Friday, December 30, 2016

Count Down 2016 – CDC Opioid Prescribing Guidelines and Chronic Pain



2016 has provided many changes in the way pain is perceived, judged, and treated. Unfortunately, some changes have had dire consequences for those living with chronic pain.


The CDC Opioid Prescribing Guidelines

There is little doubt that the CDC opioid prescribing guidelines for primary physicians have affected Americans living with chronic pain.

As suspected by advocates, the CDC's opioid prescribing “guidelines” have been perceived by many as a CDC policy, when they are NOT. 

 “Policy’ is defined as a law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and other institutions.”

In a Medscape article, New CDC Opioid Guideline: The Good, the Bad, the Ugly, Charles E. Argoff, MD dissects the CDC Opioid Prescribing Guidelines, asking many questions that would have been posed during the development of a CDC policy, had there been one. As Dr. Argoff suggests, there are some very good things about the guidelines. But, other important deliberations were not included. It is my opinion that the CDC made a grave error when they ignored their own policy process, which requires rigorous investigation, planning and implementation on public health issues.

Why does it matter?

There are drastic differences between a policy and a guideline. Look at the wording for the “Prescribing Opioids for Chronic Pain Workgroup (Opioid Guideline Workgroup)”, of which some people had an undisclosed conflict of interest. These folks had the liberty to handpick “evidence” to prove their own opinion, ignore concerns brought up by other workgroup members, and publish them without advanced notice for public comment, an action that left many to distrust the CDC and their agenda. Advocacy groups pushed back until the CDC reopened a comment period, but it became evident it was an exercise that would have no effect on the guidelines; they continued to  ignore the voices of all the people. 

So, we are left wondering why the CDC, a government agency that focuses on public health, wouldn't  follow their own policy development protocol and include all stakeholders. 

I doubt the CDC set out to harm so many, but their guidelines have. I hear the cries of abandoned patients kicked to the curb to suffer withdrawal without help. And, others who are being weaned only to have their pain return to catastrophic levels, because physicians have suddenly done an about face. I have read the stories of family members raising their voices to let people know their loved one took their own life because these guidelines have led to the denial of access to moral and ethical care. If you or someone you know has been harmed, please see  HELP - Guidelines for Pain Warriors.

Look Forward

Leaving 2016 in our review mirror, let’s look toward 2017 with hope. The guidelines have been met with great scrutiny. There is opportunity in adversity. I am grateful for Dr. Argoff and many other physicians and advocacy groups who speak up for patients and their care. 

In healing,,Celeste


Other reading you may find helpful:




"Adversity is only an obstacle if we fail to see opportunity."

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Monday, December 19, 2016

Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain This Winter


There is nothing charismatic about chronic pain regardless of its source. Pain and chronic illness are greedy and demanding. Either or both can consume our time, our relationships, and our function. Chronic pain and illness can rob us of our dignity if we let it. But, there are things we can do, perspectives we can make that prepare us for the untold side effects of living with daily pain and chronic invisible illness.

“Remember, no one can make you feel inferior
without your consent.”

~Eleanor Roosevelt

Day Twenty-three - Whole Heartedness

The winter season metaphorically offers time for our old thoughts and destructive behaviors to die off. The barren land of winter uses the season for rest, to lay sallow in preparation for the birth of spring. The books in the Broken Body, Wounded Spirit series allows us to go of old thoughts by offering  daily thought prompts, exercises, and words of inspiration, such as those in the above quote. Our readers are given tools to fight the ogre of doubt that plays on our fear, agony, loneliness, and resentment in the Winter Devotions edition.

Come with us as we walk the barren winter land, appreciating that it is necessary to rid ourselves of previous conceptions in preparation for the spring season of rebirth.



Read more about Broken Body, Wounded Spirit, Balancing the See-Saw of Chronic Pain: Winter Devotions by Celeste Cooper, RN and Jeff Miller, PhD on my website, Celeste Cooper.com. Follow me on Facebook, Google+, Twitter, Pintrest, and Linked-In. Other resources include:


Available in paperback on Amazon and Barnes and Noble, and Kindle. Also available in Canada and the UK.


In healing,,Celeste

"Adversity is only an obstacle if we fail to see opportunity."  

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com



Wednesday, December 14, 2016

Chronic Pain: Surviving an Addiction Misdiagnosis with Patti Young


Personal stories humanize the challenges we face as a society, and stories from people living with chronic pain are no exception. I have heard many accounts of what it is like—I have my own. But, do we truly understand, patient and provider, how labels like “opioid use disorder” contribute to our current pain care conundrum?

I want to personally thank Patti Allen-Young on behalf of over 100 million American’s living with chronic pain for sharing her story.

My Life With Chronic Pain After Being Misdiagnosed With Addiction
by Patti Young

I am a patient who lives with chronic pain from a lower back injury that resulted in two surgeries. My condition has led to a label many of us endure—chronic pain.

I understand it can be difficult for a healthcare provider to manage a patient with both chronic pain and a substance use disorder. But does that give them the right to mislabel or use terms they don’t understand, labels that compromise care?

I need to share my story.

Experiencing sudden severe eye pain and knowing the protocol as a nurse, I called ahead to emergency room (ER) to make sure an eye doctor was available. I never saw that doctor. Instead, I was seen by a physicians’ assistant (PA) who prescribed an antibiotic eye drop. My severe pain complaints were not only ignored the PA’s interaction changed after reviewing my medical record. Later I would recognize the uneasy feeling that something detrimental to me was about to unfold. I could have gone blind because of bias in the healthcare environment.

My next encounter with discrimination was when I sought help for severe groin and hip pain, eventually diagnosed as sacroiliac (SI) joint dysfunction from my initial lumbar fusion. I was laying on the ER gurney, my husband at my side. Once again, my extreme pain complaints were dismissed. But this time something bizarre happened. Three security guards descended on me and told me to get in my wheel chair and leave or they would pick me up, put me in it, and escort me out. I was a 59 year old, disabled woman and no threat to anyone. They must have the wrong person, I thought. My husband sat stunned beyond words. Now, I knew there was something in my medical record I needed to see.

How could this happen?

Because my care was being compromised, the investigation into that “red flag” began. What I found was that a new doctor I saw on referral mistakenly documented “history of addiction” in my medical record. I asked myself, “Did I have a dependency problem that no one was sharing with me?” I found no mention of any dependency problems in my records by my other healthcare providers. In fact, at the time I was still being prescribed pain medication. Why wouldn’t a doctor making such a judgment discuss this with me? Did he decide—not knowing me at all—I was misusing my pain medicines? Was it human error?

The Haunting

I understand that people do suffer with addiction, and I would hope those folks get appropriate care. But, a misdiagnosis, a misguided judgment, or a medical record error can affect a patient forever.

Soon after moving to a new state to escape harsh winter weather that aggravated my pain, I had to seek emergency care. You see, despite knowing primary care physicians were accepting new patients and my insurance, I had great difficulty finding one. That red flag, the label, continued to haunt me.

Physical Harm – Is that all there is?

I experienced physical ramifications from labeling, but it also caused me mental and emotional distress and problems relating to others. Even though I realize the label was unfounded, the sleight of hand unleashed more obstacles for me to overcome.

Ignored and mistreated in my times of real need, the hospital staff responsible for their role in having me removed from that emergency room demonstrated their anger by tone of voice, gestures, and curtness. I felt hopeless. It was a very dark time in my life that has become difficult to forget.

Stories like mine shouldn’t happen in a civilized world. As a nurse, I ask, “What is the treatment plan and bias for those who do live addiction or with chronic pain and addiction”? Do they “deserve” to be treated badly, judged, and denied access to the care they need? Isn’t there a problem when people living with chronic pain develop PTSD and anxiety because of their medical treatment? Is it any wonder I distrust the very physicians I have to go to for help? 

I am a person, not a label

Once a trusted fellow healthcare provider, a nurse for nearly 35 years, I no longer feel the camaraderie I once enjoyed. My reputation is important to my character; I am not a different person simply because I live with chronic pain, yet I have been mislabeled and treated harshly.

Educate – Do no harm

The medical community needs to be educated. I certainly have been. That’s why I wanted to share my story. There is a difference between physical dependence and addiction. Addiction, misuse, or opioid use disorder are not synonymous with needing an opioid to treat very real, documented pain conditions. A distinction and differentiation should be made by someone qualified.

Many medical professionals congratulated me for stopping my pain medication when I found other affective treatments. I thought they were crazy. For me, it was no mental feat, because I was not addicted, though the physical withdrawal was no party. I don’t have skin in this game now, but I still live with chronic pain and I can say without hesitation, it’s time to stop hurting and stigmatizing pain patients. It only makes their pain experience worse, their medical care neglectful, and can lead to serious mental health problems or even suicide.

Healthcare providers, make sure your diagnosis has merit. Refer your patients to someone qualified to document “their expert findings”. Have an honest conversation with your patient. Stop for a second and think about how documenting personal opinions can affect someone else’s life, health, and well-being. Join patients like me willing to share their story by becoming part of the solution. Don’t ignore your patient’s pain complaints, advocate for them.

Sincerely, Patti Young



“To create change, we must squarely face the reality of pain in our society, including both the helpful treatments and services that are currently available for people in pain and the ways that we, as a society, are falling short of giving people the help for their pain that they need."

Lynn Webster, MD, The Painful Truth


Editor’s remarks:

The patients I hear from are looking for hope. They feel mistreated, talked down to, and ridiculed; they are bullied into submission and sometimes torture. Perhaps we need better education for providers and patients on the difference between pain and addiction behaviors. Perhaps we can hold others accountable by sharing our stories. Most patients find being a change agent is empowering. So please, help us carry their stories to social platforms. We can make a difference for all those living with chronic pain.

If you feel you are being harmed, please review the ”Guidelines for Pain Warriors” and other helpful information at http://CelesteCooper.com .

In healing,,Celeste
"Adversity is only an obstacle if we fail to see opportunity."  

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Tuesday, November 15, 2016

Is Chronic Pain a Disease? My Interview with Pain Specialist, Dr. Karl Hurst-Wicker, MD


To kick off this interview, I asked Dr. Hurst-Wicker this predominant question among the scientific community,

Is Chronic Pain a Disease?

Here is what Dr. Hurst-Wicker had to say.

Pain is a symptom of some other underlying problem, much like a runny nose is a symptom of a cold or allergies. The key to solving a problem is identifying the problem and figuring out how to fix it. If we invest all our time and energies in treating only the symptom, pain, without diagnosing the cause, we risk missing the chance to fix the problem and remove the symptom. We miss the opportunity to get the patient the right treatment, right away.

People experience chronic pain for many reasons, and many patients can be treated with injections, medication, surgery, or other modalities. The tough thing for both patients and physicians is realizing that human bodies are complex organisms. We are in the process of learning and understanding this intricate machine, but we don’t have all the answers to the problems we face readily available. This means that for some patients pain could be caused by something we don’t fully understand and therefore don’t have great treatments. Eventually we will get there. But if we started saying, “Oh, the problem is just chronic pain and we need to treat only the pain,” we’d miss the opportunity to find real causes, and we would miss opportunities to develop treatments that could truly help people, instead of only masking the symptoms.

Q. How important is a history and physical?

Take chronic myofascial pain as an example. Myofascial pain syndrome (MPS) is a common cause of chronic pain. It can be the primary peripheral pain generator and at the same time, it may flare up as an indicator of other pain generator in the same area. That’s why a big part of evaluating a patient with pain is getting a good history and physical exam. 


Q. Why does pain become chronic in some people and not others?

The transition from acute to chronic pain has a variety of contributing factors. Sometimes the problem is that the underlying problem can’t be fixed, like a bad joint that can’t be replaced because the patient is too sick for surgery. In other cases, people can develop the changes to central sensitization thus perpetuating pain even after the initial problem is fixed.

Some studies indicate genetic factors play a role and may explain why some people experience chronic pain and others don’t, and other studies indicate certain pain medications could initiate the process of central sensitization.

I’m not sure we will ever develop a quick or simple way to figure out what patient will develop or experience chronic pain. There are many factors at play and I think it is too complex to determine right away. But, we continue to learn more year after year.

Q. Are there other factors that contribute to chronic pain?

MRI of amygdala and hippocampus
Stress and sleep can certainly have an effect on pain. Stress alone can change the levels of neurological hormones in our central nervous system and thus, amplify chronic pain. We discussed a study in a separate interview on centralization in fibromyalgia. In this study, they used the MRI to evaluate the size of the hippocampus in fibromyalgia patients [the region of the brain responsible for with memory and spatial navigation]. One of the things they discussed was whether the hippocampus was small due to the stress of chronic pain in fibromyalgia, or if patients maybe had higher stress levels that shrunk their hippocampus and thus got fibromyalgia. Sleep, more specifically the lack of sleep, is known to worsen pain. The restorative process of sleep allows our bodies to refresh, regenerate, and heal. So when we don’t sleep, we not only miss out on restoration, we also have a concomitant increase in both the physical and mental stress that our bodies must endure.

Patients can help themselves by being more aware of stress in their life, take time to eliminate those that they can, and find better ways to deal with the ones they must. It may mean setting aside time to take a nap in the middle of the day, or other things to care for themselves. Regular exercise has shown it reduces stress and promote better sleep habits.

Stay tuned for more answers from Dr. Hurst-Wicker about what happens when our brain perceives chronic pain as a threat.

In healing,,Celeste
"Adversity is only an obstacle if we fail to see opportunity."  


Karl S. Hurst-Wicker, MD, is a board certified anesthesiologist practicing pain management at the Desert Pain Institute. He graduated from Columbia University College of Physicians and Surgeons and completed his residency in anesthesiology at the University of Utah.


Other contributing articles written for you:

Q&A on Chronic Pain - Health Central
The Centralization of Pain - Health Central
Myofascial Pain Syndrome - Celeste's website


~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Monday, November 14, 2016

Coming Clean on Personal Hygiene: The Luxe Bidet – Chronic Illness Blogger


"I have been given this product as part of a product review through the Chronic Illness Bloggers network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company. "


Little did I know when I wrote the blog on irritable bowel syndrome (IBS), Coming Clean on A Dirty Little Secret, that I would be writing a blog from a different perspective, one of “coming clean” on personal hygiene.  

Personal hygiene means a great deal to those of us with irritable bladder, irritable bowel or other chronic illness disorders, such as immune deficiency or inflammatory bowel disease. Those of us with bowel problems, particularly those causing bowel hypermobility or other disorders, such as vulvodynia or interstitial cystitis know how important rituals of cleanliness are to our health. Accelerated bowel movement also interferes with nutrient absorption, again putting us at risk for infection.

For me, an irritable bowel attack leaves my bottom side raw and sore, breaking down my first line of defense, skin. The attack itself is very painful and the consequences are uncomfortable to say the least. Having interstitial cystitis and having IBS increases the risk of bacterial going where it should not causing frequent urinary tract infections. Personal hygiene is a priority to minimizing a great deal of collateral damage and pain from IBS.

Why is a bidet a good choice?

The Luxe Bidet (Neo 185) negates excessive wiping of watery stools that have high concentrations of digestive chemicals from the small bowel. Every boxcar of this runaway train is packed with juices that when moved into other portions of the bowel cause cramping, contracting, and spastic bowel function during an irritable bowel or inflammatory bowel attack. They are rapidly delivered to areas they should not be. While these important digestive chemicals are integral to digestion in their own portion of the digestive track, they can wreak havoc when they are rapidly moved from the small bowel into the large bowel during a painful episode. The damage doesn't end with the attack, these chemicals also irritate and breakdown sensitive tissue around the rectum and other surrounding structures. We know that stinging pain and we know this opens us up to skin infection from bacteria and candida.

Having the Luxe Bidet Neo 185 not only makes things more comfortable and clean, it gives me peace of mind when everything else is out of control.

How does the bidet work?

The Luxe Bidet Neo 185 is a dual nozzle, fresh water, non-electric mechanical bidet attachment for the commode with one-touch pressure control. It has a guard gate,  a regular nozzle and feminine wash nozzle for rear wash and a more gentle frontal wash. The nozzles drop down and retract when it’s not being used. And, it cleans itself!

The stream of water is adjustable. I feel clean without having to take a shower. I don’t have to worry about getting a yeast infection from using too many wipes, and I no longer have to worry about lurking contaminants staying behind to wreak havoc later. And it’s affordable.  

Installation

Adding the bidet to your commode doesn’t require plumbing skills. It comes with everything you need for a do-it-yourself installation. The only extra things you need is a screwdriver and a wrench. And, there are installation Instructions you can download.  Generally, it should only take about 20 minutes. It took my husband a bit longer, but we are older and it took a bit to get the connection loose at the water supply.

You can learn more about the Neo 185 at Luxebidet.com.

In healing,,Celeste


~ • ~ • ~ • ~ • ~ • ~

"Adversity is only an obstacle if we fail to see opportunity."  

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Monday, October 17, 2016

CELESTE SPEAKS - An autumn overview


The fall season is a time of harvest and preparation, and that is the metaphor for “Fall Devotions”. It is not a book of daily religious devotions; instead, it is a book for taking one day at a time, learning to live in the moment. As leaves turn brilliant colors and fall from the trees to provide a protective blanket for the harshness of winter, so does this book help our readers view life through a door open to a landscape of honor and hope.  (Excerpt from http://www.celestecooper.com/fall-devotions.html )

As we prepare for the days ahead, I thought it would be a good time to share a sampling of topics I have covered as free lance writer at Health Central and ProHealth. A few of the articles are listed below in alphabetical order according to the main topic. You can find more articles and direct links on my website.

Check out Celeste's articles for articles on topics, such as:

What is Centralized Pain: An Interview Dr. Karl Hurst-Wicker, MD
Chronic Pain and Movement Motivation
Illusive Disorder-Complex Regional Pain Syndrome
Dry Eye and Chronic Pain
The Connection Between TMJ and Chronic Pain
How to Report Foot Pain Symptoms
Tips for Managing Fibrofog
Fibromyalgia Awareness and Aggravating Conditions
Fast Facts: Fibromyalgia Is Real
Fibromyalgia Centralization and Peripheral Myofascial Pain
Fibromyalgia Concerns for a Healthy Mouth
A Nervous System at Odds: Dysautonomia and Fibromyalgia
Taking up the Slack: Flares, Frets and Fibro
Are There Objective Tests for Fibromyalgia?
Fibromyalgia Tender Points or Myofascial Trigger Questions
Essential Factors for Relating Fibromyalgia Symptoms
When Fibromyalgia Is More than Pain                                                    
Treatment of Foot Pain: How to Care for Our Feet
Joint Hypermobility and Chronic Pain
Downloading a Pain Tracking App
The Legs of Fibromyalgia and Myofascial Pain
Marijuana and Chronic Pain-QA-Dr David Barton
Migraine, Fibromyalgia and ME/CFS
Myofascial Pain Treatment
What is a Myofascial Trigger Point, and Their Relationship to Pain?
Why knowing the cause of pelvic pain is essential to treatment
Piriformis Syndrome or Sciatica, Is There a Difference?
Pitfalls & Pearls-Resistance Training - fibromyalgia and myofascial pain
Restless Leg Syndrome: Sleep, Fibromyalgia, and Myofascial Pain Syndrome 
6 Reasons Why Trigger Point Injections Aren’t Helping Your Fibromyalgia
What’s Causing This Chronic Rib Pain?
Sculpting Our Thoughts on Pain
The Romance of Fibromyalgia with Tai Chi
Yoga and Chronic Pain
and more...

Articles from Celeste at CelesteCooper.com list just updated. See what’s new at:

Be sure to check out the archives here on the blog, too.

In healing,,Celeste


~ • ~ • ~ • ~ • ~ • ~

"Adversity is only an obstacle if we fail to see opportunity."  

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Thursday, October 6, 2016

The Patient’s Playbook: Find the “No Mistake Zone” – A Chronic Illness Blogger’s Review


"I have been given this product as part of a product review through the  Chronic Illness Bloggers network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company. "

As a retired registered nurse, educator, and author of self-help books for my fellow pain warriors, I am thrilled to say that fellow author, Leslie D. Michelson, has done the patient community a great service by giving us “The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love”.


Aesthetically appealing, easy to understand attorney, Leslie Michelson, expresses relatable accounts of patient experiences, bringing it home to us as readers and patients. Using his 30 plus years of experience in the healthcare arena, he gives us “what to do’s” for nearly all healthcare decisions. We find tips for finding confidence and courage; asking questions; choosing the right doctor; working through the logistics of access, insurance, and cost; exercising patient rights; developing a support team; carrying your entire health history with you; utilizing resources, and much more.

The patient stories allow us to make objective assessments and catalog them in the file of “things to remember before, or when, it happens to me”, because in today’s fragmented and rushed healthcare environment bad things can happen. As the author suggests, hasty judgments, whether from the provider or the patient, increase the likelihood of mistakes, complications, unnecessary interventions, inappropriate referrals and other unwarranted occurrences.

I recently experienced the fall out of hastened, fragmented care. My rheumatologist became my advocate and ordered the blood tests I felt my symptoms warranted, despite the new endocrinologist telling me my symptoms couldn’t be explained by my “numbers” and to discuss my symptoms with another doctor. When my results came in, my thyroid levels had swung from critical high to critical low in 7 weeks. Because of stories like mine, finding a doctor who is a skilled diagnostician who listens and cares about patients getting the care they need is imperative. Leslie Michelson has the information you need to make that happen.  

I love this subheading in chapter six, “Forgetting Who’s in Charge. (Hint: It’s You.)”

Every patient is vulnerable when illness strikes, despite the nature or urgency. As a nurse who cared for people in the emergency department, I know patients and family members are at their lowest point, they feel they have lost all control and their duress interferes with their ability to think logically. Often, the nurse or doctor must lead the patient or family member to give them the information they need. But, this doesn’t always happen. The Patient’s Playbook gives us what we need to be in command, whether it’s finding a new doctor or being hospitalized. It teaches us to be assertive, tolerant, proactive, and partners in our care.

Lastly, a good self-help book gives us, the reader, the ability to interact with the material on a personal basis. The chapter summaries, “Quick Guides”, allow us to swiftly review areas of the book that provide information we need under certain circumstances. Even if you aren’t sick—right now—you can use the information found in The Patient’s Playbook to advocate for those you care about.

“By the time you finish reading this book, you will have completely rethought the way you interact with caregivers and hospitals.” ~ Leslie D. Michelson


Leslie Michelson, J.D., “healthcare quarterback”, CEO of Private Health Management, says his book is “A call to action to change the way we manage our health”, and that is certainly motivation enough to read it. Please take a minute and visit ThePatientsPlayBook.com, “Look Inside the Book” at Amazon and check out the “Table of Contents”, “Read a Sample” at Barnes and Nobel.   The paperback will be released on Oct. 18.  Amazon

You can also find Leslie on Facebook at Leslie Michelson @PatientsPlaybook.


In healing,,Celeste


~ • ~ • ~ • ~ • ~ • ~

"Adversity is only an obstacle if we fail to see opportunity."  

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate


Celeste’s Website: http://CelesteCooper.com

Celeste's Website

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