Download Live Healthy Pain Centers Welcome Letter

Dear Patient,
Welcome to Live Healthy Pain Centers! We are excited to meet you and to have this
opportunity to treat you. We are Dr. Leslie Ahlers, MD, and Dr. Chris Massoglia DC, both
specialists in pain management. Dr. Ahlers has extensive experience and board certification in
Family Medicine, Addiction Medicine, and Hospice & Palliative care, and Dr. Chris is a
chiropractor and specialist in sports medicine injuries and their treatment. Our philosophy of
care is improving our patient’s quality of life through the treatment of pain and any other
conditions that are a barrier to health and vitality.
We would also like to inform you of the advances in the treatment of chronic pain in
recent years. Drs. Ahlers and Massoglia are experts in this area. The Centers for Disease Control
(CDC) has recently published guidelines responding to the “opioid crisis.” Providers are
expected to strictly adhere to these guidelines. Studies have now conclusively found that the
safest and most effective way to treat chronic pain is with the combination of a long-acting
opioid (narcotic pain medicine) that lasts 8 hours or more, such as MS Contin, Fentanyl patch,
Methadone or OxyContin, along with a short-acting opioid that lasts 2-4 hours to treat pain
flares. Examples of these medications include morphine, Dilaudid, Tramadol, or oxycodone. This
is now the standard of care for treating chronic pain, and will be considered for every patient of
Live Healthy Pain Centers where it is safe and effective.
It has been well known for some time that acetaminophen (Tylenol) can result in liver
damage when taken in high doses for long periods of time. Acetaminophen is in commonly
prescribed pain medications such as in Vicodin, Percocet, and Norco. To protect you from the
risk of liver damage when taking your pain medications, when appropriate these will be
discontinued and safer medications containing only an opioid will be prescribed in its place.
Another condition often associated with chronic pain is muscle spasms, and muscle
relaxers are often prescribed to alleviate these. However, there are some muscle relaxers that
are known to be habit-forming and mood altering, making them high risk for abuse and adverse
side effects. These include Soma (carisoprodol) and Flexeril (cyclobenzaprine). In combination
with an opioid, these can produce extreme sedation and confusion. There are, however, safer
options for treating muscle spasms, such as Tizanidine (Zanaflex), lioresal (Baclofen), and
methocarbamol (Robaxin). These safer medications will be the preferred muscle relaxers
prescribed for patients of Live Healthy Pain Centers.
It is also very common to have problems with anxiety and insomnia when you suffer
with chronic pain. One of the most common types of medications used to treat these are called
benzodiazepines. Examples include diazepam (Valium), lorazepam (Ativan), and clonazepam
(Klonopin). These medicines have been around for many years, and there is now abundant
evidence that when used for long periods of time they worsen anxiety, lead to dependence and
addiction, and are associated with falls. Most concerning, however, is that when taken in high
doses with an opioid, they suppress breathing, and are often the cause of death in drug
overdoses.
To protect you from these dangerous side effects, all Live Healthy Pain Center patients
taking benzodiazepines will be assessed for anxiety disorders and insomnia, the medication
tapered slowly, and safer, more effective medications will be prescribed. In cases where these
medications are necessary, patients will be expected to receive care from a mental health
provider who is collaborating with our practitioners to ensure the safety and appropriateness of
their treatment plan.
At Live Healthy Pain Centers, we believe that pain relief requires healthy choices each
day, including the appropriate use of pain medications, and participation in non-medication
therapies such as chiropractic care, massage, acupuncture, exercise, weight loss, and mental
health care, all of which have been demonstrated to be safe and effective treatments for pain.
We expect these to be part of your treatment plan as well.
To help us monitor the effectiveness of your treatment plan, there will be forms and
assessments that you will be asked to complete at your visits, such as pain, mood, addiction,
and disability inventories. Each of these have been found to significantly impact pain, so we will
regularly assess these to ensure all factors potentially influencing your pain are appropriately
addressed. We will also continue to require periodic urine testing, some even when you don’t
have a clinic appointment scheduled. As stated in your treatment contract, your cooperation
with these is required for ongoing care at Live Healthy Pain Centers.
To quote the Center for Disease Control (CDC) who earlier this year summarized the
problems inherent in the use of chronic opioids for the treatment of chronic pain:
Based on the clinical evidence review, long-term opioid use for chronic pain is associated with serious
risks including increased risk for opioid use disorder, overdose, myocardial infarction, and motor vehicle
injury (KQ2). At a population level, more than 165,000 persons in the United States have died from opioid
pain-medication-related overdoses since 1999.
We at Live Healthy Pain Centers are committed to treating your pain while ensuring
your care is safe and effective, helping you achieve your goal of a healthy, active lifestyle, and
minimizing your risk of injury. We are glad to answer any questions or concerns you may have
and look forward to working with you.
Dr. Leslie Ahlers, MD
Dr. Christopher Massoglia, DC