Opioid addiction among young pregnant women…

Opioid Addiction among young pregnant women 3Dr. Michael J. O’Connell, PainCare, New Hampshire recently commented that as addiction to various forms of opioids becomes more prevalent, more young women than ever are presenting for delivery on methadone, heroin, oxy and other drugs.  This causes a considerable nightmare for these newborns and for those healthcare workers administering to them.

Neonatal abstinence syndrome (NAS) is the withdrawal of the baby from the drugs mom abused before and during pregnancy.  The treatment for the newborn is a continuation with gradual weaning from some form of opioid, often IV morphine.  The process can take weeks in the hospital and costs are staggering.  The treatment for the mom is less complicated and requires little additional hospital stay, but is just as unpalatable from a societal perspective.

There are few answers to this gestational addiction problem, but buprenorphine is a solid drug to address the issue while society figures out the underlying problem.  If the pregnant addict confesses to her addiction, and converts to buprenorphine (Subutex, Suboxone) early in pregnancy, the NAS is markedly reduced to just a few days.  The problem is how to convert the mother from the methadone, or oxy or whatever potent opioid she is taking to the buprenorphine?  Many studies are now emerging that support the safety of doing this in a gradual manner during the first trimester.  The process must be monitored by a provider experienced in such a transition, is very familiar with buprenorphine, and also has access to urine tox screening and quantitative LCMS.

Diet soda and obesity…

Diet sodaDr. Michael J. O’Connell, PainCare, New Hampshire commented that there is another study apparently showing that heavy diet soda consumers suffer more from obesity.  And of course the media interprets this as cause and effect.  It ain’t.

Diet soda no more causes obesity than drinking H20.  Morbidly obese folks are grabbing at whatever they can to shed pounds, and avoiding the empty calories of a regular soda is an obvious target.  So naturally, many obese subjects drink large amounts of diet soda.  Don’t think for one millisecond that diet soda CAUSES obesity.  If you are of ideal body weight and enjoy diet soda, there is no scientific evidence whatsoever that you are at risk of becoming obese by continuing to imbibe.

The media fosters, embraces and rewards irresponsible reporting.  Facts are simply not allowed to discourage a good story.  Why?  Because bland facts do not sell anywhere near as effectively as a good story.


Dr. Walter Palmer…

Dr. Palmer 4Dr. Michael J. O’Connell, PainCare, New Hampshire stated, “I am not a hunter; I have never intentionally killed anything bigger than a hornet, though I have been absolutely ruthless with houseflies.”  Dr. O’Connell commented that this Dr. Walter Palmer brouhaha is getting out of hand.  The crowds outside his private dental practice in Milwaukee were calling him a ‘murderer’ for killing a popularized lion on a recent safari to Zimbabwe, Africa.  One of his guides had apparently lured the lion out of a protected park so the killing could occur.  Given that lions are a protected species due to dwindling numbers, and the notion that he should have checked things out much more carefully before he pulled his bowstring, I think he should have been heavily fined, and he probably will be.  But jeez, extradition, a murderer?

Do these protesters understand the realities of the life and death struggle playing itself out every second, in every corner of our world?  Have these naive people ever seen videos of lions making a kill on a zebra or gazelle?  Ripping the flesh of a still alive and trembling prey?  It’s ugly stuff to watch.  But it’s life.  Have these folks watched that now infamous Planet Earth video in which a killer whale leaps out of the water to grasp a frantically fleeing seal in its huge razor-tooth maw?  THAT is murderous stuff.  Do these same folks concern themselves with the millions of slimy but unidentified bugs that smear their windshields on a warm summer night?  Do they rue the ants they themselves put to death with the malathion powder they sprinkle along their home foundations?  Or the benign appearing ant “cups” that invite the insect to carry poison back to their colonies?

I want to be very clear.  I am much in favor of outlawing hunting everywhere in the world, except in those regions where wild game is plentiful and proteinaceous calories are needed.  But, my rationale does not include that it is cruel and unusual punishment for a lion to accept an arrow to the heart for its demise.  How could it get crueler than what nature stages?  To have your neck crushed in the jaws of a lion.  Give me a break.

Is it addiction or dependency?

Addiction vs dependency5Dr. Michael J. O’Connell, PainCare, New Hampshire commented that the distinction between addiction and dependency is constantly mangled by the press, lay people and even many professionals.  The difference between dependency and addiction is not withdrawal.  Withdrawal is a phenomenon common to both.

Addiction marks a transition into pathology; the chemical, activity or behavior to which one is dependent (oxycodone, heroin, alcohol, THC, sex, eating, extrovertism/introvertism) becomes harmful…physically, psychologically and/or functionally, to the individual.  Withdrawal or craving is not necessarily a pathology and therefore not necessarily an indication of addiction.

One would be hard pressed to declare a weekly snorter of heroin or cocaine an addict.  If a person dreams much about food, craves certain tastes or dishes, but lives a functional work and social life and is not obese, this can hardly be defined as an addict.  If another has elevated liver enzymes, presence of abdominal fat in an otherwise slender body, is thinking about drinking alcohol much of the day, has a couple DUIs, occasional blood in the stools, and yet persists in drinking alcohol, this is most likely an addict.

If a chronic back pain patient has had a laminectomy and then fusion, still requires pain meds but goes into intense withdrawal with sweating, shakes, diarrhea, and piloerection, when away on a trip forgetting meds at home, this is dependency, but unlikely addiction.

Dr. Michael J. O’Connell Donates $250,000 to CVHS Capital Campaign…

CVHS2Dr. Michael J. O’Connell, PainCare, New Hampshire has generously donated $250,000 to support Cocheco Valley Humane Society’s “Bring Us Home” capital campaign to build a new 11,000 square foot animal shelter that will be located on the grounds of the Strafford County complex in Dover. His leadership gift will name the surgical suite at the new facility.

Dr. O’Connell has been a steadfast supporter of CVHS for many years; regularly underwriting events and providing financial support to enhance the quality of care for thousands of abused, neglected and abandoned animals the shelter serves each year. In addition, he has served as a tireless advocate for CVHS and has worked to champion the shelter’s mission by authoring letters of support encouraging his peers to join him in making a difference in the lives of the animals at CVHS.

According to Dr. O’Connell, “As I reach the twilight of my career, and as CVHS approaches its momentous rebirth, I have decided that my plans to include CVHS in my will are far too conservative, not anywhere near as helpful to my favorite charity as I would like and as what CVHS deserves. The old saying “you can’t take it with you”, is particularly germane for me. I dearly wish to see with my own eyes, in my own lifetime, a vibrant, robust home for CVHS. As the caretakers for the truly innocent, I can’t imagine draining my retirement funds now for any more lofty or noble purpose. The employees and volunteers at CVHS are to be commended for an awesome, yet too often thankless job in face of recurring challenges. I hope with my assistance and that of many others, CVHS can realize a long held dream.”

With 12 locations throughout NH, Paincare is the leading medical practice in the northeast dedicated exclusively to pain management. Salmon Falls is a comprehensive family health care practice treating newborns, children, and adults of all ages. The practice has been serving the tri-city area of Dover, Somersworth, and Rochester for over 20 years. The mission of the R.O.A.D. To A Better Life program is to provide therapy and treatment for drug and alcohol addiction in a safe, respectful and friendly environment that is focused on recovery, relapse prevention, and a return to normalcy.


Medical tourism…

Thailand Medical Tourism 3Dr. Michael J. O’Connell, PainCare, New Hampshire commented that Morgan Spurlock, roving special reporter for CNN, recently spent a great deal of time and resources exploring “medical tourism” in Thailand.  Turns out it was less an investigation and more an anecdote reporting on his single personal experience.

Spurlock embedded himself as a patient at a large hospital there.  A wealthy US developer has created a slick niche system which as Morgan discovered provides high quality focused care, easy access (once you have flown to Thailand), but of course cash only.  The hospital targets upper middle class Americans who may have no insurance by design, or high deductible insurance (as with Obamacare and catastrophic policies).  Morgan sprinkles his piece with repeated price comparisons between this Thai facility and those same services if one paid cash in the US.  He undergoes a colonoscopy using a ‘swallowed’ camera, fairly extensive blood work, EKG and an MRI.  For every service, the Thai price is considerably lower, and Morgan’s workup is all benign.

This piece is grossly unfair for several reasons:

  1. Those insured by more typical low deduct policies in this country could access these services at a US hospital for far less than the ‘cash price’ he indicated in Thailand.
  2. He doesn’t compute the risk of flying to Thailand – not inconsequential.
  3. The swallowed camera ‘colonoscopy’ technique is available in the US, but is seldom done here (except on unhealthy patients) since many scientific studies indicate that it misses many polyps. And of course if a polyp is found, it cannot be biopsied or removed; a colonoscopy is therefore eventually needed.
  4. What would have happened if something had gone awry in the course of his care? What if Morgan had suffered a heart attack?  Does this hospital have cardiac services, stenting or bypass grafting?  Simply a CCU?

This unfortunately simplistic and naive piece on medical tourism should not serve to discourage such competition, but rather encourage a fair and detailed analysis of that competition.  Else Morgan Spurlock could be accused of mimicking that famously unscrupulous ‘documentarian,’ Michael Moore.