Letter to medical board for compassionate care vs. narcotics addiction

Re: Compassionate care versus narcotics addiction

Dr. Stuart,

First, I want to thank you for your time and commend you and the board on the tough decisions that you have made on the use of narcotics in office based procedures.

With the amount of drug abuse in the US, it is very important that, as a clinic and a medical doctor, these problems be addressed quickly and honestly. This last part of that sentence is my concern.

With drug addiction and abuse rampant in many parts of our country, identifying and addressing these issues are very important and sometimes difficult to do. What usually happens in a situation like this is that everybody pays for those that abuse. Everyone who uses narcotics is put under the label of “addict” and is left there. It’s understandable and probably the best starting point anyone can have.

Now that this step has been made (locally and hopefully nationally), there is another step that needs to be made and this one will take a lot longer and be a little more difficult. I hope to be one of the many that helps make these steps happen.

There is a huge difference between addicts and those that truly need the help and use it responsibly. I am one of those that use it responsibly and very closely monitor what and how I use my meds. I know there is a thin line that could be crossed if total vigilance isn’t kept. With frequent and honest conversations with my incredible PCP, Dr. Fadich, we have been able to keep things on a relatively even keel. We’ve even able to back off methadone because I didn’t like the side effects of it.

Now comes the problem. Not only do I suffer from severe diabetic neuropathy and fibromyalgia, I have a skin disorder that is more painful than anything else I have ever had to deal with; Hidradenitis Suppurativa or Acne Inversa. While mine is relatively mild compared to others, it does not make it any less painful. The best treatment that we have found is just a very simple I&D with packing. I try to get to them relatively quickly before they begin the tunneling process that is happening which could make surgery necessary.

Up until recently, I would see Dr. Fadich to have these done. Knowing of his kindness, caring and compassion has always had a bit of a calming effect on me. Unfortunately, because of the issues discussed above, he can no longer administer the Demerol with Phenergan prior to using the lidocaine. I know what you are thinking, “After the first shot of lidocaine, it shouldn’t hurt anymore”, and for most things that might be true. It is not with HS. There are times that the lidocaine can only lesson the pain of the I&D. We have also found that, with me, sometimes it takes very serious poking and digging in the area to find the tunnels and make sure they get drained also. It also takes very tight packing to keep this area from getting worse as it heals from the inside out. These are all things that Dr. Fadich and I have learned after many, many procedures and, believe me, we have tried it all.

I have been to the ER to have some of these taken care of since this is now the suggested route. There is a problem with this. It is the way I am treated as a person. I am made to feel that I am either dirty, just coming in to get drugs, or just basically a waste of time. I have gone from just knowing I need to go to get it done to now having to take Lorazepam and spend a few hours crying just to work myself up to going. I also now have nightmares and panic attacks when these areas flare up. I understand that the ER is a very busy place and you are treated in order of importance and I am great with that. I would rather they take their time to save a life than clean out a boil. But I should not have to feel like I am some dirty criminal to have this done.

While I know that no one has all the answers to this issue, I would like to meet with you and anyone else that would be willing to help.

I want to start an open and honest dialogue about narcotics addiction and how it is identified and treated. I would also like to find a way for people like me to get compassionate treatment for a condition that is chronic and degrading to have in the first place.

I don’t know where this could lead or if any solutions will ever come about but I am hoping to start here and I am willing to be a part of the solution. Not just locally but nationally as well. I know there are many medical communities that discuss this terrible pandemic and I really would like to be a part of further defining compassionate medical care versus narcotics addiction and where the line should be drawn.

I look forward to hearing from you and I would love an opportunity to meet face to face.

Again, thank you for your time.


Michelle Tilton


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