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#852105 - 03/02/09 12:56 PM
Dr. Garcia no telemed until seen than ???????
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Veteran
Registered: 02/13/07
Posts: 652
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Hi, I was just informed Dr. Garcia is not doing anymore tele consults until the patient is seen plus he's prescribing nubrin (sp)only! I was told if that drug does not bring you down to a zero pain level than the office visit is refunded. Now someone is expected to fly all the way to Florida to try a drug they don't know will work? For all the people using any of his OCS you better call them. Also he will only do pain management with no anxiety meds issued period. Why all the services are just blowing everyone off today and not just saying the truth is beyond me. I called a service and this is how I know this info since I noticed little clues today saying consults with him are over unless seen face 2 face. The service I spoke with was very upfront and not just posting a "we will get back to you later" type email I saw on the Consult Direct forum. I wish everyone taken by surprise by this the best of luck and I mean it. We all thought we had one month to go. I do not use Dr. Garcia but I expect the same to come from my service. K
Edited by tango5 (03/02/09 12:58 PM)
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#852403 - 03/03/09 05:22 AM
Re: Dr. Garcia no telemed until seen than ???????
[Re: ConsultsDirect]
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Veteran
Registered: 02/13/07
Posts: 652
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Letter from Dr. Garcia explaining new treatment plan. If there is two Garcia this is the one doing the injections now.
Angel M. Garcia, M.D.
Vital Function, LLC
900 Glades Rd. 2nd Floor
Boca Raton, FL 33431
866-500-6348
How would you like to be completely pain free? I know it sounds too good to be true but I am willing to back this claim with a money back guarantee. Better yet, if you do not walk out of my office PAIN FREE, you will not be charged for the visit. Nubain (nalbuphine) is a synthetic opioid narcotic analgesic that is not controlled by the DEA and has a very low addiction potential. It has the analgesic potency of morphine. Its onset of action is less than 15 minutes and lasts 6-8 hours or more. It is given just like an insulin injection, subcutaneous or right under the skin. See the attached letter regarding nalbuphine (Trade Name: Nubain) from the DEA.
Furthermore, nalbuphine has received a patent (see attached patent registration) for the extended release tablet form. I understand that it is a hassle to give your self an injection under the skin just like a diabetic. However, with DEA controlled narcotics such as hydrocodone, oxycodone and the like, you are never pain free. Most patients at best can reduce their pain from a level of 8 to a level of 2 or 3 but are never totally pain free. Aside from not obtaining complete relief of your chronic pain, you also have to worry about being caught by the DEA for obtaining these drugs on line or being treated by doctors like a druggy. With Nubain you will be completely pain free! The DEA will never bother you for using Nubain or purchasing Nubain online.
If you desire to live a pain free life again without the use controlled and addicting narcotics, please take this opportunity to come visit warm and sunny south Florida. Call the above numbers as soon as possible and ask to make an appointment for your Nubain Program. We will show you how to give yourself a shot under the skin with a very tiny needle no different than a diabetic who uses insulin. We will also provide you with the medication that you need for 3 months and thereafter you can do your telemedicine consult with one of our PAs without the fear of the DEA. You will be able to purchase your Nubain at any pharmacy or from our dispensary with your insulin syringes without any fear of scrutiny. In fact if you use more than prescribed during a rough month, you do not have to worry nor beg for an early refill because it is NOT controlled by the DEA even though it is a narcotic. As your physician I am completely free to prescribe more Nubain or approve an early refill without being regulated by the DEA!
As your physician I strongly recommend that you make this switch from hydrocodone or oxycodone to Nubain. The cost is no more than what you are paying today through these questionable internet pharmacies. Nubain works better. It is less addicting. You will most likely not have any withdrawal symptoms. However as usual please be careful operating heavy machinery or driving while using Nubain. We look forward to seeing you soon in Florida for your one time face to face visit.
Warm Regards,
Angel M. Garcia, M.D.
Vital Function, LLC
900 Glades Rd. 2nd Floor
Boca Raton, FL 33431
866-500-6348
Note: Please be advised that we are no longer prescribing any controlled substances.
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#852439 - 03/03/09 07:51 AM
Re: Dr. Garcia no telemed until seen than ???????
[Re: stevo1]
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GRAND Pooh-Bah
Registered: 12/01/04
Posts: 1445
Loc: AL
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Tango5,
Here is the letter that I got regarding the treatment plan:
Vital Function, LLC
Pain Management and Rehab Center
900 Glades Rd., 2nd Floor
Boca Raton, FL 33431
(800) 859-WORK
(561) 392-0034
Feb. 20, 2009
Dear Patient,
Since the Ryan Haight Act passed in Sept. 2008, we can only provide telemedicine services for patients that we have seen for at least one face to face consultation. This means that as of April 15, 2009, we will only be able to refill medications through phone consultations for patients that have come to our offices in Boca Raton, FL. for their face to face meeting. The cost of the face to face consultation is essentially the same as a telemedicine consultation and you receive prescriptions for 90 days that you may fill at your local pharmacy. Alternatively, we can also dispense the medications that you need for a 90 day period right in our office. The consultation fee for a complete physical examination, face to face meeting is $ 225. You are required to have a face to face only one time, not yearly. As a promotional offer to our current patients, we will include the yearly blood work (a Complete Metabolic Panel, including liver and kidney functions and a Complete Blood Count with differential) at no additional charge for any patient that makes an appointment during the month of March.
Starting April 16, 2009, our consultation fee for the face to face meeting will be $ 295. Once you have had your face to face meeting, you will be able to continue your telemedicine consultations on the phone with one of our licensed Physician Assistants every 90 days to get your medications refilled. You are still required to have a yearly physical with blood work by any physician of your choice. The doctor who performs your annual physical exam must document that you continue to have the chronic pain syndrome and that the medications are still effective and necessary for you to live a fairly normal and productive life.
In order to make an appointment, please call our office at (561) 392-0034. We have set up special travel packages with a travel agent to include flights, hotel, airport shuttle and transportation to our offices upon request. South Florida also has many vacation activities such as fishing, golf, shopping, etc. If you would like for our travel agent to book your travel arrangements for you, please complete the attached Medical Travel Form and fax to (800) 928-7109 at your earliest convenience. Most of our patients fly into Ft. Lauderdale or West Palm Beach, FL. Our offices are located approximately 20 miles from either airport. This is a medical expense that is tax deductible. We are committed to provide you compassionate, quality pain management medical care at reasonable prices. We look forward to seeing you soon.
Warm Regards,
Angel M. Garcia, M.D.
Medical Director
_________________________
Cant I take away all this pain. (you wanna see the light)
I try to every night, all in vain... in vain.
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#852464 - 03/03/09 08:36 AM
Re: Dr. Garcia no telemed until seen than ???????
[Re: tango5]
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GRAND Pooh-Bah
Registered: 09/04/06
Posts: 10284
Loc: NOT 40!
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Letter from Dr. Garcia explaining new treatment plan. If there is two Garcia this is the one doing the injections now.
Angel M. Garcia, M.D.
Vital Function, LLC
900 Glades Rd. 2nd Floor
Boca Raton, FL 33431
866-500-6348
How would you like to be completely pain free? I know it sounds too good to be true but I am willing to back this claim with a money back guarantee. Better yet, if you do not walk out of my office PAIN FREE, you will not be charged for the visit. Nubain (nalbuphine) is a synthetic opioid narcotic analgesic that is not controlled by the DEA and has a very low addiction potential. It has the analgesic potency of morphine. Its onset of action is less than 15 minutes and lasts 6-8 hours or more. It is given just like an insulin injection, subcutaneous or right under the skin. See the attached letter regarding nalbuphine (Trade Name: Nubain) from the DEA.
Furthermore, nalbuphine has received a patent (see attached patent registration) for the extended release tablet form. I understand that it is a hassle to give your self an injection under the skin just like a diabetic. However, with DEA controlled narcotics such as hydrocodone, oxycodone and the like, you are never pain free. Most patients at best can reduce their pain from a level of 8 to a level of 2 or 3 but are never totally pain free. Aside from not obtaining complete relief of your chronic pain, you also have to worry about being caught by the DEA for obtaining these drugs on line or being treated by doctors like a druggy. With Nubain you will be completely pain free! The DEA will never bother you for using Nubain or purchasing Nubain online.
If you desire to live a pain free life again without the use controlled and addicting narcotics, please take this opportunity to come visit warm and sunny south Florida. Call the above numbers as soon as possible and ask to make an appointment for your Nubain Program. We will show you how to give yourself a shot under the skin with a very tiny needle no different than a diabetic who uses insulin. We will also provide you with the medication that you need for 3 months and thereafter you can do your telemedicine consult with one of our PAs without the fear of the DEA. You will be able to purchase your Nubain at any pharmacy or from our dispensary with your insulin syringes without any fear of scrutiny. In fact if you use more than prescribed during a rough month, you do not have to worry nor beg for an early refill because it is NOT controlled by the DEA even though it is a narcotic. As your physician I am completely free to prescribe more Nubain or approve an early refill without being regulated by the DEA!
As your physician I strongly recommend that you make this switch from hydrocodone or oxycodone to Nubain. The cost is no more than what you are paying today through these questionable internet pharmacies. Nubain works better. It is less addicting. You will most likely not have any withdrawal symptoms. However as usual please be careful operating heavy machinery or driving while using Nubain. We look forward to seeing you soon in Florida for your one time face to face visit.
Warm Regards,
Angel M. Garcia, M.D.
Vital Function, LLC
900 Glades Rd. 2nd Floor
Boca Raton, FL 33431
866-500-6348
Note: Please be advised that we are no longer prescribing any controlled substances.
If it was that good, it surely would be a drug of choice. The UK has completely got rid of it, partly because it can be completely ineffective, and indeed can exacerbate pain, in males compared to females, and the antagonistic effect of it causes complications in those patients dependent on full opioid agonists.
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#852472 - 03/03/09 08:51 AM
Re: Dr. Garcia no telemed until seen than ???????
[Re: stevo1]
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Pooh-Bah
Registered: 06/27/07
Posts: 1477
Loc: Deep in Dixie
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NUBAIN (nalbuphine hydrochloride) is a synthetic opioid agonist-antagonist analgesic of the phenanthrene series. It is chemically related to both the widely used opioid antagonist, naloxone, and the potent opioid analgesic, oxymorphone.
That is the official definition I found everywhere. It looks like it would help many of us, but there is this little problem for many of us: Patients Dependent on Opioids
Patients who have been taking opioids chronically may experience withdrawal symptoms upon the administration of NUBAIN. If unduly troublesome, opioid withdrawal symptoms can be controlled by the slow intravenous administration of small increments of morphine, until relief occurs. If the previous analgesic was morphine, meperidine, codeine, or other opioid with similar duration of activity, one-fourth of the anticipated dose of NUBAIN can be administered initially and the patient observed for signs of withdrawal, i.e., abdominal cramps, nausea and vomiting, lacrimation, rhinorrhea, anxiety, restlessness, elevation of temperature or piloerection. If untoward symptoms do not occur, progressively larger doses may be tried at appropriate intervals until the desired level of analgesia is obtained with NUBAIN
It used to be Schedule II, then was removed from controlled status. It has been discontinued in the UK. It is listed by the DEA as a " drug of concern". I called a pharmacy to ask if it was available, told her my doctor was thinking about prescribing it. She said they dispensed no injectables other than Insulin and Imitrex. I will try others later, maybe others can try also so we can get pricing info.
_________________________
Stubbornness does have its helpful features. You always know what you are going to be thinking tomorrow. ~Glen Beaman
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#852524 - 03/03/09 11:08 AM
Re: Dr. Garcia no telemed until seen than ???????
[Re: Bluefairy]
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Veteran
Registered: 02/13/07
Posts: 652
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I think it's worth a try but not at the expense of flying to florida. If this was my OCS I would hope he would try to taper me down since this came suddenly if I agreed to try this since he feels so strongly in its effectivnes(sp). One thing that was mentioned to me quickely was the reason this one OCS didn't answer their phones late last week was due to an audit. It could have been a personal office audit for all I really know. I wonder though if all those scripts he wrote caught up to him. He did work for a lot of services but I didn't know there was a father so I could be thinking wrong that he just wrote to many scheduled III IV scripts. K NUBAIN (nalbuphine hydrochloride) is a synthetic opioid agonist-antagonist analgesic of the phenanthrene series. It is chemically related to both the widely used opioid antagonist, naloxone, and the potent opioid analgesic, oxymorphone.
That is the official definition I found everywhere. It looks like it would help many of us, but there is this little problem for many of us: Patients Dependent on Opioids
Patients who have been taking opioids chronically may experience withdrawal symptoms upon the administration of NUBAIN. If unduly troublesome, opioid withdrawal symptoms can be controlled by the slow intravenous administration of small increments of morphine, until relief occurs. If the previous analgesic was morphine, meperidine, codeine, or other opioid with similar duration of activity, one-fourth of the anticipated dose of NUBAIN can be administered initially and the patient observed for signs of withdrawal, i.e., abdominal cramps, nausea and vomiting, lacrimation, rhinorrhea, anxiety, restlessness, elevation of temperature or piloerection. If untoward symptoms do not occur, progressively larger doses may be tried at appropriate intervals until the desired level of analgesia is obtained with NUBAIN
It used to be Schedule II, then was removed from controlled status. It has been discontinued in the UK. It is listed by the DEA as a " drug of concern". I called a pharmacy to ask if it was available, told her my doctor was thinking about prescribing it. She said they dispensed no injectables other than Insulin and Imitrex. I will try others later, maybe others can try also so we can get pricing info.
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