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Paul Holmgren Saved My Life? - Nick Boynton


King Knut

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Anyone catch this:

 

https://www.flyersnation.net/nick-boynton-paul-holmgren-saved-my-life/?utm_source=dlvr.it&utm_medium=twitter

 

This was definitely during the Richards and Carter time frame, but it would tend to contradict the narrative that Holmgren shipped them out because of the Partying.

 

It also shows a stark contrast as to how Lombardi handled Richards' Oxy problem.

 

Oxy BTW, isn't really good for getting you high, it's mostly good for stopping something that hurts from hurting quite so bad.  It's not wonderful at that either in my experience, but the problem is what it's best at is making you need more Oxy.  

 

I'll also point out that while it saved his life, Boynton never played NHL hockey again.  

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3 minutes ago, King Knut said:

Oxy BTW, isn't really good for getting you high, it's mostly good for stopping something that hurts from hurting quite so bad.  It's not wonderful at that either in my experience, but the problem is what it's best at is making you need more Oxy.  

 

It's the acetaminophen in it that is what is worst for you and is killing folks.

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2 minutes ago, OccamsRazor said:

 

It's the acetaminophen in it that is what is worst for you and is killing folks.

 

I just got back from my third daily dose of Tylenol.  Wait...what were you saying?

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1 minute ago, ruxpin said:

 

I just got back from my third daily dose of Tylenol.  Wait...what were you saying?

 

 

It's the acetaminophen that is in these pills that are f**king their kidneys up and leading to renal failure. The liver is resilient and can recover if given time....your kidneys it's dialysis or death.

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3 minutes ago, King Knut said:

 

What, is it destroying livers and eating stomach linings?  

 

The pill has two numbers on it. Usually 5/325.

 

The top number is how much Oxytocin is in the pill.

 

The bottom number is how much acetaminophen is in it.

 

So if you are taking 20 a day you are ingesting 6500 mg of acetaminophen a day!

 

That is insane and will destroy your kidneys.

 

Acetaminophen is abused alot.

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10 minutes ago, King Knut said:

Oxy BTW, isn't really good for getting you high, it's mostly good for stopping something that hurts from hurting quite so bad. 

 

Ok some clarification here is needed.  There are different types of Oxycodone products out there.

 

1) Percocet = Oxycodone + tylenol.  Max amount of Tylenol allowed is 325 mg.  The oxycodone component can range from 2.5 - 10 mg

2) OycContin (Oxycodone) SR = this is the sustained release product that has a duration of action of around 12 hrs or longer.  This product has NO Tylenol.  In the past this is the product that drug addicts have tried to crush and snort or crush, heat up to a liquid and tried to inject.  This product come in varying strengths from 10 mg  to as high as 80 mg per tablet.  If you are opioid naive and try to snort this stuff, it will cause severe respiratory depression.  That is what it is so dangerous.  This is used for those who suffer Chronic Pain

3) OxyIR (Oxycodone) = is the immediate release formation of OxyContin.  This too has NO Tylenol.  This is for acute pain or for those who suffer chronic pain, it can be used to relieve break through pain.

 

15 minutes ago, OccamsRazor said:

 

It's the acetaminophen in it that is what is worst for you and is killing folks. 

 

Not really.  The FDA states that the recommended max daily dose of Tylenol (APAP) is 4 grams / day.  Now if you take greater than 4 grams of APA / day every day for moths and years, then yes, it will cause severe liver damage.  The cases of acute Tylenol over dosages that I see is usually those  individuals who have ingested several grams in 1 sitting.  If they tried that with Percocet (the only oxycodone product with APAP), then you would need at least 15+ tablets to get to doses that the Tylenol component would do any harm.  The oxycodone portion would cause more harm because of the respiratory depression.

 

 

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15 minutes ago, OccamsRazor said:

The liver is resilient and can recover if given time

 

NO ...  APAP is metabolized the by the liver.  Acute Tylenol toxicity will cause liver failure.

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12 minutes ago, OccamsRazor said:

The pill has two numbers on it. Usually 5/325.

 

In this case this is Percocet.  5 mg of oycodone / 325 mg APAP

 

13 minutes ago, OccamsRazor said:

The top number is how much Oxytocin is in the pill.

 

Chuckling ... its ok  OC...it is a misspelling and I know that.  Oxytocin is actually another medication that we use to help induce Labor and then post  delivery it is used to help shed the placenta and stop post labor bleeding.

 

In reference to Percocet you are right ... the top (1st number ) represent how much oxycodone is in the product.

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16 minutes ago, OccamsRazor said:

Acetaminophen is abused alot.

 

Tylenol has no addictive properties whatsoever.  What makes it dangerous is individuals try to commit suicide via the Tylenol overdose method and it puts them into liver failure.  (we had one patient who ingested a whole bottle of APAP)  it was an insane amount of greater than 10 grams in 1 shot.  

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16 minutes ago, OccamsRazor said:

I think pilldoc can shed some light on this.

 

please see my posts above ... any other questions please feel free to ask.  I deal with  this on a daily basis.

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2 minutes ago, OccamsRazor said:

 

The pill has two numbers on it. Usually 5/325.

 

The top number is how much Oxytocin is in the pill.

 

The bottom number is how much acetaminophen is in it.

 

So if you are taking 20 a day you are ingesting 6500 mg of acetaminophen a day!

 

That is insane and will destroy your kidneys.

 

Acetaminophen is abused alot.

 

13 minutes ago, pilldoc said:

 

NO ...  APAP is metabolized the by the liver.  Acute Tylenol toxicity will cause liver failure.

 

I personally ran into problems a bunch of years ago with using plain old Tylenol to help with side effects of another treatment as I couldn't be on Ibuprofen or Naproxen.  I was probably taking about 3-4g a day slowly getting myself extremely sick in the process.  I was definitely jaundiced and they told me it was my liver levels that were way off.  Way better just to deal with the original side effects until that particular course was over.

 

My own personal experience with Oxy based pain relief was brief and essentially ineffective at relieving my pain, so I just stopped rather than risk getting myself into any trouble.  

 

I have known addicts however who would game several doctors/dentists at the same time to try to keep as many scripts going as possible for perc and oxy.  They were originally in a mild amount of pain, but by the end were just feeding a chemical addiction and getting no joy, euphoria or buzz out of it at all.  There seems to be a stigma or a myth that these addicts are just into getting high and feeling good and they almost never do by the time they're addicts.  They're not chasing a buzz, they're chasing a chemical that has convinced their body they need it desperately.  

 

Just my albeit very limited experience. 

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21 minutes ago, pilldoc said:

 

In this case this is Percocet.  5 mg of oycodone / 325 mg APAP

 

 

Chuckling ... its ok  OC...it is a misspelling and I know that.  Oxytocin is actually another medication that we use to help induce Labor and then post  delivery it is used to help shed the placenta and stop post labor bleeding.

 

In reference to Percocet you are right ... the top (1st number ) represent how much oxycodone is in the product.

 

I was going to say Oxytocin is naturally occurring too, right?  We make it ourselves... women more than men.

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Just now, King Knut said:

 

I was going to say Oxytocin is naturally occurring too, right?  We make it ourselves... women more than men.

 

Of course we make DMT and cannabinoids in minute amounts as well I guess.  

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32 minutes ago, pilldoc said:

If they tried that with Percocet (the only oxycodone product with APAP), then you would need at least 15+ tablets to get to doses that the Tylenol component would do any harm.

 

Yes. I wasn't talking about taking just tylenol.

 

I have known folks to take 20-30 a day of percocets two of the 3 are no longer with us. One a family member.

 

All 3 under 35 the ones that died was 25 and 33.

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35 minutes ago, pilldoc said:

NO ...  APAP is metabolized the by the liver.

 

I have seen/known people to lose almost 90% of their liver before they even knew it. Not saying that losing less can't kill you.

 

However if it is abused it can kill you either by the liver or kidney issues nonetheless.

 

Death is death and how you got there is how you got there.

 

It is an epidemic and it is wide spread across this country will the pills and stuff.

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6 hours ago, pilldoc said:

Oxytocin is actually another medication that we use to help induce Labor and then post  delivery it is used to help shed the placenta and stop post labor bleeding.

 

 

I've seen it all now!  A hockey thread with a pitocin reference!!

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Wonder how many players in the NHL have had similar issues.  There have be rumors for years that cocaine usage is fairly common in the NHL, especially in the POs.  That rumor dogged Lupul during his career and I always wondered to what extent some of those Flyers teams got geared up, especially for that one cup run.  

 

Glad he had a moment of clarity and told the trainers.  And good on the Flyers for doing the right thing.  IIRC, Holmgren himself did a rehab stint at one point (I think when he was a coach).   Flyers have always had a good reputation of helping players with addictions.  

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16 hours ago, OccamsRazor said:

 

It's the acetaminophen in it that is what is worst for you and is killing folks.

While long term acetaminophen is problematic for the liver, the narcotic is what shuts down the repository system. Hence acute death.

 

The problem is doctors in the 90's and 2000's were prescribing this **** like it was candy. Narcotic painkillers do not treat the underlining problem, only mask them. 

 

If the insurance companies had any balls, they would black label all narcotic painkillers and require prior authorization (from a medical review board) before allowing it to be prescribed. 

 

Sorry to be on a soapbox, but I lost two very close people in my life due to this ****

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To all my friends on here who have lost friends and loved ones due to narcotic misuse and abuse all I can say is that I am truly sorry for your loss. :(

 

7 minutes ago, Bertmega said:

The problem is doctors in the 90's and 2000's were prescribing this **** like it was candy. Narcotic painkillers do not treat the underlining problem, only mask them.

 

Part of this statement is true and part of it is not.  While it is true that medical providers were prescribing these medications like candy, some of the blame can be switched the patients and our healthcare society in general.  It has been my experience that patients want what they want, what they want..  There is is a definite role in narcotic medications for acute pain such as post op pain and those patients who have chronic pain due to such disabling conditions such as Cancer or Sickle Cell.  Patients who feel that there pain is not well controlled, for a myriad of reasons which is to great to go into depth here, go what we term is doctor shopping.  We need a better healthcare system in tracking these patients.  We as healthcare providers need to do a better job identifying which patients would benefit from narcotics and those who do not.  The 45 year weekend athlete who over did it while playing at the company softball game does not need hydrocodone, oxycodone, or tramadol for their pulled muscles.  However, the bicyclist who had a bike accident and now has a hip fracture will benefit greatly from short term use of oxycodone for breakthrough pain from having undergone a hip endoprosthesis.

 

One also has to remember that back in the 90's and early 2000's, the AMA added pain as a 5th important vital sign.  When one goes to the hospital, the MD's and RN's were constantly asking for a pain score rating base on a scale of 0-10.  0=no pain while 10 = most severe pain.  This too is inexact.  What you may rate as a 4, someone else may rate as a 7 or 8.  Providers are taught to manage pain and not to chase after it.

 

Recently there have been major strides at the way we handle post-op pain at our hospital.  With new post op pain management

strategies, which we call ERAS (Enhanced Recovery After Surgery), the goal is to use as little narcotic as possible post operatively.

 

It is true these strategies were not in place 20 years ago and our society as whole is paying the price.  We need better ways of preventing doctor shopping and polypharmacy. (using multiple pharmacies).  The state of PA is doing a better job at this when we instituted a state wide data base for tracking narcotic prescribing and patient usage.  This is a start but we need to do better.  Unfortunately there are MD's out there with a very low moral duty and will indiscriminately prescribe the medications for money.

 

31 minutes ago, Bertmega said:

If the insurance companies had any balls, they would black label all narcotic painkillers and require prior authorization (from a medical review board) before allowing it to be prescribed. 

 

Although a good idea, this will not really solve the problem and at times will be very impracticable.  Prior Auth's take time with lots of paper work necessary.  In an acute situation, this simply will not work.  Prior Auth's can take days or weeks for approval,  If you make all narcotics a Prior Auth, you WILL  over load the system.  For example do you really want to force your child to wait several days for a medication that contains hydrocodone for their several cough? (yes .. in small amounts, hydrocodone is an excellent anti-tussive)

 

Though in principle it is a very good idea, however, the practical side, and with my 30+ years working in the healthcare field, suggests this will not work.

 

What does work is for those patients who need chronic pain control, enter in to what is called a narcotic contract with their provider.  This contract states that the patient will only visit a certain provider or group practice.  Breaking this contract can result in being dismissed from the provider.

 

One also cannot ignore the illegal street dealings of narcotics.  I have read that brand name Oxy is going for $50 or more per tablet on the street.

 

I can type here for hours, if I had the time, relaying my thoughts and opinions on this subject.  I get the POV of all parties involved, from the patient to the healthcare provider.  There are no easy or right answers in solving this healthcare crisis.

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