Pain Management

Over the last 25 years, the number of Americans turning to hospice for end-of-life care has climbed dramatically -- from 25,000 in 1982 to 1.45 million in 2008, as more and more people choose to spend their final days in the comfort of home or a patient facility with a home-like environment rather than in a hospital pursuing aggressive treatments. During the last decade, Medicare reimbursements for hospice have also risen, allowing more hospices to open without relying on fundraising for survival, says Christy Whitney, chief executive of Hospice and Palliative Care of Western Colorado in Grand Junction.

Engineer George Lewis would like to move the soothing pain relief of ultrasound out of the doctor's office and into your medicine cabinet. The biomedical engineering student, who is about to receive his doctorate from Cornell University in Ithaca, N.Y., is working on a coin-size device to make ultrasound pain relief available any time, anywhere. Doctors and physical therapists use ultrasound for pain relief for conditions such as muscle spasms, tendonitis, osteoarthritis and sciatica.

Your article "Many Specialists, but Little Relief for Most Sufferers" (March 22) discusses many important issues in the field of pain management. However, two need to be highlighted. The reason pain is often poorly managed has nothing to do with concerns about prescribing narcotic medications. In fact, nerve pain that responds better to the antidepressant and anticonvulsant medications and bone pain that is better treated with the nonsteroidal anti-inflammatory drugs are just as poorly managed as pain best treated with narcotics.

An Orange County doctor featured in a Times investigative report because 16 of his patients fatally overdosed on drugs he prescribed has had another patient death, according to recently released coroner's records. Wayne Oviatt, a patient of Dr. Van Vu of Huntington Beach, fatally overdosed in January. The onetime Mammoth "ski bum," as his brother called him, suffered from chronic pain. He was known to abuse his medications and mix them with alcohol, and obtained drugs from various doctors, coroner's records state.

The long-term care facility operated by the Motion Picture & Television Fund, which in previous years faced criticism from nursing home advocates over quality of care issues and staffing levels, got some good news this week. U.S. News & World Report placed the fund's nursing home, which caters to entertainment industry workers and was once slated for closure, on its 2013 list of "Best Nursing Homes in California. " The facility, known as Motion Picture Home, received a five-star rating from U.S. News & World Report for having quality measures and nurse staff levels above state and national averages, the fund announced in a statement.

Back pain — can't live with it, can't live without it. That is, it's no fun to live with back pain, but the chances of living your whole life without it are pretty much nil. About 80% of Americans suffer from the condition at some point, so if you've never had your back act up or seize up or go out ... well ... just you wait. This explains why, in the U.S., back pain is the second most-frequent reason to go to the doctor — right after the common cold. But here's the rub. In spite of all the knowledge and skill and experience and dedication your doctor may possess, not to mention all the high-tech diagnostic tools that can be brought to bear on your case, there's a good chance you'll never find out exactly what's wrong with your back.

Ruling that the former manager of PaineWebber Inc.'s Beverly Hills office should have prevented the theft of customer funds, a Securities and Exchange Commission administrative law judge ordered her suspended for six months from acting as a brokerage supervisor. Patricia A. Johnson, 43, had been in charge of the office from 1984 until mid-1991.

The Medical Board of California has launched an investigation into a string of 16 fatal overdoses tied to powerful narcotics prescribed by a prominent Orange County physician. Dr. Van Vu, a pain management specialist in Huntington Beach, was featured in a Los Angeles Times article in November that detailed the 16 deaths. A board investigator recently began obtaining signed releases from relatives of the deceased patients, authorizing the board to review their medical records.