Dr. Luis Nieves in Hurst, TX Puts Patient Satisfaction First

,

Dr. Luis Nieves combines an approachable manner with a depth of experience in interventional pain management. As the lead specialist at PPOA’s busiest Texas clinic in Hurst, these two qualities are essential. He consistently earns high marks on reputation sites, including a 3.9 out of 5 stars on WebMD.

Dr. Luis Nieves Google rating

Nieves Google rating

 

Patient A.Y. says: “Dr. Nieves is easy to understand and explains things well. He is awesome at his job, he gave me my life back and the ability to not live in constant pain.”

Patient M.H. writes: “Absolutely one of the best doctors I’ve ever encountered.”

Patient D.H. tells Google Reviews: “I have been to MANY, MANY doctors and …Dr. Nieves by far stands out to be the absolute BEST!! He is very humble but incredibly knowledgeable, very talented, multitasking, caring and professional with a great sense of humor!!”

Patient J.C writes: “Good guy to deal with, really down to earth. If it’s your first time to see him you will feel comfortable.”

In addition to being board-certified in pain management, Dr. Luis Nieves is fellowship-trained by the Accreditation Council for Graduate Medical Education (AGME), a non-profit private council responsible for evaluating and accrediting medical residency and internship programs.

He earned his medical degree from the University of Texas Southwestern Medical Center in Dallas, and trained in anesthesiology at Baylor College of Medicine in Houston. He completed his residency in family medicine at John Peter Smith Health Network followed by a fellowship in sports medicine at JPS Health Network.

He was selected as one of a handful of trainees in a prestigious interventional pain management program with JPS Health Network and UT Southwestern Medical Center.

Dr. Nieves derives great satisfaction from helping patients transition from crippling pain to a more functional, normal life – without relying on opioid pain killers. His preferred form of treatment, interventional pain management, is designed to eliminate pain precisely where it starts and not mask it with medication. He is also trained in laser spine procedures and stem cell treatments.

He accepts Medicare and most insurance, and warmly welcomes patients to schedule a same-day appointment. Click here.

 

 

 

/by

FDA Addresses Opioid Withdrawal in the Midst of National Crisis

,

Physician Partners of America offers opioid alternatives and careful dosage reductions –

Many chronic pain patients come to interventional pain management specialists, including Physician Partners of America doctors, while taking opioid medication. PPOA, like many other practices, sets a goal of tapering them off these highly addictive medications to avoid opioid withdrawal symptoms.

Now the U.S. Food and Drug Administration is officially cautioning doctors to go easy when it comes to reducing dosages. Opioid withdrawal symptoms, recurrence of pain and mental distress has led some patients to turn to street drugs. Tragically, some commit suicide.

Says the FDA: “Rapid discontinuation can result in uncontrolled pain or withdrawal symptoms. In turn, these symptoms can lead patients to seek other sources of opioid pain medicines, which may be confused with drug-seeking for abuse.”

In a recent survey of 6,000 pain patients by the Pain News Network, more than 80 percent said they had been taken off opioids or had their dose reduced. Almost half said they had considered committing suicide because their pain was being poorly treated. Others turned to other substances – legal and illegal – for pain relief.

According to the survey:

  • 26% turned to medical marijuana
  • 20% used alcohol to quell pain
  • 20% used the poorly regulated Asian herb kratom11% got opioid medication from friends, family members, or the black market
  • 11% got opioid medication from friends, family members, or the black market
  • 4% used illegal drugs such as heroin and illicit fentanyl

PPOA has long taken the recommended go-slow approach. Its specialists may use special medications to prevent symptoms if needed.

“There are several tools at the disposal of the physicians to mitigate opiate withdrawal symptoms,” says Abraham Rivera, M.D., PPOA Chief Medical Officer. “A new drug called Lucemyra can block most withdrawal symptoms in patients with abrupt opiate cessation. Most commonly, the opiates are slowly decreased no more than 20 percent per week until the doses are minimal.”

To prevent opioid withdrawal, PPOA strives to avoid prescribing opioids in the first place. The company advocates interventional pain management treatments instead, such as nerve blocks, injections, neuromodulation, intrathecal medication pumps and laser spine procedures. These treat the pain at its source.

Careful medication management is part of treatment plans for new patients who have come to rely on opioids as a daily pain management tool.

“At PPOA we use opiates as a means to an end, not as an end by itself,” says Dr. Rivera.

Reducing a patient’s medication, a process called titration, can catch some new patients by surprise. They may be used to getting their prescriptions filled time after time by previous providers. But as laws tighten the grip on prescribing, and the effects of the opioid crisis escalate, patients will be hard-pressed to find any ethical provider who offers unfettered access to addictive painkillers.

The FDA did not give details on specific patient harm cases but said in a statement that it was tracking them. The regulatory agency indicated it will change warning labels on prescription opioids to guide physicians on safe reduction rates.

The agency also did not recommend a specific tapering schedule to prevent opioid withdrawal symptoms. Instead it recommends that physicians take into account the length of time that a patient has been using additive analgesics, the type of pain experienced and the patient’s physical and mental health. That is PPOA’s approach.

“No two persons are alike when it comes to opioid titration; however most patients can have their opiates reduced to be in compliance with CDC guidelines in six months or less,” says Dr. Rivera.

 

/by

Advanced Care Providers on the Front Lines of the Opioid Crisis

ADVANCED CARE PROVIDERS ON THE FRONT LINES OF THE OPIOID CRISIS

Patients seeking pain relief from PPOA are just as likely to see a Physician Assistant (PA) or Advanced Practice Registered Nurse (APRN) as they are a physician.

Both of these advanced care providers have advanced training and are able to write prescriptions, including those for controlled substances, without direct physician supervision. They can administer opioid antidotes  and also adjust medicine dosages autonomously.

This is significant as the opioid crisis continues to rage nationwide. Bound by a combination of policy and principle, Physician Partners of America continues to focus on interventional treatment modalities; we favor minimally invasive and laser spine procedures that treat pain at its origin instead of masking it with opioid medication.

The onus is often on the PAs and APRNs to manage medication and taper patients down.

“Advanced care providers get to be the enforcers of the number of medicines – pain pills – that can be taken at a time,” says Abraham Rivera, M.D., Chief Medical Officer of Physician Partners of America. “They get to police what to do with the results of an abnormal urine drug test. They get to educate the patients about drug interactions. They get to enforce those reductions when they are part of a treatment plan.”

The physicians design treatment plans, and work hand in hand with Physician Assistants and APRNs to ensure that these plans are followed.

“Say I’m going to design a patient’s taper-down treatment plan for opiates because the doses are too high,” Dr. Rivera says. “Over the next three months, I’m going to scale them down in a certain fashion; but it is my advanced care provider who might be seeing that patient in those three months. They will have to endure the difficult task to make sure the patient sticks to that scale-down plan. That creates some very difficult interactions. “

Eric Shelton is a Physician Assistant in PPOA’s busy Habana Avenue, Tampa, Fla. practice. He says tapering down opioids is a challenging part of his job.

“We’re the target of frustration from changes in politics to changes in protocols, and definitely tapering opioids is very, very difficult,” he says. “Patients are hurting. You reduce their opioids, they see that as a threat and therefore that’s offensive and you’re the one doing that to them.

“I can educate patients all day long on why it’s a good thing and why using interventional pain management methods instead of opioids are going to be better in the long run,” Shelton continues, “but the truth is that instant gratification in any field of medicine is the most desired, and that’s what opioids provide. And when you start to reduce that, it’s not welcomed at all.”

To be successful in the pain management field, advanced care professionals must get to know their established patients. He or she must be highly observant for such red flags as patients coming up short in their medication supply, requesting refills sooner than expected, or coming into the clinic with an “off” demeanor.

“Knowing these things contributes to a patient’s quality of care,” Shelton says, “and you’ve got to be able to pick that out and be a detective in the amount of time that you’re given. You use the tools at hand to do the job to the best of your abilities.”

In all, it takes a strong and well-educated professional to help patients in their journey out of pain, but advanced care practitioners see it as a very rewarding challenge.

“Advanced care providers need to have spring in step and happiness in heart,” says Dr. Rivera. “They have to have peace that they are doing the right thing for patients and endure the fact that we won’t please every patient. They have to be secure in the knowledge that what they are doing is the right thing.”

At Physician Partners of America, we are in the business of caring for people. Our goal is to transform the doctor-patient experience with our patient-centric model. We are a diverse and extended family of professionals bringing innovation and wide-ranging talents that to our healthcare mission.

 

 

 

 

 

/by

Tiger Woods Neck Pain Sidelines Him from Tournament

Common Golfer Pain May be Unrelated to Discectomy and Fusion

Legendary golfer Tiger Woods’ neck pain is preventing him from this week’s Arnold Palmer Invitational.

He tweeted Monday “Unfortunately due to a neck strain that I’ve had for a few weeks, I’m forced to withdraw from the API. I’ve been receiving treatment, but it hasn’t improved enough to play.”

Woods, ranked 12th in the world, underwent four back procedures, including an anterior lumbar interbody fusion, and discectomy. He hasn’t missed a tournament – until now.

“Strain of the neck or cervical spine is a common musculoskeletal injury in the sports medicine world,” says Physician Partners of America pain management specialist Chad Gorman, M.D. “The patient can irritate or strain the muscles of the cervical spine causing tightness, limited range of motion and significant pain. For a professional athlete who uses precision and accuracy with his sport, having to perform while also dealing with significant neck pain can significantly hinder your performance.”

Occasionally, spinal fusions  can impact other parts of the spine in certain patients. In other patients, neck strain can be unrelated. It appears that is the case with Tiger Woods‘ neck pain: his fusion occurred in the lumbar, or lower, spine, and it is unlikely it impacted his neck.

Fortunately, in many cases, neck pain is easily treatable.

“Neck strains can be treated with oral anti-inflammatories, muscle relaxers, ice, massage and more advanced treatments like laser TENS units,” says Dr. Gorman, who practices in New Port Richey, Fla. and is a golfer himself.

According to ESPN.com, Woods competed on the PGA Tour 18 times last year, winning the Tour Championship for his 80th PGA Tour title. In addition, he played in the Ryder Cup as well as December’s Hero World Challenge. He has played three times so far this year without injury issues.

An anterior lumbar interbody fusion is performed in a minimally invasive way by Physician Partners of America spine surgeons and other specialists. It uses small incisions at the front of the body – the “anterior” – so that the large muscles of the back are not affected.

While Woods is not out of the woods yet, he reports the fusion and disc replacement worked. He tweeted, “My lower back is fine, and I have no long-term concerns, and I hope to be ready for the Players.”

Woods, ranked 12th in the world, played a full schedule last year for the first time since 2015, which came after the first of what would turn out to be four back procedures. He contended at the last two majors, tying for sixth at The Open and finishing second at the PGA Championship.

It is uncertain whether Tiger Woods’ neck pain will sideline him from the Valspar Championship March 21-14, WGC-Dell Match Play Championship March 27 – March 31, and the Masters, which begins April 11.

Physician Partners of America treats neck and spine pain with a variety of modalities, from conservative to minimally invasive spine procedures. Find a PPOA specialist in Florida or Dallas-Fort Worth here.

/by

Laser Spine Institute Closing

, ,

Physician Partners of America Offers Solutions to Displaced Laser Spine Institute Patients and Workers

Physician Partners of America (PPOA) will open its doors to hundreds of chronic pain patients left in the lurch after Laser Spine Institute shut down operations suddenly on Friday, March 1. Some of those patients had traveled to LSI’s flagship clinic in Tampa from other states. It is also helping displaced employees, who were blindsided by the closure, to find work at PPOA, beginning with a job fair on March 6.

“We are pleased to offer to perform minimally invasive laser spine procedures on patients who were scheduled for those procedures at Laser Spine Institute in Tampa,” said Josh Helms, PPOA Chief Operating Officer. “We welcome these patients and can put them on our schedule immediately.” PPOA accepts Medicare and most insurances for minimally invasive and laser spine procedures. The cost to patients is typically much lower than Laser Spine Institute.

TO SCHEDULE with Dr. St Louis please call: 1-855-25-LASER

Physician Partners of America, headquartered a few miles from LSI in Tampa, will also see LSI patients for consultations.

 

Laser Spine Institute Closing
Dr. James St. Louis, chief of PPOA’s Minimally Invasive Spine Division since January 2018

 

 

PPOA leadership expressed extreme sadness to hear that Laser Spine Institute shut down operations citing insurmountable financial difficulties. It had closed three surgical centers as a cost-cutting measure in recent years at the same time PPOA entered a period of dramatic expansion.

PPOA operates more than 30 pain management clinics, two laser spine operations, and six outpatient surgery centers in Florida and Texas.

“Laser Spine Institute has brought name recognition to the community in Tampa and other cities and it’s an unfortunate situation,” said Helms. “At Physician Partners of America, we take comfort in hiring many of the displaced LSI workers and our ability to care for those patients in need.”

Help for displaced Laser Spine Institute Employees

Helms added that given PPOA’s expansion and commitment to the Tampa Bay community, it is in a good position to hire some of the 500 employees who lost their jobs at LSI.

“We have many open positions for the type of experienced healthcare workers that contributed so much to the culture at LSI,” Helms said. “We can offer them a new home in a strong and stable company.”

Displaced Laser Spine Institute employees are invited to a career fair at Physician Partners Institute from 11 a.m. to 4 p.m. this Wednesday, March 6 in its headquarters building, 550 N. Reo St. Tampa 33609. PPOA is hiring for 70-plus open positions, mainly in revenue cycle, collections, coding and clinical operations.

For information, they may contact hrdept@physicianpartnersoa.com.

/by

Frequently-asked Questions about Laser Spine Procedures

LASER SPINE PROCEDURES  – FAQs

The board-certified pain management specialists at Physician Partners of America now offer laser spine procedures for the most common chronic spine pain conditions. That allows you to seek pain relief close to home. It’s the latest alternative to opioid medication for back and neck pain.

Laser procedures are micro-invasive with an incision about the size of a grain of rice. The laser can be used to pinpoint and ablate pain-causing nerves. It’s precise, fast, effective, and spares your muscles the trauma of open-back surgery.

Here are a few frequently asked questions about laser spine and micro-invasive procedures.

Q: Does laser spine surgery use lasers?

A: Sometimes. The term “laser” is meant to convey the precision of the procedures. These minimally invasive techniques directly target the affected area while touching almost nothing else, acting with laser-like accuracy; but some procedures may still utilize lasers, especially on the soft tissues near the spine.

Q: Is there any recovery time?

A: There is some recovery time with laser spine surgery, but it is significantly shorter than traditional surgery. Most of the time you can go back to non-strenuous activity after only one or two weeks, and resume most strenuous activities after one month. That is far shorter than the sometimes six months some patients take to recover; but talk to your surgeon, as each individual may have different recovery times.

Q: How effective is laser spine surgery?

A: When performed by a skilled pain doctor, it is very effective, on par with open surgery. The techniques that are used continue to advance, with better approaches that offer better outcomes.

Q: Is laser back surgery covered by Medicare?

A: Yes! For most patients, Medicare covers some or all of your laser spine procedure. However, keep in mind that different plans may offer different payments. Contact us and we will be happy to provide you with an insurance benefits check to ensure that you are covered by Medicare or other insurance, or let you know how much it may be out of pocket.

Q: How do I know if I’m a candidate?

A: The best way to find out if you are a candidate for laser spine procedures is to contact us today for a consultation. We can talk to you about the available options – not just for spine surgery, but also for pain management – and see what is causing your pain and what treatment techniques are best for you.

If conservative treatment hasn’t worked for you, you may be a candidate for a laser spine procedure to treat your neck or back pain.

 

/by

Laser Spine Procedures Now in Palm Beach County

, ,

Neck and back pain relief in Wellington and Boynton Beach

Dr. Alejandro G. Tapia is a board-certified and fellowship-trained interventional pain management physician in our Boynton Beach and Wellington locations.

A familiar face on local TV, he brings extensive experience in minimally invasive techniques to treat neck and back pain. Dr. Tapia is a member of the International Spine Intervention Society, Diplomat of the American Academy of Pain Management, American Society of Regional Anesthesia and the Florida Society of Interventional Pain Physicians.

His approach is evidence-based and devoted to using the most cutting-edge approaches medicine has to offer. That is one reason he has embraced laser techniques in his practice.

Laser Spine Procedures in Palm Beach County

The laser is the latest tool used by Physician Partners of America to relieve neck and back pain without opioids. It precisely targets pain-causing nerves along the spine and ablates them quickly. The incision is just 2-3 mm. – less than a quarter-inch. That means muscles are not cut or torn, and therefore, recuperation takes days instead of  months. You can walk out of the procedure suite. The majority of patients report that the original pain is gone.

Dr. Tapia performs this procedure for two common debilitating conditions: arthritis of the spine and facet disease.  His offices accept Medicare and most insurance. You can be sure he will explain all your options, from conservative to cutting-edge, and do his best to get you back to doing the things you love.

Make an appointment today to see Dr. Tapia about laser spine procedures in Palm Beach County. Make an appointment at PPOABoynton.com or PPOAWellington.com today!

 

 

/by

Laser Spine Procedures Available in Frisco TX

, ,

Dr. Prasad Lakshminarasimhiah may have an unfamiliar last name, but his longtime patients in Frisco, TX, have no trouble saying how they feel about his approach to pain medicine.

He earns a 4.7 out of 5 stars on all the major review sites with such comments as:

“Very professional and caring!”

“He listens and cares about your pain.”

“The best pain management doctor in the DFW area.”

“Dr. P. has a great sense of humor to help alleviate your concerns.”

“I recommend him without reservation.”

Dr. Prasad is board-certified in Pain Medicine and Physical Medicine and Rehabilitation. A U.S. Army veteran, his interest in pursuing pain medicine was sparked by caring for injured soldiers at the San Antonio Military Medical Center in Texas.

His approach is comprehensive, evidence-based and devoted to using the most cutting-edge approaches. That is one reason he has embraced laser techniques in his practice.

Laser Spine Procedures in Frisco

The laser is the latest tool used by Physician Partners of America to relieve neck and back pain without opioids. It precisely targets pain-causing nerves along the spine and ablates them quickly. The incision is just 2-3 mm. – less than a quarter-inch. That means muscles and tissue are not cut or torn, and recuperation is measured in days, not months. You walk out after the procedure and, for most people, the pain is gone.

Dr. Prasad performs this procedure for two common debilitating conditions: arthritis of the spine and facet disease.  His office takes Medicare and most insurance. You can be sure he will explain all your options, from conservative to cutting-edge, and do his utmost to get you back to doing the things you love.

Make an appointment today to see Dr. Prasad in our Frisco pain relief clinic today! Call 972-737-PPOA (7762) or visit ppoafrisco.com to learn about laser pain procedures near you.

 

/by

PPOA Expands Use of Laser Procedures

,

Laser procedures speed recovery for most patients

In its mission to combat the opioid crisis and follow best practices in medicine, Physician Partners of America is pleased to announce the widespread use of laser spine techniques.

PPOA pain management physicians are in the process of being trained in the use of the Holmium YAG laser to perform neck and back pain procedures. The laser is used to ablate pain-causing nerves, as well as tissue that is pressing on nerves.

“It’s better therapy, better efficacy, and the safety is unparalleled,” says Abraham Rivera, M.D., PPOA’s chief medical officer. “It’s a new set of skills that many physicians do not have.”

The company has invested in training and equipment for each of its pain management physicians.

Are laser procedures the best treatment for chronic pain?

The laser is the next step on the continuum of cutting-edge medicine, and Physician Partners of America has always focused on the latest developments in interventional pain management. That subspecialty of pain medicine focuses on treating pain at its source, rather than masking it with medication.

Interventional pain management encompasses a less-is-more approach:

  • Noninvasive techniques, such as injections and nerve blocks
  • Regenerative medicine, such as stem cell therapy and PRP

Patients who are ready for the next level of treatment can consider other approaches PPOA offers:

  • Minimally invasive surgical techniques, with incisions of less than one inch, and small instruments
  • Endoscopic procedures, which use a series of narrow, camera-enabled tubes through which the surgeon works

The laser can be used in any type of minimally invasive procedure.

What are laser spine procedures?

The laser procedures performed by PPOA pain management physicians require an incision barely wider than a needle.

The laser allows for precise targeting of nerves and tissue, quicker healing through muscle-sparing techniques, and a reduced chance of bleeding and infection. Patients walk out the same day and can get back to work or activities in days or weeks instead of months. It is a revolutionary instrument that PPOA uses to stay at the forefront of medical technology.

“It sets us apart from the competition,” says Dr. Rivera. “It’s not a procedure we make money on. That’s not the end result or purpose of it, but it’s something we believe gives patients much better results.”

Many patients choose PPOA for additional reasons: it accepts Medicare and most insurance, and has a long history of performing interventional techniques as an effective alternative to opioids. Services are available throughout Florida and in the Dallas-Fort Worth Metroplex. Initial appointments can be made the same-day patients call and transportation is available on a first-come, first-served basis.

/by

What is Facet Joint Disease and How Can a Laser Treat It?

Minimally invasive procedures offer hope for facet arthritis

Facet joint disease is one of the most common back pain problems and is often age-related. It can cause a range of issues from mild discomfort to throbbing pain. For patients who have not achieved results through conservative treatment, minimally invasive laser spine procedures can make a big difference in quality of life.

“The laser is an amazing tool for targeting the nerves that cause pain. It offers great precision and longer lasting results,” says Dr. James St. Louis, director of PPOA’s Minimally Invasive Group.

What are facet joints?

These joints are found on both sides of every vertebra (bone) in the spine. They not only stabilize and hold the spine together; they make it possible for your back to twist. Facets are lined with cartilage that acts as a shock absorber and maintains smooth movement between the vertebrae.

Facet joint disease happens when the joints degenerate to the point where the nerves that exit them are impinged. This can happen by the normal wear and tear as we get older – in short, spine arthritis. These joints can also be damaged through trauma, disease and obesity.

Symptoms of facet arthritis

The condition adds pressure to the nearby nerves and can result in swelling and inflammation. If this occurs in the upper part of the back, it will usually cause pain in the head, neck or shoulders. If it occurs in the mid to lower spine, it can cause radiating pain in the lower back, buttocks or legs. Left to progress, it may cause bone spurs, cysts or thickened ligaments.

This condition goes by different names: facet syndrome, facet arthritis, facet hypertrophy and spinal osteoarthritis. By any name, it should be evaluated and treated if it is causing symptoms. Left to progress, it can cause bone spurs, cysts or thickened ligaments.

Laser spine treatment of facet disease

The laser treats pain-causing nerves with less disturbance to muscle and tissue than other techniques. The result is less trauma to the body and a faster recovery. Our surgeons make a 2-3 mm. incision at the treatment site. A very narrow tube, about the width of a needle, is inserted and guided by live x-ray to the treatment area.  The laser is then threaded through the tube and used to ablate the nerve that is being compressed.

When to seek help for facet syndrome

We should point out that some people with facet joint disease never experience pain; in fact, they are surprised to learn they have this disorder. In others, mild symptoms can be treated with rest, physical therapy, heat therapy and anti-inflammatory medication.

On the other end of the spectrum are people who live with excruciating pain every day. For those whose quality of life is affected, minimally invasive laser spine procedures can in some cases provide instant relief.

A diagnosis from a Physician Partners of America board certified pain management physician or spine specialist can tell you how severe your particular case is and how it should be treated.

For more information about facet joint disease and treatment options, please contact our minimally invasive laser spine specialists at 855-25-LASER.

/by