Make Pain a Thing of the Past – zolpidem – Physician Partners of America

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ERIC SHELTON – PHYSICIAN’S ASSISTANT, TAMPA

Our employees are all patient care champions, but some go the extra mile and we want to give them the recognition they deserve. They embody the PPOA values known as S.I.T.E. – Safety, Integrity, Teamwork, Empathy – which informs our service to patients and the community through high quality health care. 

As a physician’s assistant in PPOA’s busiest Florida pain clinic  Habana Avenue-Tampa  Eric Shelton, PA-C is known for his medical acumen and kindness to patients. Both are qualities he honed at a young age. He was only two when he was diagnosed with type I diabetes – and spent a lot of time in doctors’ offices.

“As I got older, I was able to recognize what a pleasant office visit was versus being passed through like a number,” he says. “Having such an experience helped me to see healthcare from a patient’s point of view. I developed the desire to help others within the healthcare field.”

A native of Johnson City, Tenn., he and his family moved to Lakeland, Fla. when Shelton was seven. After graduating from George Jenkins High School and Polk State College, he earned a Bachelor of Science in Biomedical Science from the University of South Florida in Tampa.

After working as a biomedical engineering tech for a medical device company, he realized his calling was patient care – the type he had received. But he faced an obstacle getting into PA school:

“The requirements were very stringent. They wanted 1,000 to 2,000 hours of direct patient care just to apply. My wife, Beatriz, picked up a second job so I could work as a medical assistant for free,” he recalls. “I worked 10-hour days nonstop, weekends included, with no pay. My wife picked up that full responsibility, which was very challenging.”

Eventually, Eric Shelton earned a Masters in Physician’s Assistant Studies at Le Moyne College in Syracuse, NY. He came to PPOA in April 2017 after working in orthopedics and neurosurgery. “I was taught to do several procedures that we do here and got to do them myself, so I have knowledge of what the process is before and after and what the expectations are,” he says.

“He has really taken his time to learn the company and to share his wealth of knowledge with other staff members, including myself, in order to make PPOA-Habana a ‘Clinic of Excellence,'” says regional supervisor Mary McKay.

If his experience as a patient and on-the-job training formed the foundation of his care philosophy, his education gave it focus.

“My medical training in PA school was Jesuit. They taught us to treat patients with a holistic approach. So you take all things into consideration,” he says. “You don’t go in closed-minded. You listen, you pay attention and you begin to put a treatment plan together.”

That dedication to patient care shines through, with patients giving him high marks on reputation and social media sites.

“I have personally seen the patients come to check out all smiles and raving about his bedside manner, how he always listens to their concerns and how they really feel cared for after a visit with him,” says McKay.

“Sometimes the longest part of the visit is just sitting and listening and hearing someone,” says Shelton. “But you gain so much information from just being attentive. The treatment plan just becomes more simplified. You give them time and attention, which sometimes they have not been able to receive. The heavier demands in the medical field continue to reduce the amount of time that providers have with their patients but it’s one of the key components that allow you to have a well-developed, well thought-out treatment plan.”

Beatriz Shelton is now completing her last semester in nursing school, and their son, Elijah, is about to turn three. With his career in interventional pain management in full swing, Eric Shelton plans to continue helping patients lead a pain-free life.

“I never want to stop learning,” he says. “The more I can learn, the better a provider I become.”

 

Ambien is back in the news, blamed by comedienne Roseanne Barr for some racially charged tweets and leading to the cancellation of her new show.

Details aside, there’s no question the popular sleep prescription – medical name zolpidemcan have some unsettling side-effects.  Ten million prescriptions are written each year for the medication, but headlines are forcing people to ask, is Ambien safe to take?

The answer is yes, if it is used correctly and under a doctor’s supervision.

Lower doses are best

“Ambien is a good drug in the treatment of insomnia. However, like many medications, there are side effects,” said Rodolfo Gari, M.D., MBA, founder of Physician Partners of America. “Particularly in women, Ambien is associated with strange behavior and hallucinations. This is because women are known to be slow metabolizers of Ambien.”

While metabolism may or may not factor into Barr’s claims, the Food and Drug Administration has long recognized the potential for side effects and the disparity in metabolization between genders.

“The recommended doses for women and men are different because women clear zolpidem from the body at a lower rate than men,” the FDA declared on its website. “The higher dose is more likely to impair next-morning driving and other activities that require full alertness.” In 2013, the agency lowered the recommended dosage from 10 to 5 mg for Ambien and 12.5 to 6.25 mg for extended-release Ambien CR.

Eating buttered cigarettes and sleep-driving

Ambien is classified as a hypnotic, and was approved for short-term insomnia by the FDA in 1992. It slows down the brain and brings on sleep faster than usual. For that reason it should be taken within 20 minutes of bedtime – in bed.

Not everyone heeds that warning, and stories abound of people doing strange things under its influence and having no memory of it the next day.

Blogs, Facebook groups and sub-Reddits detail the antics of people who pop an Ambien and fail to go straight to bed as directed.

Roseanne Barr is not the first celebrity to point fingers at the drug. Former congressman Patrick Kennedy caused a late-night car accident in 2006, bizarrely claiming he was late for a vote.  Zolpidem users realized they were not alone in reporting strange blackout behavior, and some sued the manufacturer, Sanofi (now Sanofi-Aventis). The attorney for the class action suit claims “people were eating things like buttered cigarettes and eggs, complete with the shells, while under the influence” of the sleep aid.

The suit was unsuccessful, but the company enhanced its warning flyer. It reads: “After taking AMBIEN, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night…Reported activities include: driving a car (“sleep-driving”), making and eating food, talking on the phone, having sex, sleep-walking.”

Preventing Ambien reactions with drug-genes testing

Ambien’s hypnotic side-effects are not the only issue. The pills can also cause severe allergic reactions in some people. This may include hives, breathing difficulty, swelling of the face, lips, tongue, or throat.

Knowing whether you should take Ambien at all depends on more than just your gender, health conditions, weight or age. Drug-genes testing, or pharmacogenomics, is a good safety check. It uses a cheek swab to determine how individual patients’ genomes metabolize certain classes of medication. Physician Partners of America offers this service to all its patients.

“This is yet another reason why pharmacogenomics is such an important diagnostic evaluation in all patients taking medications,” Gari said.

A far better choice is to practice good sleep hygiene, use this drug correctly and sparingly after a discussion with your doctor – and go straight to bed.