Tag Archives: Tampa Bay Times

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Tampa Bay Times: Chronic pain sufferers plead for a nuanced approach to opioids (w/video)

By Justine Griffin

 


Will Michele Jacobovitz get out of bed today?

That depends on how many painkillers she has left in her monthly prescription, which sometimes she’s forced to ration. Some mornings are harder than others.

Jacobovitz, 56, has suffered from chronic pain since a 1987 car accident. The Pasco County resident has had 73 surgeries since, from her neck to her ankles, and she has the scars to prove it. In December, she was diagnosed with breast cancer.

She says it’s impossible to function without popping a highly addictive painkiller with Acetaminophen and Oxycodone components, in the morning. Without it, she says, there are days she can’t get up at all. Or get to the bathroom in time. It can be humiliating.

Jacobovitz says she’s not addicted to painkillers, just absolutely dependent on them.

“It comes down to quality of life,” she said. “I’m not using these drugs to get high. I’m using them so I can have some kind of life. So I can get out of bed. They don’t take my pain away. But they mask it so I can function.”

She is one of many Floridians who suffer from chronic pain and are worried about a government crackdown that would make it even harder to get the prescription drugs they need every day.

Gov. Rick Scott has proposed legislation that aims to put a dent in the opioid epidemic by prohibiting doctors from prescribing more than three days’ worth of opioids — or seven days if doctors can explain why that’s medically necessary.

Under the measure, Florida would share a database of opioid prescriptions with other states and require doctors to routinely check it. Doctors also would be trained on proper prescribing techniques.

“When people think of opioids, they think of addicts and criminals,” Jacobovitz said. “That’s not us.”

Read more here.

 

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Tampa Bay Times: At Moffitt, a push to ease cancer’s toll in the workplace

By Justine Griffin

Cathy Bishop, a retired teacher and assistant principal in Hillsborough County, is in remission after treating stage IV colon cancer at Moffitt Cancer Center in Tampa. The disease affected key decisions about her career and retirement. [Photo courtesy of Moffitt Cancer Center]

Cathy Bishop worked as a teacher and assistant principal at Hillsborough County schools for nearly 35 years when she found out she had colon cancer.

Diagnosed after a routine colonoscopy, she had to make a tough decision about how she was going to let the disease impact her career. She would rely on the health insurance offered to her through the school district to pay for medical bills that stacked up because of chemotherapy and surgery. But ultimately, Bishop chose to work through her diagnosis and treatment plan instead of taking medical leave.

“My retirement is a teacher’s pension, which is half a salary. Basically, not much,” Bishop said. “I have two sons, and one of them was in law school at the time. I had to make a decision that was best for my family.”

Bishop told her story Monday to a room full of professionals from some of the Tampa Bay region’s largest employers. Tech Data, Port Tampa Bay, the YMCA and the city of Orlando government were just a few of the organizations in the audience at the Moffitt Cancer Center in Tampa. Moffitt hosted its first ever “Employer Forum,” where doctors and administrators shed light on the cost of cancer and its huge impact on the workforce. They also proposed a new way of collaborating with insurers to make treatments more affordable for patients like Bishop.

“It’s a topic that’s hardly ever mentioned in the workplace, but the employer plays a big role in terms of support for the patient and their family,” said Dr. Louis Harrison, chief partnership officer at Moffitt and one of several physicians who shared stories about how difficult it can be for patients to balance work and cancer.

“Just recently I was treating a patient with neck and head cancer who was worried a test was going to take too long,” he said. “He told me he had to get back to work or else they were going to be angry with him. What a predicament.”

Read more here.

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Tampa Bay Times: Yes it’s awkward, but more dentists should talk to patients about oral cancers and sex

By Justine Griffin

Dentists and dental hygienists see nearly 85 percent of children and their parents in the U.S., making them an important group of health care providers who could address HPV prevention and detection -- even if the conversation can be awkward, says Ellen Daley, a professor studying women's health at the University of South Florida. [DOUGLAS R. CLIFFORD | Times]

Dentists may soon be prying deeper in their patients’ sex lives.

The human papillomavirus, or HPV, is now the most common sexually transmitted disease, and one local researcher is urging dentists to get on board to warn patients about it.

But talking about HPV — and how it can be spread through oral sex — can be awkward.

“This is an emerging topic for dentists and not really one they ever expected to have to talk about,” said Ellen Daley, the lead investigator of a recent study on this topic published in the Journal of the American Dental Association this month. “It’s controversial and uncomfortable. No one wants to talk about these sensitive topics.”

HPV is the cause of 72 percent of oropharyngeal cancers, which can impact the base of the tongue, tonsils and walls of the pharynx, said Daley, who is also a professor studying women’s health at the University of South Florida.

Younger patients, usually pre-teens and teens, are the most at risk for HPV. But the virus can also be dormant for years, which could impact older patients who won’t necessarily experience symptoms for many years.

It’s transmitted during vaginal, anal or oral sex with someone who has the virus.

Nearly 80 million people — or about one in four — are currently infected with HPV in the U.S., according to the Centers for Disease Control and Prevention. About 14 million people become infected each year, and 30,700 of those cases cause cancer in men and women.

The HPV vaccine can prevent most of those cancers, or 28,000 of them. An estimated 50,000 cases of oral type cancers will be diagnosed this year, according to the American Cancer Society.

The Florida Legislature is currently considering companion bills in the House and Senate that could add the HPV vaccine to the child immunization requirements for school.

Read more here.

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Tampa Bay Times: Free clinics respond as more people head to the ER with dental problems

By Justine Griffin

Charles Lee had been dealing with an excruciating toothache for days.

The pain made it hard to eat or sleep or focus on work. But Lee, 54, didn’t have dental insurance. His job as a delivery truck driver offered only a supplemental policy that was too expensive. He feared he needed a root canal, which he knew could cost hundreds of dollars even with insurance.

The Department of Health in Pinellas County referred Lee to a free dental clinic in Clearwater, just blocks from his home, where a volunteer dentist found the cause of his issue and replaced two fillings for the price of a donation.

“I had nowhere to go. I had no affordable health care. I went into a Walgreens to see what they could do, and walked out with my tooth still killing me because they wanted $119 just to see me,” said Lee, one of the 27 percent of U.S. adults ages 20 to 64 who, according to the Kaiser Family Foundation, are living with untreated dental issues.

Most adults who don’t have dental insurance end up in emergency rooms because of tooth or gum problems. The number of patients who go to the ER with dental-related issues surged from 1.1 million in 2000 to 2.1 million in 2010, and continues to rise, according to the American Dental Association. The organization says that up to 1.65 million ER visits a year could be better handled at dental clinics.

While the Affordable Care Act and low-income insurance programs like Medicare and Medicaid have improved Americans’ access to health care, barriers still remain for adult dental care.

Local health departments, including in Pinellas, Hillsborough and Pasco counties, offer some low-income dental plans to residents who qualify. And children’s dental care is covered nearly in full through Medicaid, the federal Children’s Health Insurance Program and the ACA.

But Florida Medicaid plans for adults provide dental-related reimbursements only to participants who need emergency services to alleviate pain or infection or denture-related procedures, according the Agency for Health Care Administration.

At the Community Dental Clinic in Clearwater, dentists and hygienists convinced Charles Lee to come back for several follow up appointments, which helped get his dental care on track. And Lee didn’t have to worry about how much he was paying for the continuing service.

Read more here.

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Tampa Bay Times: ‘Pregnancy centers’ draw scrutiny as lawmakers seek to elevate their status

By Justine Griffin

Rose Llauget, director of pregnancy and adoption services with Catholic Charities Diocese of St. Petersburg, Inc., replaces a doll representing the early stages of pregnancyat at her office in Tampa. Llauget oversees five Tampa Bay area centers that offer pregnancy tests, ultrasounds, adoption services and general counseling for women who find themselves in an unwanted or unscheduled pregnancy. [CHRIS URSO | Times]

Annie Filkowski used to see the signs during her drive to school each morning. “Free pregnancy tests,” they said.

So when she feared she might be pregnant at 16, shortly after starting to have sex with her boyfriend, she remembered them. And walked into a center in Fort Myers.

Keisha Walters, saw the signs too, outside an old Tampa home on Armenia Avenue that had been converted into an office. Walters, 32, was pregnant for the first time and had lost her job. She felt alone, far away from her family in the Caribbean islands of Saint Kitts.

“I didn’t even know what to ask for, or what I needed,” she said.

Both women had found their way to one of the 105 publicly subsidized “pregnancy support centers” in Florida, part of a network of mostly faith-based organizations that provide emotional support and limited medical services for unplanned pregnancies — while also working to prevent abortions.

But their experiences could not have been more different. Filkowski said she left feeling pressured and duped, while Walters found a welcoming source of help that she continues to rely on today.

The contrast goes to the heart of a simmering debate as Florida lawmakers prepare to make a key decision on the future of the centers: Should the state continue to fund them every year as part of the budget process, or give them a more exalted position by enshrining them in state law as a permanent program overseen by the Department of Health?

Welcome to the latest battleground in a long-running war over state government’s role in the abortion issue.

Many Floridians know of the centers from the now-familiar billboards that have lined the state’s rural highways for years, urging women to find options other than abortion, reminding them that a heartbeat begins just days into a pregnancy.

The centers are part of the Florida Pregnancy Care Network, which has received more than $21 million in state funding since 2007, according to the Florida Department of Health, including $4 million in the current fiscal year. With services that range from testing for sexually transmitted diseases to parental counseling, they are largely unregulated and can vary significantly depending on the location. Some employ nurse practitioners or physicians. Others rely on church volunteers to take ultrasound images, provide medical information with sometimes questionable accuracy and deliver a clear anti-abortion message.

Companion bills in the House and Senate that would make the centers a permanent fixture have drawn heavy criticism from groups like the National Organization for Women and Planned Parenthood.

“The funding for this network umbrella has steadily increased over the years to the tune of millions,” said Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, whose members receive no state funding. “Women should have all the medically accurate information they’re seeking, without bias and without shaming. The women who have been to some of these pregnancy centers have felt this way and are later harassed for their decisions.”

Read more here.