Six Detroit area doctors indicted in $500M health care fraud • Hacker News Board

Re: Six Detroit area doctors indicted in $500M health care fraud

#21

Post by Johnny555 » Fri, Dec 07, 2018, 4:54 AM UTC

CaliforniaKarl wrote: post #3

Ugh. I’m going on for surgery next Thursday, for a laparoscopic partial colon resection, and one of the things I’m most worried about will be post-surgery pain killers. Hearing stories about excessive pain killer use and prescription really make me want to avoid them, but on the other hand I’ll need to be up & moving around ASAP to speed my recovery, and pain would get in the way of that.

There's some research showing that acetaminophen + ibuprofen can be as good or better than Opioids for pain relief, though I don't know that it applies to post-surgical pain.

https://media.jamanetwork.com/news-item/no-significant-diffe...

https://www.sciencedaily.com/releases/2018/04/180417181101.h...

Re: Six Detroit area doctors indicted in $500M health care fraud

#22

Post by pstuart » Fri, Dec 07, 2018, 5:04 AM UTC

dumbfoundded wrote: post #13

mindslight wrote: post #8

> "The damage that opioid distribution has done to our community and to the United States as a whole has been devastating" said U.S. Attorney Schneider I guess scapegoat big pharma is successfully finding their own scapegoats! The feds could straightforwardly address the fentanyl problem by deillegalizing opiods, allowing reputable distribution to take over. And then society could maturely deal with addiction as a pe…

It's crazy that cannabis is a schedule 1 drug. It's by far the safe way to manage chronic pain but federally illegal. I'm glad the states have the chutzpah to make it legal. The older I get the more I see how this country is run on money above everything else.

Crazier still is that kratom is getting lined up to be scheduled as well, when it is a proven safe tool for weaning people off of opiates.

Re: Six Detroit area doctors indicted in $500M health care fraud

#23

Post by uh_what » Fri, Dec 07, 2018, 5:05 AM UTC

mgkimsal wrote: post #17

akamel wrote: post #10

Earlier quoted context omitted.

Use them only when you need them. I was really annoyed when my wife’s doctor freely prescribed her oxi after her delivery even though my wife never asked for it and never showed any sign of needing it. Having free flowing prescriptions is how we end up with so many addicts.

and then... for legitimate cases... no dice. about 7 years ago my wife got sand in her eye - was problematic enough that we went to a local clinic. she wasn't going to go blind, but it was irritated enough that after flushing it out, it still looked... bad. and she indicated it was a bit sore, that she wanted to get home to just try to get to sleep. The doctor there offered a prescription for percocet. We said "no, n…

Asking for a prescription for a painkiller will make doctors label you as a drug seeker.

Asking for a referral for an x-ray/ultrasound for your back pain will often make them go "Here, why don't you try this opioid first and see if it gets better?"

Re: Six Detroit area doctors indicted in $500M health care fraud

#24

Post by rmason » Fri, Dec 07, 2018, 5:06 AM UTC

whalesalad wrote: post #20

Bloomfield Hills and Birmingham... doesn't surprise me. This isn't really fair to associate with Detroit either. These are suburbs 30+ minutes outside of the city.

Seems like it's unique to Detroit. I've tried for thirty years to get software companies to extend their road trips to Detroit. But I get told there's only 670,000 people there and that's way too small. Then I inform them there's 4.5-5 million people in the Detroit metro area. So now this is the reverse, instead of saying North of Detroit they tar and feather Detroit in the story.

One of the Doctors mentioned is in Ada which is near Grand Rapids and clear across the state!

Re: Six Detroit area doctors indicted in $500M health care fraud

#25

Post by dr_ » Fri, Dec 07, 2018, 5:10 AM UTC

CaliforniaKarl wrote: post #3

Ugh. I’m going on for surgery next Thursday, for a laparoscopic partial colon resection, and one of the things I’m most worried about will be post-surgery pain killers. Hearing stories about excessive pain killer use and prescription really make me want to avoid them, but on the other hand I’ll need to be up & moving around ASAP to speed my recovery, and pain would get in the way of that.

Having post-operative pain is a legitimate reason to use them. Just use them judiciously. Your goal should not be a pain level of zero, it should be a pain level that is manageable. You will likely have the option of using Tylenol instead if you prefer, and possibly NSAIDs, so you can try either of those before you resort to narcotics. Everyone reacts different. In the past week I've had someone who underwent a hip replacement who can't get around without heavier doses of narcotic pain meds. And I've had a guy who had his leg amputated, who just takes Tylenol.

Re: Six Detroit area doctors indicted in $500M health care fraud

#26

Post by CaliforniaKarl » Fri, Dec 07, 2018, 5:22 AM UTC

leoh wrote: post #11

CaliforniaKarl wrote: post #3

Ugh. I’m going on for surgery next Thursday, for a laparoscopic partial colon resection, and one of the things I’m most worried about will be post-surgery pain killers. Hearing stories about excessive pain killer use and prescription really make me want to avoid them, but on the other hand I’ll need to be up & moving around ASAP to speed my recovery, and pain would get in the way of that.

Maybe you can make sure to discuss this with your doctor until you feel comfortable?

Yup! It's one of two things I'll bring up in the pre-op meeting with the surgeon:

1. Make sure we're in agreement as to the things being done. Yes, it's been discussed multiple times, but best to be clear!

2. Ask what kind of pain killers I'll already be on when I wake up.

Re: Six Detroit area doctors indicted in $500M health care fraud

#27

Post by klodolph » Fri, Dec 07, 2018, 5:27 AM UTC

CaliforniaKarl wrote: post #3

Ugh. I’m going on for surgery next Thursday, for a laparoscopic partial colon resection, and one of the things I’m most worried about will be post-surgery pain killers. Hearing stories about excessive pain killer use and prescription really make me want to avoid them, but on the other hand I’ll need to be up & moving around ASAP to speed my recovery, and pain would get in the way of that.

What I understand is that addiction usually starts from misuse and overprescription. If you are given pain killers for acute pain or recovery from surgery the rates of abuse are lower.

Re: Six Detroit area doctors indicted in $500M health care fraud

#28

Post by refurb » Fri, Dec 07, 2018, 5:32 AM UTC

pstuart wrote: post #22

dumbfoundded wrote: post #13

Earlier quoted context omitted.

It's crazy that cannabis is a schedule 1 drug. It's by far the safe way to manage chronic pain but federally illegal. I'm glad the states have the chutzpah to make it legal. The older I get the more I see how this country is run on money above everything else.

Crazier still is that kratom is getting lined up to be scheduled as well, when it is a proven safe tool for weaning people off of opiates.

It will be interesting to see if they finally make kratom schedule 1. When they tried it last time, the public outcry was enough to stop it.

And I agree it would be awful if they did. Kratom is certainly not without addiction risk, but if you believe in harm reduction, it’s far better to have people taking it versus prescription opioids or heroin.

Re: Six Detroit area doctors indicted in $500M health care fraud

#29

Post by CaliforniaKarl » Fri, Dec 07, 2018, 5:36 AM UTC

ip26 wrote: post #16

CaliforniaKarl wrote: post #3

Ugh. I’m going on for surgery next Thursday, for a laparoscopic partial colon resection, and one of the things I’m most worried about will be post-surgery pain killers. Hearing stories about excessive pain killer use and prescription really make me want to avoid them, but on the other hand I’ll need to be up & moving around ASAP to speed my recovery, and pain would get in the way of that.

Have you asked about other options? Alternating acetaminophen & ibuprofen has been popular among the docs I've seen recently. Heck, around here many get a bottle of 800mg ibuprofen after a C-section, no opiods.

Ibuprofen might probably be ruled out, due to the stomach upset it can cause in larger doses, and they may not want the anti-inflammatory effect(?). But yeah, acetaminophen would work!

Re: Six Detroit area doctors indicted in $500M health care fraud

#30

Post by CaliforniaKarl » Fri, Dec 07, 2018, 5:38 AM UTC

akamel wrote: post #10

CaliforniaKarl wrote: post #3

Ugh. I’m going on for surgery next Thursday, for a laparoscopic partial colon resection, and one of the things I’m most worried about will be post-surgery pain killers. Hearing stories about excessive pain killer use and prescription really make me want to avoid them, but on the other hand I’ll need to be up & moving around ASAP to speed my recovery, and pain would get in the way of that.

Use them only when you need them. I was really annoyed when my wife’s doctor freely prescribed her oxi after her delivery even though my wife never asked for it and never showed any sign of needing it. Having free flowing prescriptions is how we end up with so many addicts.

Yeah, I remember when I got a wisdom tooth out, afterwards I got a prescription for something pretty strong. Vicodin, I think? It was years ago, and I don't remember.

But I do remember that, even though I filled the prescription, I never ended up taking it. A few days of higher-dose ibuprofen (taken with food) was enough.