Integrative Pain AZ

The Right Care At The Right Time

[Integrative Pain AZ @azPainEcho]

Thank you Dr. Joel Dickerman & Fran Gorman, ANP-C for presenting your patients @ #projectecho #pain & good luck!

[Integrative Pain AZ @azPainEcho]

To avoid inappropriate #opioid use: don't Rx to pts w/ #addiction d/o or #Anxiety/#trauma related #pain, redirect to right tx #projectecho

[Integrative Pain AZ @azPainEcho]

Is the prob #opioids or prescribing opioids to the wrong #patients? What lies @ heart of #OpioidEpidemic & how course correct? #projectecho

[Integrative Pain AZ @azPainEcho]

Rxed #opioids bc #pain psych-driven & have #psychotropic bens, unrealistic beliefs of tx, opioid titrated >max effective dose #projectecho

[Integrative Pain AZ @azPainEcho]

...unaddressed #Mentalhealth issues undermining tx, & concerning yellow flags like misusing #opioids, running out early, etc #projectecho

[Integrative Pain AZ @azPainEcho]

When do we wean off #opioids? Using for #pain but: function poor despite dose inc, unclear if helping, poor self care... #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: #PCP shouldn't feel #hostage to pt's requests >#opioids. Repeat #falls, multisourcing, misuse=good reasons for backing off #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Presents very well-curled hair, stylish clothes. Has a limp from pelvic fracture but doesn't use a cane-may benefit from 1 #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Very likely the root cause of this pt's probs is personality d/o. Requires #Mentalhealth eval & focused tx #rprojectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Low concern of #domesticabuse, seems like husband can't help guide/influence much of her tx. Afraid she'll try #suicide #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Needs #Psychiatry & #psychotherapy, may benefit from #DBT bc manifesting borderline personality d/o. Rule out #TBI #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Harming self to get her #opioids. Knows that #PCP fears she'll attempt #suicide if she doesn't get meds & manipulating #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Typically, people w/ #pain don't attempt #suicide. Prob qualifies as #SMI & focus of #care needs to be #Mentalhealth #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Also complains of poor #sleep & chronic #insomnia. Always asking for more #opioids @ #PCP visits. Extremely sedentary #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Has had multiple falls since returning from #rehabilitation. Goes to #emergency dept whenever has a flare & is turned away #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Hx #depression, #Anxiety, #obesity, seizure d/o. #PCP fears she's misusing her #opioids but husband supposed to monitor #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: Fractured pelvis, R-wrist & ankle, dislocated R-elbow, & still has low back #pain. Clear #psychological component to pain #projectecho

[Integrative Pain AZ @azPainEcho]

Pt2: 49YOF hx multiple injuries 2ndary to jump from 2nd story window bc her doc wanted to dec #opioid for her back #pain #projectecho

[Integrative Pain AZ @azPainEcho]

Unintended #consequences of repealing #ACA may be fewer resources to address #OpioidEpidemic & safe use of #opioids #projectecho https://t.co/7YCR0qw5Pc

[Dania Palanker @DaniaPal]

No essential health benefits + Medicaid cuts = less treatment for opioid addiction https://t.co/cZng0bexro #GtownCHIR @Health_Affairs

[Integrative Pain AZ @azPainEcho]

Pt1: If possible may benefit from #pain Rx b4 hand therapy-but this should wait until she has established rapport w/ #therapist #projectecho