#Primary care physician clinic Phoenix
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ereardon · 1 year ago
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Golden Hour || Ch. 2 [Bob Floyd x Bradley Bradshaw x OC]
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A Bob Floyd & Bradley Bradshaw AU [Hart of Dixie inspired]
Synopsis: Willow, Georgia. Barely even a town, just a speck on a map that you tried to wipe off, mistaking it for a crumb. You’re the outsider: a fancy New York doctor, fresh out of a failed engagement, with zero primary care experience. You’re also the new town doctor, taking over for a recent retiree who was beloved. His son, Bob Floyd, is the other physician at the practice, and takes an immediate dislike to you. But you were looking for a fresh start, and Willow doesn’t seem all that bad if you can get past the fact that there's only one restaurant in town. It helps that you've caught the eye of Bradley Bradshaw, the town attorney, despite the fact that you vowed to take a break from dating. How long until you start to make friends in a town where social circles have been set in stone since elementary school? And what will it take to make Bob Floyd see you’re not as bad as he wants to believe you are?
Pairing: Bob Floyd x OC; Bradley Bradshaw x OC
Tropes: Love triangle, enemies to lovers
Warnings: Cursing, mention of vomit, alcohol
Chapter summary: Olive settles into her new home; the town comes down with the flu; Olive has a run in with Bradley at the grocery store; Bob is suspiciously absent during the flu pandemic and Olive arrives at his doorstep to confront him
WC: 3K
Masterlist here; first chapter here; next chapter here
You showed up at quarter to seven, double checking the address Phoenix had written down on the scrap of receipt paper. 
This couldn’t be right. 
The house was palatial. It was practically a plantation, if you could still call houses plantations. A sweeping iron gate out front, with a long driveway that ran straight back to an enormous white house with blue shutters and a round driveway out front. 
You got out of the car, starting up the stairs. Just when you lifted your hand in a knock, the door swung open. 
Phoenix stood with her hair dripping wet, a towel bunched up in her hands as she squeezed it dry. She had changed out of the overalls from earlier and now wore a pair of running shorts and a cropped t-shirt. “Olive!” she said. “You made it!” 
You nodded. “Is now an OK time?” 
“It’s perfect.” Phoenix slid out of the way. “Come on in.” 
You stepped inside. The house was even more beautiful on the inside than the exterior, if that was possible. The foyer had a black and white tile flooring that led to a curved white staircase that hugged the left side of the room and rounded out gently on the second floor. An antique wood table sat beneath the curved staircase with the largest arrangement of flowers you had ever seen in one person’s home before. 
Phoenix tracked your eyes. “It’s a lot, I know.” 
“It’s fucking beautiful,” you said and her jaw dropped a little. You blushed. “Sorry, force of habit. It’s beautiful.” 
She shook her head. “Doesn’t bother me, but trust me when I say some of the folks around here are a lot less welcoming than I am.” 
You let out a sigh. “Tell me about it. Dr. Floyd has me on his shit list.” There you went again, cursing up a storm. 
Phoenix frowned. “Bob? Really? He’s so nice.” 
You cackled. “Nice? He’s been cold to me since the moment we met.” 
She led you down a large main hallway which opened up at the back of the house to a large living room and kitchen. “Cold? That’s new,” she said. “What happened?” 
You gave her the rundown of everything that had happened the second time you went to the clinic, including bumping into Bradley. 
Natasha’s eyes lit up. “So you met Bradshaw, huh?” 
You nodded. 
She gave a knowing look. “He’s single,” she added. 
“I’m not looking for a relationship right now.” 
Phoenix opened the fridge and pulled out a bottle of white wine. “And why not?” 
You debated not telling her. You had made it approximately eight hours in Willow before divulging your past. But it was bound to come out anyway. And there was something about Phoenix that made you want to tell her things. Probably why she was a good bartender. You held out your left hand, the faint indentations of a ring still visible on the bare digit. 
She nodded knowingly. “When did it happen?” 
“Last week,” you said. “I came home from the hospital and he was already there, which was rare. Just sitting on the couch, head in his hands, and the minute I walked through the door he looked up and said it was over. I stormed out and threw the ring in the East River.” 
Her mouth fell open. “You did not.” 
You nodded. “Three carats, too. But I lost my shit and it was the first thing I could think to do.” 
“Did he ask for it back?” 
You shook your head. “No. But Peter has enough money, I don’t think it’ll make too big of a dent.” You winced and then added, “He was my attending.” 
“Attending?”
“My boss,” you clarified. “He was the senior attending for fetal surgery. I was the fellow. Let’s just say that our relationship never went over well with the surgery group.” 
Phoenix let out a whistle. “Hot damn, drama. I love it.” 
You liked her immediately. There was something charming about the way she immediately poured you a drink even though she was off the clock, and the way her brown eyes locked on yours, like you were the only person in the room. Which you were, but that wasn’t the point. You knew that even in a room full of people, Phoenix had the ability to make it feel like she only had eyes for you. 
And you needed a friend. More, now than ever. 
You sighed. “Anyway, that’s why I left New York. And that is why I am definitely not ready to start dating.” 
Phoenix smirked. “Honey, this is Willow. You’re going to get caught up with someone faster than sweat piling up on your upper lip in August. I mean, look at you.” Her eyes trailed over your slim skirt, tight cowl neck shell top, coiffed brown locks. “No wonder Bob was so angry with you showing up. You’re about to steal all his male patients.” 
“Tell me about him,” you said, leaning both elbows on the counter. “I need to know about my competition.”
“Bob?” she asked. “I don’t know what to say. I’ve known him for years, since we were kids. All three of us: me, Bob, Bradley. He’s always been a little shy. He was the smart one. We all knew he’d follow in his daddy’s footsteps. He went to Emory for medical school, Bradshaw went to New York for law school, and I stayed here. But I always knew they’d come back.” She smiled ruefully. “Men always do.” 
“Wait, Bradley went to New York?” 
She nodded. “Columbia Law.” 
You frowned. “How old is he?” 
“Thirty one.” 
You two were probably there at the same time. Him in the law school, you at the medical school. 
“Bob is a good guy,” she added. “He’s a bit of a grouch. But it’s only because Dr. Robert retired and he’s been busier than ever.” 
“He doesn’t seem to like me much.” 
“We don’t get a lot of newcomers,” Phoenix said. “And the ones we do, most people tend not to like.” 
“So I’m at an automatic disadvantage.” 
“Yup.” 
You sighed. “Great.” 
Phoenix laughed, setting down her glass of wine. “Let me show you the guest house.” 
The guest house was out back. Way out back. You couldn’t even see the main house anymore when Phoenix rounded a corner and stopped in front of a slightly dilapidated green two-story house. The front porch of the house sagged slightly and the door was a little off kilter. 
Phoenix scooted up the steps and unlocked the door, holding it open. You quickly followed her inside. “It’s a little dusty, sorry about that,” she said. “And a little run down. But I think it should work.” 
Inside there was a small entryway that led to a living room on one side and a bedroom on the other. Everything was covered in a thin layer of dust, and the furniture had sheets flung over it. Phoenix opened the blinds, letting light filter into the room, and put her hands on your hips. 
“Ain’t much,” she said. “But it’s something.” 
“I’ll take it.” What other options did you have? Besides, you liked Phoenix. She was the first and only person to be nice to you in Willow.
***
Your second day went just about as well as your first. 
You showed up at the office at nine, to find it bustling with patients. A frazzled Molly sat at the front desk, hair askew. 
“Where have you been?” she demanded as you walked through the door. “People been lining up this morning.” She handed you a stack of charts. “The flu.” 
You grimaced. “The flu? In September?” 
“When it rains it pours.” 
You groaned. “Alright, give me two minutes to get a cup of coffee.” 
“No time,” Molly said, steering you toward the dusty office at the front of the building. “Mr. Schwartz has been waiting for forty minutes and he’s just about the most impatient man I’ve ever met.” She turned around, faking a smile. “Mr. Schwartz? The doctor will see you now.” 
A grisly looking man stood up, face pale and sweaty. You smiled delicately. “Hi, I’m Dr. James—”
He waved a hand in your face. “Don’t care, sweetheart. Gonna be sick so get out of the way.” 
You winced as he barged into the exam room and unloaded his stomach in the trash. Molly scampered away as you closed the door and pulled on a pair of gloves. 
The rest of the day was no better. Patient after patient sick with a mysterious flu that was going around. There was nothing you could do for them besides check their vitals, remind them to hydrate, explain proper hygiene to minimize getting other family members sick, and send them home to rest. But yet they came in droves. 
By three o’clock, you had seen countless patients, and Bob’s door had never been opened. You frowned. “Where is he?” you asked Molly. 
She looked up from a cup of tea. “The doctor is not in.”
You rolled your eyes. “I know that, it’s why I’m up to my elbows in puke. Where is he? When is he coming in?” 
“He’s not. It’s his day off.” 
“Day off?” you scoffed as the door opened and three more people shuffled into the waiting room. “Fuck,” you muttered under your breath.
“Dr. James!” Molly scolded. “This is a family town.” 
“You’re right,” you said, squaring your shoulders and turning around, gesturing to the taller man slumped against the wall. “Sir? I can take you back now.” 
Finally, it was dark out and you made your way back to the guest house to shower. But halfway through the shower the water ran cold and you realized you were out of shampoo. 
“Fuck!” you shouted, this time not caring if anyone could hear. 
At the market, you stood with sopping wet hair, staring at two bottles of Suave shampoo. So much for your Oribe hair products that were probably in the trash already back in New York. Peter never cared much for their scent. 
You sighed, grabbing the green bottle. 
“Didn’t think I’d have to fight someone for my favorite shampoo tonight.” 
You whipped around. Bradley Bradshaw stood two feet away wearing a pair of chinos and a polo, looking way too fresh for the end of a hot Georgia day. He grinned, taking in your short denim shorts and cropped tank, wet hair and bare face. 
“Long day, doc?” he asked. 
You rolled your eyes. “You have no idea. I’ve got a hot tip for you. Wash your hands when you get home. Whole town has the flu.” 
He nodded. “Yeah, I heard. Sounds like a bad day.” 
“Understatement.” 
“Then you need ice cream,” Bradley said, moving over to the freezer section. “Are you a chocolate girl?” 
“Is there any other kind of girl?” you asked and he chuckled. 
“Here, this should solve anything.” He waved a pint of Ben & Jerry’s Half Baked in the air. 
You sighed in relief. “Thank God there’s ice cream here. I thought maybe it would be a churn your own butter kind of place.” 
Bradley laughed, holding out his hand. “Here. Let me buy that for you.” 
“Really?” 
He nodded. “I insist. A girl shouldn’t have to buy her own ice cream at the end of a long day.” 
You handed him the shampoo bottle and bottle of wine that was under one arm and he grinned, carrying them alongside the ice cream to the counter. He paid, chatting with the cashier briefly, before accepting the bag and ushering you out of the store. The hot summer air hit your skin and you felt immediately filthy again. “God, is it always this humid? Feels like I’m walking through a room filled with Jell-O.” 
“Pretty much,” Bradley said. Under the glow of the street lamp, you saw no sweat on his brow. Was he even human? “Just wait until November though. Winter is perfect.”
You groaned. “Will I make it to November? Will I make it to next week even?” 
“I hope so.” There was something leading in his words. “Heard you’re staying out at the Wilkes plantation.” 
Wilkes. That must be Phoenix’s family name. You nodded. “Yeah. Phoenix offered me a place. It’ll do.” 
“She’s a nice girl.”
“Pretty much the only friend I have,” you admitted. 
Bradley flashed his bright white smile. “Looking for another?” 
You squinted. “What are you getting at, Bradshaw?”
“Go on a date with me, doc,” he said. 
You grabbed the plastic bag from his hand. “Or else?”
He put his hands up. “Or else nothing. I’m not threatening you, Olive. I don’t badger witnesses. Just wanted to take the pretty new doctor out for dinner sometime.” 
“That sounds nice,” you said. “But I’m a mess right now. I just got out of a big relationship and it’s complicated.” You looked up. “I know that sounds like a cop out, but it’s the truth.” 
“Fair enough.” Bradley fiddled with his keys. “Well, goodnight then, Olive.” 
You turned, headed back to your car. “Goodnight, Bradley.” 
You unlocked the car, before his voice carried across the town square. “Hey, Olive?”
Turning, you spotted Bradley with both hands in his pockets. “Yeah?” 
“Messes are kind of my specialty,” he said and you laughed. “Being a lawyer and all. Just thought you should know that.” 
You shook your head. “You’re trouble, aren’t you?” 
He grinned. “It’s called small town charm, Olive.” 
You slipped into the front seat of the car and turned it on, audibly sighing as the air conditioning wafted over your sweaty skin. Up ahead, Bradley turned the corner, disappearing down a darkened street. You leaned back against the headrest and closed your eyes. 
***
Where the fuck was Bob?
It had been three days of the flu and he hadn’t bothered to show up to work. Molly was no help either. 
“Call him again,” you demanded.
She gave you a sour look. “If he didn’t pick up earlier, why would he pick up now?” 
You huffed, strutting away in your Jimmy Choos. 
Add buying new, Willow-friendly shoes to your to-do list. Right behind kill Dr. Bob Floyd. 
Finally, one the last patient emptied out of the waiting room, you grabbed your purse and keys, over Molly’s cries of protest. Your rental car barreled down Bob’s suburban street, just off the main square, skidding to a loud stop in front of his house. 
It was cute. That was the first thing you noticed. The second was that his car, an old Audi sedan, was in the driveway, which meant that he was home. 
You sighed, stepping out and ringing the doorbell, foot tapping in your heels. No answer. You rang it again, impatiently, straining over the edge of the door to look through the small window at the top. Ringing it one more time, you started to knock when you heard the lock unclick, the door swinging open slowly. 
Bob Floyd stood in the doorway wearing a hoodie and a pair of pajama pants, his face pale, glasses sitting perfectly on his tiny button nose, hair combed back neatly. “Dr. James,” he said gruffly. 
You squinted. “Where have you been? I’ve been up to my ears in vomit and ear exams and dramamine and not a fucking peep about where you were or when you were coming back. Just a constant stream of sick people.” 
“You’re a doctor, Olive,” he said and his voice was more than gruff, it was scratchy. “You should be used to sick people by now.” 
“Are you?” Oh fuck. “Are you sick?” 
He raised an eyebrow. “What gave you that idea?” 
“Hoarse voice, pale pallor, heavy clothes in the summer heat.” 
“It’s like you went to medical school or something.” 
You folded your arms over your chest. “Well come on, let me examine you.” 
As you started to step inside, the cool air beckoning you, Bob held out a hand, only inches from your chest. You looked down and he removed it. “No thank you.” 
“But you’re sick,” you countered. 
“I know that,” he replied. “Do you know how I know that? I went to medical school, just like you did. I am more than qualified to take care of myself, Dr. James.” 
You frowned. “I’m just trying to help.” 
“I am one patient who really does not need your help,” he said. “Now if you don’t mind, I was enjoying a rather nice nap.” 
You took a step back, practically frozen. In New York, such bluntness would have been standard. Expected. But in Willow, Bob’s shun felt like a dig that would never stop hurting. “Are you sure?” you asked. 
His blue eyes softened a miniscule amount. If you hadn’t been watching him so closely you wouldn’t have noticed. His bottom lip dropped an inch, as if he was about to say something. But then he decided against it, mouth turned back into a fine, tight line. “Yes.” 
You nodded. “OK. Just call Molly when you think you’re ready to come back and I’ll handle the patients in the meantime.” 
“That is why my father hired you,” Bob said. 
“Yeah. It is.” You lingered. “I, um, I guess I’ll see you around.”
You climbed down the front stairs of Bob’s ivory house, stuffing yourself back into the driver’s seat. 
Why was it that you could feel the heat of his gaze burning the back of your head as you drove away? And why did it, for just a second, feel like he was about to cave when you asked if he was sure? 
You were going to crack him. Buy new shoes, order hair products online, and make Bob Floyd stop hating you. 
Your to-do list just kept on growing.
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arizonaprimarycare · 2 years ago
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bassiclinic · 3 years ago
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Every Health Care Pro should Know _ Bassi Clinic
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spookysheeppaper · 4 years ago
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accidentinjurysolutionsaz · 5 years ago
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painstopclinics01 · 4 years ago
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Nurse Advice Line Registered Nurse 24/7 Nights Weekends Compact Multi State Telecommute
The quality of care we provide our patients doesn’t change no matter how it is delivered. Joining UnitedHealth Care as an Advice Line Registered Nurse can be your opportunity to offer a higher level of care to our members. While your work will take place over the phone, you’ll have a direct impact on the lives of our members, recommending an appropriate level of clinical care and connecting them with the resources they need to make informed health decisions. You’ll act as a compass for our members, guiding them through a complex medical environment as you identify appropriate providers and services, act as a health coach and provide referrals in order to optimize health outcomes. This is an exciting time to join a truly inspired organization. Take this opportunity and begin doing your life’s best work.(sm)  
This position will work as part of a 24 / 7 inbound Nurse Advice Line and we have full – time positions available.  Available shifts are days, afternoon/evening and overnight schedules that include working weekends and holidays. 
  You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. 
  Primary Responsibilities:
Assesses patient’s current health status and recommends appropriate level of care based on clinical judgment and protocols
Adheres to ethical, legal/regulatory and accreditation standards
Assesses consumer’s understanding of their condition and identifies potential care and/or provider gaps
Provides health education and coaches consumers on treatment alternatives to assist them in best decision making
Assesses readiness to change, offering opportunities for intervention that will assist consumers in reaching their health care goals
Uses coaching techniques, activation and motivational skills to empower the member to take action and participate in the shared decision making process
Supports consumers in selection of best physician and facility to maximize access, quality, and to manage heath care cost
Empowers consumers with skills to enhance their interaction with their provider
Coordinates services and referrals to health programs and community services
Assesses and triages immediate health concerns
Manages utilization through education
Collaboratively plans care with member
This position will require active and unrestricted Nursing licensure in all 50 states, Washington D.C, Guam, and Puerto Rico.  Selected candidate must be willing and able to obtain and maintain multiple state licensure. (Application fees and filing costs paid for by UHG)   
  You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Active, unrestricted Compact RN license in your state of residence 
2+ years of RN experience
Proficient level of experience with Microsoft Office applications, and strong technical aptitude
Multiple state licensure (in addition to Compact License) or ability to obtain multiple state nursing licenses required
United States Citizenship
Ability to obtain favorable adjudication following submission of Defense Health Agency eQuip Form SF86
Ability to work a shift that includes: evenings, overnights, weekends and holidays
Must have a hard – wire internet connection in your home  
 Preferred Qualifications: 
3+ years of Behavioral Health experience
3+ years of OBGYN experience
3+ years of experience working with Pediatric population
Coaching, motivational interviewing and / or decision support experience
Triage experience 
Bilingual in Spanish
Case Management experience  
As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense eQuip Form SF86, (the National Agency Check Legal and Credit or NACLC). Successful completion of the NACLC process is a requirement for continued employment in this role. NACLC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3 – 6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NACLC approval will result in termination from this role.
  UnitedHealth Group is working to create the health care system of tomorrow.
  Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we’re doing a lot of good.
  Through our family of businesses and a lot of inspired individuals, we’re building a high-performance health care system that works better for more people in more ways than ever. Now we’re looking to reinforce our team with people who are decisive, brilliant – and built for speed.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
   *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy
    Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
  UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    Job Keywords: RN, Compact RN license, Compact license, Behavioral health, OBGYN, Pediatric, Call Center, Triage, Case Management, Telecommute, Work from home, Virtual, telecommute, Houston, Tampa, Atlanta, St. Louis, Phoenix
      The post Nurse Advice Line Registered Nurse 24/7 Nights Weekends Compact Multi State Telecommute first appeared on Colorado Jobs Hub.
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Do you have any recommendations about using progestin-only birth control to stop shark week pre-t? Does this work? Will a guy get feminizing side-effects from using hormonal birth control?
Lee says:
The progestin/estrogen combination-pill is usually the go-to for stopping your period, but I have heard of people using Norethindrone which is progestin-only to stop periods. With progestin-only pills, it’s super important that you take your pills at exactly the same time every day, and if you don’t then there’s a chance that your period might come back.
I’ve also heard of people using Seasonique (a combo pill) instead of Norethindrone, so it’s worth discussing which type is best for you since there is more than one option!
But it’s established that you can use continuous contraception to stop your period safely, and Planned Parenthood says you can safely stop your period with it.
I have heard of estrogen/progestin combos also working and they shouldn’t cause feminizing effects, but your results may vary.
“The FDA approved the first no-period pill (brand name Lybrel) in 2007. And, yes, this new pill is safe. It isn’t that different from other low-dose birth control pills that use estrogen and progestin to stop ovulation. Instead of taking four to seven days of placebo pills, however, people take Lybrel continuously, with no breaks and no period. Seasonale, another extended-use oral contraceptive, limits menstrual cycles to four per year. The FDA approved Lybrel based on two clinical trials, each lasting one year, of more than 2,400 women ages 18 to 49. The trials showed Lybrel to be a safe and effective contraceptive when used as directed.” (X)
Basically, yes, it’s possible to stop your period with birth control! You may have to try more than one thing if the first one doesn’t work for you, but it’s something you and your doctor should be able to work out. If your primary care physician doesn’t want to work with you with this for any reason, you can try a Planned Parenthood- they tend to be pretty good with this stuff.
From the NY Times: For the Teen Who No Longer Wants a Period …
I’ll collect other mod answers and follower responses from similar asks about stopping periods below for ya:
Kii says:
Estrogen-based birth control isn’t “feminizing.” If you’re AFAB and not intersex, you already have enough estrogen in your body that birth control can’t really feminize your body anymore.
You’ll have to decide for yourself if stopping your period alleviates more dysphoria than taking birth control gives you. Most people see very few physical changes when they take birth control, so it won’t make you “more feminine.”
Plus, estrogen and progesterone are not “female hormones” because everyone has them in their bodies, not just females.
Unless you have a method of birth control that’s especially designed to stop periods, your periods will not stop. There are many different types of period-stopping birth control, so your best bet is to ask your doctor or pharmacist what to expect.
You should always take prescription medication as directed by your doctor. If you want continuous cycle birth control, get a prescription for that instead, but don’t skip pills in your current prescription.
Once you’ve had your first period, you can be on birth control! My doctor once told me, “If you’re old enough to have periods, you’re old enough to be on birth control.” so I would say no, there’s no minimum age to starting birth control. For me personally, it has helped me a ton and I’m very happy that I started taking it.
Addressing a possible concern that wasn’t mentioned- I was on multiple types of birth control prescribed by multiple different doctors, and no one required me to get a gynecological exam until I turned 18. Generally, unless you’re having problems with your bits, you don’t need gynecological exams until you turn 18 or become sexually active. Here’s our big gynecology post!
Also, IUDs do not stop periods for everyone, but that’s definitely something you can try.
Kai says:
I got a hormonal IUD, which will stop my periods.
(tmi ahead)
There’s no feeling/sensation that I would know anything is in there unless I literally inserted my fingers to feel for it, and even then, the strings soften over time. I had some mild cramping and discomfort for 2 days after insertion, but took over the counter ibuprofen and have not felt anything at all since. I’m pretty sure most people, if inserted correctly, won’t be able to feel their IUDs on a daily basis unless something is going weird or they’re very very sensitive.
They would need to have the strings there so that you can tell if it’s either been dislodged or fallen out, or else you wouldn’t know and could potentially not be protected against pregnancy. Definitely talk to your doctor about it. You can also get daily birth control pills, but you will have to take those every day at around the same time, and also that’s not a localized hormone so there may be other effects you may not like, but definitely talk to your doctor about it.
Speaking of, there’s a post-IUD survey here (not affiliated with us) about people who had/have IUDs.
Archer says:
So, before starting testosterone I started on progesterone only birth control and it completely stopped my monthly occurrence. In fact I’d had issues with every other birth control method I’d tried and this one, with no added estrogen, stopped it all together. On top of that, my doctor even told me to continue taking the pill up until about three months on T so I wouldn’t have to deal with my period at all hopefully.
Ren says:
To my knowledge, most long-term birth control methods (the pill, shots, IUDs, etc) don’t cause breast growth, although some will make you more ‘feminine’. But the amount of estrogen in BC usually isn’t enough to cause any noticeable effects. Maybe some boop tenderness, but it’s not enough to, like, cause boop growth.
Phoenix says:
There are lots of non-hormonal birth control options available- you just have to tell your doctor/nurse that you would prefer a non-hormonal method and they can give you more information.
Even non-hormonal birth control can help with cramps and stuff. And honestly, even if you have to use a hormonal method, it isn’t a huge amount of estrogen added to your body. I would look into non-hormonal methods first, though. Best of luck!
Emery says:
Different types of birth control affect different bodies differently. Some birth controls are estrogen and progesterone, some are just progesterone, and some are non-hormonal. 
Side effects of birth control that could be considered “feminizing” include weight gain (including in the breasts), breast tenderness, and potentially bleeding/spotting between periods. Birth control shouldn’t significantly affect your body size/shape though.
Implant birth control is usually a good method. They last for about three years typically, and I haven’t heard any horror stories about them. The implantation is relatively painless and pretty quick, and after a day or two you basically don’t notice it anymore. Then a few years later, it’s removed, and that process is also pretty quick and pretty painless. They have no serious side effects that I’m aware of, but you should consult with your doctor about whether it’s a good option for you. 
As far as HRT goes, you would probably want to remove your implant before starting testosterone, but there shouldn’t be any complications from having had the implant previously, taking it out, and then taking T. Again, though, always talk to your doctor. None of us here have medical degrees. 
You can use BC to have a period once a month, once every three months, once a year, or even once every three years, I think. Discuss with your doctor the best options for you and your body. Also consider visiting a sliding-scale Planned Parenthood for doctor’s feedback and cheap and/or free birth control of many varieties.
Fox says:
Extra estrogen in the body for DFAB individuals actually mimics pregnancy. Generally, the most it does is keep your skin clearer and hair shinier, perhaps similar minor changes. There shouldn’t be any huge changes, depending on the kind you use– but some individuals get bigger chests or hips from it, and that’s something to consider if you experience gender dysphoria. But if you’ve been on it for awhile and haven’t noticed those changes, you should be okay! I’ve been on BC for the same reason for years, and my hips and breasts are on the smaller side of average, so it isn’t an issue for everyone.
Tyler says:
I have Nexplanon, if people have questions about that then they can send an ask.
Autumn Says:
One of your fears is having more estrogen in your body. That is completely valid. But there is a cool fact about estrogen that might put you to ease. If your body has excess estrogen, it actually converts it into testosterone. I don’t know if that will help at all, but it might.
danny says:
birth control, depending on the method, can cause your body to retain water more easily. this means that regardless of your age, it can make your breasts grow. it really depends which method you are using, though. this also means that you will gain weight elsewhere too. when i was on birth control i noticed it made my hips and thighs a lot bigger, and didnt effect my breasts that much, however, it may be different for you!
Harper says:
Yes, one concern that some folks have is weight gain. But most forms of birth control do not cause weight gain:
Tumblr media
https://www.nhs.uk/Conditions/contraception-guide/Pages/which-method-suits-me.aspx
The narrative about The Pill being linked to weight gain is based on dubious evidence:
https://www.nhs.uk/news/medication/does-the-pill-really-cause-weight-gain/
What looks like you’re gaining weight can be from water retention. it usually settles down after a few months, and will definitely go away if/when you end up going off the pill. That said if you are concerned I’d say speak to your GP if you can and also consider a the variety of birth control that has the desired effect.
Jay says:
According to this, certain types of hormonal birth control may slightly increase the risk of breast cancer. (Warning at the link for cissexist language). This page states that high-estrogen BC slightly increases your risk, but low-estrogen BC does not. Low-estrogen is the type most people use. This page says nothing about progesterone-only BC (that I saw), so it most likely does not pose a risk either. If you did get breast cancer (which is very unlikely), you could have a mastectomy (it’s actually part of the treatment). A mastectomy for cancer is actually quite different from top surgery. Top surgery removes about 95% of the tissue in and around the chest to create a “male” contour while a mastectomy for cancer removes as close to 100% of the tissue.
Followers, any personal experiences with birth control to add?
Followers say:
shmannah said: For those who cannot/prefer not to introduce outside hormones, paraguard is the only hormone-free BC that I’ve found my research (although it can affect the hormones your body naturally produces). Nexplanon is a hormone releasing implant! Just FYI.
lilulak said: Also depo-provera. Progesterone only, injection every 3 months.
timefrozen-waterstreams said: I hope its okay to say this, but please don’t take the needle variant, if you plan to stop your period with it. I did it and it kinda messed me up? I had my period for 2 whole months and even after it stopped, it won’t come normally and its longer than before. Many peoples body got messed up because of it, most will tell you not to take it. I think the name was “depo-provera”, but I’m not sure.
anon said: for anyone wanting to start the depo shot - it may make you bleed for the first 3 months youre on it due to the thinning of your uterus’ lining but i got my second shot on tuesday and my bleeding has almost stopped entirely! even so, you should talk to an obgyn if you experience this bc it could also be something more serious. its a pretty common side effect and it terrified me because they didnt tell me about it so figured id inform!
sfodijnvwipejrnfgworijnhgfrijfn said: i’m a trans dude and i’m on a depo provera shot (basically progesterone) and i haven’t had a period in years. it’s amazing. also you can continue to take it for birth control after you’re on t if you eventually do decide to go on hormones!
anon said: I’m on depo prevera and it completely stopped my periods. It’s just a shot you get every three months (unless you’re like me and I now get it every 10 weeks because I have poly-cystic ovarian syndrome). It does have some side effects but it could help those who struggle with dysphoria since it can stop periods. :)
anon said: about depo-provera!!! its great if its the right hormone combo for you, but when i talked to my gp about it he suggested taking a pill form birth control for a few months that’s the same sorta composition as depo so you can see how you react to it. some birth controls can lead to like. nausea and depression etc if it’s the wrong composition, so its better to test it out before you put it in for three months!
anon said: trying a different version (?) of depo first to see if the chemical composition works for you is a good idea. i had a really weird experience w/ depo, it messed with my mental state for about a week after i took it. & it only stopped my period for a month or two, then it just made it rlly irregular for a while. everything is back to normal now but i wish i could have tried a version that didn’t last as long.
rammyrue said: It’s worth noting that a few of these options (possibly all, I haven’t tried Seasonale) can mess up your libido but it won’t necessarily be mentioned by your doctor or in the Choose Which Is Best For You type pamphlet (but will in the paperwork with the pills.) I’d say that info is more than just a ‘nice to know’ if getting the 3-monthly injections and don’t get a side effects list. These medications can also make you put on or struggle to lose weight, which can sting if dysphoric about hip size. Oh, and also birth control meds in general can be horrible for your mental health. You might need to try a few different options until you find what works for you :)
anon said: I briefly went on birth control for really painful periods and dysphoria, and i ended up having a nervous breakdown. for any one with mental illnesses who’s considering going on birth control for whatever reason, make sure you talk to your doctor about any and all side effects!!! because stopping periods was not worth the severe depression and panic attacks in my opinion and my doctor never warned me
knifegoth said: I use it, it stops shark week but my chest grew, then again I’m still a teen so it might have just been me
rosemarionttyler said: My sister takes birth control (she takes them so she won’t get her shark week) and she hasn’t had any breast growth
theeightandtheone said: I’ve been on almost a year and my experience is they didn’t grow on their own but when I gained weight it went straight to my chest which is :/ but I recognize that if I lose the weight it should stop
anon said: I’ve been on birth control for awhile and it actually didn’t change my body at all! No more acne. I can skip shark week whenever now! It’s made me more accepting of my non binary identity. But it’s diff for every1
alexisthegayestofgayboys said: it didn’t always stop the bleeding i did this and i bled for 3 months straight
schizo-fractured said: I use nuvaring which stopped my period completely- and you only have to change it once a month so you don’t have to think about it that much, if that helps.
patmolandcornedrue said: i got a prescription for the patch from my family doctor without seeing a gyno, but she did a breast exam, so you should be prepared for that to possibly happen
anon said: to the person wondering about the birth control patch, i have found it to work really well. i have had no side effects, and it makes my periods shorter and less emotionally taxing. i highly recommend it for people like me who have issues with pills because it doesn’t have some of the harsher side effects assosciated with other non-pill birth control methods
xfelvesandmen said: You can also get an IUD for terrible pain since it generally stops periods, I’ve personally found it has fewer side effects that emphasize areas id rather ignore (breast tenderness, etc) than pills but it’s different for everyone
anon said: having and IUD put in is really quick once you’re in for the procedure. However, getting it put in hurts A LOT if you don’t get numbing stuff/pain meds (I’ve fallen asleep getting tattoos and I almost fainted during this), and outcomes vary a lot. Instead of making my period shorter it just made it last a lot longer but each day was lighter. There is a type of pill where you don’t have to have your period more than 3 times a year. I’d ask your doctor about your options and tell them what you want from it.
narrito said: When I was put on birth control when I was 12 or so, they didn’t do a pap smear or anything like that (because I was 12) and hell, they didn’t even do one when I was 16 and given an IUD. (Mostly because both times I could honestly answer no to if I was sexually active or not). So you may have to see a gyno, but you probably won’t have any sort of uncomfortable experience beyond having to answer weird questions with an adult around.
iteraltortoise said: Be aware tho anon some people w iuds end up w complications bc of them
madrigalfan1 said: my mother, aunt, and other people my mom knows have tried the mirena and have experienced really negative side effects like having it cause severe pain from piercing into other body parts bc it moved and being extremely difficult to remove bc of tht
theboychosenbythekeyblade-riku said: I’ve been using an IUD for close to 3 years and I have found that it doesn’t cause breast growth.
sleepyanimal said: Mirena is an IUD that releases progesterone and can be used with testosterone if you are thinking of eventually going on it?? I know this because this is why I chose this birth control method– but yeah it does stop/lessen periods and is a really effective birth control method
tigerqueer said: I second the mirena- it completely stopped shark week for me! Best of luck!
narrito said: I also have the mirena, the only downside is it is vaginally inserted, so it can get kinda uncomfortable. It does take 6+ months to stop your period, but some of the PMS can linger even after that like cramping and all that.
heyhosers said: I’m on Mirena which is an implanted birth control that ONLY relies on progesterone, NOT estrogen, so I’ve heard (not 100% positive) that you can be on it and T together. Anyhow, whether you’re on t or not, I HIGHLY recommend it. It makes most people’s periods stop, so it alleviates that dysphoria for me and it also doesn’t mess with my emotions!! Feel free to talk to me abt it ~
demiiboy said: Progesterone based (ie implant, depoprevera) is okay too, according to my pp. I’ve been on depo for 4 years and testosterone for 5months. No affect on the speed of my physical transition
demiiboy said: Progesterone based birth control (depo preva) is your friend. Has no feminizing effects
socollectioncyclesblog said: Progesterone is an androgen! I’m on continuous progesterone to stop my shark week axtually and it xan make you look a litttle more masxuline in some xases
magicalfairyprince said: Just get the depo shot. Thats what I did. You get it every 3 months and its one of the only forms of birth control that doesnt contain estrogen as well! 
anon said: Just wanted to say that I’m on T but I also take a birth control pill. Its a progestogen only pill so I get no oestrogen from it. The good thing about this birth control pill is it stops your monthly stuff, or at least it did for me, so for about 2 years before I started T I never got my period which was great. For some it might be embarrassing to go to the pharmacy to get it but no one has ever raised an eyebrow. Just thought I’d share for people who are interested.
we-came-as-times-new-romans said: Estrogen based birth control and T may affect each other slightly, and you should probably not plan to be on estrogenic BC forever if starting T, but it’s ok
thelaner said: if it adds estrogen to your body in a consistent way, your body should make less estrogen of its own and it really shouldn’t change your hormones that much other than stabilize the hormone cycle
i-am-nathaniel said: I used to use birth control for my periods but the extra estrogen in my system kinda wrecked me mentally. Testosterone will stop your periods altogether if you can get on it.
soldierslightwillforeverburn: Basically from what I know the only one that won’t counteract/will be safe on T is a copper IUD.
toryinnismoved said: ive taken norethindrone and depo provera before and didnt notice any real weight gain on either (compared to gaining quite a bit upon starting T)
palethsharkstudent said: I take Norethindrone and it’s awesome!! completely stops menstruation without any physical changes estrogen-based pills would cause!!
httpcaden said: I took Norenthindrone which is an estrogen free birth control but I do NOT recommend taking it because it gave me 2-3 cycles per month and they were extremely painful and dysphoria inducing so. That’s one i don’t recommend, so if someone mentions it to you be hesitant about going on it. But Depo provara is an injection that - hormonally - is incredibly similar to testosterone and halts the cycle all together with very limited side effects
anon said:  i took norethindrone before i took the depo provera. it worked fine (i still bled but even now i still bleed after a year on T and two years on the depo so thats more of a me thing, i think?) but my issue with it was that i had to take it twice a day and if i missed doses frequently my period would hit me Hard (w/ all the lovely cramps and gastro trouble) so if you dont have issues with remembering to take medicine every day it should be fine, but i recommend the depo provera
radical-boy said: Someone I know says the shots stopped her period completely so you could ask about that
crystal-jem said: I’m on the depo shot and have been for about a year, and its awesome. I don’t have a period or cramps at all, and mine were so severe they would make me throw up. Its a shot every three months on your butt cheek, and if you want to do it yourself you can even ask for a needle and syringe with your prescription
Lukas said: If there are any trans guys out there who are looking into BC pills as a way to control or manage their monthly “shark week” but aren’t sure what to use, I would personally recommend Seasonique. Seasonique comes in 3 month packs, which means you get your period only 4 times a year. It also means fewer (and possibly embarrassing) trips to the pharmacy. If you do experience spotting, you can talk to your gyno about adjusting your schedule. I have been using it for about a year and have experienced only minor spotting, my chest did not grow at all, I’ve not had any changes in sex drive or had any changes in weight or mood. While it might not be right for everyone, I know many people who’ve been very satisfied with it; again, it’s something to work out between you and your doctor/gyno.
tangible-crisis said: Cryselle has been really helpful for me. It’s a very small amount of hormones so there is not many feminizing effects. It worked great for me
anon said: I take cryselle (a 28 day pill) for 9 weeks instead of 3 and then take one placebo week! This was prescribed to me as I wanted fewer periods for blood loss reasons. I had tried a pill specifically made to be taken for 9 weeks but the dosage was too low so that’s why I take mine like I do! I can’t say there are any different side effects than the ones I already noticed taking it normally
anon said: i’m a pre-t trans boy on birth control and it hasn’t changed anything about me except made me healthier and more able to do things when i’m menstruating! the chemicals in birth control (well the ones in mine anyway) are actually the same ones used in oestrogen blockers, so you’ve got nothing to worry about!
anon said: I’ve been on birth control, and although it affects everyone differently, I can offer some advice. LoLoestrin FE has been really good for me. I’ve had heavy periods too and it fixed that. Ashlyna, the three month stuff, made my boobs grow though
anon said: The birth control I take is called LoLoestrin. It has really low doses of estrogen and progesterone, and hasn’t given me any side effects while being really effective at managing my period and cramps. I recommend it for afabs who want to use BC!
space-boy-3000 said: This worked well for me for a while but the low dose may not be enough for you, I had to switch to a higher dose because it didn’t have any effect
courteous-lamp said: I take LoLoestrin too and I had side effects. I got a lot of acne and unpredictable mood swings. I’m generally extremely sensitive to medication though
chaeslife said: there’s this one implant that they can put in your arm called Nexplanon that can lighten your period and for most people it will stop completely.
pimptier said: Get the stick! I’ve had my nexplanon stick for a year and it completely rids me of my period and almost all of its symptoms!! Plus there isn’t a pill you have to take every day (mines good up to 3 years but I’ve heard of some good up to five!)
anon said: I’m a cis girl and I got the nexplanon implant. It can stay in your arm for 3 years. After the bruise goes away you hardly notice it’s there. (For most people) it stops your period. It’s great if you can’t remember to take pills.
superbananatime said: My doctor gave me these pills I would take only when I get my period! It makes it not as heavy flow and usually I have like 10 day periods also but it was like seemed like 5 days.
frogprincesstsuyu said: I’m not sure what your pills look like, but if there’s a 4th row of different colored pills (they may be reddish brown, yellow, or another color, or you may only have 3 rows) then you skip that row and immediately start the next pack. This means you pick your pills up one week earlier. The 4th row is placebo pills that don’t contain hormones, so you get withdrawal bleeding. If you skip the placebo pills, then you won’t have the withdrawal bleeding/ “period”.
pageollie said: my best friend takes tri-montly birth control and just skips the week where the pills are just placebos. they’re transmasc and their period causes extreme dysphoria as well as physical pain/issues. they have their period every 6 months I believe?
we-came-as-times-new-romans said: There is a 3-month cycle pill. Please don’t misuse a 1-month prescription without talking to a doctor about it.
physicsmagics: Yeah, some people take the active pills for the entire month instead of taking the sugar pills for a week out of the month, which is what causes you to get your period. It depends on why you’re on the pill. My dr wanted me to do that for 90 days due to painful periods
anon said:  I’m on a progesterone-only pill called Desogestrel, and for me it’s been great because: A) it has completely stopped my menstruation B) there’s a 12-hour window for taking it each day, so it’s still effective even when you forget to take it at the usual time (great for my ADHD self) and C) I’ve had no noticeable side effects at all for the whole 2 years I’ve been on it. Not started T yet, but multiple doctors have said the pill should still be effective once I do. :)
anon said: For ppl in the UK I just went to my GP and said “my period is giving me awful gender dysphoria can you prescribe me something to stop it?” and she just gave me a choice of 2, discussed the difference and gave me a prescription for the one I chose! No touching or further explaining was needed :)
anon said: Some doctors will refuse to use continuous birth control to stop your periods. If you get one like this, ask about Seasonale or another similar birth control. It doesn’t stop your periods completely, but it makes it happen every three months.
anon said: In my experience ( and those I know of who also take it) it doesn’t make your body more feminine! You can skip it for ~2 months, shorten the time span & how heavy it is, and virtually no cramps, headaches, other icky stuff.
anon said: My doctor put me on Jolivette, which is a non-estrogen birth control pill. (I wasn’t out, but estrogen birth controls can cause blood clots and my family has a bad history with those kinds of things) It doesn’t make the cramps go away 100% but it helps a LOT (before, I was missing school two days at a time because I would sometimes black out)
sanguis-ripam said: You should def stay in check with blood work to watch your hormone levels, and like if one doesn’t work for you because of mood or physical shit tell your doc. A lot of AFAB people have to experiment with which birth control is best.
trans-chat said: Liam says: I was on birth control for a while and the only thing it did was lower my sex drive and control my periods a bit. You probably won’t gain weight in any way unless you’re on something really strong. Another mod, Lukas, has been on birth control for a while and hasn’t noticed anything other than a lower sex drive, less acne, and a slightly lighter period. I would give it a try and if you don’t like it switch. There are shots you can get every three months that completely stop your period so maybe talk to your doctor about that.
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un-enfant-immature · 5 years ago
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Amazon is piloting worker healthcare clinics near its warehouses
Amazon this morning announced a partnership with Crossover Health to build worker healthcare facilities near its fulfillment centers. The plan is still in a pilot phase, as the commerce giant employs the services of Crossover, which builds clinics for corporate clients. The startup has built such facilities for Apple and Facebook, and was even rumored to be a potential target for an Apple acquisition a few years back.
Amazon’s first such Neighborhood Health Center  has opened in Texas’s Dallas-Fort Worth, potentially serving up to 20,000 employees, half of whom work for Amazon operations. The company says it plans to open 20 such centers in five cities for the initial phase, bringing the total potential coverage up to 115,000. The other cities are: Phoenix, Louisville, Detroit and California’s San Bernardino-Moreno Valley. If things go well, more locations will be added.
“Across the U.S., an increasing number of patients do not have easy access to a primary care physician and instead utilize emergency or urgent care options, which is not only more expensive for patients, but also overlooks important preventative care opportunities,” the company’s HR VP Darcie Henry said in a release, addressing some much larger systemic issues with healthcare in the United States. 
Resources have, of course, been even more strained across the country of late as the COVID-19 pandemic shows no sign of stopping more than four months in. As designated essential workers, Amazon warehouse employees have been particularly at risk. And while the company has taken great pains to discuss its response to the virus, it has come under fire from workers, political office holders and members of the media for its handling of COVID-19.
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fitnesshealthyoga-blog · 6 years ago
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New Post has been published on https://fitnesshealthyoga.com/its-a-fentanyl-crisis-stupid-national-pain-report/
It’s a Fentanyl Crisis, Stupid! – National Pain Report
By Kaatje “Gotcha” van der Gaarden, PA-C, MPAS. 
Editor’s Note: This story was originally published on Dec 17, 2018 on Medium Health.
Featured Image: TEDxABQ 2018 “A Working Parachute: spinal cord injuries, ketamine & comedy” which turned into a 9 min stand-up set! Photo credit Allen Winston Photography
In 2012, life was great: I proudly wore a white coat with a stethoscope around my neck and finally felt useful to humanity. Two decades earlier, as a stuntwoman, my parachute did not quite open, and I landed on my sacrum (tailbone) at 70 mph, crushing the sacral nerves. I had lost two inches of my spine, fractured several vertabrae, and would spend a year in ICU, hospitals, and a spinal cord clinic. I was left with traumatic cauda equina syndrome,¹ suffered from residual pain, and was left with a “sitting disability.” For my atrophied lower leg and foot muscles, I used leg braces, a cane or scooter and I sat on a padded office chair. I’ve schlepped pillows and camping mats with me ever since my skydiving accident. Frequently, lying down for a few minutes was the only way to deal with my disability.
Kaatje “Gotcha” van der Gaarden
As a Physician Assistant in primary care, I loved my job and providing a true provider-patient collaboration. I had ample opportunity to prescribe opioid medications. Responsibly, of course. In my toolbox, I had excellent interview skills, the State’s Prescription Monitoring Program (PMP), and a urine test. The PMP would let me know me if patients were doctor or pharmacy shopping, although it couldn’t take into account other states. A urinalysis would tell me if the patient was taking the opioids as prescribed, or diverting, or using other, illegal drugs, or medications that were not prescribed. Heck yeah, I even had my patients sign an Opioid Use Contract.
One patient’s husband worked for the Drug Enforcement Agency (DEA), and he told me one that opioids went for about 70 cents per milligram on the street, in 2012. However, I never assumed someone was gaming the system and tried to keep an open mind. Some patients did want me to refill their emergency room (ER) hydrocodone prescription, for complaints like a mildly strained knee. At that point, I would print out knee exercises instead. I always tried to understand my patients’ emotional and physical health and encouraged exercise and healthy habits (even if most days, I couldn’t prepare food so I ate LAY���S® Limón Potato Chips and gummi worms).
Another patient had just moved from Arizona, with a history of using 30 mg of MS-Contin, a long-acting morphine tablet, three times a day, plus another opioid, Percocet 10 mg instant relief (IR), one tablet every four to six hours for breakthrough pain. The patient was full-time employed, doing fairly intense labor, and was incensed when I wanted evidence of his “bad back.” The patient did not bring any records during his first visit, but he later returned with a lengthy health record — his pain deriving from five back surgeries, three of them revisions for the original surgeries.
I had never heard of “ultra-rapid” or “slow” opioid metabolizers² which affect adequate treatment, and still believed the Center for Disease Control (CDC) had society’s best interest at heart. The opioid crisis seemed far away, and I believed that did not affect my patients, or myself. Mistakenly, I thought there hardly would have been an “opioid epidemic” had medical providers only accompanied any opioid prescription with this warning: “Use your IR (instand relief) opioid medication when you truly have breakthrough pain, a 7–8 or higher, or it will no longer be as effective.”
Perhaps. But complicating matters was that opioid medications did seem to be prescribed for relatively mild to moderate pain, or in situations where acute pain would soon resolve. For example, to my patient with that strained knee, seen in a Colorado ER. In 1991, I’d fractured my lower leg above the ankle, after a car stunt gone awry, and wasn’t prescribed any opioid medication. The ER doc in Florida who applied the hot pink cast, from my toes to my knee, pointed me to a Walgreens to buy Tylenol (acetaminophen) for the simple, uncomplicated fracture.
Although I was in tremendous pain myself from the sky diving accident and crushed sacral nerves, I denied suffering from intractable pain. Yet I was battling worsening neuropathic (nerve) pain, as well as residual musculoskeletal pain from the sacral and vertebral fractures, on a daily basis. I made it through each workday by lying down on the exam table during lunch. Work gave me great happiness, but physically I had no energy left to cook, maintain friendships or even have a hobby.
That year I recall having to do five mandatory continuing medical education credits by the State on “responsible opioid prescribing.” This seemed ludicrous since I always looked at the PMP before going into the exam room. Especially with a patient that was on medications that fell under the Controlled Substances Act.³ As a non-contract employee, I also paid my own DEA license at $780 every three years for the privilege of writing controlled substance prescriptions. I was ticked off with the cost, but also with what I perceived as government encroachment on my medical decision making.
Sure enough, over the years, after the CDC Opioid Guidelines came out (which are voluntary, and not legally binding), I began to realize that there is no true opioid epidemic. There’s an epidemic alright, of people taking opioids with multiple medications and then adding alcohol and other illegal drugs on top. What we most certainly have is an alcohol epidemic, with 88,000 deaths⁴ annually, and this epidemic is starting to effect millennials. I blame those hipster beers with ridiculously high alcohol percentages, as millennials are dying of liver cirrhosis in record-breaking numbers.
Despite the ongoing alcohol epidemic, from 2012 to 2016, using opioid medication became synonymous with being a “drug seeker.” The “opioid crisis” narrative was perpetuated and fueled by mainstream media, whose culpability lies in using labels like “opioid overdose deaths” instead of the more appropriate “mixed drug intoxication.” True opioid deaths (opioid medications alone) range around five thousand deaths annually, according to Josh Bloom, writing for the American Council on Science and Health.⁵ New York City’s medical examiner’s office is unsurpassed when it comes to accurately determining cause of death: in 2016, 71 percent of all drug-related deaths involved heroin and/or fentanyl.⁶
Looking at the numbers, most of the so-called “opioid deaths” seemed to be people who did not take their medication as instructed, if opioids were legally prescribed in the first place. Seriously, because who cooks their Fentanyl patch and injects it? Not chronic pain patients, who need slowly titrated medication to bathe, cook, work, take care of kids, or go to school. Patients were indeed dying from respiratory depression, caused by taking legal or illegal opiates. But how many of those deaths are suicides? If patients with severe pain, on a stable regimen, are denied access, they may turn to suicide, or illegal opioids like heroin, now tainted by illegal fentanyl. That is not an opioid crisis, but another iatrogenic consequence of the “guidelines.” The Law of Unintended Consequences never fails.
How was it that the CDC took advice from an anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP)⁸ in constructing the Opioid Guidelines? PROP had lobbied Federal officials and the FDA for years, to change opioid labels. When they were (mostly) rebutted, PROP got involved with the CDC, behind closed doors. The Washington Legal Foundation⁷ notified the CDC in 2015, as in their opinion, the CDC broke the 1972 Federal Advisory Committee Act (FACA) law. Washington Legal Foundation states that a Core Expert Group, advising the CDC, conducted their “research” and “Draft for Opioid Guidelines” in secret, without input from pain experts, pharmocologists, or patient groups.
Dr. Jane Ballantyne (current PROP President) was part of that Core Expert Group and is notorious for her anti-opioid stance. Another Core Expert Group member is PROP executive director, and founder, Dr. Andrew Kolodny, who refers to opiate medication as “heroin” pills and proclaimed that “oxycodone and heroin have indistinguishable effects.”⁹ Yet you oughtn’t compare a 5 mg tablet of oxycodone to IV heroin, without qualifiers on potency. Dr. Kolodny, an addiction expert, doesn’t even distinguish between “plain” heroin, and heroin cut with fentanyl, which is 100 times stronger than morphine. About 80 percent of fatal overdoses are now due to illegal fentanyl. By muddying the issues of opioid dependence, opioid addiction, and heroin use with either false or incomplete statements, PROP also does a disservice to people who are addicted to heroin or illegal fentanyl.
Research has found that 75% of heroin addicts have a mental health illness, and 50% have trauma from (sexual) abuse before age 16, something that gets drowned in Dr. Ballantyne’s simplified narrative of “continuous or increasing doses of opioids [… ] can worsen a person’s ability to function and his or her quality of life. It may also lead to opioid abuse, addiction, or even death.”¹⁰ Like many others, I argue that (illegal) fentanyl, and indirectly, profound loss of hope, is the main driver behind the current “mixed use overdose” deaths.
Dr. Kolodny was Chief Medical Officer of The Phoenix House, an addiction center, at the time he helped draft the CDC Guidelines. PROP also avoids mentioning the Millennium saliva,¹¹ or other DNA tests, to identify how individual patients metabolize opiate medication and that some are “ultrafast” metabolizers. PROP fails to mention opioid blood concentration measurements, no matter how imperfect.¹² However, no one doubts the conflict of interest: PROP Board members are involved with grants from the CDC, addiction centers, medical device companies to develop an opioid tapering mechanism, and even consulted with law firms investigating lawsuits against opiate pharmaceutical companies.
PROP was originally funded by Phoenix House, one of many addiction centers that prescribes buprenorphine. PROP is currently funded by the Steve Rummler HOPE Network,¹³ another anti-opioid group that lists Dr. Ballantyne and Dr. Kolodny on the medical advisory committee. Dr. Kolodny admitted in a 2013 New York Times article titled “Addiction Treatment with a Dark Side” that as a New York City Health official, he lobbied on behalf of the buprenorphine pharmaceutical industry. He was quoted as saying, “We had New York City staff out there acting like drug reps [with $10,000 incentives -KG].”¹⁴
Buprenorphine was the supposed miracle drug after methadone, but its known side effects include serious diversion, addiction, and possibly, lifelong treatment. Dr. Kolodny publicly promoted buprenorphine in various media outlets, despite evidence of buprenorphine overprescribing, pill mills, and overdoses. The true scale is not known, as most ERs and medical examiners do not test for the presence of buprenorphine. The CDC does not track buprenorphine deaths, despite a 2013 study¹⁵ that found a tenfold increase in buprenorphine-related ED visits, according to the Federally funded Substance Abuse and Mental Health Services Administration (SAMHSA). As “bupe” availability increased, so did diversion and overdose deaths.
Interestingly, that Dr. Kolodny promotes the idea that heroin and opioid medications are the same molecular compound. Actually, buprenorphine has a molecular profile¹⁶ that more closely resembles heroin, than hydrocodone. Dr. Kolodny indirectly claims that CDC “Guidelines” are effective, when the truth is that by the time PROP advised the CDC, prescriptions had already tapered off. This is evidenced in his statement as chief medical officer from a Phoenix House Q&A,¹⁷ dated December 2015: “It will take some time, but we’re already beginning to see a plateau in opioid prescribing.” Dr. Kolodny appears to take credit for a trend that had nothing to do with PROP, and he omits the fact that prescriptions are down since 2011, and yet overdoses are up.
Mainstream media occasionally, and accidentally, reveals the truth. CNN¹⁸ in 2018: “Fentanyl-related deaths double in six months; US government takes some action.” Then again, the echo of Dr. Kolodny’s statements, as reported by CNN: “The recent rise in popularity of these synthetics has been called the third wave of the opioid epidemic; the first wave was attributed to the overprescribing of painkillers like oxycodone and hydrocodone and the second to heroin. The drugs are all chemically similar and act on the same receptors in the brain.” Again, not one word about potency.
Few realize that when the CDC issued the Opioid Guidelines in 2016, there was inadequate research done ahead of time to determine the true cause of the rise in opioid-related deaths. There are no long-term studies on the effects of chronic opiate therapy. Very few, if any, pain management experts or pharmacologists were consulted to determine potential impacts on their practice. Neither veterans nor chronic pain patients were given a true opportunity to issue public comments to the CDC or any other Federal authority prior to the implementation of these new prescribing mandates. The CDC ended up targeting one of the most vulnerable groups, patients with intractable pain.
The CDC’s Guidelines also affect patients with cancer and patients who no longer receive cancer treatment because, unfortunately, both groups report similar pain levels. The guidelines allow the use of opioids during cancer treatment, but they are confusing when it comes to equally severe, post-cancer treatment pain. I fear this “opioid” crisis is far from over, and yet, trust me, this will go down as “reefer madness” in another hundred years. It is a manufactured tragedy that does real harm to patients with intractable pain. The “opioid” crisis also hurts human beings who suffer from heroin, opioids or other addictions by siphoning money, goodwill, and energy.
Few people realize that the CDC hired a PR agency to help sell the American people myths on the “opioid epidemic.” The agency, PRR, designed graphics to “educate” primary care providers that “one in four patients on opioids will develop addiction.” Even the National Institute of Health,¹⁹ another federal entity, estimates this to be 5 percent, not 25 percent. Another research team²⁰ concluded in Pain Medicine that opioid therapy for chronic pain patients (note: in absence of prior or current drug abuse) resulted in a 0.19 percent incidence of abuse.
The language used by the media as well as PROP contributes to misunderstanding; using words like addiction, tolerance, dependence, abuse or opioid use disorder as if they mean the same, directs the casual observer to bias. It’s clear that PROP never was an independent, neutral entity advising the CDC, yet they ended up dictating federal policy, based on flawed evidence. Dr. Ballantyne, Dr. Franklin, and Dr. Kolodny in Politico.com²¹ in March 2018: “We agree with Satel that the answer is not to force millions of chronic pain patients to rapidly taper off medications they are now dependent on (Italics mine). But then, neither is the answer to absolve overprescribing for pain.”
I’m not a linguist, but in that essay, PROP uses the word “addiction/addicted” 16 times, and “dependence” twice. The CDC could have ensured that patients with severe to intractable pain (no such distinction is made) would not lose access to their medications. And yet, that is exactly what happened. Stable patients on long-term opioids were tapered against their will, as the CDC “Guidelines” state it is undesirable to titrate above or equal to 90 morphine milligram equivalent²² daily (aka MME/day). But this was meant for opioid-naive patients, not those on long-term opiate therapy. Primary care providers, who were forced to follow these “Guidelines,” either stopped prescribing opioids altogether or forced patients to rapidly taper to below 90 MME.
Dr. Ballantyne is correct in her remarks that it isn’t realistic to expect zero pain levels, especially for acute pain that is expected to resolve quickly, like a sprain or an uncomplicated fracture. But people with severe to intractable pain are condemned to a world of suffering. Recall my patient with the five back surgeries? I wonder about him. He was working full time, on 180 MME a day, but in his mid-fifties, arthritis would worsen soon. My own story did not end well; I ended up with yet another spinal cord lesion, a benign hemangioma at chest level, which causes “central neuropathic pain syndrome.” My old cauda equina syndrome morphed into “severe, chronic adhesive arachnoiditis.” This is an incurable, intractable, progressive neuroinflammatory disorder whose pain is considered on par with having terminal cancer pain. Still, I try to make the best of it, see my essay, On Being Bedbound.
The CDC and PROP came for me: after using opioids exactly as prescribed, and less than 30 MME daily, my primary care clinic was forced to stop my opioid prescription, and that of all patients. I was not accepted in any pain management clinic, in an urban area of almost one million. Pain clinics here no longer provide “medical management,” yet perform epidural steroid injections ($3000 a pop), which may have contributed to, or worsened my adhesive arachnoiditis syndrome. I’m lucky to live in an urban area, where the academic hospital’s pain team took over my prescription.
But what about elderly and impoverished patients, or those in rural areas? PROP and the CDC claim primary care providers “overprescribe” and are responsible for most of the opioid prescriptions. But they fail to publicly acknowledge that pain management clinics no longer accept patients. This epidemic of undertreated patients will become known as one of the cruelest moves by a Federal agency on an already compromised population. I do feel for teenagers and adults who become addicted. Yet there ought to be a different, more sensible approach towards legitimate, chronic pain patients who need opioid medications, as well as people who develop a substance use disorder, who deserve our help and sympathy.
It is a conundrum of extraordinary proportions. At a time when managed care and Electronic Health Records dictate the length and quality of an office visit, there is less and less time to sit down and connect with a patient. Not just with chronic pain patients. Medicine and society would benefit greatly from the extra time clinicians deserve, to encourage exercise, eat healthier, lose weight, stop smoking and assess if a patient needs other support, like therapy.
In my opinion, it is loneliness, the feeling of not being connected to humanity in a meaningful way, combined with economic hardship, that leads to unhealthy lifestyle choices, as witnessed by the Rustbelt being hit hardest. Research shows that rats who were offered spring water or water laced with heroin, choose heroin. When those same rats were given ample toys, space, and other rats to play and have sex with, they did not choose the heroin laced water. That’s right, happy rats don’t need no heroin!
It cannot be denied that in previous decades, pain was both undertreated, and opioid medications prescribed for relatively minor, self-resolving aches and pains. Forget for a moment, the narrative that places blame on overprescribing, the opioid manufacturers, or the pharmaceutical distributors that, for example, flooded impoverished communities like those in West Virginia.²³ Forget all that, and focus on what is going on. Ultimately, patients with intractable pain pay the price of ignorance by scientists, journalists, politicians, and laypeople alike.
For this humanitarian crisis, there are no perfect answers. For example, as Red Lawhern, Ph.D. and prominent pain advocate²⁴ recently communicated with me (12/3/2018): “there is promise in genetic testing but hasn’t yet been fully reduced to routine practice and may not be covered by insurance.” Luckily my DNA testing was covered, on the condition it tested for depression. I also discovered that ketamine infusions help me most, but will leave that topic for my upcoming book, The Queen of Ketamine. Sadly, amidst the opioid paranoia, non-invasive alternatives like ketamine infusions aren’t mentioned for neuropathic or intractable backpain, which often has a neuropathic component. Research also shows that adding an anti-seizure medication to an opiate mediation provides better neuropathic pain contral, with less morphine²⁵.
In the end, I don’t think Tai Chi, Tylenol and Cognitive Behavioral Therapy is going to cut it for meningeal inflammation or other (neuropathic) pain syndromes. I believe the tide is turning. It will take time, and in that time, patients with intractable pain will choose to end their lives. But we are not alone, and it helps to know that courageous voices, notably the Alliance for Treatment of Intractable Pain, are speaking up for us. The print and online magazine Reason²⁶ has long been a voice of, well, reason. As Red Lawhern stated in a must-listen November 2018 radio interview,²⁷ “We must address underemployment, socioeconomic despair and hopelessness which are a vector for addiction. And end the War on Pain patients.”
Love, Kaatje
Kaatje Gotcha, model and stuntwoman-turned-Physician Assistant, found comedy, writing and advocacy after developing Adhesive Arachnoiditis. This spinal cord disease causes intractable neuropathic pain and leaves her mostly bedridden. Prior to that diagnosis, she’d survived a nighttime skydiving accident, landing at 70 mph. This caused Cauda Equina Syndrome; a subsequent lumbar puncture and epidural steroidal injections may have exacerbated her previous injuries.
Kaatje’s courageous spirit led to writing “The Queen of Ketamine,” available on Kindle in February. This is a comedic yet pragmatic memoir  on adhesive arachnoiditis, the opioid “epidemic,” neuropathic pain, dating with a disability, while offering hope and practical advice. Kaatje’s 2018 TEDx talk and book publication will be posted on her Facebook page, at www.kaatjegotcha.com and Instagram @kaatjegotchacomedy. Find her essays on Medium, and follow her on twitter.
Cauda Equina Syndrome https://emedicine.medscape.com/article/1148690-overview
Opioid Metabolism https://www.medscape.com/viewarticle/771480
Controlled Substance Act https://www.dea.gov/controlled-substances-act
Alcohol Epidemic https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
Opioid Epidemic Deception https://www.acsh.org/news/2017/10/12/opioid-epidemic-6-charts-designed-deceive-you-11935
Overdose Deaths by Heroin/Fentanyl 71percent https://www1.nyc.gov/assets/doh/downloads/pdf/epi/databrief89.pdf
Washington Legal Foundation and PROP https://www.forbes.com/sites/wlf/2015/12/15/cdc-bows-to-demands-for-transparency-and-public-input-on-draft-opioid-prescribing-guidelines/#c82eda135bc3
Physicians for Responsible Opioid Prescribing http://www.supportprop.org/
Dr Kolodny refers to “Heroin” Pills https://www.healthline.com/health-news/secondary-drug-industry-booming-amid-opioid-epidemic#2
Dr Ballantyne’s Narrative https://www.statnews.com/2015/11/30/chronic-pain-intensity-scale/
Millennium Opioid Metabolite DNA Test https://www.millenniumhealth.com/services/test-offerings/
Opioid Serum Measurements http://paindr.com/serum-opioid-monitoring-wheres-the-evidence/
Medical Advisory Committee https://steverummlerhopenetwork.org/our-team/
NYT: Addiction Treatment with a Dark Side https://www.nytimes.com/2013/11/17/health/in-demand-in-clinics-and-on-the-street-bupe-can-be-savior-or-menace.html
Sharp Rise in Buprenorphine ER Visits https://www.samhsa.gov/data/sites/default/files/DAWN106/DAWN106/sr106-buprenorphine.htm
Heroin and Buprenorphine Molecular Profile http://paindr.com/heroin-hydrocodone-buprenorphine-prop-aganda/#comment-334500]
Q&A with Dr. Kolodny, Phoenix House https://www.kolmac.com/2015/12/qa-dr-andrew-kolodny-chief-medical-officer-phoenix-house/
Fentanyl, as Reported by CNN https://www.cnn.com/2018/07/12/health/fentanyl-opioid-deaths/index.html
NIH Estimates Pain Patient “Addiction” 5 Percent https://medlineplus.gov/magazine/issues/spring11/articles/spring11pg9.html
Pain Patient “Opioid Use Disorder” without Risk Factors 0.19 percent https://academic.oup.com/painmedicine/article/9/4/444/1824073
Rebuttal by Dr. Kolodny and Dr. Ballantyne https://www.politico.com/magazine/story/2018/03/13/opioid-overprescribing-is-not-a-myth-217338
Morphine Equivalent Dosing https://www.wolterskluwercdi.com/sites/default/files/documents/ebooks/morphine-equivalent-dosing-ebook.pdf?v3
https://www.wvgazettemail.com/news/cops_and_courts/drug-firms-poured-m-painkillers-into-wv-amid-rise-of/article_99026dad-8ed5-5075-90fa-adb906a36214.html
Red Lawhern, PhD and nationally known Pain Patient Advocate http://face-facts.org/lawhern/
Combining epilepsy drug, morphine can result in less pain, lower opioid dose. https://www.sciencedaily.com/releases/2014/09/140915153613.htm
Jacob Sullum, Reason journalist and syndicated writer https://reason.com/archives/2018/03/08/americas-war-on-pain-pills-is#comment
“Unleashed” Matt Connarton Interviews Red Lawhern 11/28/18 https://www.spreaker.com/user/ipmnation/matt-connarton-unleashed-11-28-18
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optometrist0 · 7 years ago
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I Need An Eye Exam
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Dr. Gary Heiting explains eye exam costs, how frequently you should have your eyes examined (based on your age and other factors) and how to prepare for your eye exam.
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Eye exams are available through several different venues, including an independent eye doctor’s office, the eye department of a multidisciplinary medical clinic, a group eye care practice (optometrists, ophthalmologists or both), and at an optical retailer or optical shop that also offers eye exams by an affiliated optometrist.
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Because there are little to no symptoms to alert a patient that there is a bleeding blood vessel in their eye, diabetic retinopathy is a leading cause of blindness. Regular eye exams then … to help them know if they need to make …
In the rush to get everything settled for the coming school season, an eye exam for your child might not rank high on your to-do list. But an eye exam is one test that EVERY kid should have. * Your child’s eyes are their most important learning tool.
Jensen said he heard about the free eye exams through the school. He and his wife decided to take Rainah because they and most of the other members of the family all need glasses. “We just want to know,” he said. “We just want to be cautious and get …
The Great Canadian Flag might look a little smaller for the next few months. The massive standard at the foot of Ouellette Avenue has been taken down for the season to protect it from weather damage. A smaller Maple Leaf will be fluttering …
You may think your eyes are healthy, but visiting an eye care professional for a comprehensive dilated eye exam is the only way to really be sure. During the exam, each eye is closely inspected for signs of common vision problems and eye diseases, many of which have no early warning signs.
Eye exams by phone are just another form of telemedicine … prescription expires within a year (or whenever you run out of disposable lenses) and you’ll need to have your eyes examined to get a new prescription and any more lenses.
Maintain healthy vision by finding an eye exam location near you. Easily set up an eye test at your local LensCrafters today.
Dr. Stephen Gildersleeve, optometrist with Eyes on Lincoln, said that routine eye exams can start around the age of 3 and … the importance of a child’s primary (baby) teeth and the need to keep these baby teeth in place until they are lost naturally.
How Often Should I Have an Eye Exam? Getting regular professional eye care is part of maintaining healthy vision as you age. … may need an eye exam more frequently.
PHOENIX — The world’s only flying eye hospital — yes, you read that right, a flying eye hospital — landed in the Valley earlier this month. The Orbis Flying Eye Hospital will spend some time in Goodyear for “vital maintenance work” before it …
Newswise — BIRMINGHAM, Ala. — Back-to-school shopping lists might include school supplies, new clothes, and even a haircut, but does it include an eye exam? Physicians in The University of Alabama at Birmingham Department of Ophthalmology think it should.
Free Eye Exam When You Buy 2 Pairs of Glasses for $69.95
With or Without Insurance. Discover A New Way To Shop. Book an Eye Exam Today.
Find more information about eye exams and the importance of keeping your prescription up to date.
Back-to-school shopping lists might include school supplies, new clothes, and even a haircut, but does it include an eye exam? Physicians in the University of Alabama at Birmingham Department of Ophthalmology think it should. "More often than not, vision …
Vision requirements & restrictions. … If your eye exam indicates you must wear corrective lenses to pass the vision … If you no longer need telescopic lenses, …
Not just about seeing "better or worse," eye exams are important for the early detection of diseases ranging from diabetes to glaucoma.
Eye exams for adults can include many tests. WebMD let's you know what to expect. … You'll need an exam ASAP if you're diagnosed with type 2 diabetes.
Your doctor urges you to have an eye exam … These basic guidelines will help you figure out how often you and the rest of your family need to to see an …
In the rush to get everything settled for the coming school season, an eye exam for your child might not rank high on your to-do list. But an eye exam is one test that EVERY kid should have. * Your child’s eyes are their most important …
But Opternative is a new online eye exam that promises to take away that hassle. The company says all you need is 30 minutes, a computer to display the test, and a smart phone to record your answers. An ophthalmologist then reviews …
Common questions about eye exams include: How much does an eye exam cost ? How frequently should I have my eyes examined? What should I bring with …
If you have any of these eight symptoms, you may need more than a yearly eye exam. Make an appointment with your eye doctor if you notice any vision changes.
“Should my child have an eye exam?” As an optometrist and mother to four young kids, I am asked this question quite often. Unfortunately, most parents never consider having a child’s eyes examined until they notice a problem or are told by a school …
Ideally, one eye exam every year should help you to stay on top of your eye health, but some people might need to schedule more than one exam in a year. Vision can change quite a bit over the course of a year, especially for those over the age of 50, and it is important to know when you need to schedule an exam.
Back-to-school shopping lists might include school supplies, new clothes, and even a haircut, but does it include an eye exam? Physicians in the University of Alabama at Birmingham Department of Ophthalmology think it should. “More often than not, vision …
Do I need glasses? Learn 10 signs that could mean you need glasses. Vision symptoms may indicate it is time for you to schedule and eye exam.
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from http://bestoptometrists.net/i-need-an-eye-exam-5/
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joshuajacksonlyblog · 7 years ago
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Arizona Care Network (ACN) Adopts Solve.Care Platform for Streamlining Healthcare Administration and Payments
Solve.Care has announced a multi-year contract for its decentralized healthcare administration platform with Arizona Care Network (ACN), a leading accountable care organization (ACO) in the US.
ACN manages value-based care contracts for its network of more than 5,000 physicians covering 250,000 members. ACN is based in Phoenix, Arizona and is a joint venture of Dignity Health Systems and Tenet Healthcare.
Solve.Care is an innovative healthcare administration platform that empowers patients, employers, physicians, healthcare organizations and insurance companies such that care delivery can be more efficient, effective and affordable. The platform is designed to decentralize processes and synchronize all parties using the power of distributed ledgers and intelligent process automation. The partnership between ACN and Solve.Care is a first in the healthcare industry in that it applies blockchain technology, cloud computing and cognitive learning capabilities to healthcare to directly reduce administrative costs and friction associated with value-based care delivery and payments.
“ACN is focused on innovation in the healthcare industry and seeks to be the leading technology-enabled ACO in the US. This is why we chose to partner with Solve.Care, a true innovator in the healthcare care administration and payments sector,” said Dr. David Hanekom, CEO of Arizona Care Network. “Solve.Care brings a lot to the table in terms of their ability to simplify and decentralize complex processes related to value-based care delivery and payments. We couldn’t be more excited as a result of this partnership and look forward to launching the platform with our providers and members.”
This partnership is one of the first between a significant healthcare administrator and a blockchain technology leader. Solve.Care CEO Pradeep Goel agreed with Dr. Hanekom and commented on why this partnership furthers the mission of Solve.Care:
We are committed to decentralization of processes and delegation of greater authority to patients and physicians, without loss of control over cost and utilization. Solve.Care platform is a perfect match with the mission of Arizona Care Network and we look forward to helping them define and implement the future of value based care administration.
About Solve.Care
Solve.Care Foundation was established with the goal to revolutionize administration of healthcare and other benefit programs globally. The stated mission of Solve.Care is to “Make healthcare and benefit programs work better for everyone.” The platform brings a relationship-centric approach to care coordination, administration and payments that addresses all three pillars of healthcare: clinical, administrative and financial.
Solve.Care platform is designed to enable insurance companies, government agencies, hospitals and providers, pharmacies and businesses to build care coordination and delivery networks and engage their stakeholders. Solve.Care is launching a number of groundbreaking innovations such as Care.Wallet, Care.Cards, Care.Coins, Care.Vault and Care.Protocol through their platform. Solve.Care is implementing the relationship-centric approach by using distributed ledger technology and Blockchain.
For more information about the company, please go to http://www.solve.care or contact us via email at [email protected].
Media Relations: Mariya Ozadovskaya, [email protected]
About Arizona Care Network
Arizona Care Network is a physician-led and governed accountable care organization that improves healthcare and reduces costs by actively managing care for its patients.
ACN is a partnership between Dignity Health Arizona and Abrazo Community Health Network and is affiliated with Phoenix Children’s Care Network for pediatric care.
The network is comprised of more than 5,500 primary care and specialty physicians providing a broad range of clinical and care coordination services to adult and pediatric patients in Maricopa and Pinal counties. For more information, visit www.azcarenetwork.org.
Images courtesy of AdobeStock
The post Arizona Care Network (ACN) Adopts Solve.Care Platform for Streamlining Healthcare Administration and Payments appeared first on Bitcoinist.com.
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ijoyfulfoxstudent · 6 years ago
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Best Family Doctors in Phoenix AZ with Phone & Address
Best Family Doctors in Phoenix AZ with Phone & Address
Best Family Doctors in Phoenix AZ with Phone & Address
Lee Anne Denny, MD Specialty: Family Medicine Practice Locations Banner – University Medical Center Family Medicine Clinic 1300 North 12th Street, Suite 605, Phoenix, AZ 85006 Phone: 602-839-4567
Christopher Peterson, DO Specialty: Addiction Medicine, Family Medicine Practice Locations Banner – University Medical Center Family Medicine Clinic
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oliviaemily707 · 6 years ago
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Best Family Doctors in Phoenix AZ with Phone & Address
Best Family Doctors in Phoenix AZ with Phone & Address
Best Family Doctors in Phoenix AZ with Phone & Address
Lee Anne Denny, MD Specialty: Family Medicine Practice Locations Banner – University Medical Center Family Medicine Clinic 1300 North 12th Street, Suite 605, Phoenix, AZ 85006 Phone: 602-839-4567
Christopher Peterson, DO Specialty: Addiction Medicine, Family Medicine Practice Locations Banner – University Medical Center Family Medicine Clinic
View On WordPress
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lovejossbd · 6 years ago
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Best Family Doctors in Phoenix AZ with Phone & Address
Best Family Doctors in Phoenix AZ with Phone & Address
Best Family Doctors in Phoenix AZ with Phone & Address
Lee Anne Denny, MD Specialty: Family Medicine Practice Locations Banner – University Medical Center Family Medicine Clinic 1300 North 12th Street, Suite 605, Phoenix, AZ 85006 Phone: 602-839-4567
Christopher Peterson, DO Specialty: Addiction Medicine, Family Medicine Practice Locations Banner – University Medical Center Family Medicine Clinic
View On WordPress
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painstopclinics01 · 4 years ago
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Treatment Options For Various Injuries After An Auto Accident
Regardless of how safe a driver you might be, each time you get into your vehicle, you face the danger of a mishap. Now and then it is you the driver who is a flaw, in some cases, the mishap might be the deficiency of a person on foot or some other driver. Regardless of who is to blame, these are the most well-known injury types that thusly require the correct auto injury treatment center Phoenix az. 
Whiplash is a condition that depicts wounds to the delicate neck tissues comprising of muscles, tendons, and ligaments. The back sway on a vehicle during a mishap powers the lower neck bones into hyperextension while the upper neck bones get hyper flexed to give an 'S' shape to the neck. 
The best home car crash injury treatment for whiplash is what tops off an already good thing 20 minutes consistently the principal day. Ensure you don't straightforwardly apply ice to the skin envelop it with a towel first. At times, your primary care physician may likewise propose wearing neck support and back rub treatment with rest to forestall any exacerbation of the circumstance. Acetaminophen is additionally taken for help with discomfort while ibuprofen is taken as a calming. 
Cerebrum wounds 
Close to death, cerebrum wounds are the most frightening of car crash wounds. A fender bender can prompt any cerebrum injury like wounding and dying. It's excessive that the skull gets infiltrated or broken for a mind injury to happen. When the head moves after sway, the power on the mind connects within the skull; and this is a blackout. 
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The awful mind wounds require three phases of car crash injury therapy, which are intense, sub intense, and constant. Intense therapy includes saving the casualty's better half utilizing crisis techniques like unblocking of aviation routes, giving breathing help, and observing and treating mind-expanding. 
Sub intense car collision injury therapy starts once the casualty is settled. It includes identification of entanglements, counteraction of extra wounds, and working with neurological and utilitarian recuperation. 
Constant stage therapy is the last phase of therapy wherein the clinical expert uses long-haul restoration and treating hindrances for complete and careful treatment of the injury. 
Back and appendage wounds 
The back can likewise get harmed through an injury, strain, herniated plates, or cracked vertebrae during a fender bender. Your PCP will subsequently recommend a torment executioner, active recuperation, and exercise as car collision injury treatment. 
Additionally, an auto crash can likewise prompt broken bones, cuts, and even loss of appendages. If it's a gash, your PCP fastens up the wounds, if it's messed up bones, the appendage must be placed in a cast for half a month or months and in outrageous cases, non-intrusive treatment might be informed to recover full use concerning the harmed appendage. 
For more data about the article, visit personal injury center Phoenix az.
Our Source:-https://sites.google.com/view/personal-injury-center/home
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