy the next day. Well, it seems that it takes two hours  to get into the bloodstream so if you take it before you go to bed it won't take effect for two hours. No wonder people are groggy in the morning! 

The BESTFIT protocol (BEdtime, Sublingual, TNX102SL, as Fibromyalgia Intervention Therapy.) uses a very low dose cyclobenzaprine. The great part of using it sublingually is that it enters and leaves the bloodstream quickly.  This trial is a 12 week, randomized, double blind study. 

This study has approximately 120 patients taking either a tab or placebo at bedtime for twelve weeks and then measuring the change in pain intensity. The trial is fully enrolled and will report the top line results early in the 4th quarter. It will measure reduction of pain, fatigue and mood. The study chair for this trial is Dr. Daniel Clauw, Professor of Anesthesiology, Medicine and Psychiatry and Director of the Chronic Pain and Fatigue Research Center at the University of Michigan. 

We're about 100 days out from finding out what has come out of the trial.

To me, it can't come soon enough. 

I have to mention one other thing about Dr. Lederman. He was a rheumatolgist and had a practice.

Then, in his words, committed "professional suicide" by going into Fibromyalgia research.

How many people would leave a thriving practice to research Fibromyalgia? 

And this man is passionate about helping those with CNS (central nervous system) disorders. 

After speaking with him?

I was more than impressed. 

He listens. Really, really listens.

All I can say.........

His patients must REALLY miss him.







Friday, July 4, 2014

IS IT HOT ENOUGH FOR YOU?








110 degrees.
Under the eaves.
In the shade.


I've never liked the heat and I like it even less now. You'd think that after 51 years in Las Vegas that I would get used to the desert heat.

Not only no.
Hell no.

I didn't mind it as much when I was in the pool but with the onset of age and some common sense, I stopped baking in the sun. Then, when I was working, I spent a great deal of the day in the sales office. I only ventured outside when I couldn't talk anyone into not looking at their home site in the middle of the day. 

Now I just stay inside.

Since the thyroid regulates temperature is it still a by-product of the autoimmune issues I have with it? I take enough thyroid medication to keep it in the "normal" range but maybe it isn't enough. I just can't seem to deal with the heat anymore. I think heat intolerance doesn't adequately describe it.

It makes me sick.
The upside? I can use the Vitamin D.
Did you catch the sarcasm dripping off of that last statement?

We're going to have excessive heat this week. I wasn't kidding about the 110 degrees. The official heat is measured at our airport about 30 feet up and under the eave in the shade. Really. In all actuality it will probably be 117 in the lower parts of the valley. This kind of heat is smothering. The temperature in the car can easily get to 140. You don't mess around with those kind of temperatures.

It gets dangerous.
No kidding.

You have to plan any errands in the "cooler" part of the day. That means before 10 in the morning and after 7 at night. Even then I take a cooler with me to the store because a quick trip can mean frozen food can start to thaw. Sunglasses are a must if you have light sensitivity (which I do). 

And you have to stay hydrated.
Again, no kidding.

So I'm hibernating this week and praying that the heat will break, otherwise, it's going to be a doozy of a summer. That doesn't take into account the amount of money I'll be donating to Nevada Power.

Gee, I can't wait.

So here I am wishing I was in Antarctica.

But.......hey........

it's a dry heat!

So I think I'll watch the fireworks on TV.......

UPDATE: the clouds moved in and it now has started to rain. Yay for the ground, bad for me.








Sunday, June 29, 2014

CAN I EVEN REMEMBER MY OWN NAME?









I am truly Miss Erable. 
Not only am I in pain.
But my brains are fried.

I had the greatest start. I got a call from Tonix Pharmecuticals and spoke for about 45 minutes with Dr. Seth Lederman. He's the CEO of Tonix and it was absolutely an amazing phone call. 

More on that in the next post.

Then, I realized my real estate license requires education within the two year of the four year period. Now, that means I have to sit in class for 3 hours..... and I need to do this for a total of twelve hours.

First of all, I hate sitting in classes. It hurts because the chairs are hard and by the time I get up I can't walk. The pain is shooting down my legs and I'm crying because I'm only a quarter of the way done.

Oh my.
But I've come to a decision. 

I'm making an appointment with a neurosurgeon. I always said that when I could no longer sit or stand without pain I'd give in and do something about my back. I can handle the Fibromyalgia pain but the back pain is beyond handling anymore. So I'm making the appointment to see what needs to be done. Years ago the odds were not that good that they could repair my back and have the outcome favorable. 

Hopefully, things have changed.

So between the back and the real estate classes I haven't had the time or the motivation to write about the wonderful research that Tonix Pharmaceuticals has done.

And it could be a game changer.

So off to more torture tomorrow.

Did I mention that I also missed the cutoff for my classes?

That's a lovely little $100 fine.

Great......