DR WINTER – MEDICATION ASSISTED TREATMENT – OPIOID OPIATE ADDICTION – POST FALLS ID

Belgium PRIVATE

Pawni PERSONAL

PROFESSIONAL

PHYSICIAN LEVEL SERVICE

CALL 208-626-2949

NORTH IDAHO LOCATION – EASY ACCESS –

POST FALLS off I-90 Seltice

OPIOID and opiate abuse/addiction medication assisted treatment (MAT) with Suboxone, Buprenorphine, Subutex.  PHYSICIAN level service.  PRIVATE.  Successful integration into daily life without fear and guilt.  START TODAY.

Emergency Poetry

POETRY BY DRJPWINTER

****************************************************************

TO SEASONS OF COEUR

drjpwinter

As young love brilliance faded,
Storms of passion now jaded –
As friendship salvage tenets stated,
Love and the spirit must be traded.

*****

“TO FAMILIES OF EMERGENCIES”

drjpwwinter

Harmony or storms

Riding life’s ocean waves –

With dangerous sneaker forms

Which always, love saves.

*****

“TO EMERGENCIES BONDING”

jpwinter

Nature’s bucky balls fly

In cosmos carbon flight –

Not to any naked eye

Bonds of absolute might.

*****

“TO THE CALL – STAT, STAT, STAT”

drjpwinter

ER team looks for life’s sign

DOA, Trauma Red and Code Blue –

Emergency calls define

As malpractice and lawyers ensue.

*****

TO FAVORITE DAUGHTERS

drjpwinter

One never knows of  love

As depth of breaths recede –

And graceful prayer rains from above,

A newborn rainbow when dark clouds preceed.

*****

“TO THE SEASONALLY EMERGENT”

drjpwinter

Winter wonderland

Spring wildflower in hand –

Summer parade band

Fall colors in ocean sand.

*****

“TO MY MENTOR MRYUK”

drjpwinter

Wizard to honor

Comrade to hail –

Physician of poisons

Career sunset sail.

anxiety and worry

Today is now.  Now is current.  It is what is.  Yesterday is a trail of previous now.  Tomorrow is a feeling of now coming to be, but it is not.  Now is the moment.  Worry less by focusing on now.  Now is the mind not thinking but of the now.  Remember as in an emergency, only the focus is the emergency.  All past and future stop.  Focus is now.  Time leaves as focus intensifies to the now.  Less anxiety happens when focus is on the now moment.  Now…

music is not soul…it is the soul

Music is the soul.  Music is the release of life.  Music is the now.  Do not wonder how the musician can create but wonder why.  Music is not the future, nor the past.  Music is the now.  Be bold musicians.  Be brave musicians.  Wonder only beyond the noise, create only beyond the universe.    drjpw

“DRUGS’ HALL OF SHAME” – IT’S NOT ABOUT PERFORMANCE

DRUGS…PROFIT…PERFORMANCE…DRUGS…CHEAT…ILLICIT…UNETHICAL…

PROFIT…

PERFORMANCE…CHEAT…ABUSE…LIE…DIE

So much of our world is drug oriented. We understand overall, that without drugs, even chemicals, our world would be full of disease, food sources would be lessened, and conveniences would be limited. As this thesis is written, the touch is embracing plastic keys, rubberized mouse pads, vinyl coated wiring – my elbows pushing steadily on laminate. The rubber tips of my work tools include rubber ear tips on my stethoscope, rubberized tubing to the metal plated bell to listen to patients’ hearts with a plastic cover shield to clean off.

So what is the deal with the lead in the toys? The recent recall included over 405,000 lead contaminate toys from the Chinese manufacturers. Some of the toys recalled were “Duck Family,” Robot 2000, Big Red Wagons, Winnie-the-Pooh spinning products.

To my knowledge, no child has been severely poisoned with these toys, nor injured in a poisoning sense with these lead toys. The greatest majority of lead cases these days are from old paints…pre-1976…when lead was taken out of the USA marketplace of paints. So old paint chips that children eat or ate, especially in older home and apartment buildings renovations, was and are the source. But the biggest reduction in lead overall in the USA was the reduction of lead in gasoline. This essentially stopped the big problem. More discussion of lead poisoning was when under Clinton’s administration, the lead limits were reduced to an absolute low level despite little or no data to support the new change. But even with this new limit in children, few ever have had disease.

Nicotine in itself is a drug, a chemical that has been used obviously in smoking addiction, but in itself is not a bad thing. It has been used in industry in a variety of compounds. Nicotine, however, is the buzz in smoking. Just good old craziness allowed the U.S. to create multi-millionaire attorneys fighting for “our rights” and for those who “didn’t know” cigarettes were bad, yet the USA funds tobacco, the tribes sell tobaccos at reduced prices to entice smoking, and the CDC funds research to explore “the nicotine drug cure,” and it is all still legal. At a recent American Heart Association meeting, research on the new nicotine vaccine has made some promising head roads. One year and five shots later, the vaccine doubled the number of “stopped” addicted smokers from about 6% to 15% over the year. The problem still exists that less than 10%, some say lower, smokers of cigarettes ever stop that consistently try to stop. How many smokers? About 46-50 million in the U.S. and about half of them will try to stop sometime. The vaccine is a potentially great drug to help. The nicotine blocker med which castMD has written on before still helps to, but so far is not necessarily more effective than the patch or the gum. Stopping smoking takes good old will power.

And then there is the date-rape drugged toys. Most of this happened if not all was with the “Aqua Dots” toys. It seems that one of the chemicals in the surrounding coating changes or gets metabolized in the body when eaten. This is an extremely unique and interesting mass-market finding. It is really quite amazing that it was found. The GHB that was found is extremely difficult to measure generally. Many times in the ER, labs can not find it. It is metabolized quickly. Some of the previous day’s internet drug providers (illicit) sold chemicals that would convert to GHB. Some of these chemicals are still passed around and used at “rave parties” and other parties. GHB is a dangerous drug. It is illicit. It can kill you or make you unable to defend, protect, or interact. Thusly, called the date-rate drug. However, it was a prescription drug known as Rohypnol that was one of the original date rape drugs. It is also now illegal in the U.S., but probably can be found in the international markets illegally…not sure of legally however. Always open your own beverage and never leave one sitting around…especially in the club scene.

Did Bonds do it or not? Will the “asterisked” marked Hall of Fame baseball be delegated a fraud by another drug story? Not just another drug related story in recent and past news. Maybe all steroids should just be allowed in all athletics. Tell the athletes the risk, the wrestlers, the baseball players, and the Olympians. All these steroid abuse stories have hit the news just in the past months.

But the problem with that is…this story…

Doping in sports is a problem. But would you give or have someone else give your daughter or son steroids for performance enhancement? Watching little league and junior to senior sports makes me wonder. How far would a parent or caregiver go?

From the 1976 Olympians of East German come the latest stories of abuse, which is being called in a new documentary “The Great Olympic Drug Scandal: Revealed.” The sports “theme plan” developed relied on anabolic steroids. That year, 40 gold medals were placed over East Germany’s team members with a heavy emphasis on women’s swimming events winning all the golds in nearly all the events. Children were given oral tablets and injections, even on the day of competition in the Olympics, untraceable at that time. Coaches were rewarded by success, despite the unethical mark. Some athletes recruited prior to teenage were started on performance enhancement drugs. Doctors were required to sign confidentiality agreements despite the unethical mark.

Some of the athletes had sexual identity and self-worth problems while growing up. Many had obvious gynecological irregularities. In later life, sexual identity was explored and some even had sex changes. But many have been left out of the story lines…How has their lives been altered? How many have died unknown, changed forever by the decay of human value, gross ethical breaches of doctors, and limitless greed of self-flagellating coaches.

Systematic. Documented in abusive performance. Involuntary. Organized to destroy human life. Sidelined by death. Welcome to professional sports and Olympian sports.

Welcome to Beijing anyone?

Welcome to the Drugs’ Hall of Shame! It is NOT about performance…

EATING DISORDERS NEEDS INTERVENTION BEFORE IT’S TOO LATE

Recently an article on “Scary Skinny” appeared in a tabloid which included many of the female movie stars and entertainers. This article was not a prelude to Halloween; however some of the eating problems at Halloween may be of note. Most of the stars highlighted are anorexic, or shall I say anorexic-appearing – so eating Halloween candy is out. Purging the calories is also a problem for the eating disordered patient.

Jessica Alba appeared in the photo with the shoulder girdle (shoulder, shoulder blade, collarbones) quite concave. It estimated her 5’6” body to be at a possible 110 pounds is all. Her supposed 15 pound weight loss was after a love breakup.

Now the world savior Angelina Jolie was more ill appearing. Her cachectic body with all front side ribs, collarbones, and breastbone sticking out was quite shocking to see. The article highlighted her weight at 105 pounds for this 5’8”. Brad Pitt was begging her to eat according to the article – a common loved one’s frustrating request in eating disorders. According to the article, she was eating under 1000 calories, which is a weight losing diet, as her needs would be 1500 to 2000 or more calories per day, depending on baseline activity and that beyond. Eating a daily small meal or a drink of lemon impregnated water is not a normalized diet for an active mother.

The actress, Renee Zellweger, at about 38 years old, should not be showing ligaments and tendons in her arms and legs. This star struggles with the fact she’s is getting older, and will struggle with weight as she ages, according to this article. This is a finding in eating disorders.

Other stars, Keira, Kate Bosworth, and even prior, Eva Longoria are intermittently grossly underweight. Their bony gauntness is a similar finding in eating disordered patients.

Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight.

Eating is controlled by many factors, including appetite, food availability, family, peer, and cultural practices, and attempts at voluntary control. Dieting to a body weight leaner than needed for health is highly promoted by current fashion trends, sales campaigns for special foods, and in some activities and professions.

The main types of eating disorders are anorexia nervosa and bulimia nervosa. A third type, binge-eating disorder, has been suggested but has not yet been approved as a formal psychiatric diagnosis. Eating disorders frequently develop during adolescence or early adulthood, but some reports indicate their onset can occur during childhood or later in adulthood.

Eating disorders frequently co-occur with other psychiatric disorders such as depression, substance abuse, and anxiety disorders.

Females are much more likely than males to develop an eating disorder. Only an estimated 5 to 15 percent of people with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder are male.

Anorexia Nervosa

An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime.1 Symptoms of anorexia nervosa include:

Resistance to maintaining body weight at or above a minimally normal weight for age and height

Intense fear of gaining weight or becoming fat, even though underweight

Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight

Infrequent or absent menstrual periods (in females who have reached puberty)

People with this disorder see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession.

The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population

The most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide.

Bulimia Nervosa

An estimated 1.1 percent to 4.2 percent of females have bulimia nervosa in their lifetime.1 Symptoms of bulimia nervosa include:

Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting or misuse of laxatives, diuretics, enemas, or other medications (purging); fasting; or excessive exercise
The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months
Self-evaluation is unduly influenced by body shape and weight
Because purging or other compensatory behavior follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height. However, like individuals with anorexia, they may fear gaining weight, desire to lose weight, and feel intensely dissatisfied with their bodies.

People with bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet relieved once they purge.

Binge-Eating Disorder

Community surveys have estimated that between 2 percent and 5 percent of Americans experience binge-eating disorder in a 6-month period.  Symptoms of binge-eating disorder include:

Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
The binge-eating episodes are associated with at least 3 of the following: eating much more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of being embarrassed by how much one is eating; feeling disgusted with oneself, depressed, or very guilty after overeating

Marked distress about the binge-eating behavior

The binge eating occurs, on average, at least 2 days a week for 6 months

The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise)

People with binge-eating disorder experience frequent episodes of out-of-control eating, with the same binge-eating symptoms as those with bulimia. The main difference is that individuals with binge-eating disorder do not purge their bodies of excess calories.

Therefore, many with the disorder are overweight for their age and height. Feelings of self-disgust and shame associated with this illness can lead to bingeing again, creating a cycle of binge eating.

Because of their complexity, eating disorders require a comprehensive treatment plan involving medical care and monitoring, psychosocial interventions, nutritional counseling and, when appropriate, medication management. At the time of diagnosis, the clinician must determine whether the person is in immediate danger and requires hospitalization.

Goals:

(1) restoring weight lost to severe dieting and purging; (2) treating psychological disturbances such as distortion of body image, low self-esteem, and interpersonal conflicts; and (3) achieving long-term remission and rehabilitation, or full recovery.

The primary goal of treatment for bulimia is to reduce or eliminate binge eating and purging behavior. To this end, nutritional rehabilitation, psychosocial intervention, and medication management strategies are often employed.

Several family and twin studies are suggestive of a high heritability of anorexia and bulimia, and researchers are searching for genes that confer susceptibility to these disorders. Scientists suspect that multiple genes may interact with environmental and other factors to increase the risk of developing these illnesses. Identification of susceptibility genes will permit the development of improved treatments for eating disorders.

(adapted: cdc/intouch/commentary)

Cocaine – Hydros – Weed – “The Three Amigos” in the Workplace

Workplace drug tests recently have shown a decrease in cocaine positives during the first half of 2007. The positive tests for cocaine dropped 16% as the overall rate was 0.58 percent. This rate is the lowest since tracking the information back in 1997 by one lab. The lowest rate of decline was in the Midwest while the highest rate of decline was in the New England areas. The total tests counted for this tracking included about four and one-half million urine drug tests, which all included testing for cocaine and other drugs of abuse. Some believe the shortage of cocaine and higher costs are driving the decline, while European cocaine abuse is becoming increasingly popular, adding to world-wide demand. As a Medical Review Officer for Work-Place Drug Testing, cocaine remains popular.

In another report on drugs of abuse, marijuana recently was highlighted. It is apparent that reefing the great weed is about 5 times more harmful than one cigarette. The apparent problem is a greater intensity of airway obstruction. This effect may be caused by an increased “holding” of the smoke which is a longer time of interaction with the lung tissue. Another concept is that the smoke is literally hotter, creating a deeper thermal injury to the lung tissue itself. Interestingly, when compared to regular smokers, the marijuana smokers had less emphysema changes.

DAWN, or the Drug Abuse Warning Network, continues to focus on hydrocodone. This narcotic goes with the brand names of Norco, Lortab, Vicodin – but is generic in many prescriptions. Sales of hydrocodone and oxycodone have dramatically increased over the past years. The Pharma industry spends over 3 times as much on advertising as it did a decade ago.

www.castMD.com has written on this plague and the advertising push to addiction by the Pharma industry in past postings.

Despite the pressure to put these dangerous and addictive drugs on a higher schedule of restriction of prescribing, Schedule II, the FDA and DEA has been lobbied heavily to not do so.

With all the Pharma advertising, a push toward better pain management, and the abuse of narcotics, hydrocodone based drugs and combo drugs ranked number 2 in 2006 just behind the cholesterol lowering brand name, Lipitor. From 2001 to 2006, hydrocodone prescriptions rose by 2/3rds.

Hydrocodone is the number one drug in its category to arrive at the Emergency Department. It is also the number one drug of its category reported to the National Forensic Lab Info System.

www.castMD.com says, “Ban hydrocodone or elevate the Schedule.” It is a considerable concern of abuse in junior high kids, high school kids, and patients.”    Should it be banned?

adapted:  acoem/castMD

PRESIDENTIAL CAMPAIGN DONATIONS – SILENT BIAS OF THE QUID PRO QUO

IF YOU MISSED THIS POLICY-PUSHING DONATION GROUP LISTING IN USA TODAY NEWS, HERE IS A SECOND CHANCE TO SEE THE MONEY MIXERS.

And the money makes the politics “responsive!”

PRESIDENTIAL CAMPAIGN

 CONTRIBUTIONS

TIME: JAN 1, 2007 THROUGH JUNE 30, 2007

TYPES OF BUSINESS                                    DOLLARS         PARTY

LAW FIRM-LAWYERS                             27.8 MILLION 78 % TO DEMS

SECURITIES-INVST                                   18 MILLION 56 % TO DEMS

RETIRED                                                     16.5 MILLION 51 % TO DEMS

REALESTATE                                             11.7 MILLION 50 % TO DEMS

BUSINESS                                                     8.2 MILLION 75 % TO DEMS

BUSINESS SERVICE                                      6 MILLION 63 % TO DEMS

FINANCE                                                       5.9 MILLION 46 % TO DEMS

MOVIE-TV                                                    4.6 MILLION 82 % TO DEMS

HEALTH PROF                                             4.4 MILLION 53 % TO DEMS

EDUCATION                                                  4.1 MILLION 75 % TO DEMS

SO, THE DEMS ARE IN THE LEAD SO FAR WITH DONATIONS ACROSS ALL WALKS OF EMPLOYMENT.

It is amazing that the discrepancy of donation dollars regarding the legal industry is so extraordinarily excessive compared to many other business sectors. No wonder tort reform is impossible in many areas of the country. This non-action on tort reform effects all businesses, not just medicine. Now you know. The money follows the “silent bias of the quid pro quo.”

(The data is from the Center for Responsive Politics)