Pain sufferers say fired doctor, opiods helped them
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David Opie accuses the Mercy Health System of deliberately making it difficult for chronic pain sufferers like himself to get the medical care they need to lead quality lives. Opie and two other patients interviewed by the Gazette credit heavy doses of narcotic painkillers for improving their conditions. However, the three said they’ve had a hard time finding a doctor to treat them or continue their prescriptions after Mercy Health System fired Paul Mannino, the doctor they had been seeing.
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The husband of one of Dr. Paul Mannino’s former patients rifles through his wife’s medical records. The man says that Mercy Health System’s records omit letters from other doctor’s confirming Mannino’s treatment of the woman.
JANESVILLE — David Opie’s nonstop pain after spinal fusion surgery ruined his marriage.
It left him unable to sleep, put him in tears because he couldn’t play with his daughter and led him to “cave in” on himself. Treatment that included narcotics restored his quality of life, he said.
Jason White’s unrelenting pain radiating through his left side made him contemplate suicide.
Taking opioids helped him manage the pain, he said, and he’s now attending school.
Lisa Rasmussen’s shooting pain and joint aches left her unable to work, sleep or perform household tasks.
Taking Oxycontin and oxycodone eased her fibromyalgia symptoms, allowing her to get out of bed in the morning, she said.
“I wouldn’t be able to go shopping with my daughter. I wouldn’t be able to do anything,” she said. “It’s the quality of life that it gives you.”
Although all three patients credit heavy doses of narcotic painkillers for restoring the quality of their lives, they and others interviewed by the Gazette said they’ve had a hard time finding a doctor who will treat them or continue their prescriptions after Mercy Health System fired the doctor they had been seeing.
Paul Mannino, a family physician who worked at Mercy East Clinic in Janesville, was fired April 7 because he breached his physician agreement “by repeated violations of appropriate prescribing standards after numerous discussions and restrictions designed to conform your prescribing practices to accepted medical standards,” according to his termination letter.
Mannino contends that Mercy “basically doesn’t want physicians to utilize opioids in the management of our chronic pain.”
In a time when abuse of prescription painkillers is on the rise, the use of narcotics for pain management raises serious questions about the risks of addiction or the diversion of prescription drugs to recreational use.
Some doctors say their colleagues won’t prescribe opioids, fearing action by the federal Drug Enforcement Administration.
Mannino questions how hospital or clinic policies can trump a doctor’s ability to prescribe what he feels is necessary for patients. The fear of prescribing narcotics also could lead to the under treatment of pain.
Patient concerns
Opioids are among the oldest and most effective analgesics, or painkillers. They include oxycodone, codeine, hydrocodone, morphine, methadone, tramadol and fentanyl. While they are the drugs of choice for cancer pain, controversy remains over their use for non-cancer patients, doctors say.
Although effective, opioids can be addictive and often are abused.
The oxycodone overdose death of a 13-year-old Milton Township boy in February made headlines around southern Wisconsin.
But area pain patients say they are the faces of responsible opioid use for the treatment of chronic pain. They say opioids have restored the quality of life they lost when other treatments didn’t ease their suffering.
“We’re just trying to raise more awareness. These patients traditionally have been shunned, minimized,” Mannino said. “I think they deserve respect and compassion.”
Mercy officials declined to discuss Mannino’s firing.
Gregory Love, an anesthesiologist and pain management physician at Mercy’s Pain Center, said he could not discuss Mercy’s prescribing policies for chronic pain patients.
“What I can say in principle is we make every effort to get a proper diagnosis, to prescribe enough medication to do the job to improve the quality of life and improving the goal of pain (relief) without undue risk of abuse or addiction, and then we monitor the patient to make sure that continues to be true,” Love said.
Some of Mannino’s patients told the Gazette they are having a hard time finding new doctors and continuing their prescriptions. They have been meeting—forming a sort of support group—in their efforts to continue their care.
Opie, 41, had his first episode of sciatica—pain that radiates along the path of the sciatic nerve—in 2003. He needed pain medication just to function, he said. He didn’t receive lasting relief from cortisone injections or acupuncture and admits he tried “other avenues that insurance doesn’t cover.”
Under Mannino, Opie’s prescriptions included Oxycontin, Percocet, generic Valium, amitriptyline, trazadone and Zoloft, and his doses increased as his tolerance grew over the years, he said.
He said he has not had a high from medication in years.
“The only thing it’s done is hit the pain and allow me to function,” he said.
An independent medical exam that his former employer requested found no signs of abuse or misuse of any of the drugs and indicated that he was functioning with relief, he said.
When he called to schedule an appointment to get a refill after Mannino was fired, Opie said Mercy told him he would have to go outside Mercy’s system. He said he was cut off from his prescriptions, including the generic Valium that other doctors told him could cause seizures or death if the dosage is not gradually reduced.
Love said he could not comment on individual patients because of privacy laws, but he said Mercy has a triage process to properly take care of Mannino’s patients. He said he has never cut off a patient from medication when there are signs of dependence.
Doctor’s case
Mannino has filed a complaint with the state Department of Workforce Development claiming Mercy discriminated against him because he has bi-polar disorder and is retaliating against him for a previous suit. He said his peers didn’t face the same scrutiny, and when he tried to phase out pain management from his practice, Mercy wouldn’t allow him to do so.
“There was no way out for me,” he wrote in his complaint.
Mercy Vice President Barb Bortner declined to comment on anything related to Mannino because she said it is a personnel issue. But Mercy officials’ explanation of why they fired Mannino, according to their written response to his complaint, describes Mannino as a doctor who over-prescribed and didn’t consistently follow the system’s prescribing guidelines.
Mannino provided a copy of Mercy’s response to his complaint. He disputes Mercy’s allegations, saying none of the complaints has been substantiated.
Mercy’s response document indicates patient complaints about Mannino’s prescribing practices began to surface in 2003. The document outlines at least three cases in which a family member of one of Mannino’s patients contacted Mercy with concerns about the high doses of medication prescribed.
In one case, a father of a patient requested his son be put into detox because he said Mannino over-prescribed Oxycontin. In another case in January, a family member of a patient reported the patient received up to 300 pills a month and was in a comatose state every day.
In response to what Mercy saw as a “troubling pattern of over-prescribing medication,” Mercy set up specific procedures for Mannino, but Mercy said the doctor’s “disturbing behavior” didn’t stop.
Mannino said except for discussions in January, Mercy never brought to his attention the patient complaints from prior years.
Mannino served a two-week paid suspension in 2006 after he said three copies of prescriptions he wrote didn’t copy through the carbon to make duplicate copys and because he paid a patient in the parking lot for fixing his sister’s computer and gave a bag of sample insulin to the patient, who had no insurance.
According to Mercy’s documentation, Mannino was observed taking medications from the “shot room” and giving them to the man in the parking lot in exchange for electronic equipment.
'Worst of the worst’
Mannino said opioids aren’t the only option to treat pain, and he prescribed opioids often after other treatments failed to improve patients’ pain.
“They can say what they want about the use of opioids and pain management, but the documentation is right here, and it’s completely valid,” he said, referencing a folder full of medical journals. “The correct dose of opioids is the one that provides the patient help without causing significant side effects.”
Patients said Mannino was the only doctor they had who took the time—often an hour per appointment—to listen to them.
“He’s the only doctor that has given me any help so that I can function for the last seven to eight years,” Opie said.
Mannino started at Mercy 12 years ago and began seeing pain patients in about 2002, Mannino said. His own interest in chronic pain led him to get additional training and take on such patients. Between 60 and 70 of his hundreds of patients were chronic pain patients, he said.
Many of the chronic pain patients he treated were considered high maintenance, he said. Many of them had multiple ailments.
“I tended to get the patients that other doctors didn’t want, so I had some difficult patients,” he said. “I was taking the worst of the worst. Those people sometimes required large doses of opioids.”
Mannino contends he was never trying to get people high but only trying to get patients back near where they were before pain. Opioids should be used with other treatments, he said.
“The problem is by the time I see a patient, they’ve already done everything but the opioids, and they’re frustrated, and they don’t want to do any of that other stuff,” he said.
Opioid use
Mannino gave the Gazette a copy of Mercy’s guidelines for prescribing controlled substances for non-malignant chronic pain. The guidelines indicate daily doses in excess of 200 milligrams per day of morphine or equivalent are to be avoided.
Opioids have no ceiling doses, Mannino said, and some of his patients were on about 1,500 milligrams per day of morphine or equivalent.
“I felt if that’s what the patient needed, then it should be fine,” he said.
“This is an extreme case of where administration is setting policy in violation of patient’s rights to access care,” he said.
Love said patients might not know all the implications of taking high doses of pain medication.
One of the issues patients don’t understand, Love said, is the concept of opioid-induced hyperalgesia, which is an increased sensitivity to pain associated with the long-term use of opioids. Doctors still are trying to understand the phenomenon, Love said, but patients are at risk for hyperalgesia when they take more than 200 milligrams per day equivalent to morphine, he said.
The more medicine patients receive, the less it works, resulting in “dramatic and frightening” escalations in pain medicine with no real sedation or pain reduction, he said.
Half of all pain is subjective—no lab tests can show the pain, Love said.
“That’s why we get back to trust and verify,” he said.
Many patients don’t need much more than 60 milligrams per day, said June Dahl, director of the Wisconsin Pain Initiative, Alliance of State Pain Initiatives and a professor at UW-Madison’s School of Medicine and Public Health.
While some people need much more, she said when she finds “pretty hefty doses,” sometimes the patient hasn’t been well evaluated.
“I think sometimes if someone is a very good-hearted physician who doesn’t want to see people hurt, I think sometimes it’s easier to write a prescription than to do all the other things,” she said. “Chronic pain patients are often very needy, and the reimbursement isn’t there.”
The patient needs to be part of the treatment plan, she said, so the physician is aware of depression or anxiety problems and the patient’s lifestyle.
Risks
Opioids are not just a drug of last resort for pain; for many, they are the best drugs, said Jim Cleary, director of the palliative care program at University Hospital in Madison.
But prescribing narcotics clearly poses the risk of misuse. It’s a balance issue, he said.
When new drugs are approved, representatives of disease-related groups question why the drugs are only for cancer patients, he said. They wonder why the opioids can’t be used for others with significant pain, he said.
One of the problems is there’s no data as to how common prescription drugs are diverted to recreational use, he said.
Will Taylor, a federal Drug Enforcement Administration spokesman, confirmed there are no statistics to say how often prescription drugs are diverted, but he noted that prescription drug abuse causes more overdose deaths than heroin and cocaine combined.
A level of trust has to exist between the physician and patient, Cleary said.
“I often say to people, ‘Tell the truth; this is about trust,’” he said.
Doctors reduce the risk of diversion by having patients sign agreements saying they will use their drugs as prescribed, scheduling more frequent appointments, using random urine testing and doing a complete screening on patients, including their histories of drug use and addiction.
Local patients interviewed by the Gazette say they are not addicted but have become physically dependent on their prescriptions.
Some studies indicate that addiction is a result for 2 to 20 percent of patients, Cleary said.
Love said worldwide addiction literature shows patient addiction rates of between 12 and 14 percent.
Addiction is a disease characterized in part by craving for the mediation and seeking the drug despite the harm it does to the person, Dahl said.
If they’re taking a drug and not doing anything with their lives, then the drug is doing them harm, she said.
When assessing the effect of a drug, physicians need to look not only at what it does to the pain but what it does to the patient’s ability to function, she said. Is the patient getting back to work? Is the person getting tasks done around the house? Can the person interact with family and friends?
“Sometimes I’ve encountered folks who aren’t having any problems with the drug, then find they aren’t doing anything—(they’re) laying on the couch all day,” she said. “They may have pain relief, but the drug is just stopping them from doing anything meaningful with their lives. That’s not good pain management.”
“It gets kind of tricky in terms of are those people addicts? (It’s) a fine line.”
Under treatment
Even so, documentation shows that pain of all kinds still is inadequately treated, Dahl said.
“One of the issues that seems to be very up front is that pain does not seem to be adequately assessed,” she said.
Studies show patient pain may be well controlled in the hospital after surgery, but patients are in pain when they go home because there’s no continuity of care, she said.
Cleary said some doctors fear prescribing opioids because they believe the federal Drug Enforcement Administration is watching them.
A survey of Wisconsin physicians that assessed their knowledge and attitudes toward opioid analgesic use found most physicians thought it lawful and acceptable medical practice to prescribe opioids for chronic cancer pain. But only half held that view if the pain was not related to cancer, according to the study published in the Journal of Pain in 2006.
About two-thirds of the about 222 respondents were not concerned about being investigated for their opioid prescribing practices, but some admitted that fear of investigation led them to lower the dose prescribed, limit the number of refills or prescribe a lesser-controlled opioid.
The physicians held many misconceptions about prescribing opioids, the survey found.
“Such views, coupled with a lack of knowledge about laws and regulations governing the prescribing of controlled substances, may result in inadequate prescribing of opioids with resultant inadequate management of pain,” according to the study.
Cleary acknowledged the stories of some physicians who have poor professional practice that results in criminal charges.
According to the Drug Enforcement Administration, less than 0.01 percent of physicians in the United States lose their controlled substance registrations based on a Drug Enforcement Administration investigation of improper prescribing.
When appropriate medical doses are used and patients are seen regularly, the risk of diversion can be reduced, Cleary said. For example, he has a number of patients for whom he writes weekly prescriptions.
Demetra Ashley is the diversion program manager for the Drug Enforcement Administration’s Chicago field office. Her program has diversion investigators in five states, but if something comes to their attention, it’s “generally particularly egregious.”
Physicians shouldn’t fear investigators, Ashley said.
“I know physicians want to be very careful, want to operate within federal and state laws, but … I don’t feel there should be a fear for a physician to prescribe to their patient for a legitimate need,” she said.
Dahl said it’s much more than the fear of federal drug officials.
“I think there’s just a lot of lack of knowledge because we just don’t do a very effective job of teaching people,” she said.
“Often they (physicians) really haven’t had the education to know exactly what to do.”
Dahl and her colleagues have been developing curriculum on pain management for medical residents.
“I think a big factor is a lot of responsibility falls on the family physician. The data I have say these people have seven to 10 minutes with each patient,” she said. “That’s not enough time to work on a chronic pain problem.”
Moving ahead
Finding family physicians who will even treat pain patients can be a challenge, Mannino’s former patients say.
Rasmussen, the fibromyalgia patient, has struggled to find a new doctor. Mercy gave her a list of three doctors who were accepting new patients, but the first doctor she saw told her he wasn’t comfortable treating her because she was on opioids.
She has found another family doctor through family members.
Opie, the patient who is now off opioids, has since received injection treatments in Madison. But when those didn’t work, he said he was told the clinic could do nothing else for him. He’s been seeing a new family physician in Beloit—outside of the Mercy system—who has talked with Opie about referring him to a pain clinic in Milwaukee.
Opie believes that might be his last resort, he said, so he’s still trying to find a doctor in the area who will treat him in case Milwaukee turns him down.
“Now it almost seems like I’m doctor shopping,” he admitted. “That’s not the case.”
He thinks doctors may fear putting him back on narcotics because he has been off of them.
“I will always say it’s (opioids) the one and only thing that I’ve been through that has managed my pain,” he said.
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Mercy’s Pain Center
Mercy’s Pain Center in Janesville is an outpatient, referral-only treatment center that sees 500 to 600 patients a month, said Gregory Love, an anesthesiologist and pain management physician at the pain center. When a patient is referred, the center starts with an intake process, which verifies and reviews the patient’s type of pain, he said.
Then a treatment plan is developed, and it is frequently multimodal, he said.
“No one modality takes precedence over others,” he said. “Yes, we use controlled substances. We use them in amounts that are generally believed to be appropriate or reasonable for a particular condition.”
Treatments also include interventional care, injection therapy, procedures to reduce the need for depending on narcotics only or when everything else has failed, acupuncture and chiropractics, he said.
Love also pointed to new technology that allows a pump to dribble pain medication into the spine 24 hours a day. The pump reduces drowsiness, tolerance and addiction potential and reduces costs after two years when the equipment—at $8,000 to $10,000—breaks even, he said.
Aug 5, 2011 at 12:11 a.m.
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Does anyone know how this issue was started in the first place?
Aug 4, 2011 at 11:35 p.m.
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One more thing to add, if a person does not get relief by a Dr., I have seen alot of drugs and alcohol take the place of monitored prescriptions. Quality of life sucks and you will do what ever needs to be done to feel better.
Aug 4, 2011 at 11:25 p.m.
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I did not read any of the posts. I know one thing for sure, Dr. Love hurt me more than anything or anyone. The injections were very painful and he refused to prescribe me anything for pain. (hello, isn't this the point?) He told me he couldn't!? I had 5 through X_ray and NONE of them hurt that bad! I was physically sick from the pain. And the side affects were so much fun! Dieing did seem to be a way out! No one understands until you are in those shoes! The pain from my back made life HELL!
Aug 4, 2011 at 10:39 a.m.
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I think if anything abusive its doctors placing too heavy an emphasis on addiction of them. There are some doctors who write too many and others who don't write enough prescriptions!! Take orthopedics for instance, one of most painful fields out there to have a problem in and yet their doctors rank among highest for not prescribing enough pain medicine! If you ask them point blank for a prescription they will not give it regardless what you have based solely on notion that because your asking you must have an addiction. That or they're making a snap judgement based on how you look. How stupid is that!? Yeah ok I have a clean legal record perfect credit no evidence of any addictions never drink alcohol or perform drugs and all kinds of orthopedic problems and this clown thinks i'm a habitual offender trying to hit him up for drugs. Read your chart & perform a little history already!
Sep 5, 2010 at 1:35 p.m.
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I have injuries that date back to before the Vietnam war, as well as war related injuries, and a crippling car accident in 1976.
Paul Mannino was treating me for chronic pain in the back, left leg and foot, and shoulder. Old injuries like this do not respond to modern medical "miracles". Paul was not only my docctor, he was a good friend. I trust him.
To those who have never lived with chronic pain year after year, yet pontificate on "addicts", "overtreatment", and some sort of ignorant "morality", I can only say you should be grateful to your God that He has not saddled you with such misery. But since you DO speak from ignorance, you really have no say in this matter.
Aug 17, 2010 at 9:46 p.m.
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2no24give/ To what do you attribute your bad heart to? Medication I'll bet. The doctors should not have just took you off narcotics cold turkey, that was wrong. But I can't believe high doses of narcotics are the only solution for your problem. You don't say if surgery was an option. You don't say how high doses of narcotics affect your motor skills, your thought process and your daily life. if you say it doesn't affect you, you're either lying or in deep denial.
Aug 11, 2010 at 9:27 p.m.
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My husband and I started going to see Dr Mannino when he was dying from cancer and I continued to see Dr Mannino after he died. Dr Mannino is a good doctor. Mercy is in the wrong for firing one of the only doctors there that actually cares about their patients.
Aug 11, 2010 at 8:47 p.m.
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scooter.... said, "Mercy runs Janesville since GM left and Bliss Communications is right behind them!"?????
Now that you've unruffled your folds, explain that.
Aug 11, 2010 at 6:26 p.m.
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I made a lot of them, gazettefan, which are you refering to? You do not read everything that goes on in the world on here. Somethings are seen and heard in person if that is what you were looking for.
Aug 11, 2010 at 3:23 p.m.
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scooter...., you made a statement that needs explanation. Explain it after you unruffle your folds.
Aug 11, 2010 at 12:41 p.m.
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You know as a diabetic, and if I did not have insurance, I would be thankful and do whatever I had to to get my insulin, its incredibly expensive and your life depends on it...so if this doc gave insulin samples out (which i have been given before) because one of his patients needs it and has no insurance and that guy fixed a computor..so be it...its calle humanity you jerks...not a crime..I hate Mercy and will not take a dog to those butchers, I cannt wait till the new hospital is open, then maybe that dump will close up, shut up, or at least get it together they just plain suck
Aug 11, 2010 at 12:08 p.m.
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Thanks!
Aug 11, 2010 at 11:40 a.m.
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pm, you are right on the way you are handling this. I am a chronic pain sufferer, I agree with every thing you have posted. Some people just tick me off, they think they can just sit back and judge others and not listen to facts or reason. I do not like that on here but that is what you get. If I was your patient I would back you up fully. I hope things go well for you in the future.
Aug 11, 2010 at 9:41 a.m.
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I put my livelihood at stake because it was the right thing to do. There are so many suffering needlessly, because of fear, misinformation, and intimidation. The use of opioids is clearly supported by the literature. Would you rather see people getting the drugs off the streets, or through their physician? Obviously, we need systems in place to prevent diversion and abuse.
Aug 10, 2010 at 10:47 a.m.
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I will explain that comment because you, sir/maam, tick me off! I explained in my last post that no one is going to disclose things in this tiny town of Janesburg when this is all we have is Mercy and Bliss. Do you not understand English? I do, it is the only language I know. Why, even professionals such as this doctor, would people put their livelyhood at stake? Did I make it clearer? If not, try getting out more and notice humankind, it is amazing.
Aug 10, 2010 at 10:19 a.m.
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Gazettefan, crawl back under your rock.
Aug 10, 2010 at 9:57 a.m.
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2no24give: You are absolutely correct. I am a certified addictions registered nurse (CARN) and I can verify that too, too many physicians and nurses are under-educated in regards to pain and medications to help control the same. It sounds like you were sent into an extremely painful withdrawal. That is unethical and makes me embarrassed to be a peer to these misinformed nurses.
Aug 10, 2010 at 4:07 a.m.
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I wasn't aware I could post the actual names of Dr;s,etc,on here. PAIN...Contact Dr. Douglas Kheen,Advanced Pain Management:6088291400...I've been his patient for years. As stated other posts,I AM a long-term chronic pain suffer.I understand your feelings,and the BS run arounds you go thru!IE:I was recently hospitalized,the admitting doctor removed me from "ALL" my medications,determining in brief meeting that "I didn't need then". Against my demands,my wishes,yet,anoth Dr. did this same thing. I in just 3 days went into massive,and extremely painful spasms,ended up begging them thru my tears to please get me back on track! Took them 6-8 weeks to correct what they'd done in just 3 days! I believe hospitals,dr.s,etc. have absolutely no right to make such changes and currently while I am recovering from open heart surgery,I am determined to bring these horror stories to light,to stop Dr's.,nurses,etc.,from interefering with another Dr's. studies,presciptions,etc. We are suffering from terrible pain,in isn't fair,nor right,that they can wave their pinky and disrupt years of efforts.Cause severe pain they know nothing about! Simply because they don't understand what each patient has on their plate,or because they don't happen to agree! I am on massive prescribed doses of pain meds. I am not addicted,I do not violate them,instead,I protect them,dearly!How about stopping some of this longterm Welfare Fraud for a change! Please write me,provide some details of your situation/s,how long,what,etc. at my email:rwcccone@charter.net...Provide phone info. I've been working on a book detailing our suffering,of my 40 yr. battle against pain,so please put your thots down and forward. Let me say to TJ,etc.I've been that cure route,it 's been a part of my 40+yr. battle. Initially,I was injured in a fall(wet floor),I fought like the dickens against being disabled.Eventually,my spine was probed,the severity of my injuried found,and severe scarring,tissue damage prevented anymore Phy. Therapy. After surgery as a control/palliative management attempt,doctors apologized that I'd gotten so bad. Still,I supported my wife and children totally,until 35 yrs. later I couldn't do it. But believe me,a cure for spasmic,chronic pain,will also have it critics! I've terrible nerve damage from many surgeries,and Phy.Ther.,doesn't work. Huge numbers require pain meds,and more,i.e:implanted pumps. Contact me..Wishes,Rodger
Aug 10, 2010 at 3:22 a.m.
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CALL ME!A topic I am expert in pain management and services. For those needing pain management services call me! I will provide you the information you require!I have fought severe pain for decades,having had far to many cut and dice surgical interventions,some needed,some done poorly! I have two Morphine Implants,feeding this and other drugs directly to my brain and they work wonderfully! I am NOT addicted,and never get "high"! Send me your email,briefly state your problems,how pain affects you.Note,I am NOT a doctor! I am a cancer(3 time survivor),DiabetesII survivor,Lymphedema survivor,many surgeries survivor. You need help,write me now for the addresses(local) you need. Wishes,Rodger
Aug 9, 2010 at 10:49 p.m.
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"Mercy runs Janesville since GM left and Bliss Communications is right behind them!"?????
Explain that.
Aug 9, 2010 at 11:13 a.m.
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Duffer, I do! Mercy is always looking for publicity be it negative or positive. Seen it first hand, and gazettefan I will not reveal sources on here and neither will any other poster. Mercy runs Janesville since GM left and Bliss Communications is right behind them!
Aug 9, 2010 at 9:14 a.m.
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to melstew47- Come on now, do you really think Mercy would try to get something like this in the media ? Far more likely is that one of Dr. Mannino's patients, or Dr. Mannino himself contacted the gazette........WHO is stirring the pot really........?
Anyway, I am not sure this is unique to Mercy.
I have been told that the CDC has data that prescription narcotics are misused millions of times each month. I have been told that in rural America misuse of narcotics can be over 20% of the amount prescribed by doctors....THAT is frightening.
Aug 7, 2010 at 12:29 p.m.
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why is it, that i only read about mercy health system having this problem?theyre always raising some kind of crap about pain meds.but they dont mind giving people those dangerous pain shots,that has caused some of their patients to have strokes,not to mention how painful they are.an also if you refuse those shots,they dont want to see you anymore,lol,you know why?those shots are very expensive,its all a money game with mercy,there are a few doctors an nurses there that actually care about you,the rest,its all a money game,they dont give a squat about you,havent you noticed they pull this crap with the pain meds,every few months an make a big deal about it,an makes sure its in the papers.lol then guess what?they go right back to prescribing the meds.if they took all of you off pain meds,that take them,it would be very bad business for them,lol they get huge kickbacks from pharmaceutical companies to push these drugs,so who are they kidding,acting like they care about someones addiction.hahahahahahahahaha
Aug 7, 2010 at 11:29 a.m.
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As a current patient of Dr. Mannino who has suffered through pain issues myself, in his care helped me find alternative to straight up hardcore pain medication, like diet, surroundings in the home or elsewhere...to help me stay off the medications.
As a patient when he was fired, I stand behind all that he did, am still grateful for his help and actual care that he showed in resolving the issues, not just loading my system up with drugs as an easy fix, which I had been accustomed to with prior Doctors before him.
If this good Dr opens a practice in this town, or is hired elsewhere, I would ask to continue being his patient because he is in my experience, one of the better Doctors who has ever treated me and my family, and we have seen many doctors.
Thank you Dr. Mannino for everything. You have our family's support.
Shane Oswald
Aug 7, 2010 at 9:04 a.m.
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TJRockCounty, I'm interested in pointing out bad thinking -not necessarily to stir the pot. However, pointing out bad thinking has a tendency to stir the pot.
Aug 7, 2010 at 8:38 a.m.
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Gfan- I understood what you meant, we need a poster who brings up topics that get people riled up and your our man! Admirable, that's all.
Aug 7, 2010 at 7:21 a.m.
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TJRockCounty, I was taking the complainers to task. If what they're saying is true, I'm saying where is the attempt to remedy the problem? As you can see, none of the complainers are doing anything to reign in a "rogue outfit." Which strongly suggests that there's no substance to their complaints.
I should have used quotes before.
Aug 6, 2010 at 11:33 p.m.
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Dear Gazette Readers,
.
Despite what you have been told-
There are still medical professionals who care not just for you, but about you.
Despite what you have been told -
Your suffering does not have to be in silence.
Despite what you have been told -
You don't need to continue a plan for your own health care that you do not agree with.
Despite what you have been told -
Our family members don't have to die alone, connected to tubes and electrodes, suffering needlessly in an ICU while apart from the people that love them.
Despite what you have been told -
You can choose the healthcare providers that truly care for you and your family.
Despite what you have been told -
You have absolute control over the decisions that impact the health of your loved ones.
Please do not give up these rights.
I applaud the work of providers such as Nurse Hoffman and Dr. Mannino. They struggle daily on the front lines to help the most vulnerable members of our human family. I am sure they would love to use all their energies fighting the pain, suffering, and disease around them - unfortunately, much of their time is overtaken with fighting administration, insurance companies, and their own employers in order to protect those under their care. The fact that they return daily to those front lines is a testament to their dedication and devotion.
We will never stop defending my brave colleagues who stand up for the weak, the voiceless, and the forgotten. We are all that they have.
Bless you, Dr. Mannino, and your patients.
"For the secret of the care of the patient is in caring for the patient"
- Francis W. Peabody, MD ; New England Journal of Medicine (1927)
Doug Hobson, MD
Family Physician
Janesville, Wisconsin
Aug 6, 2010 at 10:14 p.m.
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I applaud Dr. Hobson's support of a colleague he admires and for Dr. Mannino, a physician who followed his Hippocratic Oath.
“ I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan."
Pain is subjective. None of us can judge or rate an individual's true pain, except for that individual who is suffering from it. Recovery and quality of life are affected by a person's perception of their pain.
As a RN, I advocate for my patients and believe that less pain can improve an individual's quality of life. Not everyone will be 100% pain free. The goal is to use therapeutic measures to lessen their pain to a level that is comfortable for them to perform activities of daily living. This is done while maintaining a therapeutic level of any prescribed medication and ensuring the patient does not have life threatening adverse effects. This can include massage, physical therapy, heat, ice, acupuncture, over the counter and prescribed medications.
Every person is a unique individual who responds to different treatments in different ways. Some people may benefit from non steroidal anti inflammatory drugs such as Toradol and over the counter products like ibuprofen and Aleve. Others need prescribed opiates and muscle relaxers to lessen their pain.
Tolerance does build up over time and a medication that was originally prescribed may become ineffective or need an increased dose. This does not make an individual an "addict."
Abrupt withdrawal from medications such as Valium that have been prescribed over a long period of time can cause a reaction known as benzodiazepine withdrawal. This can be potentially life threatening.
I would like to end this with a quote:
"When I hear a baby's cry of pain change into a normal cry of hunger, to my ears, that is the most beautiful music." -Dr. Albert Schweitzer
Cheri L Hoffman RN
Children's Hospital of Milwaukee
Aug 6, 2010 at 9 p.m.
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Gfan- are you stirring the pot again? What is everyone on Mercy for? Doing the right thing? Prescription drug addiction is huge and Mercy is trying to make sure it doesn't happen in their health system. They are stepping up and doing something about the problem and your blaming them? Are all of you on prescription narcotics or what? As far as this article goes that could be the only reason your angry.
Aug 6, 2010 at 5:52 p.m.
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Where is the trust in the doctor-patient relationship? It seems like admistrative rules are trying to supercede patient care.
exactly!!
Aug 6, 2010 at 5:51 p.m.
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gazettefan: I would say that the opposition is building a new hospital in town. And many of the villagers are celebrating because of it.
Aug 6, 2010 at 3:57 p.m.
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What is the opposition doing to clean up this mess with Mercy?
Aug 6, 2010 at 3:38 p.m.
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To Mercy Hospital System:
I hope you are reading these posts and I hope that you will consider the following.
1. Pain Management Clinic to include doctors, meditation, acupuncture, laser thereapy, opoid & other prescriptions, physical therapy/exercise, addiction specialist, counselor, and others.
2. Bureaucracy: Is your bureaucracy, insurance, etc. driving patient care or is patient care with the doctors?
3. Doctors: Where is the trust in the doctor-patient relationship? It seems like admistrative rules are trying to supercede patient care.
Aug 6, 2010 at 1:18 p.m.
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Several of you miss the point of difference between cars, alcohol, etc and controlled substances. A doctor prescribes controlled substances and has a duty under the law to prescribe appropriate amounts and monitor patients for effectiveness, side effects and aberrant behaviour. Why ? Because patients cannot be completely objective about the impact, either positive or negative that these powerful drugs have on the mind and the body.
That is why they are CONTROLLED substances. If a patient lies to a doctor, then it is on the patient's head until the doctor discovers the lie through monitoring. If a patient is confused or suffering side effects, it is the doctor's responsibility to counsel the patient and look for a better solution. Trust is important on both sides.
Aug 6, 2010 at 12:36 p.m.
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Does anyone have any information re: what's being done about Mercy's rogue behavior re: professionalism and ethics?
What authorities and agencies have been contacted? What is the status of the matter?
Aug 6, 2010 at 11:03 a.m.
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wisciowa, I take these at night, for your information, not lyrica though. Just amitryptaline and flexeril. My gosh, give it up. If you would have read all these posts from the get go you would see I am not the only one. I don't work around machinery and I really hardly ever drive if you must know. I am a homebody except for PT. So layoff, will you? As for Mercy, they do suck. I also know that they are getting rid of an abundance of people from the kitchen up to doctors and some are fired without a valid reason. Would you go up against Mercy in a lawsuit? I hope this doctor makes a stand for all employees and patients. JMO
Aug 6, 2010 at 10:10 a.m.
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pm7988: I do appreciate your posts. I have seen you in the past when my normal physician has been out and I have no complaints on the treatment you provided. I simply was trying to bring awareness to the fact that a person defending your medical actions was using the opiates you prescribed in a manner that seems to be more in the area of an addict and not a true pain sufferer. I feel that hurt the article to a certain degree. I also realize you can only "police" your patients to a certain degree and the rest is up to the patient.
Aug 6, 2010 at 10:09 a.m.
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duffer..., inject some sarcasm into my post. I was addressing the opiod doctor's (and his allies) description of Mercy as some rogue outfit that evades the professionalism and ethics required of a hospital.
Aug 6, 2010 at 10:08 a.m.
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SarahB1: Thank you for your 1:50am post. The information you wrote in that post is exactly the message I was trying to get out. I have no problem with a person with chronic pain taking opiates, as long as they are taking them in the manner prescribed. I just know that one of the people in the interview abused the presciption opiates, which IMO made that person an addict, instead of using them as directed.
Aug 6, 2010 at 9:46 a.m.
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Mercy's problems ? How about the problem of a doctor who refuses to follow the rules ? He got fired for refusing to follow guidelines that other doctors seem to have no problem with (basd on what I read in the article).
Aug 6, 2010 at 8:49 a.m.
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What actions are being taken to report Mercy's problems to the proper authorities and the proper agencies?
Aug 6, 2010 at 6:32 a.m.
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I am VERY sad and surprised that Mercy did this to Dr. Mannino - he was a very good doctor to my husband and I (we moved out of state). Dr. Mannino - come to Florida! There are many pain management clinics here where teams of professionals use every method available to manage chronic pain in patients, including prescribing high doses of opoids and even methadone when needed.
Mercy needs to get up-to-date. Remember, it wasn't too long ago that many in the medical field thought that people suffering from fibromyalgia and lupus were making it up - they barely even recognized these diseases! I would not want anyone I love to suffer pain OR become a drug abuser. It is hard for anyone to know when a Rx drug user becomes an abuser of prescriptions, that is why Mercy should get modernized in its approach to treat the WHOLE person for pain and pull together a number of specialties to help sufferers.
Aug 6, 2010 at 1:50 a.m.
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treeandcoon: I just now got back to this discussion. Regarding your question in your 1:25 p.m. (August 5) post: Yes, a lot of the difference between dependence and addiction is seen in behaviors. Addiction involves a compulsion for and obsession toward the drug and is seen in the behaviors one takes on once addicted.
But if a pain patient is not being medicated appropriately (meaning, the dosage is not adequate to ease their pain), that same patient may take on behaviors that others mistakenly view as signs of addiction. This is called pseudo-addiction. In this case, the patient is trying to relieve pain and not trying to get a "high".
Pseudo-addiction is just one thing that makes this issue so complicated for the patient and, sometimes, the physician too.
Both dependence and addiction involve withdrawal when drugs are stopped abruptly.
As far as your question about "crushing and snorting," this is usually a sign of abuse or addiction. In my opinion, it would only be seen in dependence if the patient's pain level was exceedingly high and he/she needed to get the medication into their system as fast as possible. Remember, the patient who develops dependence alone (and not addiction) usually does not get a "high" off the medication and would have no reason (except that which I meantioned above) to "crush and snort".
This method is seen very, very often in those with addiction and, and unless the disease is halted, will more than likely progress to the person injecting the drug. Of course, this is all just my opinion. But I can tell you that I am a nationally Certified Addictions Registered Nurse who has mostly worked and focused on this area of nursing for the past eight years.
Aug 6, 2010 at 1:26 a.m.
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A sad situation when a great number of your employess from Docs and nurses right down to the kitchen help and housekeepers openly express displeasure with the Mercy Machine. Seen it first hand when I worked there briefly a few years ago. The attitude of the employees speaks volumes and will eventually affect the care patients recieve. Just a few weeks ago, a doctor confided in my daughter that things aren't going very well working for Mercy in reguards to the strict prescribing guidelines implemented and having an increased workload to cover for other doctors recently let go. Of course, what he told her then....now makes sense with this news story surfacing!
Aug 6, 2010 at 12:27 a.m.
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Gazettefan, there are side effects to everything...be it OTC or prescribed! Some side effects have been found to be beneficial...for example sildenafil citrate (as I'm sure many of you would agree). Like the good doc said, you must weigh the benefits agaist the risk. So what amount is too much? We have guidelines to go by (start low and go slow)...but everyone is different. A good example would be my mother-in-law who was on high doses of narcotics and remained sharp as a tack...as do many people.
I suppose that is why they put warning labels on meds with a high likelihood of causing impairment.
To all of you naysayers and critically outspoken bloggers out there...just wait. Your day will most likely come when illness or injury strikes. Do you want a strict and unforgiving rule that if a med has even a glimmer of causing impairment...your right to drive and work be revoked? Heck, I've known many who are knocked out by benadryl! How your body reacts to meds is an individual experience and you as the individual are responsible to know when your safe to drive.
Aug 5, 2010 at 11:29 p.m.
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PM says "What about the profound sedation of neurontin, lyrica, amitriptyline, flexerils?" Arent these some of the drugs you take scooter? Then drive?
Aug 5, 2010 at 9:40 p.m.
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This story has been beaten up from every perspective. It's time to move on.
Aug 5, 2010 at 9:20 p.m.
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and obviously Paul you are not alone, others doctors have agreed to your method of treatment, ironically those papers have disappeared from patient files. A handful of patients have even gotten lucky and found doctors who continue your exact route of treatment... outside of Mercy of course. That in itself says something about Mercy itself. We've been lucky, we have dealt with wonderful, compassionate and well educated doctors!
Aug 5, 2010 at 9:11 p.m.
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TO PM7988:
Here here doc, I'm with you. Just because there are irresponsible patients who abuse, does that mean the rest of us have to pay for their crimes? Before I came to you I was treated like a drug seeking dope feind. I hated it and still do. Thankfully I was able to find another compassionate doctor in Madison willing to treat me until I could get in to Meriter's system. The doctor they sent me too at Mercy did a drug test and said it came back I smoked crack!!! OMG, I about flipped out. I started to laugh. Believe me if the rest of you saw me you would know I don't smoke crack. I had some drug tests since and passed cleanly everytime. Needless to say it is unfortunate that I live less than a mile from a nice, clean hospital but won't go because of the way I have been treated there. When I read in one of the comments that you were seen in the parking lot giving a patient a sample, it reminded me of my doctor back home in Michigan who did the same often. Even my pharmasist would give me a few pills under the counter until the rest of my order came in. They both cared enough not to let me suffer. Anyway, if it comes that you need someone to back you up, just call and I will be first in line. You are doing something good that no one else had the guts to do and that tells me that your compassion for the patient is what being a good doctor is all about. Without patients why would we need doctors? Keep up the good work and don't give up!
Aug 5, 2010 at 9:03 p.m.
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so gazettefan a priest taking pain medication would be shunned by a religion becuase prayer should be enough...
Enough already get over it.
Aug 5, 2010 at 8:44 p.m.
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freeradical, what post are you referring to?
And as for your post addressed to me, none of it reads like you read all the posts here. RevWhite brought religion into this in response to another poster. RevWhite mentioned prayer. RevWhite flip-flopped all over the place re: the efficacy of prayer. Clergy preach that people should pray. RevWhite said prayer in not for the relief of pain. Pain has something to do with the proper and improper use of opioids.
RevWhite's religiosity calls his credibility into question re: his defense of the questionable dispensing of opioids.
There, that's a better summation of what you're complaining about. And it required fewer words and is much more readable.
And there's the matter of how the people who run a hospital can be so wrong about one of its employees.
Aug 5, 2010 at 7:50 p.m.
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I'm very pleased with the discussion--good and bad. This is what it's all about!
Aug 5, 2010 at 7:47 p.m.
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If 1 patient in 100 becomes addicted, does that mean we don't treat the other 99? If someone dies from opioids, do we not treat someone at risk of suicide because they are in constant, excrutiating pain? It makes me very sad that these meds are ending up in the wrong hands. Those in possession of these meds who gives/sells them to someone else, who then dies, should be prosecuted to the full extent of the law. Patients are responsible for keeping these meds safe, and out of the reach of others. It is often easier said than done. There is a new tracking system in Wisconsin, which will help immensely. Electronic medical records have been disappointing, in that information is not transmissible between clinics(which I thought was one of the reasons EMR's were touted).
Aug 5, 2010 at 7:45 p.m.
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and freeradical very very very well said.
Aug 5, 2010 at 7:40 p.m.
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"What I am trying to bring awareness too is the fact that this family member has been observed drinking at the same time he has taken his opiates and then driving. Safe?"
Really? You can take opiates out that whole comment and its still not safe. You should not drink and drive. period.
I am just speaking out about the one person, my husband, who is responsible and active, while on opiods. He does not get any sort of high or comatose from it, it actually does the opposite, while it lets him sleep without pain it also lets him enjoy his children and actually be able to play something as simple as catch with his 3 yr old or help his 10 yr old with her homework. I would rather him take his narcotics and be functional then turn to something like alcohol. He is coherant enough to take care of his two children and keep a 4.0 in his college courses. Yes there are people who use them to get high or use them uneedingly or irresponsibly as with anything else, alcohol, pot etc.. that is not what this article is about. I think that this article is about the one of very few doctors that was willing to actually try helping these patient find some sort of comfort getting fired, and to bring awareness to these patients in need and to Mercy trying to shut them out.
Everyone is entitled to thier opinion and just becuase its different then mine does not make it wrong. What offends me is people calling these patients addicts, or saying they take the easy way out without having any idea of what they are going through. I pray that those of you on here not suffering with a form of chronic pain never have to.
Aug 5, 2010 at 7:40 p.m.
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No, the doctors aren't fully responsible. Any medication has benefits and risks, and we try to educate the patient on those. As I mentioned in previous posts, there are medications far more impairing than opioids. The law, I believe, is if a physician prescribes in good faith, they cannot be held accountable. This is clearly different than one who prescribes indiscriminately, or for sex, etc. I have always acted in cooperation with my patients to provide the best outcome for their health, reagardless of their condition. I've made mistakes, and been fooled--I'm by no means perfect. All I'm asking is to rethink our approach to those suffering from chronic pain. Most patients with chronic pain have nothing, and therefore have been shunned and excluded from the health care system. I wanted to give them a chance at a semi-normal life, be productive, find employment, enjoy their families. Is that too much to ask?
Aug 5, 2010 at 7:25 p.m.
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Duffer to pm7988- If you are a doctor, then you are responsible if someone is in an accident, or hurts someone else or dies as a direct or indirect result of prescibing too much or the wrong kind of meds. Wouldn't you agree ?
Then every drunk driving death should have a lawsuit tied directly to the makers of every alcohol consumed before the fatal crash,wouldn't you agree?
People, it's the PEOPLE and their own will that are held responsible. It is not the doctors, the pharmaceutical companies, the drug store. It is the people who take too much and drive. Mix them and drive. I see a lot of finger wagging at everyone except the root of the problem. The person TAKING them. Say you're 30 years old. No one makes you buy alcohol. No one makes you drink it. No one makes you drive. But many do. Who's fault is it?
....
I'll wait, some of us seem a little slow to put this all together...
Maybe it's because people have lost people to these scenarios and don't want to admit the people responsible are the people who consume whatever it is.
There are warnings, disclaimers, common sense. I apologize for getting my feathers ruffled, it just seems like a lot of people are holding the drug responsible. It's an inanimate object. THat means it cannot feel, care, do, anything of it's own recognizance.It has no will of it's own. No motive. It cannot be held responsible for what it does. It has become common knowledge these days of what most drugs can do.
It's like getting mad at Wisconsin because you're fat. No, you're fat because you make poor living choices, not because you live in Wisconsin.Not because you "just have bad genes". Stands to reason, the drugs are not bad. The doctors are not bad.I couldn't get mad at someone for wanting to get high on their meds if they live with things like fibromyalgia)sp?) everyday, or slipped discs in their back, or a plethora of other conditions. SOrry to rant. I fell better. =)
Aug 5, 2010 at 7:14 p.m.
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As far as abusing the meds...
Is that really anything to put in light? Is alcohol generally bought and consumed to be "sipped"? Why Is alcohol even on the market? Tobacco? For choices given to the masses such as Everclear(That's almost 95% grain alcohol, for those who did not know), Jack Daniels, Beer, Wine coolers....They are sold as commodities, for no real medicinal value. Not a single person in the world has a legit medical reason to consume these things, in fact they are proven to be detrimental to your health, even in small doses. I'm looking at you "I only have one glass of red wine a day" drinkers. Yet someone with chronic pain goes to the doctor, get some opiates, and suddenly the world is on fire? Heaven forbid someone with chronic, debilitating pain gets treatment-hell-even feels GOOD for awhile, right? Yes, opiates are powerful. Yes, they can kill you. That is why we normally only give them to people who NEED them from people who are TRAINED to give them to those people! Booze, Tobacco? ID and age limit required only. Yet someone in need of professional medical help is ostracized for seeking the help they need from the very medicines that were developed specifically for their scenarios? Let's get real here.
Aug 5, 2010 at 7:06 p.m.
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Gazetetfan, why are you singling me out? Lol who are you to play "god" of this discussion??"
Your objection to the discussion of religion here is overruled."
LOL what do you have some sort of superiority complex? You can tell us all we have to talk about the bible now? I don't understand your angle completely. I have read all these posts, yours included, but I still make no sense of your burining desire to make religion the focus in a discussion about opiates and a doctor. I realize you are really taking joy in this discussion and all the attention and banter you are instigating, but seriously, have some decency to stick loosely to the topic at hand. Not telling you what to do, o lord, just kind of reiterating why we're all here in the first place. To have a discussion about the story. It seems fitting someone preaching about god is trying to assume the position. You may be a fan of the gazette, but from the looks of it you have no fans of your own. Please refrain from religious babble and keep your thoughts loosely structured to the topic at hand. I realize by typing this I am not only being a hypocrite, but giving you what you want. For those of us who have stayed loosely on topic, or took the tangent of religion with a grain of salt, and without an angle of converting all of us sinners, it is appreciated. Good luck to the chronic pain sufferers, as well as every American in need of medical care but without the means to acquire it. Heaven forbid(lol) ;) we spend the GM bailout money, the "never-ending-war" money, the inflated politicians money,or even 10% of OUR tax money to help our own. Hey gazettefan, take 1/2 the time you spend on these forums and go donate it somewhere. Go preach to people in the flesh, if that's what you desire.
Aug 5, 2010 at 6:13 p.m.
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I live with fibromyalgia everyday without pain medication and it is very hard. I don't want to take opiates ever. But I was told that if someone REALLY needs the strong pain meds it shouldn't affect everyday life and give you the "high". People NOT addicted don't get "high" from these meds, it just helps with chronic pain. I do agree though, some people DO NOT need to take these types of meds if they can't take them correctly.
Aug 5, 2010 at 5:20 p.m.
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Treeandcoon; Thanks for keeping it real. You are correct that some patients DO abuse the doctor patient trust and misuse the narcotics. I don't feel you are bashing anyone. Telling the real side of this story is to include both the positive stories of narcotic pain relief AND the negative stories. We can only hope that the awareness of both sides of the story will bring about the change that is needed to prevent the negative aspects.
Aug 5, 2010 at 5:20 p.m.
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Sorry treeandcoon-didn't notice any misspellings until you mentioned it-and then only one. Shoulda kept quiet.
Anyway, it seems to me if the issue is patient safety and health, why weren't things put in place by the persons in charge of these decisions so that all of the doctor's patients, especially those needing pain control and others needing ongoing uninterrupted care, would have a smooth transition? I don't mean just a generic letter that leaves you in the dark, but perhaps they should have initiated arrangements of individualized plans in cases where it was more than just making an appointment with a different doctor on your next visit. Isn't continuity an important part of medical care? Wouldn't that have shown the degree of concern they suggest they had when firing one of their staff?
If there is more that his patients don't know about to explain this oversight, maybe patients who have been treated for years in some cases have a right to know what it is (assuming it is even remotely related to his care and treatment of patients).
Aug 5, 2010 at 4:57 p.m.
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Before the spelling police arrive, yep, I know I mis-spelled some words. :-)
Aug 5, 2010 at 4:42 p.m.
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My problem with the whole blog is anytime a person says anything negative it is being taken as an insult. I am not trying to be insulting but I have watched my family member that took opiates on several occassions. I am not bashing the doctor or the relief that the opiates can give. What I am trying to bring awareness too is the fact that this family member has been observed drinking at the same time he has taken his opiates and then driving. Safe? I think not. Not everyone abuses the way they take their medication, but how are those that witness the abuse supposed to react to this article? I am not saying all of Dr Mannino's patient are like my family member. I am saying that in this persons case the opiates seemed to make him a zombie, so what king of quality of life is that? And what dangers to the community does this person present when getting behind the wheel of a vehicle?
Oh, and I am not bashing, but if the police can pinpoint the last place an alcoholic beverage was served, and by whom, that person CAN be held accountable in the eyes of the law.
Aug 5, 2010 at 4:39 p.m.
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I agree that most people in pain do not want to get high, but they may not be objective either. I think that a doctor needs to be caring, compassionate and observant. we have all seen people who say things about themselves that don't add up, they are not lying, just not objective.
Aug 5, 2010 at 4:21 p.m.
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So give them pain medication to dull the pain (these patients do not get high, they get relief) so we are suppose to medicate them so they have a higher quality of life, but restrict them in how involved they can be in society??? Pm you will always be greatly appreciated by my family. You have helped give my husband back to me and a wonderful father back to my children. It's very sad that some people will never understand everything involved in the life of a chronic pain patient, they think its the easy way out when that couldnt be further from the truth. Your compassion has given you a permanent place in the hearts of my family and me. God bless you.
Aug 5, 2010 at 3:42 p.m.
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"Do opiates help with Palin suffering?"
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No, that is called psychiatry.
Aug 5, 2010 at 3:24 p.m.
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Dr. I have no doubt in my mind that you are a caring, compassionate physician. Unfortunately, and sadly, there are patients who sign the contract just to get their meds and don't care if they hurt someone else in the process. I am concerned with the social aspect of this issue. I believe that there have to be restrictions at some point in the escalated dosing where the doctor should be doing something to, at the very least, have the patients drivers license taken away(possibly a fax to the DMV) while the patient is receiving the higher doses. I realize this is not a policy that you yourself would be making. But somewhere along the line, something really does need to be changed. Hopefully if any good can come from your case, it will be some kind of policy change that is beneficial to society as a whole.
Aug 5, 2010 at 3:23 p.m.
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pm7988- If you are a doctor, then you are responsible if someone is in an accident, or hurts someone else or dies as a direct or indirect result of prescibing too much or the wrong kind of meds. Wouldn't you agree ?
Aug 5, 2010 at 2:38 p.m.
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You all bring up great points. Would I be responsible if I sold cars, or served beer in a tavern, or sold guns? Patients need to be responsible, and they are aware of the risks--they sign a contract. Studies have clearly shown that pain is far more impairing than the pain medicine. What about the profound sedation of neurontin, lyrica, amitriptyline, flexeril? I would not want to prescribe something that made a patient's condition worse. Remember that primary care physicians can't perform neurosurgery or inject into someone's back, although we have a keen insight into the whole patient's being and situation.
Aug 5, 2010 at 2:25 p.m.
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pm7988, what were the uncarboned prescriptions for. And describe the condition(s) of the patient(s).
Aug 5, 2010 at 2:25 p.m.
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Now the self-righteous posters are going to start on here. pm7988 is the doctor in question if you haven't already figured that out. And poozy, this is your first post, would you mind explaining yourself better. wisciowa, most of your posts are on this article also, you need to do some research on prescription narcotics and other meds. WebMd is a good place to start.
Aug 5, 2010 at 2:23 p.m.
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What about the side effects?
Aug 5, 2010 at 2:16 p.m.
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wisciowa, why in the world would I get busted? Most of these meds I take in the evening before bed. Are you a doctor or something? Some posters on here take more than I do and also oxycontin which I would not touch with a ten foot pole. My prescriptions are just that, prescriptions. If my doctor did not think I needed them, she would not have prescribed them. You need to get out of the dark ages. I function quite normally with my medications. Some of you negative people need to stop putting chronic pain sufferers down. That is really rude.
Aug 5, 2010 at 2:11 p.m.
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Dr. Hobson? Really? If any of you knew why he was "released" from Mercy you would be shocked. Same with Mannino. Just because there is a MD or DO behind a name does give total credibility. Let me phrase this is simple terms to best describe them: NUTS! There are two sides to every story folks. Just remember that.
Aug 5, 2010 at 2:02 p.m.
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pm7988, If you are a doctor prescribing higher and higher doses of narcotics to a patient who gets behind the wheel of a vehicle and in turn causes an accident, are you not partially responsible? What about the patient who is driving with a child in the vehicle while his or her judgment is impaired by narcotics, is the prescribing doctor partially responsible for the child's safety? Even if you pose the supposition that these higher doses are not harming the patients themselves, what about the danger they pose to others? Please do not insult us by insisting that there is no danger! We are not as blind as you would wish us to be.
Aug 5, 2010 at 1:25 p.m.
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SarahB1: Dependence vs. addiction: The effects of stopping the medication creates the same response in the body. So, this is a debate that will never be won. Perhaps the difference is the behaviour of the person taking the opiates. Would crushing and snorting the opiates be considered dependence or addiction?!
Aug 5, 2010 at 1:21 p.m.
Aug 5, 2010 at 1:19 p.m.
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I can't speak about the pressure involved while writing prescriptions. All the others printed through, and I can't explain what happened, other than the pad was defective, or another piece of paper was in between. These meds are FDA approved, and all meds have side effects. Benefits clearly outweigh risks. The risk of addiction is <1%, which is different than physical dependence(withdrawal and tolerance). I'm glad all are having a discussion about this--I definitely don't expect all to agree, and everyone has a right to their opinion. The decision should be between patients and their doctors.
Aug 5, 2010 at 12:54 p.m.
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Physical dependence is the result of your body becoming dependent on a medication. You find yourself depending on the medication to get through the day without pain or with a reduction of pain. unfortunately, as time goes on, you build up a resistance, then you start taking higher and higher dosages per day and eventually are taking doses high enough to do you more harm than good. Your body begins to shut down.
Aug 5, 2010 at 12:31 p.m.
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Do opiates help with Palin suffering?
Aug 5, 2010 at 12:27 p.m.
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Kciraryal: Your latest comment is great but has little to do with most patients taking prescribed opiates. Most of your points have more to do with "addiction" and not "dependence". There is a very, very big difference between the two and many people do not understand this.
In fact, the vast majority of patients who are prescribed opiates never develop addiction. One recent study focused on 24,000 patients who were prescribed opioids. How many of these 24,000 developed addiction? JUST SEVEN (7)! Per a review of this study: "... The rare few who do develop a problem are often highly susceptible to addiction due to a genetic predisposition."
Unfortunately, comments such as your recent one only add to the stigma these patients face which, I am sure, only makes things more painful for them.
Aug 5, 2010 at 11:51 a.m.
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Very valuable contribution, kcit.....
Aug 5, 2010 at 11:38 a.m.
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WOW, so much off topic talk about religion! Let's remember the issue at hand;
Opiates?
1. Opiates are painkillers, and release from the brain endorphins, a naturally-produced chemical. When endorphins flood the body, resulting in a calming, euphoric feeling. Opiates include heroin, morphine, codeine, and prescription medication such as oxycontin, percocet, and vicodin.
Dependence?
2. The more a person takes opiates, the more tolerance he builds up, which results in larger doses for the euphoric feeling he is seeking. Eventually, long-term users no longer create endorphins naturally, as the brain becomes dependent on the drug to deliver the chemicals to the body.
Physical health consequences?
3. Prolonged opiate use can result in heart infection, liver disease, and pulmonary problems such as pneumonia. Other effects include decreased sex drive, constipation, and infertility. Also, long-term intravenous usage can lead to collapsed veins.
Poor hygiene?
4. The longer a person abuses opiates, the more likely he will be to ignore personal hygiene, which greatly increases the chances of acquiring disease and alienating people close to him.
Crime, death?
5. Ultimately, long-term opiate use can lead to a life of crime for the user to continue supporting her habit, and possibly death, either due to an overdose or to one of the health problems listed above. Truth is not a concern for these patients, nor is the safety of others whom they may potentially harm.
Now here is the real issue; Is a doctor adhering to the rule "First do no harm" when he or she prescribes larger and larger doses of narcotics to a patient in chronic pain? With the side effects and the social dangers involved, in the long run, the doctor is creating more harm than good. The patient is unable to concern themselves with future consequences when the need for opiates clouds their logic and judgment.
Aug 5, 2010 at 11:27 a.m.
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Okay, I will never interrupt your religious talk again unless aimed at me. And yes,I know of all my medications, how to withdraw and everything else. I do not wish to be on these meds all my life. It will take determination and support to do so, but eventually I plan to detox off of one at a time, not all of them at once, I am not that naive. For chronic pain sufferers as myself, daily life is a challenge, somedays you just want to cover your head up and stay in bed all day, but life does not allow us to do that.
Aug 5, 2010 at 10:39 a.m.
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pm7988, how common a problem is it for a doctor to not write prescriptions hard enough to produce carbon copies?
I guess such misfortune gives the impression that something unacceptable was done with the originals.
Aug 5, 2010 at 10:34 a.m.
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scooter...., the problem comes when you insert yourself into a religious debate between others and me. If you don't want to be criticized for slamming me, then, don't slam me. You've done this before, and under another screen name. Take your own advice and mind your own business if you don't want to be involved in a particular debate.
As for your five powerful meds, have you checked to see if any of them are contraindicated re: any of the others? And are you well versed on all the harmful side effects of said meds? And what's your time frame for withdrawing from said meds?
Aug 5, 2010 at 10:30 a.m.
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pm7988, you will find a place to be the wonderful doctor you are and your patients will follow, I am sure. Have faith (in whatever religion you chose) and things will work out for you.
Aug 5, 2010 at 10:25 a.m.
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I can't comment on any further course of action.
Aug 5, 2010 at 10:17 a.m.
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Who said I was a bible thumper, gazettefan and it is my prescriptions from my doctor for my pain that you are talking about. I am not ashamed nor am a bible thumper. I have my beliefs, which are none of your business and I take my meds for a reason not for fun. I know in the long run what they do to your body and am seeking alternate routes to help with my chronic pain. You are just teed off because a couple people told you off, that is all! Keep your religion to yourself and we all will do the same.
Aug 5, 2010 at 9:42 a.m.
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pm7988, are you going to pursue your cause of action against Mercy? And would the invoice and canceled check come into play then?
Aug 5, 2010 at 9:22 a.m.
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RevWhite brought religion into this. Religion goes to credibility.
Someone who's religious and on five powerful drugs has a credibility problem.
Aug 5, 2010 at 9:17 a.m.
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Mercy saw the invoice. I don't think they saw the canceled check. It didn't matter to them, anyway, as they were convinced I was doing something wrong, just because I take care of pain patients. Pain patients aren't necessarily criminals, nor are the doctors. What's criminal is the pain and suffering patients have to endure, because of hearsay, lack of education, and false and mistaken beliefs.
Aug 5, 2010 at 7:27 a.m.
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GFan- Please note my friend that Scooter has stated earlier in this blog that she will be trying a different method of pain management so she won't have to take the narcotic pain killers. Admirable.
Aug 5, 2010 at 1:27 a.m.
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very well said chronicinjanesville. My families prayers are with you and yours.
Aug 5, 2010 at 12:59 a.m.
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ALL YOU DOUBTERS TAKE A LOOK AT THIS!!!
I too was a patient of Doc Mannino. I came to live in Wisconsin about three years ago and found the pain management system at mercy a joke. In Michigan (where my back injury occurred) NEVER had me sign anything for drugs. So I come here and have surgery at Mercy. Dr. Sturm, the guy on TV him and Dr.Love. Well when the surgery didn't work, I got kicked to the curb after a year. I was told a year is all the time allowed unless they can perform more surgery on you. I went to Dr. Love's pain management clinic and got treated like I was two years old. The nurses were rude and he said he could do nothing more for me. I found Dr. Mannino. What a savior of the true chronic pain patients. He always took the time to listen and truly cared about my health. Unless you have experienced chronic pain, you should not have the right to comment because you have no idea what you are talking about. The nights spent watching TV at 3am because you can't sleep or do anything else. I work full time everyday and without the drugs, that would not be possible. I told Doc that the goal was to keep me working and he always made sure I had what I needed to do that. I have no idea about the charges against him I know how he treated me versus how all the others treated me. Thank GOD everyday that you do not have to live with dabilitating pain because it is not fun. Most doctors treat you like your drug seekers. Doc never made me feel bad for needing drugs to function. I would drive miles to see him at another practice, that is how much faith I have in him. I hope is exonerated soon.
Aug 5, 2010 at 12:31 a.m.
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Goodnight, everyone and I look forward to reading everyone's posts tomorrow and hopefully we can get back to an intellectual debate or exchange of ideas and opinions. This is not meant toward any one person, if any of my comments have caused this blog to lose some of its meaning. I am sorry and I hope we can overcome the last two days of what some might see as childish, I too appreciate most of your comments and will too try to keep an open mind when reading all of the posts. Sometimes when I see others making comments and judgments against people when they most likely have never experienced the level of pain chronic pain patients live with everyday. However, you all have a right to your opinions just as I have the right to express mine. Thank you to people on both sides of the debate. So again, goodnight to everyone and God bless you all.
Aug 4, 2010 at 11:33 p.m.
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Gazettefan, read the last line of my 11:02 PM post (a reading assignment I know you approve of.)
Aug 4, 2010 at 11:14 p.m.
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scooter...., according to your August 1, 7:54pm post you are on:
percocet
flexeril
xanax
amitryptaline
paxil
Aug 4, 2010 at 11:08 p.m.
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RUSerious, Rev White brought religion into this. As I said before, religion goes to credibility. The more religious a person is, the more they are a liar.
Aug 4, 2010 at 11:05 p.m.
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hooter, your indirect confession that writing posts is difficult for you is duly noted.
scooter...., your posts add nothing to this site that don't amount to vapid musings. Your blind defense of religion is the sort of thing that threatens the world today. You are dangerously over-medicated by your own account.
Aug 4, 2010 at 11:02 p.m.
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Gazettefan, your reply to my comment was cute and not offensive (thanks), but my caps were to highlight what I meant (and a textual raising of my voice); Eyster needs no tribute from me.
I was upset with a capital P***** because this article, and pertinent posts, were important to me because someone very close to me had his life-sustaining prescription (not pain reducing) medications interrupted because of this. Unannounced, without warning.
A letter was received awhile ago with very vague information about the doctor leaving. The person I'm speaking of had ongoing prescriptions, good for a year at a time between visits, and mailed by Mercy pharmacy every 3 months after a phone call. So, the last time they were called in, they never came. They didn't say "We can't honor these". (We had no idea he was fired, he could have moved to Tahiti for all we knew, and we were not informed that his current prescriptions would not be honored. This article, read while he was still waiting for his meds, was the first we knew about it!) They took the order, and said nothing. After they didn't come, a reminder call was made, and again, they said nothing about not honoring it. After one prescription had run out, and having to do without it, another call was made, and the situation discussed, they said they'd take care of it and call back. No call back. Another call was made to the pharmacy and they said, sorry, you'll have to make an appointment with another doctor and get a renewed prescription (with 6 months left on this one.) That was done-we had no other choice. They couldn't even provide another doctor to check the medical records and call in a temporary precription for the one medicine that had run out. Upon picking up the prescriptions, a mistake in one of the medicines was discovered, was rectified, and finally, after 2 weeks without an asthma medicine (with all the ill effects from that) the medicines were obtained.
Now, I ask you, were they still looking out for the patient in this case?
Now, Gazettefan, despite the fact that your continual comments against religion (though irritating to most) may or may not belong under a story relating to religion, (and certainly your right to state in the right place) you should understand why they could be frustrating here for someone just trying to get some more information on the specific story. Don't read 'em, you might suggest? You have to look at them to see what they say, I might answer.
You could point out that other posters may have brought it up-and I don't know because isolated comments can be overlooked, but yours against religion are incessant and never-ending no matter what the subject (as mine are overly long so no need to point it out.)
Aug 4, 2010 at 10:43 p.m.
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Gazettefan, YOU are the one that is overruled here, not me. This is about a doctor who was fired for prescribing meds and giving away samples to a patient. That is what I read anyways. If you are so against the bible and God, why do you have to keep repeating yourself on all these posts? We get it, we got it along time ago. We all understand that you do not believe but you need to stop pushing it onto everyone on here. I truly would hate to meet you in person. The subject of religion seems to be the only one you know. You would be kind of boring to talk to. Keep posting your gibberish and maybe someday someone will read it and not laugh.
Aug 4, 2010 at 10:23 p.m.
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No way gazettefan can have a job! He/she spends too much time on the computer blogging! Over 7000 posts....really??? The Rev has it right, gazettefan loves to stir the pot (probably smoke it too?).
Aug 4, 2010 at 8:47 p.m.
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Okay boys, I respect your comments Gazettfan and Revwhite but it's time to give it rest and stop the debate. Let's get some fresh comments on here about the article and issue. Anyone??
Anyone? Beuller? Beuller?
Aug 4, 2010 at 7:19 p.m.
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I actually have no need to establish anything with you. You try turning every article you post on into a ridiculous debate. I am now done commenting back 2 you. Have a great day, do something productive and God bless you and yours.
Aug 4, 2010 at 6:53 p.m.
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jwhite.., the very meaning of your post means you shouldn't have left it.
Establishing credibility has some people flustered here.
Aug 4, 2010 at 6:16 p.m.
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gazettefan you are obnoxious and nobody should waste thier time reading your posts, its a waste of time and website space. If you dont have anything nice to say, stay quiet.
Aug 4, 2010 at 6 p.m.
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RUSerious, I don't take reading assignments by way of links and I don't give out such reading assignments. And I only tell people to read posts they should have already read. And I tell them to read the bible so they can comment on it with something other than ignorance. When someone repeatedly comments on a post without actually responding to it, it's reasonable to point that out too.
Re: your caps. Nice tribute to John Eyster.
Read my 3:49 post. And when you're done with that, read your bible.
Aug 4, 2010 at 5:53 p.m.
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Rev, how many times are you going to stop doing something before you stop doing it?
Everything you've said in your recent post is a lie. You have no credibility.
Read my 3:49pm post.
Aug 4, 2010 at 5:53 p.m.
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WOW! Who died and left Gazettefan board moderator and religion adviser (with prounion as his understudy) on any and all story subjects he chooses to make his own?? Is that why he can dictate that he doesn't take reading assignments but others must:
"chem....., read my 3:49pm post."
"freeradical, read my 3:49pm post."
"Read your bible"
"Read your bible."
et al
And then has the ***** to dictate how others must comment:
"When you get around to apologizing for not responding to those comments and questions, don't bother. JUST RESPOND APPROPRIATELY TO THE COMMENTS AND QUESTIONS." (caps mine to highlight demand)
Aug 4, 2010 at 5:37 p.m.
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I have apologized several times for any misunderstandings my comments might have made but I am done apologizing because after reviewing my posts there was nothing to apologize for. If anyone wants to see what I have written they are more than welcome to, they will see the truth, and that you are just playing games. I have done a little research and it seems that you are exactly what your screen name suggest, a Gazette fan. The reason I say that is you seem to post to about 90% of all article that are posted to this site and from reading your posts or at least the ones that can be reviewed since you have more posts that are removed than left, it is clear you enjoy confrontation. Having realized this, I will not be responding back to any of your posts from here on out. I see no reason to communicate with someone that makes it a point to start confrontations on every subject he or she comes across. My guess is the reason you do this is to try masking the fact that you do not really have anything of value to say and enjoy getting people away from the more important discussions because your wouldn't be able to follow them otherwise. God Bless and I wish you the best in your future endeavors.
Aug 4, 2010 at 5:26 p.m.
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freeradical, read my 3:49pm post.
Aug 4, 2010 at 5:21 p.m.
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I'm glad most of us understand and sympathize this situation.Religion has nothing to do with medicine. Medicine is real, research-able science. Religion pertains to HOPE, and you do not need to practice religion to find or have hope.Do not confuse hope, faith and religion. This Dr. sounds like a great man, and It's unfortunate he was not able to help more. There seems to be some gray area, possibly some cases where he may have over perscribed medicine, but he seems to have reason. Comatose? Possibly. In pain? Probably not. For people with sever chronic pain, living in a happy comatose state sure beats living in hell and waiting to die, or thinking about ending the pain themselves. In whatever way. As I stated before, people in chronic pain are driven to "find a way" because the pain encompasses their whole life, they are unable to function. Their every thought and desire revolves around pain, how to stop it. I really don't understand why religion has turned into a topic here. I do thank Dr Hobson for his insightful and genuine reply to all of this.
Aug 4, 2010 at 5:16 p.m.
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chem....., read my 3:49pm post.
Rev, I know what you said. And everything I've written in response to what you've said factors in what you said. So, don't pretend that you didn't say what you said in order to avoid responding to reasonable comments and questions.
When you get around to apologizing for not responding to those comments and questions, don't bother. Just respond appropriately to the comments and questions.
Aug 4, 2010 at 4:14 p.m.
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How did this go from narcotics to religion?? Anyways.... I find it sort of humorous that David's last name is Opie.. and the artical is about Opoids... kinda hilarious actually. However, pain is pain, whether it is understood or not. Some people take the meds and then become addicted, and then it's just another kind of pain... it's a vicous cycle... but if you think about it... the world is just full of people telling other people how to live and what's right or wrong.
Aug 4, 2010 at 3:56 p.m.
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gazettefan, once again you are mistaken, no offence but you need to go back and read what I have written. I am not going to keep have discussions with you on religion becaue it no matter what I say you are just going to look for any way to argue or tell me how wrong I am.
To everyone else, thank you for your support and kind words. God Bless you all.
Aug 4, 2010 at 3:49 p.m.
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scooter...., credibility is an issue in this matter. Religion, particularly the bible contains a lot of things that can't possibly be true. Accordingly, if a preacher justifies or denies behavior that is suspect, religion is a valid point of focus here.
If someone believes things in the bible that can't possibly be true, then, his credibility is impugned regarding the main point of the story.
When a defendant or a witness in a criminal trial who cites being religious as an indicator that he or she is credible, he or she is regarded as a liar.
Your objection to the discussion of religion here is overruled.
Aug 4, 2010 at 3:44 p.m.
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Dr. Mannino always made an effort to talk to his patients, sometimes for up to an hour or more during their appointments that are usually only scheduled for 15 minutes. He did this so he could not only explore what is going on in his patients lives to see if there is anything he needed to be concerned about but to also make his patients feel like they were being listen to. I have been treated by a lot of doctors in my short life and so far between Dr. Mannino and Dr. Hobson are the most attentive and caring physicians I have ever had the pleasure of knowing and being treated by. I hope one day Mercy realize what they have lost in Doctors Hobson and Mannino. Unfortunatley, Dr. Hobson is correct, It isn't the hospitals and clinics that are going to suffer, it is and will continue to be patients that suffer.Again I appologiz to anyone that may have gotten upset about I opinioins or how praying for God to relief your pain. It was not my intent.
Aug 4, 2010 at 3:34 p.m.
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RevWhite, your flip-flopping on the efficacy of prayer isn't exactly a ringing endorsement for prayer. When you preached, did you ever talk about prayer in this way to the congregants?
What part of the bible informs your knowledge and preachment of prayer?
Aug 4, 2010 at 3:29 p.m.
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pm7988, what happened when the doctor showed the canceled check to the appropriate Mercy officials?
Aug 4, 2010 at 3:28 p.m.
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I agree with Rev. White about the opioids. No one wants to be on them, but they have no choice if they want to have any quality of life. He is a perfect example dispelling the myths about opioids and functioning--pain is far more impairing! There are also no long-term effects of opioids other than constipation and sexual problems. If there's something better out there than can do the same thing, I'd like to know about it. Remember that all my patients had failed other treatments. Earl in the course of pain, I think all should be done to relieve pain, so as to encourage return to normal function as quickly as possible(think better performance in physical therapy), and lessen the risk of transformation to chronic pain.
Aug 4, 2010 at 3:21 p.m.
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wow! interesting comment Dr. Doug. Where is it that you work now, how is it that you know all about this..... Back on topic.. 1500 Mg of morphine is hospice level pain relief, dying pain relief, not sustainable pain relief. To put it into perspective - that is the pain relieving equivalent to 2,000 Vicodin a day. To tell a doctor that is over prescribing is not only appropriate but necessary to prevent law suits in the future. 200MG of Morphine equivalent is a realistic high dose for any kind of pain control. Dr. should be more careful that he first of all didn't kill someone, second that he doesn't loose his license because although some might say he helped, some are going to say he did damage. To the Gazette who imitated the article, you or the Doc?
Aug 4, 2010 at 3:14 p.m.
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I agree with some of you that there are valid concerns with the prescribing and use of narcotics, if people are misusing them, they should be help accountable to the fullest extent possible. However, just because there are people that misuse the medication, that does not mean everyone one does or will. As far as the pain medications causing people to look their quality of life, I cannot vouch for everyone taking the medication, but I do know from my situation, the medications provide me with enough pain relief to be able to interact with people and do some of the everyday tasks that I did before I had these problems. Finally, I am able to go back to school and get my Bachelors Degree in Criminal Justice Administration and not only am I attending college, I am carrying a 4.0 GPA. If the medications in question did what some of you claim, there would be no way I can be achieving what I am. That being said, if anyone, doctor or otherwise has or can come up with a way to relieve my pain, and I am not even asking for it to all go away, but if someone can come up with a treatment that is legal and works, I will gladly hand over the pain medications without a second thought. I refused to take the narcotics for the first two years I was having the pain and tried every avenue of treatment that my doctors could think of with no relief. It was only after everything else was tried and failed did I accept the opioids for pain relief. As far as checks and balances, I suggested a long time ago that patients with chronic pain that need the opioid prescriptions to improve their quality of life because every other treatment failed to work, should go up to their doctors office everyday to have their medications distributed by a medical professional. That way doctors can make sure the medication is being taken correctly as to help eliminate the chances of them being misused or sold. However, I doubt Mercy or any other medical organization would even consider that. I can not speak for other doctors but I know for Dr. Mannino's patients like me, we did sign a contract saying that we understood the effects that narcotics have on a persons body and agreed to only use the medication as directed, only have Dr. Mannino prescribe, and only use one pharmacy to fill our medications. In addition, we were given drug tests regularly to ensure we were, not only taking the medication we were prescribed but also to make sure we were not using any other elicit drugs in addition to our prescribed prescriptions.
Aug 4, 2010 at 2:36 p.m.
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I don't know where to start after all these posts. Gazettefan, you really need to get off of this religion kick you get on in every article you post on. It is getting really old. You notice thekid laid off on this one. Dr. Hobson was my daughters doctor and she loved him, he helped her a lot, now she sees a physician in Madison. Mercy is digging their own grave lately. People are going to realize how phony and unfriendly they really are. I have inside sources. They are losing patients daily because of this attitude. You would think with a new hospital by Dean being built they would try harder to satisfy their patients, yeah, right!! It seems they are doing the opposite. I am a chronic pain sufferer, I take opiates, I am human, I am a mom and grandmother, I function at a normal level, I drive carefully and guess what? I feel normal when I take my prescribed medication. It does not take all the pain away, but it makes my quality of life tolerable. This ones for you, gazettefan, GOD BLESS YOU ALL!
Aug 4, 2010 at 1:48 p.m.
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Dear Gazette Readers,
I am sure Dr. Mannino thanks you for the outpouring of support you have given - he needs and deserves it.
While I was serving as the Vice-Chairman for the Department of Family Medicine at Mercy Hospital, one of our colleagues described Dr. Mannino as "on a mission" for the care of his patients. I completely agree with this. He was constantly on a mission to provide the best possible care for those that had been abandoned by their health system and did everything he could to help them.
If anyone has ever been sick ...
If ever you have had a family member who is hurting ...
If ever you were confused, worried, scared about what various conflicting medical professionals were telling you ...
If you have been told that your suffering is "within the normal range" or "to be expected" ...
If you have been shuttled between numerous uncaring providers just waiting for you to leave their waiting rooms ...
Then, my friends ...
You will appreciate a physician like Dr. Paul Mannino.
The bulk of my sympathies are not for Dr. Mannino. He is a fantastic doctor, husband, and father, and will do well wherever he decides to practice. The majority of my sympathy lies with the hundreds of Mercy patients that lost - or will never know - his amazing care.
Janesville's sufferers lost an incredible asset this year. I can only hope that other physicians follow his lead in listening, treating, and caring for those who need it.
Respectfully,
Doug Hobson, MD
Family Physician
Janesville, Wisconsin
Aug 4, 2010 at 1:23 p.m.
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gazettefan, again I never said praying was a waist of time for pain relief or anything else. I made a simple statement of opinion, that just because you pray to God for pain relief that does not mean he is going to miraculously make your pain go away, he gives us the strength to find a way to deal with our pain or what ever is going on in our life. It is up to us, we have to make our own decisions in life; we cannot just ask for something and expect it to happen. However, like Dr. Mannino stated, this should not be a debate on religion, I respect everyone else's beliefs and would never presume to dictate to them what they should or should not believe. This is the last comment I will indulge on the subject of religion, as that is now what this article is about.
Aug 4, 2010 at 12:46 p.m.
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Also, a very heartfelt thanks to Rev. White and the others for their support. This shouldn't be an attack on religion or God. I think most of us look to religion to provide strength and encouragement, especially in this sort of situation. Obviously, just because we ask God, or pray, doesn't mean our problems will be resolved. Regardless, we need to remain faithful(think the story of Job).
Aug 4, 2010 at 12:39 p.m.
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Again, the samples were not sold. He was paid with a check. My heartfelt thanks to Dr. Hobson. I, as well as his many patients, feel the same about him. I would never say my way is the only way, but the literature supported it, and patients did well. Obviously, we have a long way to go.
Aug 4, 2010 at 12:13 p.m.
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And are we to suppose that the only time one of the doctors in question got caught selling samples was his only time doing such? I don't think so.
Aug 4, 2010 at 12:12 p.m.
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It's really unfortunate that this doctor was treated this way for trying to understand and be there for his patients but, I am not surprised coming from mercy.It is very diffucult to find anyone that understands chronic pain. No one understands another persons pain calling someone high maint. is really unfair that sort of label always comes from the uncaring doctors it gets put in your file for your new doctor to see and hopefully they will judge you them selves based on really getting to know you. I wish this doctor good future employment hopefully he will find a better system to work for.
Aug 4, 2010 at 12:12 p.m.
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JMO, but I hope for all your sakes who have something negative to say about pain meds never have to use them for any reason! I am a chronic pain suffer, I do not take medicines because they mess up my stomach. I did have surgery for what they could fix but it didnt fix everything. I have to push each day to get through it. I am sure some of you will say something smart like "Well you are doing it without drugs" which is true but my quality of life sucks and it would be much better and I wouldnt miss so much work and my children wouldnt suffer so much if it was better. I do use alternative medicine such as acupuncture, massage and hot tubes but it doesnt help. Not everything is fixable by surgery. SO WHAT DO ALL OF YOU SMART PEOPLE WHO HAVE SUCH NEGATIVE COMMENTS SUGGEST? If you can come up with a good answer, then I suggest you put your money where your mouth is and spread the word. I am sure these doctors would like to know your solutions as well as the patients!
Truth is, no pain mgmt. clinic or drugs can fix anything, but it can help ease some of the pain.I do use a pain killer for my migraines, and most times it puts me to sleep. You people say your sick of hearing the comments about walking in our shoes, well the truth hurts and until you have to go through it you have no idea about it or what its like. I understand the people who are concerned about kids getting ahold of the drugs, but then it is the adults responsibilty to lock up the drugs and be an adult so the kids cannot get them. Thats just common sense! I dont drink and drive, and those on the medications should no better and if they dont then they should have to pay the consequences.
So all of you people please come up with a win win solution so we can all move on and feel better!
Aug 4, 2010 at 12:09 p.m.
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RevWhite: "Its a personnel matter" not personal. Confidentiality prevents Mercy from commenting on about anything, I know of many who are prescribed these meds, entering into these "pain med contracts" and when they are asked to submit a urine test, they refuse, and try to find another doctor, knowing they wont pass either due to illegal substances in their system, or non-theraputic levels of the prescribed meds in their system...meaning they are selling them, not taking them as prescribed or purchasing extra on the street, whatever the case, If I was a physcian I wouldnt want to be the one dishing out prescriptions to the ones putting them out for sale on the streets, some docs dont follow up and keep writing scripts blindly because the patients complain of more pain. I'm not saying this is the case for these patients in the article, but it is the case for SO MANY out there, and as these patients are doped up on prescribed meds, they are driving the streets with my kids, operating machinery, and caring for the elderly....in a daze.
Aug 4, 2010 at 11:58 a.m.
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Rev White, can you cite something in the bible that says prayer doesn't relieve pain?
JWhite, we are only supposed to pray for our own concerns. Can't we pray for the benefit of others? And if not for pain relief, what?
This is all very relevant to the story because a man of the cloth doesn't seem to benefit from prayer re: his pain. That's a shame. Brings those troublesome narcotics into play. Don't recall reading that prohibition in the bible.
Aug 4, 2010 at 11:20 a.m.
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I personally have had contact with one of the patients from the article who has had automobile accidents during the time of narcotic use. They can and are a danger behind the wheel.
Aug 4, 2010 at 11:06 a.m.
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I think there is some good discussion here.
But what is the solution?
Should doctors be able to prescribe as much of a drug as necessary to make the patient comfortable at all cost (even at risk to the public), or should there be a limit and if it causes the patient to be in some amount of pain still then that is just something they have to live with?
I am not in chronic pain, in fact I live every day pretty much pain free except for things I do to myself (sore muscles from exercising, or doing a yard project that involves muscles that don't normall get used), so I am not going to judge anyone. I know some people have a high pain threshold and some do not so everyone is different.
I know that some people are in pain and based on doctor after doctor, no one can tell them why, but they are in pain. No one should have to live in chronic pain if there is a treatment that helps them. However, there is a duty to protect the public from those who fake it in order to get pills and drugs to sell or to abuse or those who do have pain, get hooked on pills and then when the pain is gone still take them and will do anything to get them.
So what's the answer?
Maybe people who need higher doses should be held to a higher standard and be forced to go the extra mile to ensure the public interest is upheld. Perhaps they have to have a nurse come to dispense the meds prescribed to them daily to ensure all meds are taken by the person they are prescribed to (some way to keep accountability of the medication to be sure it's not being sold or given to someone else). Some people may be forced to give up driving, or any other activites that may put others in danger. A small price to pay for those truly in pain who need the drugs to function. They should also sign something saying that they are aware that these high doses of meds will probably cause them to be addicted, damage other organs, or may cause death and that despite the risks, this is how they want to live their lives at NO LIABILITY to anyone but themselves. I don't know the answer.
I do know that this doctor had rules in place by his employer and he crossed them. Also drug samples are normally given out in the office during office visits, not from the front seat of your car in a parking lot.
Dr. Hobson was my personal doctor for 3 years. I have nothing but good things to say about him. He was kind, caring and did a great job for me. I don't know why he got fired, nor do I care. While he was my doctor, I was very happy. I was able to go within the Mercy System and get another great doctor (as they have a WHOLE BUNCH of great doctors there).
So what's the answer to be sure that people living in pain get the treatment they need, yet the public is protected?
And should doctors be able to side step rules put in place by their employer based on their judgement?
Aug 4, 2010 at 10:47 a.m.
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It does relate to this article because these drugs are on the streets and they are only on the streets because of patients who do turn around and sell them for $30/pill. We dont know the statistics of these patients who used them properly, who sold them for profit or abused them themselves. I am sure there is some of all of these people who saw Dr. Mannino.
Also, I am sick of listening to these pain sufferers saying how bad their lives are and how people should walk in their shoes. There are a million people in this country who have it way worse. I was just suggesting everyone remember that.
Aug 4, 2010 at 10:40 a.m.
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wisciowa: Your comment makes a lot of sense ... sort of. The examples you give of problems opiate use can cause are mostly valid, but I don't really see the correlation of those consequences and patients under a doctor's care being perscribed these medications. Most of these patients DO NOT sell their medications or allow them to get into the hands of others.
Aug 4, 2010 at 10:31 a.m.
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Alright, so all the patients in this article talk about how bad their lives are and we should all walk in their shoes. How about the mom of the child who overdosed on these meds? How about all of you pain patients walk in her shoes. How about the child who is born to a mother who is a drug addict, popping opiads, snorting opiads, and even shooting up opiads? Walk in that child's shoes. What about the sole survivor of a car crash, after their whole family is killed, because they got hit by someone high on opiads. Walk in that person's shoes. How about the parents of a young adult who flatlines because they overdosed on opiads. Walk in their shoes. I could go on and on with examples, it happens all the time. These drugs are an epidemic. Anyone in this town can get them on the street, it is very scary. So before any of these people think they have it so bad, please think of others who have it worse. Be thankful you have your lives!
Aug 4, 2010 at 10:20 a.m.
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Lets call it what it is- people upset that the feel good train has left the station. If it was a safe and standard medical practice to pump chronic pain sufferers full of narcotics, it wouldn't be so difficult to find another doctor to prescribe them. Justify and deny all you want, nobody is being fooled.
Aug 4, 2010 at 10:08 a.m.
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Y'all may want to know that dr. Hobson was also fired from Mercy. Perhaps he would like to explain. I know that around that time there was a doctor let go for prescribing too many narcotics.
Aug 4, 2010 at 10 a.m.
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RevWHite, Mercy has not copped out. Mercy cannot comment at this time because this is an ongoing investigation.
Aug 4, 2010 at 9:51 a.m.
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I have asked the same question for some time now....with no answer in sight. I DO believe people tell lies when they are afraid... afraid of what they don't know, afraid of what others will think, afraid of what will be found out about them. But every time a person tells a lie, the thing that they fear grows stronger.
Aug 4, 2010 at 9:50 a.m.
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To gazettefan: No I am not a practicing reverend at this time. School and my family takes my free time right now. I apologize to everyone for bringing religion into this discussion. That was not my intent. I usually say god bless to everyone so again I am sorry if it upset anyone.
On another note, as far as who benefited from the incident in the parking lot that mercy alleges took place as a trade for computer equipment. The computer equipment was paid for via personal check and the insulin was in trade for NOTHING. It is not out of the ordinary for doctors to give their patients samples of medications they need when they have no insurance or their insurance does not cover the needed medication. I have had it done more times than I can count because my insurance wouldn't cover specific medications. I wish everyone would remember that just because Mercy said something happened a specific way, that does not mean it is so. Think about it, if they indeed caught him trading prescription sample medications for computer equipment then he would have indeed been not only breaking Mercy's policies but he would have been breaking the law. Mercy would have been obligated to call the authorities about the situation because it would be a felony. So think about that for a second and then ask yourself if he did what they said in that instance why was there never any involvement from the authorities? So because there was no trade, no one benefited from the non-existent trade. Another thing, if Mercy is in the right then why is it they refuse to comment on not only Dr. Mannino's release from employment, but also refused to disclose what their policies are for prescribing opiates for chronic pain patients? One of their responses to those questions was, "It is a personal matter." That is a problem in it self, an employer is not supposed to fire someone for personal reasons. Sounds like a copout to me. Again, these are just my opinions and I am sure there will be people that agree and disagree with me. Have a good morning all.
Aug 4, 2010 at 9:30 a.m.
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Did any of it make its way into the bible?
Aug 4, 2010 at 9:23 a.m.
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Truth is like the sun. You can shut it out for a time, but it ain't goin' away.
Aug 4, 2010 at 7:31 a.m.
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Rev, is your source of income derived from your reverend status?
Aug 4, 2010 at 7:30 a.m.
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freeradical, read everything, not just what you want to read. The doctor didn't give the samples away. He traded them for a service. In so doing, he swindled his employer and the patient.
Aug 4, 2010 at 7:27 a.m.
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yada, the blankheadedness that you feel when reasonable comments and questions are posed about religion and prayer is cause for concern.
What would you be without your belief. It is that monster that haunts you? It is that monster that makes you run away?
Aug 4, 2010 at 7:21 a.m.
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jwhite..., this sentence makes perfect sense:
"If someone doesn't have the wherewithal to get a loved one to someone such as your doctor, why doesn't god allow prayer to relieve pain?"
Your pretending that it doesn't make sense is avoidant. And you think the bible makes sense?! Read your bible.
It was the Rev who brought prayer into this discussion.
Aug 4, 2010 at 6:21 a.m.
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"In this case only the doctor benefited from the "trade.""
Really? I would say a patient who probably doesn't have or can't afford health insurance probably was benefit. Weren't they meant to be given away? Samples are handed out regularly, permitting you can actually afford to GO to the doctor. Medications and practice are overpriced. This story should spin off on why we can afford to kill thousands of our own for oil, spend billions for AND against ourselves to stay there- yet friends and family at home go sick without medical care. How about them apples?
Seriously there are bigger problems than a doctor taking some samples of meds to give to someone in need, whether he is benefiting from the trade or not. He's also HELPING SOMEONE. Better than money. Health.
Aug 4, 2010 at 6:18 a.m.
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Thank you Dr Hobson for the positive remarks about Dr Paul M. that you have added. I would like to also reply(for the FiNaL tiMe) to GaZEtTeFaN - by saying that I do believe in prayer, but nothing in my remarks here relate to your question. I would imagine after almost 8000 posts at this site that you are a bit confused who you are talking to. I was very curious and looked back on many of your previous comments(which are usually negative or often deleted) and hope that you can find some positive things in your life. Being around and talking to those that are usually negative about life brings you down to a low level feeling. So please understand that I will choose to ignore you regardless of your comments. Try to lighten up a little bit and you will find that your outlook will improve. Low self-esteem, passive-aggressive tendencies, attention seeking, are the usual characteristics of one that may have low level depression - seek some help my friend and it may change the outlook of your life.
Aug 4, 2010 at 4:49 a.m.
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Aug 3, 2010 at 11:59 p.m.
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This is my last post for the night; I would just like to thank those of you that are not just bashing people without really knowing what you are talking about. I hope those of you that are not knowledgeable on the subject prescription opiates and their use on A Typical chronic pain diseases take it upon yourselves to educate yourself prior to judging others, and to remember that everyone's body reacts differently to trauma and medication. Just because a treatment works for on person does not mean it will work for all people with pain. This article was meant to educate the public on the subject and to help find a way to properly treat chronic pain patients to give them a better quality of life with any and all treatment methods. No one is saying that doctors should only use opiates to treat chronic pain, as I have said before everyone that I know that is afflicted with chronic pain would gladly give up the medication for other treatment methods that work. I hope that this blog does not continue to go the way that it is otherwise it may be shut down and then no one gets to express his or her points of view. If that happens than everyone loses. Goodnight and God bless everyone.
Best regards,
Rev. J. White
Aug 3, 2010 at 11:32 p.m.
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He has done the non narcotic, and physical therapy and pain managment through Mercy's Pain center. They didnt work... its not the easy way out. And we are dealing with it. God bless you and your family. I am glad that you've found a way that helps you cope with your pain, but you really shouldnt judge others just becuase your method doesnt work for them. Narcotics were his last resort after many years of trying other methods.
Aug 3, 2010 at 11:29 p.m.
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pain...a very broad subject matter...that which may be perceived as pain by one might well be a simple matter of discomfort by another...difficult problem with nearly impossible answers...
Aug 3, 2010 at 11:24 p.m.
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Actually I do know how pain affects people. I have a very serious back condition where my spine fuses itself together over time. It is very painful. I take non-narcotic meds, do physical therapy and deal with it. I have children, a spouse and work 65 plus hours a week. There are days I am in alot of pain, deal with it, it's life. Also, I get blood work done every 3 months to make sure my non-narcotic drugs are not harming my liver, kidney, etc. Should I take the easy way out, narcotics? I would not remember my life it I went that way. I choose to be in control of my life, not under the influence.
Aug 3, 2010 at 11:20 p.m.
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"have the wherewithal to get a loved to someone such as your " dosnt even make sence. This is not a religious blog. please refer to your bible and pray about stuff that is important to you. he had already said that people do not have to believe as he does... freedom of religion. Move on.
Aug 3, 2010 at 11:17 p.m.
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Wis... that was before he became a reverand. You have no idea how pain affects a persons state of mind. Obviously he didnt do it and found his way through it, a lot of that credit goes to the wonderful doctors that he has had.
Aug 3, 2010 at 11:16 p.m.
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Well, RevWhite..., seems like you expect humans to be more sensitive to the human condition than you expect god to be sensitive the human condition. How can this be? What's the problem with god?
How are those in pain and how are those with loved ones in pain supposed to rationally believe in or respect your god if he doesn't relieve pain through prayer? If someone doesn't have the wherewithal to get a loved to someone such as your doctor why doesn't god allow prayer to relieve pain? Does this really matter to you? Seems like you're not very perturbed about the problem.
If not pain, what things can be affected by prayer? Settling the outcome of football games? Does that question seem snide? I'm actually interested in your answer.
PS Don't refer me to any reading material. Answer in your own words.
Aug 3, 2010 at 11:15 p.m.
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A Rev. contemplating suicide? Two things I don't believe go together...
Aug 3, 2010 at 10:59 p.m.
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gazettefan, to answer you question, no, I do not believe people are ever wasting their time when they are praying to God. I was just saying that in my opinion just because you pray to God to take your pain away that does not mean he is going to miraculously make it happen. I believe he gives us the strength to find a way to deal with and overcome our pain. I apologize if anyone took my earlier comment the wrong way. In my opinion God is all around us and is always listening to our thoughts and prayers, it is up to us to keep an open mind, listen, and watch for his answers. Thank you for the question provided it was truly a question and not just another snide remark. I do not claim to understand everything about God; these are just one person’s opinions, so please do not feel as though I am trying to push my beliefs, opinions or views on any of you. Goodnight and God Bless.
Aug 3, 2010 at 10:34 p.m.
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I do have to agree with Doug's comments. Losing a doctor abrubtly whether a pain patient or not is heart breaking, especially if it was one of those 'one of a kind' doctors that take the time to listen and show extreme compassion for thier patients. Dr.Mannino is NOT the first doctor that this has happened to in the Mercy system, and it is NOT fair to the doctors or the patients.
Aug 3, 2010 at 10:34 p.m.
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RevWhite..., when people pray for the relief of the pain of their loved ones are they wasting their time because god doesn't work that way?
Aug 3, 2010 at 9:49 p.m.
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Physical therapy is meant to make is so that when we do have to do physical activities we are able to without having our pain increasing. I know there are people that are going to abuse medications but not everyone does. If you or anyone else in the medical profession or otherwise can come up with a legal viable alternative that works, I can guarantee all of the chronic pain sufferers I know would gladly give up the pain medications in a second to live a normal healthy life. I think a lot of you might have some different opinions if you were either forced to live with such debilitating pain that you don't even want to get out of bed in the morning, or at least take the time to meet someone afflicted with a incurable chronic pain disease and listen to their experiences or watch what someone's quality of life is like without taking any of the opiate pain medication after they have explored every other medical treatment. Then I am willing to bet if you really listened with an open mind not going in with preconceived notions you would feel a little differently they you do now. I am not saying that you would totally change your views on the subject because I haven't even done that. I am always skeptical of people taking large amounts of opiates for pain relief, but I give them the benefit of the doubt until they give me reason to do otherwise. Doesn't everyone deserve that consideration? Well for now I am done, I hope I have been able to educate some of you on the subject. God Bless and goodnight.
Aug 3, 2010 at 9:49 p.m.
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To TJRockCounty, not that I agree with your statement about Mr. Opie, which I don't, but even if I did, taking your opinions about one person and then assuming everyone else is the same isn't really fair. On another note, I agree that narcotic pain medication can be addictive, however, with regards to chronic pain patients, there has been scientific studies to show that only about 1% of the chronic pain patients taking prescription narcotics to relieve pain actually become addicted. And it seems even though there is evidence to back that statement up, people are trying to say that all of Dr. Mannino's patients are addicts. Not only is that an untrue statement but it is virtually impossible to happen. What are the chances that out of the 1% of chronic pain patients that actually become addicted to narcotic pain killer, that Dr. Mannino somehow ended up treating all of them. Also I agree that in some cases there are other avenues of treatment that can and does relieve pain, such as surgery, trigger point injections, or other non narcotic medications to name a few. However, after a patient has been subjected to all of these treatments and there is no pain relief as a result, what are they supposed to do from there. I can not say what all of the patients motives are for wanting the pain medications but I can say for the ones that I have personally met and talked to, the opiates were only started after all others avenues had been explored. As far as physical therapy being a method for reducing pain, I currently participate in physical therapy and that is not what it is for.
Aug 3, 2010 at 9:20 p.m.
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Dr. Mannino is a great doctor, that cares about me and my family. I did get notice from Mercy, but it was vague, and explained nothing. It took this article to find out what had happened.
Whever Dr. Mannino is, I would like to stay on as a patient. Mercy, good luck, many people will be going to other providers.
Aug 3, 2010 at 8:53 p.m.
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To Dr. Hobson, I would like to thank you for your comments. It is about time that a licensed physician put their opinion in. Unfortunately, I fear that your words may have fallen on deaf ears. Having met and been cared for by Dr. Mannino and having had you as my families physician, I can honestly say I have never known doctors as carrying and empathetic as you two. I hope that one day I can do something to repay both of you for the outstanding medical care and friendship you provided to not only me and my family but to thousands and thousands of the patients you have treated in your careers. We miss you both and wish you both the most sucess.
Aug 3, 2010 at 7:50 p.m.
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I'm sorry Doc but perhaps the other Dr.'s recognized that some patients want the narcotics and nothing else, maybe that's why they were difficult to treat. Too large of a dose of narcotics will KILL you either slowly or quickly and too many people become addicted and dependent on them to the point that they claim it's the only thing to give them relief. There has to be other treatment and therapy, sometimes surgery without the super doses of narcotics.
Aug 3, 2010 at 7:40 p.m.
Aug 3, 2010 at 7:17 p.m.
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Dear Gazette Readers,
I have known and respected Dr. Paul Mannino for many years during my practice in the Janesville area. His medical training, residency education, and professional qualifications are impeccable. Furthermore, he has dedicated his career to the compassionate care of all those in need who presented to him - regardless of station or financial resources.
Paul has always chosen to be a true and caring family physician for his patients. To him, this means that he will always be available for his patients, and will do what his training and experience tell him is best. Numerous times he has used whatever means available (free samples, uncharged visits, home consultations) to circumnavigate the byzantine regulations just to make sure that the patient received the care they deserved. I have personally seen him rail against insurance companies, hospital administration, and clinic managers in order assure the correct care for his hurting patients.
Dr. Mannino was fired because he cared too much for his patients. He took the time to talk to, evaluate, and care for the patients that no one else in his medical system wanted to. These were the patients that had been shuttled around between so many overworked and uncaring physicians after surgeries and treatments didn't live up to their promised outcomes. After countless wasted consultations with yet another uncaring doctor, it was he who answered their calls, held their hands, and treated them when no other physician would.
After his abrupt firing, hundreds of patients were left without the only doctor that truly cared for them - and that is a tragedy. This tragedy was compounded by a medical system that did not take responsibility for their ongoing care and allowed them to suffer needlessly. They did not have protocol in place to stand in for the excellent care given by Dr. Mannino, and the prior comments reflect that.
Dr. Paul Mannino is an outstanding physician, and one that I hope young doctors in training continue to look up to. If you, or one of your loved ones, encounter such a caring advocate for your health and life, I strongly advise you never allow a "health system" to take them away from you.
I know that Dr. Mannino will continue his career with the dedication to those patients who are truly suffering and need his excellent care. It is sad that none of those deserving patients will ever be from Mercy Health System again.
With The Utmost Respect,
Doug Hobson, MD
Family Physician
Janesville, Wisconsin
Aug 3, 2010 at 6:58 p.m.
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Gazette staff:
Might you care to comment on Mr. Opie's 'double felon' status? When one of the very few patients highlighted in your tear-jerking article is revealed to be a felon who then chooses to possess and conceal the identity of a firearm (an additional felony), doesn't it reflect poorly on your research? I'm normally your biggest defender but feeling duped right now. A short follow-up to your article would be most responsible IMO.
Aug 3, 2010 at 6:36 p.m.
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That's just ridiculous behavior after spinal fusion. Where is the common sense? or has that been altered by the drugs as well!
Aug 3, 2010 at 6:33 p.m.
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I think the Rev boogied.
Aug 3, 2010 at 6:30 p.m.
Aug 3, 2010 at 6:23 p.m.
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yada, how 'bout praying for the relief of pain? Does it work?
Aug 3, 2010 at 6:21 p.m.
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Rev, answering prayers for the relief of pain is not how god works? But prayer works in the matter of someone else's maturity problem?
Aug 3, 2010 at 6:17 p.m.
Aug 3, 2010 at 6:17 p.m.
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I have known Paul / Dr Mannino for many years and I feel very comfortable when I say that I have the greatest confidence in his ability as a physician. He has always been a good listener and he asks questions that indicate to me that cares about those that are making appt. to see him. Paul without a doubt has two qualities that I feel are of the utmost importance in a physician - empathy and compassion. Paul is originally from this area and has obviously come back to Rock county because he cares and wants to make a difference. Dealing with patients that have serious pain issues in not a easy task. Matter of fact, you can see by what is unjustly happening to him that he is caught between a rock and a hard place when dealing with the multiple issues that each and every patient brings. Those that have let him go at Mercy have lost a physician of integrity and now they will do their best to make it sound like he is totally wrong. I am so very happy that St Mary's Janesville Hospital is in the construction phase and will soon be completed. In closing, I can honestly say that Paul has always put the welfare of his patient number one.
Aug 3, 2010 at 6:13 p.m.
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His record makes me question his motives to get more meds. Could he be selling his meds? It's a posibility, especially if he has a felony record.
Aug 3, 2010 at 6:09 p.m.
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The answer to you question, no prayer does not "handle" the pain, God does not really work that way lol. Now who is throwing insults? I wish you all the best.
Aug 3, 2010 at 6:07 p.m.
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C'mon, Rev, you think prayer is going to help someone with what you think is a maturity problem, but it won't handle your pain?
Aug 3, 2010 at 6:06 p.m.
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I understand that and to a degree agree, but without knowing all of the facts with this particular person I do not think it is fair for any of us to pass judgment on him.
Aug 3, 2010 at 6:05 p.m.
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Rev, prayer isn't handling the pain?
Aug 3, 2010 at 6:05 p.m.
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gazettefan and TJRockCounty, if I insulted either of you I apologize and wish you both the best. I may be a reverend but I am still human. Seeing people pass judgment on people without really having any clue of what those people deal with everyday tends to upset me. I know that is no excuse for being rude and again I apologize. Best wishes to both of you.
Aug 3, 2010 at 6:04 p.m.
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When the pain is subjective to any degree, criminal problems call credibility into play.
Aug 3, 2010 at 6:01 p.m.
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I am not sure how his record has anything to do with his pain issues. His medical records clearly show his injuries, and causes of his pain, not to mention if you look at the records you are refering to, I can find dozens if not hundreds of people that are not chronic pain sufferers with the same or worse offences against them. However, I still do not see what that has to do with the subject at hand, and another thing, I can tell you being a pain patient myself, he does not want yours or anyone elses pity. All we want is to be able to live as normal a life as possible with the least amount of pain as possible. I respect you opinion but I do not agree with it.
Aug 3, 2010 at 5:56 p.m.
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Rev, at least an insult didn't follow the well wishes this time.
Aug 3, 2010 at 5:53 p.m.
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I find it extremely difficult to have pity on this man (David Opie) when I see his name listed in the arrests column in today's paper being charged with a felony.
Aug 3, 2010 at 5:48 p.m.
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Yes we are related and it was not ment as an insult, it was an opinion based on the comments. Thank you for asking though.
Aug 3, 2010 at 5:46 p.m.
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And the maturity bleeds through. However, I am not going to continue to respond to you if we cannot have an intelligent exchange of ideas and opinions, I wish you the best in life sir.
Aug 3, 2010 at 5:45 p.m.
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hhhhmmmmmmm doesn't sound like a real Reverend to me...
Aug 3, 2010 at 5:44 p.m.
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Are the two "Whites" related?
LOL, TJRockCounty.
Will the insult follow the prayer, Rev?
Aug 3, 2010 at 5:42 p.m.
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No I don't. Please don't condemn me to he** because of it.
Aug 3, 2010 at 5:41 p.m.
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Anyways.. to all the pain patients and to Paul.... you are in our continued Prayers.
Aug 3, 2010 at 5:40 p.m.
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I am sorry, I am just trying to educate people like you that are clearly ignotant to the subject. I wish you the best I will pray that you GROW UP!
Aug 3, 2010 at 5:38 p.m.
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when there is an actual comment made to defend the pain patients you have nothing more itellegent to say TJ?
Aug 3, 2010 at 5:36 p.m.
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Doctor or drug dealer? You decide. What's up with the lengthy disertations Rev? This is a blog not an essay contest.
Aug 3, 2010 at 5:32 p.m.
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In saying everything that I did, I just want to add; I hope and pray all of the people that are making the negative comments never have to experience the pain that we live with everyday. Even though I know that if they did, they would have a different outlook on the subject. I know this because I used to be them, ignorant of what chronic pain is and how debilitating it can be. To all of Doctor Mannino’s former patients, do not give up; keep fighting for your life. I know some of these comments are going to upset us but remember that these people that think they know everything there is to know about the subject are just ignorant on the subject and maybe if we keep fighting we can help educate them. I will continue to pray for every one of you and hope that all of us one day can find a cure for our ailments and to Dr. Mannino, I would just like to say thank you for everything you have done for me and the countless others you helped and I am sorry it continues to cost you. You too will stay in my prayers.
Aug 3, 2010 at 5:30 p.m.
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For all of you wondering, I went to UW-Madison for my undergraduate degree(biochemistry and molecular biology), and stayed there for med school. Much of pain management has its roots in Madison, and Dr. June Dahl, whom I have the utmost respect and admiration for.
Aug 3, 2010 at 5:23 p.m.
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There were never any controlled substances in the sample or supply room--they are locked up in a place I'm not aware of. The diabetic patient was paid by check for computer work, and was given insulin samples because he had no insurance. I have over 170 hours of medical education on pain management, and scored in the top 10% in the nation on my boards. My goal was to dispel myths, and educate patients and the public about the millions who are suffering needlessly with chronic pain. I was trying to offer relief, based on the medical literature, and with the support of major medical organizations(e.g. AAFP). Obviously, this is a controversial topic, and I don't expect everyone to agree with me or my patients.
Aug 3, 2010 at 5:21 p.m.
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Most of those patients had been on opioid therapy for many years. Of the whole group, very few showed any signs of drug abuse, drug craving, or drug-seeking behavior. Every one of these cancer patients was dependent on their medication. However, their physical needs were worlds away from addiction. Addiction is a biological and psychological condition that compels a person to satisfy their need for a particular stimulus and to keep satisfying it, no matter what. It is a compulsive behavior that demands more and more drugs, regardless of the consequences that lead to dysfunction. A person who is addicted to opioids has a disease that undermines optimal function and drives one to compulsively use a drug, despite the negative consequences.
The pain patient who is effectively treated with opioids finds life restored-even if he is dependent on them. With the pain muted by stable and steady controlled use of long-acting opioids, a patient can reclaim his life, go back to work, return to family life, and pursue favorite pastimes. Dependence is a physical state that occurs when the lack of a drug causes the body to have a reaction. Physical dependence is solely a physical state indicating that the body has grown so adapted to having the drug present that sudden removal of it will lead to negative consequences such as a withdrawal reaction. This can occur with almost any kind of drug. A good example of dependence is a heavy coffee drinker's use of caffeine. If you are used to drinking several cups of coffee each day, you soon learn about physical dependence when you miss a day or two. This does not mean you are addicted to the caffeine; it only means your body is surprised not to see what it has come to expect. In the case of opioids, a certain amount taken every day fills the glass, and no more may be needed or desired. If the medication is removed, the consequences are physical (sweating, running nose, diarrhea, racing heart, or nausea), not psychological. As any diabetic will testify about insulin, or any heart patient will testify about blood pressure medication, dependence is not necessarily indicative of addiction or drug abuse. In fact, regular use of these medications may be essential for good health.
The difference between a patient with opioid addiction and a patient who is dependent on opioids for chronic pain is simple. The opioid-dependent patient with chronic pain has improved function with his use of the drugs and the patient with opioid addiction does not."
Aug 3, 2010 at 5:21 p.m.
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Now I am not saying that I agree that opioids use to manage pain is the first or only course of action, in fact I believe like me, people should avoid them if possible. I have been seen at Mercy and UW’s Pain Management Clinics. I had trigger point injections, stellate ganglion blocks ect., none of which relieved my pain. I have also tried all kinds of different non-narcotic medications commonly used to treat chronic pain and again they had no effect. Like many pain patients, only after I tried all other avenues of treatment did I start getting treated with opioids to manage my pain. I honestly know that if it were not for Dr. Mannino, I would not be here today. It is easy for people that have never been in our position to pass judgment on us but I just ask that before you do, make sure you understand the complexities involved. I would like to just say that to the people that are throwing words like addiction and addicts out there, you might want to educate yourselves before making statements you do not understand. Less than 1% of chronic pain patients taking opioids become addicted and it seems a lot of people are confusing addiction and dependency so to those that are confused here is a link to an article written by a pain expert, Dr. Scott Fishman;
What is the difference between being addicted and being dependent?
Fear of addiction has prevented many physicians from prescribing needed pain relief and many patients from controlling their pain and reclaiming their lives. Pain doctors have known for years that taking opioids over long periods of time for medical reasons does not have to lead to addiction. More than a decade ago, neurologist Russell Portenoy, who was most recently President of the American Pain Society, reviewed studies of almost 25,000 cancer patients.
Continued in next post
Aug 3, 2010 at 5:20 p.m.
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My name is Rev. Jason White, I was diagnosed with incurable disease known as Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome, as well as several other debilitating conditions that cause me an enormous amount of pain. I am a former patient of Dr. Mannino and I am truly heart broken for what has been done to him. I started having pain in February of 2004 and it has been unrelenting since. I have seen more doctors then I can even remember, trying to find the cause of my pain and fix it. I let the doctors try everything the could think of the help minimize my pain excluding the use of opioids because I was afraid of addiction. So even though none of the non-narcotic medication were working I still refused the opioids for almost two years and was in constant pain that I can not even begin to describe. My pain got to the point I could not get out of bed less much care for my children. I finally gave in and tried using opioids and my pain levels started to get lower. Because of the opioids, I am able to interact with my family again and have some sort of normalcy in my life. Now right now I am not where I was before the pain started but I am on my way there. I am in college now getting my Bachelors Degree in Criminal Justice Administration and so far have been carrying a 4.0 GPA, all while taking opioids to manage my pain. I do not deny that there are people out there that abuse prescription narcotics and they should be held accountable for it, but to stick everyone that takes them with the stigma of they must be addicted or junkies or what ever it is people want to think, is wrong. I have told every doctor I have seen since all of this started that I am more than willing to give the opioids up, if they can relieve my pain another way. I do believe it is a excellent idea for pain patients taking opioids to participate in physical therapy and to see a psychotherapist to help with the their pain management. I know from personal experience that talking about it does help. People with chronic pain sometimes feel like they are alone in the world, which can cause stress, and depression, both of which can cause pain levels to increase.
Continued in next post
Aug 3, 2010 at 5:20 p.m.
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TJ, thank God (hahaha, yes I said God) your blogging world is perfect! I was sooooo worried about that!
Aug 3, 2010 at 5:06 p.m.
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Scooter, Gazettefan, Billnewbie, Janesvillean, thekid, SarahB, and Beeferer are all perfect in my blogging world!!
Aug 3, 2010 at 5:03 p.m.
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I've grown tired of the countless spouses on this blog who think their narcotic-taking significant others have been saved by this Doctor. You're in denial right along with your spouses (who probably know perfectly well they're addicted) if you think narcotics improve the quality of life. Why don't you research the long term effects of narcotics on the web, you may think a lot differently about quality of life.
Aug 3, 2010 at 4:57 p.m.
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treeandcoon, that's a very good question! Let us remember that science has proven long term use of narcotics, which attacks the brain and damages key parts of the cerebral cortex which in turn, alters the patients capacity to exercise judgment and inhibit impulses.
Aug 3, 2010 at 4:39 p.m.
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First of all, my husband is a pain patient of this Dr. he is a wonderful person and is one of the few that takes the time to listen to his patients. He shows compassion and really tries to find a solution for people to have meaningful lives, where they are able to actually control the pain and function almost normally. I don’t know all of his pain patients personally but I can say that with my husband the medications work, he is a great father of two and in no trouble with the law. He is going to school for his bachelors degree and to cope with the stress side of pain he does see a psychologist, which I recommend all pain patients do. It helps him a lot. Without this doctor and these medications my husband would have way less quality of live and not be able to do nearly what he is doing now. Just wanted to add my comment to the list. - Gina, Article was very well written thank you for putting so much time an effort into it, it is appreciated.
Aug 3, 2010 at 3:40 p.m.
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And scooter are you perfect. No don't think so.
Aug 3, 2010 at 3:39 p.m.
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So I guess I don't need a medical degree now do I
Aug 3, 2010 at 3:38 p.m.
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No I do not have a degree about this, but I do know from some people that went thru it. So seen it first hand. They are doing very well. The drug in my opinion should be taken until the withdrawls subside, along with intense counciling. If you quit cold turkey you suffer with the withdrawl and that is about 14 to 30 days. I myself have been thru it both ways so I DO KNOW!
Aug 3, 2010 at 3:02 p.m.
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nailqueen didn't leave a comment that would require a medical degree.
Aug 3, 2010 at 2:52 p.m.
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A physician should treat his patient to the best of his ability, understanding and knowing his patient's history, medical complaint, and any possible side effects of drugs prescribed. That being said, there are 3rd party observers to what a physician does in relation to prescribing narcotics. Family members, the FDA, pharmacists, and supervisors in the health system over that doctor. It appears that at least 2 of those groups raised red flags...some families and the supervisory health group.
In the end, we have to trust that the system worked.
As for drug seekers, I feel very sorry for doctors who have to walk a fine line between good care of patients and preventing drug abusers from gaming the system. In my own personal experience, I was seen at the Mercy ER for a fall and injured wrist. It was visibly swollen and still the ER doc was abrupt with me. As soon as she said she would go write a prescription for pain killers and I said I couldn't take them and would self-treat with motrin & tylenol, she became MUCH nicer to me. Not the best way to handle the situation, but I understand where she was coming from. It is an epidemic that affects everyone because docs have to be very careful with dispensing scripts for hardcore pain killers.
What a mess.
Aug 3, 2010 at 2:45 p.m.
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Yes, I would like to know the same thing, when did you get a medical degree, nailqueen? Seems to me you need a spelling lesson also. It is a program that should last a year. Look it up. WebMd has lots of info. And, thank you, wiggle.
Aug 3, 2010 at 2:33 p.m.
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Kciraryal: Why would he post it then?!! Especially knowing it would someday harm his credibility!
Aug 3, 2010 at 2:18 p.m.
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There's an ad for drug rehab centers following this article for anyone that needs it.
Aug 3, 2010 at 2:17 p.m.
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nailqueen- what year did you get your medical degree? When addicts go into rehab, Soboxone is given for up to a year. It helps the addicts while they relearn how to live life with out painkillers or the withdrawl. Then they are weened off the Soboxone SLOWLY so withdrawl is next to nothing. Get your facts first.
Aug 3, 2010 at 1:19 p.m.
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Soboxone is just a crutch and if the person taking don't have it they will find either opiates or H. Once that soboxone is out of your system the body is sick, hurts, gut rot. hot and cold sweats and will be irritable till the next fix. Hopefully she really wants to stop. And for soboxone therapy shouldn't take any longer than 2 weeks to a month...and that pushing it.
Aug 3, 2010 at 1:19 p.m.
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treeandcoon, IF that is true, I now completely understand his search for another doctor to continue prescribing his narcotics! IF that is true, he has no right to expect sympathy and compassion for the state of his condition because he has 'chosen' to hurt himself more! Ah, but will we ever hear the whole truth?....doubtful!
Aug 3, 2010 at 12:55 p.m.
Aug 3, 2010 at 10:56 a.m.
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shman010, you are right. Suboxene works for my daughter. She was never in chronic pain, just got hooked on opiates. So she is now in the suboxene program. I pray for her daily. It is supposed to decrease the need for opiates in your system. Thank you for mentioning this.
Aug 3, 2010 at 10:38 a.m.
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chelleandlou, I also ask, where did you go to college or medical school? Just asking. And gazettefan, I agree with the improper way this doctor handled this. I remember when a doctor could give out samples of almost anything, even narcotics, now they cannot. I don't know why. Even like amoxicillin, I know when my kids were young and I was poor, the docs would give me enough samples to make it. They don't or can't do so anymore. Chronic pain is a pain in the a$$ to live with, but with the proper treatment and medications, you can make it atleast tolerable.
Aug 3, 2010 at 10:32 a.m.
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This article seems to confuse the issue about what exactly happened with the insulin/laptop incident. First it says that Manino paid the patient for fixing his sister's laptop, then it says that Mercy said that he was observed trading drugs for electronic equipment. If he was observed paying the patient for fixing the computer, then he wasn't exchanging drugs for electronic equipment in the manner that Mercy is suggesting since he paid for the repair work and his sister owned the laptop to being with. Obviously Mercy's investigation was unable to prove that he actually exchanged drugs for electronic equipment since he wasn't fired at that time.
If the problem was that he wasn't "consistently" following Mercy's guidelines for prescribing pain meds, then why didn't Mercy allow him to phase pain treatment out of his practice? Perhaps he wasn't "consistently" following the guidelines because he treats patients on an individual basis, instead of by some regulation book Mercy concocted. Maybe we can just have health care performed by robots that ask your symptoms and follow a predetermined flow chart to figure out what's wrong with you. No personal attention needed. Since there is no mention made of any change in the status of his medical license or in criminal charges, the problem here seems to be that he wasn't following Mercy's policies to their satisfaction, not that he was grossly negligent in treating his patients or breaking the law. If that's the truth, that may give Mercy grounds to fire him, but it doesn't necessarily make it right.
The examples Mercy provided regarding his conduct are dated 4 and 6 years ago, I'd say the whole issue is highly suspicious given that Manino had filed some other suit (not detailed here) against Mercy at some point. I hope it is thoroughly investigated by the DWD to determine if this firing was retaliatory.
Aug 3, 2010 at 9:58 a.m.
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That is: In the matter of the hospital and the doctor, only the doctor benefited.
True, the patient benefited, but the patient would have benefited had the doctor merely given him or her the samples for nothing in return. As it was, the patient's benefit was adulterated due to the fact that a service was required in exchange for the samples.
Among the principals, the hospital, the doctor, and the patient, only the doctor benefited without a negative. Except for getting caught.
Aug 3, 2010 at 8:06 a.m.
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In this case only the doctor benefited from the "trade."
Aug 3, 2010 at 8:04 a.m.
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From the story:
"Mannino served a two-week paid suspension in 2006 after he said three copies of prescriptions he wrote didn’t copy through the carbon to make duplicate copys and because he paid a patient in the parking lot for fixing his sister’s computer and gave a bag of sample insulin to the patient, who had no insurance.
According to Mercy’s documentation, Mannino was observed taking medications from the “shot room” and giving them to the man in the parking lot in exchange for electronic equipment."
Is it legal and ethical for a doctor to trade drug samples (property of the hospital) for anything of value whether or not the hospital benefits from the trade?
Aug 3, 2010 at 8:01 a.m.
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For chronic pain sufferers, quality of life is important. There are other routes to go, but to each their own. You are the master of your own life, you make your own decisions. If you want to take some opiates to increase your quality of life, by all means, go ahead.My biggest gripe with all of it is the amount the pharmaceutical companies make off all of this. The insurance problems. The people who don't even have the option because medicines are such a soft monopoly. They are expensive for those is need, especially considering most of those in need cannot work.
If your pain merits opiates, by all means, use them. I have talked to a number of people of all walks of like with chronic pain. Some of them do opioids coupled with massage therapy, etc. I ask them if the pain is manageable without it. For those who say no, I ask them what they would do if they had to live with the pain all day, every day. How would you cope? How would you live? A Resounding "I would find a way" is what I've heard. And for many, that doesn't mean LIVING with the pain. Understand? To each their own, who am I to say what someone else can and can't do? It's not my body, my pain, my money, my life.It's theirs.
Aug 3, 2010 at 7:27 a.m.
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Well, if they're not taking the drugs and they're not functioning, are the drugs so bad? Before you swing that judgement around, perhaps you should look at the other side of it. Opiods often make people drowsy, but pain also keeps people from sleeping. If I had to choose between pain and sleep, the answer is pretty easy - I don't like pain.
But that's not the point. You've also got to look at the life they led before they took that pain medicine. If they're unable to walk to the store or drive a car or even work, is that life better than a little drowsiness?
It's funny how some people think that by reading a few lines in the paper are enough to convince them that the people they talk about are addicted. Where exactly did you earn your medical degree?
Aug 3, 2010 at 3:27 a.m.
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You can't tell me that these people are or were addicted to the medications this irresponsible physician prescribed. I'm glad he was fired. I wonder how many of his patients became addicted to these powerful medications. Anyone who relies on these drugs, as well as other addictive drugs and medications, to function are addicted. They may think they're functioning...but are they or is their mind clouded?
Aug 3, 2010 at 12:13 a.m.
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Mercy is just terrible I was in their care for years and at the end I was on so many prescriptions I was spending over $850 a month out of my own pocket after insurance and was still in pain 24hrs a day, I switched to Riverview and within 3 months of seeing my current Dr. I was off almost all of what Mercy had me on and am pretty much pain free and am just glad to have my life back. If I had stayed with Mercy I am certain that I would've probably ended up dead, as I since found out that one of the prescriptions I was on was at almost a toxic dosage (confirmed by my current Dr and my pharmacist at Walgreens) Mr Opie I would strongly suggest trying Riverview before going all the way to Milwaukee, I know several people that have switched and are in better health now as a result. People just remember this, when a person graduates from med. school and does his residency he is a Dr. and like every class there is someone at the TOP of their class, and someone is at the bottom of their class, that said I wonder why Mercy is content on filling their staff with the later of the two..... It will be so nice when Dean Care finishes the new hospital. I'm just lucky I was able to escape with my life!!! I also hope Dr. Mannino finds a new home soon, Paul is a really nice guy and is just ahead of where Mercy is at as far as pain management goes, he has done his work and has been schooled in this (I'm sure those who make policy have never even seen the inside of a pain management class room) I could go on and on about this but I'll leave you all to your thoughts! Good luck David Opie, Jason White and Lisa Rasmussen. have faith their are Dr's who can help you, all you have to do is get away from Mercy and their lack of care for patients.
Aug 2, 2010 at 10:57 p.m.
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Medicine USA style anyone who needs pain relief is a drug addict and any doctor that cares for their patients is a dealer.Same old story, fools believe the anti-drug baloon juice and people with real problems suffer. Makes you want to move to a country with more intelligent health care and drug policies and kinder people.
Aug 2, 2010 at 10:44 p.m.
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Don't assume that every comment here that is against narcotics use is from a person who has no idea what chronic debilitating pain is, because that assumption is wrong. Furthermore, once we realize that imperfect understanding is the human condition, there is no shame in being wrong, only in failing to correct our mistakes.
Aug 2, 2010 at 10:30 p.m.
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I fired a doctor from Mercy because he had a bad attitude, poor bedside manner, and implied that I was a "drug seeker" (after seeing him 3 x's). Thankfully, I found another doctor in the Mercy system, who knows what he's doing and follow's the Mercy system protocol. A lot of people judge those of us who are in legitimate chronic pain based on their so called research. Notice how the majority of those who judge don't even have chronic pain? I say, walk in someone else's shoes for a week - or 2 days; then they would know what chronic pain is like.
Also, why do insurance companies rely on the decisions of people who aren't doctors? They have too much power to approve or deny claims, surgeries or prescriptions. I've been on a medication for years, and because I have to use the mail order RX program, the company sent me a letter saying that I was not qualified enough to be taking the same medication.......WWWWWWHHHHHHAAAAATTTTT?
Aug 2, 2010 at 10:29 p.m.
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First of all, the doctor was NOT passing pain meds in exchange for electronics. He was giving the diabetic man INSULIN because he didn't have insurance, for fixing his sisters computer. This is obviously a very caring doctor (one of the few) who really wants to help people. And if any of you have never sufferred with chronic pain then you have no business posting on this page. Get Out.
Aug 2, 2010 at 8:17 p.m.
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If a doctor is breaking policy meant to keep patients safe and passing pain medication in exchange for electronics in the parking lot, gee, maybe I don't want him as my doctor. Maybe I should be grateful that the system has high standards for the doctors they employ and has let the substandard go. Perhaps I should raise my own standards and choose a quality doctor to treat my health issues.
Do you get it now?
Aug 2, 2010 at 6:51 p.m.
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I agree with the posts that mercy has turned its back on Maninos patients I was a patient and now have no doctor and no luck finding a doctor...I am a diabetic who can wait months to see the doc at the diabetes center but you had better know what your doing in 2,3,4 months or never miss an appointment because they will kick you to the curb as well. I am sorry but Manino was a good doc, I am not on opiates, and thought he did a great job with the issues I had, I certainly do not condone the treatment I have gotten since they let him go, I think its a shame that they can turn their backs on people...can not wait till the new hospital opens..I will move my family to those doctors..they sure cannt be worse than the treatment we are recieving now
Aug 2, 2010 at 6:50 p.m.
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For the people that need to get off pain med they should try the suboxone program it probably saved my life and i had a close friend that had chronic back pain and was on an outrageous amount of pain pills and went through and completed the suboxone program it really helped us.
Aug 2, 2010 at 6:27 p.m.
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this man,(dr. mannino was my husbands doctor for years,he saved my husbands life.my husband had a brain tumor an no one else would listen to him about his headaches,but dr.mannino,my husbands tumor was bleeding by the time,they started the surgery,he could have died,paul didnt do pain management long with my husband,but he treated his other health issues,such as his diabetes,etc:he suggested my husband go to pain management,he thought it would be better,because dr.love gave injections also,which is great,because they work a lil while for my husband,but omg!!! a couple of those nurses had no idea what they had comeing when they started talking to my husband,with smart ass attitudes,an just rude as can be,lol,im still laughing,my husband let loose on them an i dont think they will ever forget it.an we filed a formal complaint with the director of nursing,even dr.mannino thought it was funny.its sad you get sick to your stomach,everytime you go to pain management,because of the way some of the nurses treat you,an thats what gives dr.loves team a bad name,because he truly is a great doctor. some of the patients that went to doctor mannino,were way over prescribed,an heres one that really gets me.if your taking heavy duty pain meds anywhere from 4 to 6 times a day,what in hell do you need a pill for this so called break thru pain,that one made me laugh,thats why we have so many problems with opiates,people think that they need a pill in between the six they already have taken,lol.
Aug 2, 2010 at 5:57 p.m.
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"They need a doctor who is willing to find the source of the pain and treat it without turning the patients into addicts who can't live without narcotics. This really IS possible, IF the patients really want to be helped." This is a rational comment spoken like someone who has never experienced chronic pain. Ashley said in the article, "I don’t feel there should be a fear for a physician to prescribe to their patient for a legitimate need.” Also nice in theory, and yet here is a Dr. who prescribed what he felt his patients legitimately needed, and he was fired. That would tend to make a physician fearful! The article mentioned several times that this is "a matter of trust," and yet the trust has to go 6 ways: Administration > < Physician > < Patient. In this case the Physician and Patient had trust in the treatment. The break-down is between the Administration & Physician. If the insurance companies aren't telling doctors how to doctor, the administrators are.
Dahl says, "If they’re taking a drug and not doing anything with their lives, then the drug is doing them harm." If the patient is taken OFF the medication, and can't do anything with their life because they are in so much pain, then NOT having the medication is doing them harm. And isn't the physician's creed, "Do no harm?"
Dr. Maninno tried to get out of pain treatment and they wouldn't let him. He tried to treat his patients as he felt best and they fired him. He was my dr & now that he was forced to leave, my family has switched to Dean. My elderly mother suffers from chronic pain and Dr. Maninno is not her dr, but can we expect the same "mgmt control" of the doctors who DO treat her? And when her needs don't meet their "guidelines," what can we expect? That they are going to whithhold treatment from her because they are afraid she's going to be an "addict?" Addiction is not always the worst case scenario. HER drs know she's not looking for a buzz. She has several health issues, which limit the treatment options available to her, so "This really IS possible, IF the patients really want to be helped" doesn't really apply. They know the sources of her pain. They are chronic. They don't have a "cure." If her choices are living out her remaining few years in constant debilitating pain, or living them out as an "addict" at a manageable level of pain -- if achieving that is even possible -- I'd reather she was an addict, and "doing nothing with her life" other than being able to make it through the days, I"m for that.
Aug 2, 2010 at 5:40 p.m.
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welcome TMF...new peeps joining daily...email me and let me know when you would like your 'new team member' bong rip...;)
Aug 2, 2010 at 5:25 p.m.
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...and speaking from experience with someone who went through unbearable pain after having the vertebrae in his spine removed, his spinal cord cut open, a tumor removed from the area where the spinal fluid is, then had his vertebrae fused back together and held his place with pins and wires, and was stitched back up leaving a 10 inch scar, I can tell you a little bit about the effects of pain medication. Anyone that has ever been through anything like this can tell you that the doctors tell you over and over that the most important thing is that you take your pain meds while you're recovering because if you do not, you will not be able to function. If you are in too much pain to do your physical and occupational therapy you cannot get better. My husband had to relearn how to walk and wouldn't have been able to do so without serious narcotics. To the average, normal, healthy person the amount of pain meds he was taking hourly would have knocked them out completely. The difference is that when you actually have pain that requires those kinds of doses it doesn't give you a high. It doesn't make you impaired. It treats the pain. If it did in fact make you high as a kite and inebriated they wouldn't require that you take your dosage before going to the physical therapy gym. The people that are intoxicated by the meds are the people that don't need them. Continuing to spout out examples of people you know that abuse pain meds is completely irrelevant unless they were being treated by the physician in question.
Aug 2, 2010 at 5:14 p.m.
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Im on team kid. If people have pain they should look into pot. It is so safe that SNORE.........................SNORE........................SNORE........................................SNORE
Aug 2, 2010 at 5:01 p.m.
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In my opinion, unless you have personally met Dr. Manino and been treated by him you have no business judging is professionalism or quality of care. I was seen by him in an urgent situation when my normal physician was on vacation. I found him to be more thorough and engaged than most physicians I have seen. I was so impressed by him that I referred a number of people to him, including my husband when he starting having chronic back pain (as my physician was not taking new patients). Dr. Manino did and exam and ordered physical therapy for my husband. He did not prescribe pain medication. He gave him instructions that if the pain did not get better, or got worse, he should be seen again. The pain did in fact get worse. Dr. Manino listened to the progression of my husbands symptoms and quickly recognized that it was not a typical back problem. He ordered an MRI which found a rare spinal tumor. It was not until after the tumor had been found and it was clear that there would be no relief until surgery was done that Dr. Manino prescribed pain meds and referred my husband to a neurosurgeon. Those pain meds were necessary for my husband to be functional and be able to sleep even a few hours at a time. Dr. Manino only prescribed enough pain meds to get him to the appointment with the neurosurgeon at UW. His conduct was thorough, professional, and compassionate. We owe him a great thanks for catching something that, if my husband had seen a less thorough doctor, could have been easily attributed to something else. Had that happened, the tumor would have continued to grow, causing irreversible spinal damage that would have resulted life long pain and loss of function. And by the way, since when is it a crime to pay someone to fix your computer, or give drug samples to a patient? I have insurance, and have on a number of occasions been given samples by my doctor. Was the real problem that Dr. Manino was trying to help a patient that had no insurance without charging him through Mercy? I hope Dr. Manino goes to Dean and his patients follow. He is an asset to this community and his patients don't deserve to get caught in the middle of this. Mercy did not so much as send a letter out to his patients notifying them that Dr. Manino is no longer there, and offer a list of alternative doctors. We found out my husband no longer has a physician in the Gazette. Thanks a lot for that Mercy.
Aug 2, 2010 at 4:26 p.m.
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Dr. Paul Mannino was my family's primary for many years. He is and will be a great Dr. again i hope in a locating that deserves him! Shame on Mercy for letting a very good Dr. go! I now was referred to 3 others and one of them i had already tried and never got the feeling that they were looking out for our best interests! If my wife's insurance wasn't Mercy Care, we would be seen at Dean Care!! I have had Heart Surgery, colon cancer surgery, and many other treatments and Dr. Mannino by far has had the best care and customer service! I think Mercy is retaliating against him and i hope he prevails in if nothing else the correct opinion about Mercy.
Thanks Dr. Mannino for your great care!!
The William Evans Family
Aug 2, 2010 at 3:23 p.m.
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I have an example. Somebody I know was addicted to pain meds for "the pain" . Well when he was off of them finally-guess what-no pain!
scooter- I think you mean spondalois(sp) narrowing of the spine.
I would take "belisamasana"'s advice an see a chriro. If you fix the PAIN you wont needs the meds. Email me I will get you to a good one. It has helped my hubby a lot. He has sponalosis. Whe he goes to ER they just load him up with meds. Finally the sent him to his Doctor after they FINALLY took an xray. He went to Chiro and they adjusted him. Last time he had an eppisode he went to Chiro vs urgent care and felt better that day! w/o pain meds!!
Aug 2, 2010 at 2:43 p.m.
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correction: I was referring to Dr.
Mannino not Dr. Love from Mercy's pain clinic in my previous comment.
Aug 2, 2010 at 2:20 p.m.
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Mopsy, you got it right. Winter-plus-fibro-plus name about five other chronic conditions, and for the last ten years I could have chosen between staying in bed or raising (on my own) two children, if it hadn't been for the VERY MEASURED doses of opioids. Then you could all have bitched when their names appeared in the courts. They are both highly successful adults. Extremely successful.
It doesn't just affect the sufferer.
Aug 2, 2010 at 2:04 p.m.
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Oh, I see. Because Dr.Love is such a fine looking fellow, Mercy should allow him to over-prescribe Oxycontin to a patient who 'received up to 300 pills a month and was in a comatose state every day' I don't think so! Mercy has a responsibility to protect their patients from the highly questionable actions of this or any other physician.
Aug 2, 2010 at 1:37 p.m.
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DR. LOVE is a fine looking fellow as well. If he were a OB/GYN, I would be blushing way too much to be his patient. lol
Aug 2, 2010 at 1:33 p.m.
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Paul was my Dr. for many years. I think he was a pretty fair one at that. He really does look out for his patients. I have fibromyalgia and he didn't know what was wrong. He didn't just prescribe me "drugs." He referred me to another Dr. that was more familar with what might be going on. Thats where I was diagnosed. Today, after trying all the meds they have to treat Fibromyalgia, I am not on any meds and I suffer day in and day out. The one fibro med caused me to gain 40 lbs in 3 months and the other one cause my levels in my body to raise up and I would pass out upon standing. I personally chose not to use the opiods because I fear addiction. Some people truly need these meds. Manino was a good Dr. and Mercy has Always been a PIA.... My choice is to suffer, but I don't think it should have to bee that way but at the same point, I don"t want to be label by the Health system as an addict either.....
Aug 2, 2010 at 1:31 p.m.
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There is an appropriate use of narcotics for chronic, intractible pain. Many people commenting here have no idea what they are talking about. Many conditions that cause unbearable pain cannot be cured. Thank God for compassionate doctors who understand how to manage this pain with narcotics.
Those of you who spout off and have no expertise, shame on you for causing more suffering for those who have already had enough!
Aug 2, 2010 at 1:25 p.m.
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Thank you, TJ. I cannot wait to get my machine. It will help greatly. My pain gets so bad I cannot sit still or stand still for more than about 5 minutes, then I have to move. Gave up on movies a long time ago, even on TV, I have to get up too many times, I miss the good parts! I have been told I have springs on my butt, but that is the way I have to be to avoid the pain even when on pain killers. They do not take away all the pain.
Aug 2, 2010 at 1:23 p.m.
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none taken. of course it alters brain function and chemicals. would you believe it if i said it altered mine in a positive way?? it made me a better person?? am i trading one addiction for another?? worst case scenario...yes. but if the worst case scenario keeps me out of handcuffs(13 times w alcohol) then ill gladly take the worst case scenario:) its actually called harm reduction and im not the only one who this has worked for.
please read...
http://www.harmreductionjournal.com/cont...
Aug 2, 2010 at 1 p.m.
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Kidd, no disrespect meant here, but, aren't you just trading one addiction for another? Weed does alter brain chemicals and function also.
Aug 2, 2010 at 12:37 p.m.
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It’s good to know he’s out there, thekid3477, taking her easy on behalf of all us sinners.
Aug 2, 2010 at 12:14 p.m.
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And reefer gives you an edge in food eating contests.
Aug 2, 2010 at 12:12 p.m.
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By the way, good for Mercy Health System for having a policy in place to eliminate prescription drug addiction.
Aug 2, 2010 at 12:08 p.m.
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why would you hope that tj?? i was a detriment to society as a drinker...now im not. what thedudeabides said is absolutely true. several recent studies have shown marijuana to be a useful tool in ending alcohol/hard drug problems. hard to grasp im sure, what w all the misinformation we've been fed about the plant...but true just the same. marijuana helped save my life.
i apologize techmasterflex if what i write about annoys you. as ive said numerous times before, i will not be offended if you do not read my posts. im annoyed at the number of deaths caused by alcohol/tobacco/scripts and yet im a criminal for the mere possession of a plant. your annoyance will never trump mine and keep me silent. i apologize in advance for causing you continued annoyance.
Aug 2, 2010 at 12:04 p.m.
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Dr. Mannino was an awesome doctor. He had been my primary for years. Now that he's gone, there is no quality care at Mercy. I will be going to Dean.
Aug 2, 2010 at 11:49 a.m.
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One more thing. Kid, you smoke pot, WE GET IT. You are a big boy that smokes pot bla bla bla bla bla.
Aug 2, 2010 at 11:47 a.m.
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This guys was my doctor I like him. I had no pain issues but he was fine when it came to everything else. He was a great doctor for one reason. HE WAS NEVER LATE!!!!! If I had a 1 o'clock appointment he was in within a few minutes. I have waited for other doctors (baby and pedi docs) for over an hour on regular basis. The ER would be faster. I even left a pediatrician appointment and went to urgent care because I waited an hour and forty five minutes.
Aug 2, 2010 at 11:38 a.m.
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Kidd- I hope you're not smoking marijuana INSTEAD of drinking alcohol.....???
Aug 2, 2010 at 11:35 a.m.
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Scooter, obviously you are a chronic pain sufferer who is seeking a safer treatment other than narcotics. I think the contract you signed with your doctor is a great idea. I hope you can get relief from your new method soon.
I am not saying that there is no such thing as chronic pain, of course there is, I'm saying that just pain medication is not the answer to the problem. I have witnessed someone who claimed they had to take narcotics for the pain who was obviously 'out of it' or high all day long. They felt they had the perfect prescribed excuse to keep taking the narcotics and didn't think anyone could tell they were buzzed. They claimed they didn't get a high from the narcotics, it was just for the pain. They were only kidding themselves.
Aug 2, 2010 at 11:27 a.m.
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im walking proof that it can help with alcohol addiction so i agree w that. to use the word 'cure' means i had a disease, but it certainly keeps my mind clear enough to know why i dont want to drink alcohol. i use marijuana as pain medication. does it take the pain away?? not completely but it certainly takes the edge off an puts me in a frame of mind where i can deal w the pain better. plus it makes me feel better to know that i use a natural medicine vs a dr prescribed, a big pharm profiting, drug. it absolutely works for pain. ask a doctor.
Aug 2, 2010 at 11:11 a.m.
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Right On Dude!
Aug 2, 2010 at 11:01 a.m.
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Thekid- I'm not to sure that marijuana would be any more effective than a white russian when it comes to pain relief but recent studies have shown it to be effective at treating alcohol and drug addiction. That is one of the reasons I think this aggression (against marijuana) can not stand, man.
Aug 2, 2010 at 10:46 a.m.
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All of the true chronic pain sufferers are not taking these medications for a buzz, we take them so we can have a quality of life that was missing by concentrating on our pain. In fact, I do not get a buzz, I get relief. When it is hard to sit, stand, walk, etc., you will do anything to take that pain away. Physical therapy helps but it does not "cure" the pain. Pain management with marijuana would hinder me. It makes me sleepy and hungry and that's about it. I stay on my meds, do my therapy (at home and at the sports center) and try to limit my lifting. I will someday be able to not take narcotics as soon as I receive a machine that sends electric shockwaves through my back, it is on order now. In therapy it helps a lot. So now I will get one to bring home. But as for the depression/anxiety drugs (paxil, xanax and amitryptaline) I will probably be on those the rest of my life.
Aug 2, 2010 at 10:45 a.m.
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Can you imagine if Dr. Love were a gynocologist?
Aug 2, 2010 at 10:37 a.m.
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right on ehousewife. why would the medical community want you to be able to grow your own medicine though?? no more free golf trips for the dr's. i asked, and dr love is pro-medical marijuana for pain...but what would he know...he's only a PAIN DOCTOR.
Aug 2, 2010 at 10:13 a.m.
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Aww, all the comments about criminal records about the subject of the article have been removed.
Makes me mad.... a few bad apples ruins an effective treatment for all of us. Just like methheads made it harder for us normal citizens with a cold to get Sudafed.
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What I don't get is that people say all the time that is it is easier to get prescription drugs on the street than it is to get a prescription. So where are the dealers getting them??? Why can a 15 year old girl get them and not a legitimate pain patient??
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This is why pot should be legal.
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Aug 2, 2010 at 10:10 a.m.
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gazettefan, I do not disagree with your point. I simply find this situation sad, in that the doctors questionable barter and trade for prescriptions has not only hurt his patients credibility, but also left suspicions as to the psychological state of the patients who continue to search for a doctor with similar prescribing methods.
Aug 2, 2010 at 9:13 a.m.
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Kcl....., the point is not that the drugs cause the bad behavior, the point is that the bad behavior impugns the credibility of the one claiming the pain.
Aug 2, 2010 at 9:06 a.m.
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TJRockCounty makes a valid point. If you consider that narcotics impair a person's judgment,(especially at higher and higher doses) this in turn can lead to impulsive behavior that can lead to violations of the law. As previously stated, there are better options for a patient looking to improve his or her quality of life. Those options consist of a combined approach to medication with psychosocial and physical therapies.
Aug 2, 2010 at 9:01 a.m.
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Yes, and especially if the guy supplying the drugs is fired for Dr Feelgood-type violations re: said drugs.
Aug 2, 2010 at 8:48 a.m.
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People seeking narcotic pain medications from a doctor who "was observed taking medications from the shot room and giving them to the man in the parking lot in exchange for electronic equipment". Nope, nothing suspicious there! I wonder if he has ever been reprimanded for “over-prescribing medication”? Oh, Mercy fired him for that exact reason.
He may not have broken any laws, but these don't sound like the actions of a doctor practicing in a professional manner.
Aug 2, 2010 at 8:44 a.m.
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Especially when the kind of pain in question is based on what the patient says and the source is not directly observable by others, and when there are powerful drugs involved.
Aug 2, 2010 at 7:08 a.m.
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My point in 'comments removed' was simply that it's difficult to demonstrate ones credibility when one frequently violates the law.
Aug 2, 2010 at 5:52 a.m.
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CoPPerGuY - thank you for the intelligent and thoughtful comments. It is nice to see someone that understands the issue and is able to express it so well.
Aug 2, 2010 at 5:28 a.m.
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There are those in society who simply want to attack and accuse others. They want to find fault, and refuse to accept that they don't know everything about every subject.
As one who has had an undiagnosed pain since early childhood, I know first-hand that some pain simply cannot be "cured." Granted, I am not in constant pain, but when it hits I AM debilitated. I have had every test known to man - including exploratory surgery - trying to locate the source of the pain over the past 40 years.
Because of the episodic nature of my pain, taking opioids is not a viable option. I just have to wait out the attacks when they occur. But for those who have constant and intense pain, I have zero doubt that opioids do provide some benefit.
Aug 2, 2010 at 3:59 a.m.
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jb888: I agree with your post. For some of those commenting here to make assumptions about these patients based on court records is unfair and ridiculous. I have little doubt that because of these specific comments that the Gazette will be "disabling this comment section" later today.
Aug 2, 2010 at 3:39 a.m.
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I can't believe you people...really. Do you have so much time on your hands that you research the court system to find dirt to dig up on people? The name calling is unfair. Calling pain sufferers drug addicts who are looking for a new dealer is completely wrong. I have had chronic pain 24 hours a day for the last four years and I can honestly say that without medication I wouldn't be able to function. Every night before I go to sleep I pray that tomorrow this constant burning pain will be better, that I can be a Mom, a wife, and a daughter like I was before this living hell started. I don't want a 'buzz', I just want to live. The frustration of going to doctor after doctor trying to find some tiny bit of relief and being treated like a 'drug seeker' is a hopeless feeling I hope you never, ever have to deal with. Thank God that your not in constant, unrelenting pain. Lets try to have some compassion and empathy for others and not kick them when they are obviously down. Thanks. J.
Aug 2, 2010 at 1:43 a.m.
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He was my doc and I had good luck with him. I have a back injury. He at one point asked me home much Vicodin I was taking knowing my pain. I told him and he told me to take one and drink a beer right away. It helped and reduced the amount of vicodin I was taking. At a later point he told me I needed to get used to the pain due to the fact it would never go away. I have since done that. I wake up with pain every day and due still wish I was on the vicodin. I have no complaints from his doctoring skills.
Aug 2, 2010 at 1:34 a.m.
Aug 2, 2010 at 12:27 a.m.
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I think it's important to remember that long term narcotic use causes an addiction that attacks the brain and damages key parts of the cerebral cortex which in turn, alters the patients capacity to exercise judgment and inhibit impulses. Therefore, medication treatment needs to be balanced with psychosocial and physical rehabilitation. Quality of life is so much more than just pain relief that leaves a patient irrationally fearful, incoherent, and/or withdrawn. There ARE wonderful Doctors who are willing to work with these patients in the search for better treatment options.
Aug 1, 2010 at 11:23 p.m.
Aug 1, 2010 at 9:59 p.m.
Aug 1, 2010 at 9:50 p.m.
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TJrOckCOUty - My cousin is a family doctor in another state and I emailed him the story. He then went online and AlSo read the comments that were in the forum at the time. The reason I share this is because he sent me a reply about the article and the forum comments. He commended PM7988 for an excellent comment, but thought the comment by TjrocKcouNty about people needing pain management and not medication was not correct. He felt that they need to combine both for patient success.
Aug 1, 2010 at 9:50 p.m.
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It's been over 4 hours since the story was posted and thekid hasn't given his usual advertisement for green, leafy medicine. I'm quite surprised to say the least.
Aug 1, 2010 at 9:04 p.m.
Aug 1, 2010 at 8:57 p.m.
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I agree with you TJRockCounty. Just reading the comment from Dr Mannino;
“We’re just trying to raise more awareness. These patients traditionally have been shunned, minimized,” Mannino said. “I think they deserve respect and compassion.”
and then taking a look at the public records for some of these patients and you can see why their need to find a new 'supplier' is such a strong concern for them. The DudeABides pointed out(this is where the TRUE AWARENESS resides) a very important aspect of this issue in that you have to wonder what the real motivation for their complaints is. As TJ stated, These patients become more disabled from the drugs than from the true nature of any pain they may(subject to opinion again) be suffering. They need a doctor who is willing to find the source of the pain and treat it without turning the patients into addicts who can't live without narcotics. This really IS possible, IF the patients really want to be helped.
Aug 1, 2010 at 8:42 p.m.
Aug 1, 2010 at 8:11 p.m.
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I have a prescription for Flexeril that I cannot take. If I take one pill, I'm down and out for a day and a half. Thankfully my chiropractor has done more for my neck pain than my Mercy physician ever has and I don't need anything more than Ibuprofen every once in a while. I feel very sorry for those who have chronic pain that has to be managed with prescription drugs. If you've never seen a chiropractor, I highly suggest it.
Aug 1, 2010 at 7:54 p.m.
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Pain management is a touchy subject. I see a doctor at Mercy who has me on a pain contract. That means you need to follow the correct dosages, use the same pharmacy and physical therapy is a must. I take percocet, flexeril (muscle relaxant), xanax (anxiety drug), amitryptaline (an all around pain med, sleep med and anxiety med) and time released paxil(an antidepressant). I use my drugs wisely and they control my pain. I have a bad back, narrowing of the nerves, arthritis and swelling of the disk in my lower back. I also have depression and anxiety problems. I am not a walking zombie or anything close to that. I am, in fact, a lot more active while taking my pain medication. That is what it is prescribed for, pain. I have a sister that will not take them, even though prescribed by her doctor, and sits around complaining that her back hurts. Well, duh! The doctor prescribed them for a reason. So life is more comfortable and you can feel "normal". I do not consider myself an addict but some of these drugs are addicting and cannot be stopped abruptly. They can cause heart problems from withdrawals that need to be monitored as am inpatient by the doctor. I feel for these people, keep looking people, there is a doctor out there that will help with your pain. Have faith.
Aug 1, 2010 at 7:41 p.m.
Aug 1, 2010 at 7:09 p.m.
Aug 1, 2010 at 6:56 p.m.
Aug 1, 2010 at 6:53 p.m.
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Sarah, I respect your point and you probably know more about this than I do. I'm not a doctor, I only speak from experience with a close friend of mine who insisted medication was the only thing that brought them relief when in fact there was a miriad of physical therapy procedures and even surgery that they refused to explore. Instead this friend latched onto a doctor too lazy to deal with the real problem (addiction)who just prescribed more narcotics. Just my perspective on the whole thing.
Aug 1, 2010 at 6:48 p.m.
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Sadly, chronic pain cannot often be "cured". It has more to do with changes in neurologic pathways, than something happening right at the site of pain. Each patient is different, as far as pain medicine needs, and tolerance does definitely develop, but escalating doses can also result from disease progression. It's not always easy to sort out. I have never seen anyone disabled from the medications, and opioids do not cause addiction, rather they are an avenue through which those at risk become addicted. The rate of addiction in those suffering from chronic pain is <1%.
Aug 1, 2010 at 6:17 p.m.
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TJ: Over an extended period of time, the more opioids one takes the higher the tolerance usually becomes. This is one reason cancer patients can end up taking extremely high doses.
Also, in some cases there is no "cure" for pain and it can become truly disabling. I am grateful that I have never been in the situation where these patients find themselves.
This area of medicine is extremely difficult to understand and to manage. TJ, can you describe what you mean by "pain management therapy"? What does it involve and where can these patients find such help?
In addition, I think this article's writer Gina Duwe has done an outstanding job trying to explain the issue to us laymen. The number and variety of sources she uses in the story far exceed what this reader is used to finding in a daily newspaper.
Aug 1, 2010 at 5:36 p.m.
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We the general public are not as stupid as some may think, including the fired doctor and these former patients. Narcotics mask the pain, they don't cure the source of the pain. A persons body builds up a tolerence to the drug and doses must be increased to have an effect. However, at the same time, the more a person takes, the more addicted they become and eventually too much results in death. These people become "disabled" from the drugs not the pain. These people need pain management therapy not drugs. The doctor should have been fired for not following policy and for not treating these people correctly and the addicts should stop whinning about not being allowed to take the drugs and instead have their medical problems treated.
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