California doctor convicted of murder charges in overdose of patients – LA Times

October 30, 2015 3:46 PM

A Rowland Heights doctor was convicted of second-degree murder Friday in connection with the overdose deaths of three patients, capping a landmark case that was closely watched by medical and legal professionals across the country. Dr. Hsiu-Ying “Lisa” Tseng, who prosecutors say is the first doctor convicted of murder in the United States for recklessly prescribing drugs to patients, was accused of ignoring “red flags” about her prescribing habits, including the overdose of a patient in her clinic and nine phone calls in less than three years from authorities informing her that patients had died with drugs in their system. As the jury’s decision was read, Tseng cocked her head and listened, showing no emotion. “The message this case sends is you can’t hide behind a white lab coat and commit crimes,” Deputy Dist. Atty. John Niedermann said afterward. “A lab coat and stethoscope are no shield.” April Rovero, whose son, Joey, died nearly six years ago after mixing alcohol with Xanax and oxycodone he had obtained from Tseng, said she believes the verdict will resonate throughout the country. “I really hope this sets a precedent that will allow other dirty doctors to be prosecuted,” said Rovero, who blogged daily throughout the trial. “We feel that finally we have justice.” She wrote them a prescription for the very thing they’re addicted to. She shoved them over that cliff. – Deputy Dist. Atty. John Niedermann She warned against simply blaming addicts when physicians are in a position to know the harm their prescriptions can bring. “Addicts and people seeking medications aren’t in control,” Rovero said. “Doctors are the ones who are supposed to push back. They have a duty.” Tseng’s mother, who declined to give her first name, said through an interpreter that her daughter was deceived by drug-seeking patients. “My daughter is someone who loved to save lives,” she said, crying and shaking her fists outside the courthouse. “She always believed in her patients, and always tried to help her patients. She’s innocent of all these accusations.”

Read the conclusion:

Source: California doctor convicted of murder charges in overdose of patients – LA Times

Commentary-

This is an unfortunate casualty of free will. Accidental overdoses can occur, however most are from being irresponsible. If this was a case of an adverse chemical reaction as a result of the prescription drugs prescribed then it would have been the doctor’s fault if the patient didn’t know any better. People know better when they take more medication than is prescribed and they know better when they mix it with alcohol or other substances. Lets not minimize it by claims that the addict didn’t know any better. Addiction is a serious problem and one that does need to be addressed. Families have a responsibility above a physician. They generally always know the tricks the addict plays. The physician isn’t able to see that far.

When do we start taking responsibility for our own actions and the consequences that are sure to follow?

~Twinkle V.

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Flash Flood

by Twinkle VanFleet

Image Credit- Blossom of Heaven by Delere

Image Credit- Blossom of Heaven by Delere

Flash flood,
Almost could’ve.

Bled out,
Still hoping about.

High risk,
Twice amiss.

Damaged,
Let go.

Oh my!
What do ya know.
Smiling,
Whoa!

Wait!
“What do you mean?”
Flash Floods,
Just a bad dream.

Break down, shake down,
Advisement under care.
Back down, throw down,
Submission to despair.

Let down,
No one around,
Breathe!
3 abound.

Flash Flood,
Back into the blood.
Always there,
Forever loved.

©2015 Twinkle Wood-VanFleet/Golden Rainbow Poetry/All Rights Reserved.

Copyright Laws and Regulations of the United States  http://www.copyright.gov/title17/

17

By Twinkle Wood-VanFleet

For my husband Erik VanFleet

 

If 17 could last forever, my flight just left the ground-

 

Heading for my home town, young and summer bound.

 

If 17 might last forever, oh yes! That’s where I’d be-

 

Ssh! Can you feel that moment, the first time you laid eyes on me.

 

Listen! Can you hear the music? Would you have looked my way again?

 

Would the song still be playing, or ending just as friends?

 

If 17 could last forever, still at the river, in the sand?

 

Or strolling through Old Sac, while walking hand in hand.

 

Hey! Can you feel the summer time heat? June through hot August nights-

 

Our first night at Garcia’s Bends, together beneath the moonlight.

 

Oh! Can you feel that memory, as you first took me in your arms?

 

If that summer had just begun, would you still shower me with charms?

 

If 17 would last forever, could you have loved me in the end?

 

I just close my eyes and remember, I’m still 17 again.

17 - Twinkle V.

17 – Twinkle V.

©2001-2015 Twinkle Wood-VanFleet/Golden Rainbow Poetry/All Rights Reserved.

For viewing purposes only. May not be copied, reproduced or altered in any way without permission. Published at several poetry sites throughout the years. Originally published by Golden Rainbow Poetry licensed as a small business in the City of West Sacramento 1995. OL- 1997. Written in the 1990’S.

Copyright Laws and Regulations of the United States http://www.copyright.gov/title17/

Family, Indie, Pain

Squirrel! But it really was. I’ve been staring out the window watching it for 30 minutes now. Running along the back fence, through the branches of the large tree that’s limbs cover the roof above my bedroom. It’s green, brown and yellow-gold leaves scattered about the ever-changing arms of fall. I gazed over as the quick little animal hurried over the Tuff Shed, back along the other side of the fence and eventually disappeared again. And then I was reminded of all the distractions.

The day before we left for the Stanford transplant center on behalf of our daughter for the second time in a month, my 6 month old puppy Independence stopped eating, drinking, became lethargic, ceased playing. No more kisses, no more loves, no greets. He’s always extremely perky, playful and active. He loves his ropes, always tugging with me, but not anymore. This was on Wednesday, the 14th that this began. We’ve already spent $2,000 saving one puppy many years ago from Parvo, nearly lost another that I was able to save by IV home care I’m not sure what’s the matter with Indie. I know, take him to the vet, but unfortunately it’s not an option. If you’ve been following any of my story relating to our daughter, no matter how much I want to and wish that I could I’m just not able.

Independence (Indie) October 6, 2015

Independence (Indie)
October 6, 2015
Before he became sick.

I started force feeding him sugar-water on the 14th. Other than in the A.M. I was gone all day on the 15th and didn’t get home until nearly midnight from Palo Alto, CA. Our daughter seen her specialist and had a pre scheduled MRI immediately after. Her doctor added a brain scan as well. We drove another 20 minutes to the imaging center and learned that the scans hadn’t been authorized by the insurance. I could understand the second not being yet as it was just added, but the first hadn’t been either and had been scheduled 3 weeks prior. We signed the papers to take financial responsibility still hoping that the insurance would be approved or that we could appeal if all together denied. She has to have these scans. She was taken back and came out 15-20 minutes later in her gown into the lobby. They wouldn’t proceed without a $10,000 down payment. Oh my! Then we learned none of her Stanford appointments have been covered. Nothing we could do. She went to change and we drove back home to Sacramento.

When we got home Indie short for Independence was in the same condition as when I left. I gave him more sugar water. He wouldn’t even look at food or water. His head was droopingI rested a bit, I was exhausted, I hadn’t been feeling well, I’ve been in a flare, but my arms were hurting too much, numb, losing feeling, difficult to raise, electric shocks, my chest aching. I started researching all that I could on sick puppies. I gave him a dose of RFD Liquid Wormer for puppies and dogs and comforted him. I already had it on hand. I finally fell asleep about 4:00 a.m.

When I woke, I could barely lift my head, I couldn’t feel my arms, I could barely carry myself my back was so heavy, hate is a strong word, but I really hate the word pain, it really hurt, my collarbone area, the side of my face, my lips were having spasms and sharp spikes. All in addition to my lower back and bilateral CRPS. I was diagnosed with Fibromyalgia in 2003 also, but I know that pain enough to differentiate it from CRPS and what’s going on here. For me, Fibro feels like I’ve been run over by a truck. Really deep muscle pain. Or if I haven’t worked out in a long time, and did for a day, it’s similar to the next days muscle burn pain we get from it. My arms first started doing this a couple of years ago, lasting for over 6 months straight at one point, all day and night long in the seize and release. The only way I’ve been able to describe it is that it feels like my spinal cord stimulator is in my arms for seconds at a time. Being turned on, increasing in intensity until it reaches its peak, locks my arm up, in whatever position my arms are at the time it occurs, until the buzzing/intense tingling/shocking eases down and releases. I suppose if I didn’t have an SCS, I couldn’t describe it this way and maybe because I do I had been accidentally misleading doctors in my description. The only way to describe accurately is to truthfully describe as something feels. It’s really painful. Bringing me to tears more than a few times. I really hold back crying over my CRPS pain, I hide pain fairly well, including pain behaviors and guarding, but this has caused tear drops to rain on their own accord. Automatic. It feels like a line running through the side of my head and continuing down my neck into my arms. Worse on the right,  though both are effected. And the headaches, disorientation. Phew! By the way it’s not possible for the actual stimulation from my SCS to be in my arms. Plus, back when it first occurred, I inquired to the possibility just to be sure.

Barely being able to make it down the hall because evening out my spine wasn’t an easy task, I got my coffee, and tended back to Indie. I’ve found him in the backyard twice and that scares me. I know animals often go away to pass on. He’s not an outside dog like that and because it’s not part of his normal routine it makes me uncomfortable.

I got everything ready I asked my husband to get from the store the night before. I’m bound and determined to make him better. Today is the 5th day since he’s not eaten. My husband brought back Pediatric Electrolyte, Karo Syrup, and 4 containers of chicken and rice baby food. All day long, I’m giving him a 3 ml syringe of the PediaE, 3 x each time, every hour at least. I have to pry his jaws, or attempt into the back side of his cheek between his teeth. He’s that sick. I rub the Karo on his gums to raise his blood sugar. I used a spoon to force feed him the baby food. It was messy. On the 3rd day, he finally drank water from his own bowl, but he vomited it up on my bed. Laundry! He did drink too much for not having drank in 3 days, I think. I’ve been watching for blood, there hasn’t been any that I know of. He didn’t drink any water again yesterday and he still hasn’t eaten any food and is still inactive. My 9-year-old grandson just said to me as he pet to soothe the puppy laying beside me “I miss when Indie was all hyper”.

Last evening, I added Tylenol into his daily care. I didn’t have baby Tylenol, so I put one of my Acetaminophen into a water bottle cap with a few drops of water to let dissolve. The Tylenol is a OTC 500 mg. Once liquid, I pulled approximately 150 mg of it into the syringe with the rest PediaE, shook it up, opened his mouth, and shot it down his throat and gave him 2 more 3 ml PE.

He’s so skinny.

It’s hard when you have to make choices, or rather, you don’t have any, but there are options and I’ve used my knowledge, past experiences, and the research to do as much as I can for him, as I do for the rest of my family. I hope I’m not prolonging his survival to cause him suffering but instead saving his life with all the love and compassion within me. I really don’t give up, not even on a pet.

Today I started using the syringe to get the baby food down him. Too many days have gone by. I pray I’m doing something right, he’s still hanging on.

Friday night I was diagnosed with Cervical Radiculopathy, previously diagnosed as only Paraesthesia. As long as I’m not going to drop dead of a stroke, I can figure out a way. And nope, wheels (wheelchair) are still not an option at this time. I’ve already beat being in one permanently by 10 years due to my lower extremities, not letting my upper body steal the good hard fight. Nope, not yet.

It’s taken me 2 hours to type this. A bit of a setback.

… But only a setback.

#StrongerThanPain

A Call for Action- 2016

A Call for Action 2016

By Twinkle VanFleet

disabilityIntegration

‎Since 2012, the estimated rise in addiction and opioid related abuse was an astounding 26.4 to 36 million people throughout the world. The accidental overdose of prescription related deaths were 4 times the amount of similar deaths in 1999.[1] According to the National Survey on Drugs Use and Health, 70 percent of all people who abused prescription analgesics got them from friends or relatives while 5 percent got them from a drug dealer or the internet.[2] While most of the focus has been on patients abusing their medications we must not lose sight that the majority of these patients take their medication as prescribed. The  negative innuendos influence the positive conclusion that long-term opioid treatment does in fact give quality of life to not only cancer patients, but non-cancerous chronic pain patients whose pain cannot be controlled any other way.

In an effort to deter abuse and/or misuse in patients, family, friends or associates, decrease the value in street sales, reduce the drug epidemic in certain populations, abuse deterrent formulations (ADF) are beneficial step forward in the diversion of the prescription drug issue.

OxyContin, Nucynta ER, Opana ER, Oxecta, Embeda, and Targiniq each contain abuse deterrent formulations (ADF) or tamper deterrent formulations (TDF). The most common form of abuse is by swallowing the medication. Other forms are chewing, swallowing, snorting, ingesting, inhaling, and injecting for the fast acting euphoric effect. Naloxone is a narcotic that reverses the effects of other narcotic medicines and can be used to treat drug overdose in emergency situations. Naltrexone hydrochloride blocks the effects of opioids by competitive binding (i.e., analogous to competitive inhibition of enzymes) at opioid receptors. Naloxone and Naltrexone are both opioid antagonists and each conclusively block the body from experiencing the opiate and related endorphins. This occurs by binding of the opioid receptors with higher than affinity than agonists, but do not activate the receptors.

TDFs will protect people who decide to modify the medication’s original form by removing the opioid for prompt use and abuse. Otherwise, extraction acts quickly and the time it takes to produce its effects can be immediate.[3]

ADF’s contain ingredients for safer distribution. Patients would continue to receive the management of pain and physicians would be less likely to stop providing access to pain care.

Not all patients should be diverted to ADF or TDF by their physicians. Patient Evaluation and Risk Stratification should be utilized to mitigate potential risks. Pharmacies and insurance companies should not be allowed to replace an Abuse Deterrent Formulation prescription opioid for a similar generic non ADF opioid. The prescription drug abuse issue has brought an adverse impression onto honest patients with incurable and intractable chronic pain syndromes and diseases and has left some pain professionals feeling perplexed.

With the continued development of these safer opioid medications we are contributing to the future of better health and pain care practices. Pain patients must remain a high priority in the midst of the current and ongoing concern that prescriptions will likely be misused or abused. It is imperative that patients be assessed on an individual basis and not as an assumption to the status quo.

We must find a balance that separates patients who truly need opioid medication to live productive lives and those who are abusing them. Responsible patients should not be punished in an attempt to crack down on prescription drugs and opioid abuse. Legislators, health care professionals and pharmaceutical companies must work together to stop opioid abuse while keeping the needs of chronic intractable pain patients in mind.

Patients are being labeled for their chronic pain identity. In the last year or more they have not been receiving their medication management either by their physicians, insurance or pharmacy. In one instance, I was informed that a patient with no history of abuse was being referred to what seemed a drug rehabilitation program in order to get her medication. If she did not comply, she would not receive.

Another gentleman, previously prescribed Suboxone for pain management, now cannot receive opioid managed care because the information in his Prescription Drug Monitoring Program insinuates prescription drug abuse.

Steps need to be taken to ensure that notes are added to the PDMP/CURES database on individuals. Suboxone itself is only an implication without verification for what the medication was prescribed for.

On behalf of those who need, not want, but need medication to sustain quality of life, I call upon our legislative leaders to be proactive in this area.  Help stop the abuse without penalizing those of us who are able to live at least a modicum of life due to the effectiveness of these prescription pain medications.

Think about it,  as if you’re needing to… no! really needing to, begging to, ease your Mama. Close your eyes and imagine.

I call on you to not make any compromises for a standard not yet met.

  1. America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. Nora D. Volkow, M.D. May 14, 2014.

Senate Caucus on International Narcotics Control. NIH National Institute on Drug Abuse

http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2014/americas-addiction-to-opioids-heroin-prescription-drug-abuse

  1. 2. Prescription Drug Abuse. Office of National Drug Control Policy

http://www.whitehouse.gov/ondcp/prescription-drug-abuse

  1. 3. Tamper-Deterrent Opioid Formulations: Who Needs Them, and at What Cost? Robert Twillman, PhD. Pain Practitioner

http://www.aapainmanage.org/resources/articles/tamper-deterrent-opioid-formulations-who-needs-them-and-at-what-cost/

Twinkle VanFleet, Sacramento resident, pain patient, Executive Board Member and Advocacy Director for the Power of Pain Foundation.

Written Thursday, ‎December ‎04, ‎2014

Updated Wednesday October 14, 2015

Believe

(Originally Titled and published as “Belief”)

By Twinkle Wood-VanFleet

(What Heaven will look like) Photo taken by my son Kurtis Ozie (Ozra) VanFleet Sept 24, 2015. Bay Area, CA.

(What Heaven will look like) Photo taken by my son Kurtis Ozie (Ozra) VanFleet Sept 24, 2015. Bay Area, CA.

Without hope,

 

We would have nothing to pray for-

 

Without faith,

 

We would have nothing to believe in,

 

Without life and death,

 

We would have nothing to look forward to-

 

Without God,

 

We would have been nothing at all.

 

©1995-1999-2015 Twinkle Wood-Vanfleet/Golden Rainbow Poetry/all rights reserved.

Copyright laws and regulations of the united states http://www.copyright.gov/title17/

One of the few non-rhyming I’ve written. First public publication 1995, written awhile before that. x

 

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#painPOP – Do You Have The NERVE To Be Heard?

I have the nerve to be heard, do you have the nerve to be heard? POP for PAIN with hashtag #painPOP by the Power of Pain Foundation. We invite you to take the challenge or donate to either spread continued awareness and advocacy efforts or assist in educational funding for nerve pain diseases, syndromes and conditions.

Our balloons are safe for both you and the environment. Instead of a balloon release, our #painPOP offers you the opportunity to be involved even with physical limitations. We considered the noise in the pop, we considered those whose hands are not well and we considered the air.

We have taken into account those with PTSD from wartime. We would not wish you harm in any way, nor would we have you pop to startle you. No one is forced to do either. This is meant for fun, a distraction from our own pain; enlighten pain in others, and to promote understanding, compassion and hope. I participated in the ice bucket challenge last year and my body had a fit, but for ALS sufferers, I did it. I don’t have ALS, I have CRPS, CSA, OSA, other sleep disorders, Cheyne Stokes, Hypertension, Anxiety disorder, DDD, Arthritis (Juvenile Arthritis), PTSD and various extras.  Pain is hard, not being able to breathe evenly is hard, having a brain that doesn’t send the proper signals to the muscles that control breathing is hard, not being able to stay awake is hard and not being able to sleep is hard,  being on my legs is hard, but we don’t always have to be hard on ourselves.

I was challenged in the #painPOP by Power of Pain’s Executive Director Ken Taylor. Of course, I accepted, even though I’ve been quite unwell for weeks now.

If we tell ourselves we can’t participate in anything due to the setbacks in pain then we never will.

Here’s how it works:

Instructions
If your balloon has a POP (Power of Pain) logo, be sure to have it facing the camera.
To the camera say: I have the NERVE to be HEARD! (pop the balloon) do YOU have the NERVE to be HEARD! hashtag #painPOP participate or donate to powerofpain.org
Or if you want to challenge someone:
I have the NERVE to be HEARD! (pop the balloon) I challenge (state their name’s) to Have the NERVE to be HEARD! hashtag #painPOP participate or donate to www.powerofpain.org

You can have fun with it. Be creative. We also want you to be safe and content.

We look forward to sharing your submissions and celebrating with you.

 

NERVEmber Just Ahead Power of Pain Foundation

 

Our mission

Power of Pain Foundation recognizes the value of every person who makes up the chronic pain community. We are guided by our commitment to excellence, leadership and patient empowerment. We demonstrate this by:

 

* Providing educational resources for physical and emotional care * Advancing excellence in pain awareness of the over 150 conditions involving chronic pain and what patients are faced with on a daily basis * Strengthening our relationships with hospitals, pain clinics, pharmaceuticals, support groups and our chronic pain community * Demonstrating social responsibility through the use of our pain resources. The commitment of volunteers, physicians, community partners and friends to the Power of Pain mission, permits us to maintain a quality presence and tradition of caring, which are the hallmarks of the Power of Pain Foundation.

 

We hope that you participate in our #NERVEmber projects and if you are unable due to any restrictions that instead you share someone who has so that together we can fulfill the mission of the Power of Pain Foundation to give a voice to the communities that need it most.

 

#NERVEmber is International Nerve Pain Awareness Month (including RSD, CRPS, Diabetes, and more). Each day during the month of NERVEmber the @PowerofPain Foundation will present an awareness task that we can all perform!

This year we are also giving away over $1000 in prizes available for everyone who registers to participate and use the hashtags, complete tasks, host or attend an event. The more you participate in OFFICIAL #NERVEmber events, the more chances you have to win! Check out all events going on in our NERVEmber Event Calendar.

Find out more at: NERVEmber.org

 

A list of diseases, syndromes and conditions that involve nerve pain as a symptom.

AUTONOMIC*

The autonomic nervous system is a control system that acts largely unconsciously and regulates the heart rate, digestion, respiratory rate, pupillary response, urination, and sexual arousal. This system is the primary mechanism in control of the fight-or-flight response and its role is mediated by two different components.

AUTOIMMUNE**

Autoimmune diseases arise from an abnormal immune response of the body against substances and tissues normally present in the body (autoimmunity). This may be restricted to certain organs (e.g. in autoimmune thyroiditis) or involve a particular tissue in different places (e.g. Goodpasture’s disease which may affect the basement membrane in both the lung and the kidney).

OTHER

Other types of neuropathy conditions include; toxic, metabolic, trauma, compression entrapment, infectious, and congenital hereditary. These conditions are typically treated by multiple types of medical professionals.  The goal of treatments should be to understand the physiological system of the condition and then working to prevent permanent painful neurological transformations.

4 Q Deletion Syndrome
Alcoholism*
Alexander Disease
ALS Lou Gehrig’s Disease
Arachnoiditis**
Behcet’s Disease**
Bell’s Palsy
Blepharospasm
Bloch-Sulzberger Syndrome
Burning Mouth Syndrome**

Cancer Neuropathy*
Carpal Tunnel Syndrome
Causalgia**
Charcot-Marie-Tooth Disease
Chemical Injury Neuropathy*
Chiari Malformation
Cranial Neuritis*
Diabetic Neuropathy*
Dysautonomia*
Endometriosis
Fabry’s Disease

 

 

Fibromyalgia**
Friedreich’s Ataxia
Guillain Barre Syndrome**
Herpes Simplex 
HIV/AIDS**
Interstitial Cystitis
Leprosy**
Lupus**
Lyme disease**
MonoNeuropathy*
Multiple Sclerosis*
Neuro Muscular Dystrophy**

Optic Neuritis**
Peripheral Neuropathy*
Polyneuropathy**
Post-Surgical Pain
Pressure Palsy
RSD / CRPS**
Shingles*
Shoulder Hand Syndrome
Sjogren’s (“SHOW-grins”)**
Tarlov Cyst Disease
TMJ
Trigeminal Neuralgia**
Vestibular Neuritis*

Check back for more information on these conditions soon

Central Cervical Cord Syndrome

Central Pain Syndrome

Cerebral Palsy

Chemical Injury Neuropathy

Choreoacanthocytosis

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

Craniosynostosis

Cushing’s Syndrome

Brachial Neuritis

Ehlers Danlos

Electric Discharge

Failed Back Syndrome

Neuralgia Post-Infectious

Neuro Inflammatory Disease

Toxic Homeopathy

Vasculitic Neuropathy

See http://powerofpain.org/conditions/

 

Help us share and make aware

Hashtags (Please be sure to use the hashtags in their entirety)

#painPOP

#NERVEmber

#PaintTheWorldOrange

#IHaveTheNerveToBeHeard

#DoYouHaveTheNerveToBeHeard

Check out the video’s of those who’ve been challenged already, and those who’ve accepted at: https://www.facebook.com/powerofpain

Twitter- @powerofpain

https://twitter.com/powerofpain