If the FDA follows the recommendations from a federal advisory board, the answer is yes. While I understand the logic, I fear for specialists everywhere who have never been trained to write for anything other. I fear all their patients will go without pain medicine or get a "hospitalist consult for pain managment"
FridaWrites, a patient with chronic pain gives her take on it all.
23 Outbursts:
Jeez, English is my second language but even I know it should be "ARE" percocet and vicodin going to be banned... You lose all credibility when your subject and verb don't agree. And you're right... don't know what all those Internists are gonna do... figurin out those tylenol doses are hard...
Frank
Fine with me. I tend to separate out tylenol and oxycodone any way so you can up titrate the oxycodone with out worrying about tylenol toxicity. One of my hospitals tells me they have an oxycodone "shortage" however. Besides, how much pain relief does the acetominophen add anyway?
Frank, speaking as someone who's all but dissertation in English and who has taught it for years, I think you're being rude. If people lost credibility every time they make grammatical mistakes, absolutely no one would have credibility with me. Mistakes happen, sometimes when people add a word back in. I intentionally write comma splices in informal work, sue me. :)
In my own case, I am resourceful enough to find other options, though they may be expensive surgical ones to ablate nerves or install morphine pump (what if it malfunctions?), remove bursae, inject botulism into surrounding muscles, and suppress my immune system. (Am I worth an extra $15,000 in medical care a year? Plus more surgeries? God, the angst).
Or I could just suck it up as I have before (said after an hour of circling the living room and kitchen in pain, unable to settle, rocking back and forth on my hands and knees, while on 5mg of hydrocodone). As my mother-in-law says, I would be all better if I would just fight it more, ignore it, and be really positive.
IMO taking the Tylenol out is going to result in a hell of a lot of narcotic overdoses. Pardon me for my lack of faith in the trauma population but I guarantee that the only reason a third of my patients don't take the entire bottle of Percocet at once is because they know it'll kill them.
I agree that overdoses will increase. In fact, I believe acetaminophen was specifically added to the combo drugs to limit the daily doseage taken.
Yes, the FDA has disallowed pure hydrocodone to discourage more drug abuse--by law, it must be sold with acetaminophen.
I think a big problem is the overprescribing of these medicines when people have minor, temporary pain--that gets people hooked. As someone who took no medicine for a hip fracture, took a few NSAIDs after wisdom tooth removal, and wouldn't let my husband use hydrocodone after vasectomy (he didn't need it and has yet to try it), I do think people need to just learn to deal with some pain, to the extent someone's not becoming truly disabled by pain.
People have to realize that any medicines they take are going to affect them, especially if taken for the long term. There is no safe pain medicine.
What'll you bet there's more trafficing and medical tourism to Mexico and Canada?
Did you teach your students to spell?
Trafficing: must be Olde English.
Glass houses.
also, I don't like the phrase "grammatical mistakes"
wouldn't "grammatical errors" sound better?
how about install "a" morphine pump
install morphine pump sounds like my Russian neighbor
Daniel son (or daughter), I hope that student teaches teacher.
I truly doubt you could write better while in this much pain. I have cognitive problems at the point I'm considering the emergency room for pain.
You're missing the point, that it's rude to point out other's errors.
P. S., learn to capitalize.
And use punctuation. Oh no, I started a sentence with a conjunction. What does Daniel son mean? You should put "install morphine pump" in quotation marks, and paragraphs should be more than one sentence.
As Winston Churchill said when caught using a preposition at the end of a sentence, "This is the sort of pedantry up with which I will not put." I was aware of the two errors but it seemed stupid to delete them to microedit.
You're just mean. Feel better?
"Jeez, English is my second language but even I know it should be "ARE" percocet and vicodin going to be banned... You lose all credibility when your subject and verb don't agree. And you're right... don't know what all those Internists are gonna do... figurin out those tylenol doses are hard..."
Edited, though the editor may stick in line breaks at brackets:
Jeez [omit, slang], English is my second language[,] but even I know it [what? unclear antecedent] should be [:] "[']ARE['] [P]ercocet and [V]icodin going to be banned ["?] You lose all credibility when your subject and verb [do not] agree. [And-delete conjunction] [Y]ou're right[ . . . (three spaced ellipses when mid-sentence] [I] don't know what all those [i]nternists are [going to] do. . . . [F]igurin[g] out those [T]ylenol doses are hard. . . ."
Overuse of ellipses, I'd say.
"Jeez, English is my second language but even I know it should be "ARE" percocet and vicodin going to be banned... You lose all credibility when your subject and verb don't agree. And you're right... don't know what all those Internists are gonna do... figurin out those tylenol doses are hard..."
Edited, though the editor may stick in line breaks at brackets:
Jeez [omit, slang], English is my second language[,] but even I know it [what? unclear antecedent] should be [:] "[']ARE['] [P]ercocet and [V]icodin going to be banned ["?] You lose all credibility when your subject and verb [do not] agree. [And-delete conjunction] [Y]ou're right[ . . . (three spaced ellipses when mid-sentence)] [I] don't know what all those [i]nternists are [going to] do. . . . [F]igurin[g] out those [T]ylenol doses are hard. . . ."
Overuse of ellipses, I'd say.
Yes, "others' errors" and "Daniel's son" in quotation marks. If you can do better during suspected bone sepsis, go for it.
Anyone else think that Frank is a psycho nutjob? Geez, he's almost as bad as Nurse K.
anybody who suggests a magnum lobotomy to a commenter on his blog is yes a little on the edge and maybe a psycho nutjob. But gosh darn it he's real smart so he gets a free pass on being rude.
WTF is bone sepsis?
Geez, English Nazi, didn't you see the "The Karate Kid"?
Daniel's son- wtf??
I'm curious Happy.
Don't you make a living by seeing the "Specialist's" patients?
I don't mock the internists when they send me common things that they could treat....I figure they are happy to see my general medicine patients post op.
Am I wrong?
anon 625. We are all specialists. Some are more subspecialized than others. So yes, I make my living almost entirely from the referrals of out patient family medicine and internal medicine specialists.
As far as being happy to see "general medicine" patients, I don't have any idea what that means. If there is an acute issue that needs to be addressed, elevated blood pressure, abnormal blood sugar, chest pain, fever I am more than happy the evaluate patients who need a physician specialist as my self to evaluate an acute issue. This is not general medicine. This is internal medicine.
If you are asking me if I am happy to see post op surgical patients to write discharge order, address home meds and field nuisance pages, then you must be mistaking me for someone you should be hiring to do your work for you.
No specialist as myself needs to address stable medical issues. It's one reason why 99.999999999999999999% of the worlds population does not have a live in physician outside the hospital. You do not need an internist "to follow for medical managment", any more than I need an orthopaedic "to follow for orthopaedic managment" on a patient admitted with pneumonia but has a history of a hip fracture
I am happy to consult on surgical patients when I am being asked to evaluate an acute issue. I am not needed to see a patient "to follow". If that's what you need, you should hire your own PA or NP to assist your needs. The patient certainly doesn't need me in these situations.
Oh yeah, the comment about consulting a hospitalist to write for pain management was not meant to be taken seriously.
I guess that is what happens when you are dealing with naive surgeons!
I wouldn't think of writing for a hospitalist for a routine D/C....much less expect them to field post op questions, but do it for elderly patients with multiple med problems and drugs that I haven't dealt with in years.
Perhaps I need to update my practice style to better utilize your services! /humor.
Hip sepis=joint infection? I really don't know. I don't have the same hip I did 3 weeks ago, and it took my sense of humor with it.
LOL, my memory of that movie is limited to a few lines from the Chicago song, something about "a long time ago."
Blogged my two cents about this: Should Opioid-Acetaminophen Combination Painkillers Be Banned? YES.
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