I am sending out a quick blog post for all that may be attempting to contact me about my proposed future direct care clinic in Ashe Co., NC. Here are the bullet points that I want you to have: This will be a direct primary care business. It will file no insurance. Cost is expected to be $20/month for membership and $125-135 per medical visit. New patient visits will be higher but this has not been determined yet. We will offer Direct primary care, pain management and subst

What happens next when you are on 10mg hydrocodone 4X a day and Xanax as needed for Fibromyalgia and RA but it is no longer working? What is a good next step? Also on Savella and Synthroid (probably misspelled) once a day. I’ve tried injections for RA with no relief. First, let me say, you spelled both of those correctly :) The issue of where to go next is both simple and complex. Here is the simple, as described in the appropriate chapter of my book: Tell them the plan is

Im currently on suboxone many yrs prior i was hydro 5/7.5 i have spinal stenosis and bulging disc and was told i need lumbar fusion. Im type 2 diabetic and surgeon wants my A1C in better range before the fusion. They put surgery out 4 months docs involved what to give pain meds. What do i do? If I am your friend, and I would like to think that me taking the time to try and give you an answer means that I am, then my first advice is pay much more attention to your diabetes.

In Kentucky, the sale, possession, or distribution of isolated or concentrated forms of 7-hydroxymitragynine (7-OH), is illegal.. How do I make sure this is not what I am getting? Is it the same as Kratom? The simplest explanation is that if you can find in KY, you don't need to worry about it being 7-OH but the other simply way to know that 7-OH is a concentrate so it will not be in a ground dry leaf. Capsules will be identified as one of the four main varients of the Krato

I’ve been in chronic pain for over 20 years and not one person will help. I’ve been to PCP’s and pain management with no help. I struggle most days getting up and just cooking dinner and caring for my disabled mom and child. What would you do? The last chapter of my first book says, "Don't let the flokkers win" and in response to your question my friend, my honest word to you is don't give up. I would begin with trying to find out if you respond to Kratom just so you feel a l

Hi Dr.Mike, question I was going to ask u on live today. My last appointment, I did urine screen. It showed a little bit of alcohol from night before. I'm on oxy IR 20mg 5x per day. They called me a week after the test came back, and they said the doctor wants to reduce 50%. How do I handle that? To answer your question, I have a few of my own. 1) Are you a diabetic and is your diabetes controlled? - the number one reason for having alcohol in your UDS is actually uncontroll

This is from a primer that I am including in my second book to train new providers on how to manage controlled medication patients. ...

Question submitted to DrMikeSays.com : I am currently on Oxycodone 7.5-325 x4 and they just added Oxycontin ER 10MG X2 but I have see...

Here is a small except from the ongoing work in the second book. These are the kinds of things I aim to teach new providers. Pick your...

What is the question/concern?: As CCP of 20 years I find if I get behind the pain I have a tougher time bringing the pain to a...

I was pregnant probably about 9 weeks ago… Tuesday I took my shot, Saturday I miscarried… do you think that was possibly the reason?...

A friend writes: "I’m struggling really bad with pain. And nobody will write me anything stronger than Tylenol #4. So I don’t know what...

I’m sure you have had it grilled into you that you never prescribe an antibiotic without a visit.  I can tell you that in day to...

I get tired. Today one of my most adherent chronic pain patients told me today two things that pissed me off. 1) She was told by a...

One of the things I have really been enjoying even more than seeing the book go out the door to people who need it are the 1:1 coaching...

First of all, thank you for all of you following the content. As we continue to grow, expect it to get more robust. Make sure you...

So, I had another 1:1 conversation today, and the topic came up that the previous provider placed in the patient's chart that "may have a...

I had a 1:1 coaching call yesterday, and obviously I can't tell you most of it because of privacy, but there are a few key things that...

If I was to ask you what the scariest words were in health care, many of you would reply "cancer", or "Lou Gehrig's Disease", or possibly...

Dear Dr Mike: So I have I.C. of the bladder, fibromyalgia, arthritis, osteoarthritis, 4 pinched nerves in my neck, dis function SI...