Articles Posted in Pain

soccerknee-300x97Here’s another painful reminder to grownups about youngsters and sports: Moderation matters, and youthful games are supposed to fun, diverting, and character building—and most definitely should not leave today’s aspiring athletes as tomorrow’s hobbled adults.

The New York Times has reported on what a pediatric sports medicine expert has described as a “dirty little secret” of orthopedics, which is “the chance of getting arthritis within a decade of tearing a tendon or a ligament in the knee is greater than 50 percent.” And more and more youths, as they participate aggressively and frequently in sports programs, are undergoing surgeries on damaged or torn anterior cruciate ligaments, a procedure well-known as the ACL repair.

The sports medicine doc says he is gathering data for a study that will show that patients at 26 children’s hospitals he has focused on underwent 500 ACL repairs in 2005, but by 2014, more than 2,500 youths had these surgeries.

urine-sample-cup-263x300With opioid drugs now the leading cause of death for Americans 50 and younger and killing more than 64,000 people last year, was it inevitable that some shady characters are profiteering off the miseries of those struggling to get off potent painkillers?

And is it predictable that key politicians keep talking big but still haven’t backed up their boasts with the money and means to attack a public health crisis that is claiming more lives than cars or guns and at a faster pace than HIV-AIDS did at the peak of that epidemic?

Americans have plenty cause to be — forgive the vulgar word play — pissed off at the doctors and labs that are raking in profits on urine testing for drugs. This business has exploded but with little or no oversight. As reporters Fred Schulte and Elizabeth Lucas have written:

epipen-300x119Big Pharma’s rapacious profit-seeking can seem to hit no bounds, even if it afflicts millions: Just consider what federal and state regulators are mulling about the makers of a popular anti-allergy therapy and those who supply a critical diabetes medication.

The federal Food and Drug Administration has replied to Bloomberg News Service that, so far, in 2017, it has recorded 228 reports of EpiPen or EpiPen Jr. failures, and the failure of EpiPens to deploy correctly has been cited in seven deaths through mid-September.

The agency said it is monitoring closely these “adverse event complaints.” These are unconfirmed reports that do not necessarily tie a product to a harm. But they might constitute sufficient grounds to investigate further and to potentially order product recalls, though, so far, the FDA says it believes patients can keep using EpiPens on the market without worry.

choosing-wisely@2x-300x197Up to a third of medical spending goes for over-treatment and over-testing, with an estimated $200 billion in the U.S. expended on medical services with little benefit to patients. But getting doctors and hospitals to stop this waste isn’t easy, nor is it a snap to get patients to understand what this problem’s all about so they’ll push their health care providers to do something about it.

Which is why kudos  go to Julie Rovner, of the nonprofit, independent Kaiser Health News Service, and National Public Radio for the recent story on how older women with breast cancer suffer needlessly and run up wasteful medical costs due to over-testing and over-treatment.

Rovner and Kaiser Health News worked with a medical benefit management company to analyze records of almost 4,500, age 50-plus women who received care for early-stage breast cancer in 2017. She found that just under half of them got a medically appropriate, condensed, three-week regimen of radiation therapy. Research has shown this care is just as effective as a version that’s twice as long, costs much more, and subjects patients to greater inconvenience, especially with more side-effects.

trumpdrugs-300x177As the Republican-controlled Congress rams through a national budget and a package of changes to the tax system, President Trump and his partisans are staying true to course. They’re determined to slash taxes for the rich, even if they only half-heartedly tackle one of the biggest public health crises in decades, and if they inflict great harms on the health of the poor, sick, young, and old.

In answer to long and increasing criticism, Trump finally declared the opioid drug abuse epidemic a “public health emergency” (with zero new dollars in spending)  but not a “national emergency,” which would have opened the door for millions in new spending.  He scored points with some commentators with his discussion of how alcoholism destroyed his older brother Fred’s life, and, how his brother’s advice and example had kept him from any temptations of substance abuse. (He also reminded critics of ineffectual “Just say no” anti-drug campaigns.)

But for all his pronouncements, the president’s actions fell short of what many anti-drug experts and advocates had hoped would be White House leadership against opioids abuse and overdose deaths, a scourge that has claimed almost 60,000 lives since 2016.

marino-300x169Some powerful political players deserve a big dose of public condemnation for bungling and stalling the nation’s desperately needed war on the epidemic abuse of opioid drugs.

President Trump  can step up for the first of a series of smacks for nominating yet another dubious candidate for one of the nation’s high offices—in this case the “drug czar,” who plays a critical role in the campaign to curb the tens of thousands of deaths now blamed on opioids’ abuse.

Trump had put up for the position Tom Marino, a Pennsylvania Republican congressman (photo above). The president spoke with enthusiasm on his behalf. He did so even after CBS TV’s “60 Minutes” and the Washington Post put out their joint investigation of Marino, showing how the congressman had acted as a Big Pharma tool. Marino arm-twisted the federal Drug Enforcement Agency and congressional colleagues to get a law passed that gutted regulators’ authority to prevent Big Pharma’s wholesale distributors from flooding parts of the country with tens of millions of opioid doses, drugs that caused untold addictions and deaths.

pills-drugs-300x215The epidemic of opioid drug abuse, which increasingly is claiming children’s lives, has plenty of blameworthy causes. Here’s a new one: health insurers which steer patients to cheaper, more addictive painkillers while playing Scrooge for less addictive but pricier alternatives.

Pro Publica, a Pulitzer Prize-winning investigative journalism site, and the New York Times get credit for their expose of  penny-wise and pound-foolish prescription management practices.

By analyzing “Medicare prescription drug plans covering 35.7 million people in the second quarter of this year,” the news organizations say they saw repeated patterns in which insurers and the spin-off businesses that run their drug payment plans (so-called pharmacy benefit mangers or PBMs) easily and quickly approve opioids for patients in pain, medications that cost relatively little. They throw up all kinds of obstacles, however, to doctors and patients who try to use less potent but more expensive drugs, including patches containing Butrans (a lesser opioid) or lidocaine. They also drag their feet on approving payments for addiction-fighting medications like Suboxone.

syphillis-150x150The myriad problems tied to the nation’s opioid drug abuse epidemic seem only to worsen and grow more complex by the day. They are, recent news reports say:

spinning-300x200Although many sports enthusiasts relish the summer as a peak time to train hard to get especially fit, wise athletes for safety’s sake may wish to build their way up to exhausting workouts, and to ensure they’re staying hydrated in healthful ways, while also recognizing that endurance competitions may alter their bodies in ways that they should at least be aware of.

The New York Times has posted an eyebrow-raising story on the perils to hard-driving jocks, male and female, of “rhabdo,” aka rhabdomyolysis, a “rare but life-threatening condition often caused by extreme exercise. It occurs when overworked muscles begin to die and leak their contents into the bloodstream, straining the kidneys and causing severe pain.”

Two doctors say they treated three recent, severe rhabdo cases brought on when novices in not great shape leaped into intense spinning classes, demanding exercise regimens lasting around an hour and involving specialized stationery bicycles. They found in medical literature 46 other, documented rhabdo cases, with 42 tied to novices’ spinning.

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