dr spanos pain management

"They should be reserved for people for whom the benefits justify the risks and baggage that come with the drug and the most tricky problem is that we do not know the size of the risks.". The information is submitted by each doctor and we make no guarantee or warranty as to the accuracy of the information. "He had a hamburger, but instead of biting the hamburger he would actually be biting his hand," she said. The drugs helped her recover from her injury. 100 N Mario Capecchi Dr, Salt Lake City, UT, 84113. A cousin, Marilyn Frey, said Pitchal had suffered from mental health problems for years and may have doctor-shopped for pills. Dr. Sarti attended National University of La Plata. Trusted Pain Medicine Physicians & Orthopedics serving the patients of Edison, Clifton, Hazlet, Jersey City and West Orange, NJ. Often a life long Problem. 2023 Wellness.com is a registered trademark of Wellness.com, Inc. If the patient says they can still feel the area, believe them! Specialties: Vestibulum ac diam sit amet quam vehicula elementum sed sit amet dui. Multidisciplinary. more about these programs, our physicians, or how to enroll, call (888) John Sarno, M.D., An American Hero. Contact us at 973-270-9906 or visit us at 1117 Route 46 East, Suite 301, Clifton, NJ 07013. We use cookies to give you the best possible user experience. So, its important to make the right diagnosis. Favorites: She was in her mid-40s and suffering from severe low-back pain until she went to see Spanos, who prescribed OxyContin. "I was pain free," she said in an interview with the Journal Sentinel/MedPage Today. Mary Lou took him the emergency room and he was put in intensive care for 24 hours, but he never remembered the incident. A pain management doctor is specially trained in the practice of pain relief. Narciso Gonzalez, III, M.D. Since the practice's founding in 2001, Dr. Daitch has been committed to offering Southwest Florida with unsurpassed skill levels and the latest in techniques and technology. With offices in Colonia and Livingston, New Jersey, they offer long-term, interventional pain-relieving solutions that focus on non-opioid and nonsurgical interventional treatments for spine and orthopedic . on of administering safe, modern pain management treatments to ease our patient's SamWell Pain featured on the TV show The Balancing Act which aired on Fox 5 and WPIX 11. No matter Opens in a new tab or window, Visit us on Twitter. I graduated in medicine from Oxford University in 1973 after taking a Masters degree in Philosophy and also a Postgraduate Diploma in the History and Philosophy of Science. Hospital affiliations include Sanford Medical Center. Her husband Kevin has to help her stand up and she walks slowly, often grimacing in pain. Over time, doctors began writing more and more prescriptions for opioids -- including Oxycontin, Vicodin (hydrocodone bitartrate and acetaminophen) and Percocet (acetaminophen and oxycodone) -- for more and more chronic conditions, such as back pain, fibromyalgia and arthritis. You should verify the accuracy of the information directly with the physician's office. Make sure you are getting the correct treatment for your needs! "He would fall asleep while we were eating," she said. Motor Vehicle and Worker's Compensation Insurances Accepted. Wellness.com does not verify the accuracy or efficacy of user generated content, reviews, ratings or any published Stephanie Spanos, MD, graduated from the University of Virginia, and received her medical degree from Eastern Virginia Medical School. All rights reserved. Sutter Health is a registered Consumer Feedback Add a Review There are no recent reviews. Rigorous clinical trials still have not been done to measure the long-term safety and effectiveness of opioids for various kinds of chronic pain. Privacy Policy A Pain Management Specialist is a physician who has four extra years learning anesthesiology and pain medicine to help patients with pain management. Contact our professionals to start exploring your pain management options. We are not currently accepting Medicare insurances and are not currently accepting self-pay patients at this time. Pain Management Accepting new patients Anesthesiology Sutter Gould Medical Foundation 1401 Spanos Court Suite 130 Modesto , CA 95355 (209) 550-4762 Offers MyHealth Online View Profile Juan Sarti, M.D. Opens in a new tab or window. Dr. Pardew-Spanos provides telehealth services. I graduated in medicine from Oxford University in 1973 after taking a Master's degree in Philosophy and also a Postgraduate Diploma in the History and Philosophy of Science. But theres hope in our innovative treatments that address the new pain and restore your function. This provider currently accepts 14 insurance plans. Such sedation can lead to respiratory depression and even fatal overdoses. Rocky Mount North Carolina Pain Management Physician Doctors physician directory - Learn about pain management and pain treatment options for nociceptive, neuropathic pain (for example fibromyalgia, irritable bowel syndrome), and chronic pain. For serious accidents, injuries and conditions that require immediate medical care. ", "They saw me right away and provided great information and assistance concerning my ailment. ", "Nothing could be further from the truth," he said, noting that sedation usually settles to "little or nothing within two weeks.". However, real-world pain treatment does not. In the video, the doctor, Alan Spanos, MD, a paid specialist in North Carolina, urged doctors to consider prescribing opioids more often. Dr. Spanos is an anesthesiologist in Charlottesville, VA and may see patients with General Anesthesia, Pain Medication Management, Regional Anesthesia, and more. Institutions that have invited me to teach their staff include Johns Hopkins Medical Center, the Cleveland Clinic, Duke University Medical Center, UNC School of Medicine and many others around the country. One trip to the hospital began with a strange incident at a restaurant. Dorothy appeared in the video wearing a neck brace. By continuing to use the site, you agree to the use of cookies. Through novel, non-surgical, and minimally invasive interventional techniques, our interventional pain specialists utilize the latest technologies to help restore and maximize function and quality of life of patients with chronic musculoskeletal pain related to degenerative conditions as well as sports-related or traumatic injuries. Anyone addicted to opioids will write a positive review anyone who knows what dangers this guy has caused knows the truth. Dr. Seth Spanos, MD Dr. Seth Spanos, MD Family MedicineMaleAge 49 Family Medicine 3.7 (24 ratings) Saint George, UT Dr. Seth Spanos, MD is a Family Medicine Specialist in Saint George, UT. Joseph K. Fluence,M.D. Curabitur non nulla sit amet nisl tempus convallis quis ac lectus. Our treatments include non-surgical orthopedic procedures for disc herniations in the neck and back, low back and sciatica pain, neck, knee, shoulder, and hip pain as well as nerve pain after neck or back surgeries. When she tried to do without, she spent days on the couch curled up with withdrawal symptoms. injections, Migraines and headaches, - We treat individuals ages 12-18 who are struggling with teenage depression, teen anxiety, and trauma-related issues, along with co-occurring eating disorders and teenage substance abuse. headaches, and lower back pain to postoperative discomfort, arthritis, Opens in a new tab or window, Share on LinkedIn. Then her dose had to be doubled. Takes the time to go over the treatment plan. If she has a flare up, she gets a prescription for a few days of a different opioid, such as hydrocodone (Vicodin). Cookie Preferences. "I would hope that what was conveyed in the video is that there are patients in whom tolerance doesn't happen," Spanos said. from a medical procedure, or a chronic, reoccurring condition. Dr. John Sarno, a pioneer in mind-body medicine, emphasized the age-old concept that . People with EDS often have pains that dont seem to come from their joints, but rather from nerves. You werent designed to sit all day, so if you do, your body will let you know somethings wrong, like sending pain signals to your brain. He works in Stockton, CA and Modesto, CA. At least twice he was taken to the hospital because of an accidental overdose, Mary Lou said. Anesthesiology Pain Management Accepting new patients Sutter Gould Medical Foundation 1401 Spanos Court Suite 130 A few years later, Pitchal was found dead in his Florida apartment at age 62. Looking back on his claim that opioids didn't wear out, Spanos said he wanted to address a 1990s stereotype that all patients would develop tolerance and need higher doses. 20052022 MedPage Today, LLC, a Ziff Davis company. To learn more about these programs, our physicians, or how to enroll, call (888) 724-7123 today. A magna cum laude graduate of Texas A&M University in . At SamWell pain, we are spine, joint, and nerve pain specialists, whose expertise includes non-surgical and non-opioid pain relieving treatments performed under precise image guidance, such as spinal cord stimulation and Dorsal Root Ganglion Stimulation for complex nerve pain disorders including CRPS/RSD, and minimally invasive therapies such as MILD, Vertiflex, Kyphoplasty, Sacroiliac joint fusion, and Endoscopic procedures. With offices in Colonia and Livingston, New Jersey, they offer long-term, interventional pain-relieving solutions that focus on non-opioid and nonsurgical interventional treatments for spine and orthopedic conditions. Pain management is a branch of medicine that applies science to the reduction of pain. Numerous medications were found in his kitchen cabinet and he had pills in his pocket, according to a sheriff's department report. Create an account to follow your favorite communities and start taking part in conversations. Donec velit neque, auctor sit amet aliquam vel, ullamcorper sit amet ligula. Her mouth was often very dry, a common side effect of opioids. View results and review profiles to find the right Pain Management Doctor for you. Treatment options are varied and can include medications, physical therapy and talk therapy (psychotherapy). He is affiliated with St. George Regional Hospital River Road. 1050 E South Temple, Salt Lake City, UT, 84102, 50 N Medical Dr, Salt Lake City, UT, 84132, 8TH AVENUE AND C ST, SALT LAKE CITY, UT, 84143, 8TH AVENUE & CST, SALT LAKE CITY, UT, 84143. Strangely, the above facts are hardly ever taught in American medical schools, or even in postgraduate specialty courses. Other Emergency Medicine Physicians Nearby, Emergency Medicine Physicians Nearby by Procedures, Emergency Medicine Physicians Nearby by Conditions. "We don't know whether success stories like this are one in five, one in 15, one in 100, one in a thousand", Spanos said in an interview. 724-7123 today. We offer complimentary insurance verifications and explanations of benefits. I came in with neck, back and knee pains. I cant write in the post description, but Dr. Spanos, leading EDS pain management doctor, writes in his patient guide that EDS patients may need more pain meds or sedation. Pain can be a symptom of something wrong, part of a patient's recovery I have trained in clinical hypnosis at Duke, acupuncture at UCLA and Vancouver, and myofascial pain treatment from the revered Dr. Janet Travell. 2 In the video, Susan said finding the right medicine made her life "wonderful again.". trademark of Sutter Health , Reg. Add to He noted the video was made 14 years ago and has not been shown in a decade. Instead of paying her bills or her mortgage, Cambra bought OxyContin. We can provide the following pain management treatments: Finding the pain management solution that is right for our patients depends click here. To book an appointment, please call us at 856-485-5007 or visit our office in Mount Laurel, Sewell, Galloway, Toms River, Vineland and West Orange, NJ. Without such research, it is difficult to know who is likely to benefit and who is likely to be harmed. All rights reserved. By continuing to use the site, you agree to the use of cookies. We have placement logins where you can customize your listing and even get FREE premium placements for your Clinic! I felt that people with a condition with so many components, should have at least some input from knowledgeable doctors who could help them with all of their symptoms, not just those coming directly from loose joints. I now devote myself entirely to working with people who have just one of these conditions, namely Ehlers Danlos Syndrome (EDS), and conditions that resemble it. Dr. Pardew-Spanos' office is located at 1107 E Matthews Ave Ste 103, Jonesboro, AR 72401. Limited research suggests that about 30% of pain clinic patients may benefit from using opioids for long-term pain, according to Ed Covington, MD, director of the Neurological Center for Pain at the Cleveland Clinic. Read or printin-depth articlesabout Ehlers Danlos Syndrome (EDS) and other joint hypermobility conditions. Our office based procedures require minimal recovery time to help you decrease pain and restore function. They may have various problems with their stomach and intestines. Please have your insurance information ready when booking your online appointment to help us expedite your experience. (713) 222-2273; . Dr. Spanos is an anesthesiologist in Columbus, OH and may see patients with Pain Medication Management, Sedation, Regional Anesthesia, and more. Spanos acknowledged in a July interview that the 1% addiction figure did not come from long-term studies of chronic pain patients and that he went too far by suggesting it did. Jackie Chan,M.D. Discussion of Munchausen By Internet, related conditions and toxic "Chronic Illness Influencers" for whom evidence suggests they may be lying, feigning or exaggerating illnesses and medical crises for attention and/or profit. We are specialists collaborating to provide the best possible care, discover better treatments, and train tomorrow's health care experts. We speculate from a distance ONLY and forbid contact with those discussed in any form. Proin eget tortor risus. I know first hand! When OxyContin was approved in 1996 there was less concern about addiction because opioids were being used mainly to treat cancer and short-term pain, said Mark Sullivan, MD, professor of psychiatry and behavioral sciences at the University of Washington in Seattle. 209-550-4762. pain management. In July, a group of nearly 40 doctors, researchers and public health officials petitioned the FDA to change the labeling on opioids in ways that would make it more difficult for drug companies to market the medications for chronic, non-cancer pain lasting longer than 90 days. She is board certified in Pediatrics and Pediatric Emergency Medicine. is a Pain Management Board Physician who earned his medical degree from the University of Texas Health Science Center at San Antonio. "Those of us who were impressed by the clear benefits for patients did not have a big enough eye on the possible unintended consequences of our enthusiasm rubbing off onto some of our colleagues,," Spanos said of opioid painkillers. If you are the Owner and would like to claim this Clinic listing (to update, edit and boost), reach out to us on the contact us page. Sullivan had been prescribed both OxyContin and morphine. Our team will reach out to you ASAP to verify your benefits upon booking online. OxyContin also made life livable for Dorothy, a patient who asked that she be identified only by her first name. Press question mark to learn the rest of the keyboard shortcuts. They may sometimes be mentally foggy enough to harm students class performance. Please enter a valid 5-digit Zip Code. To learn I had an absolutely amazing experience seeing Dr. Jay Shah for my chronic lower back pain. That wasn't true, and in 2007 The Purdue Frederick Co., an affiliate of Purdue Pharma, agreed to pay $634.5 million in penalties for misbranding the drug as part of a U.S. Justice Department investigation. There is much more to EDS than loose joints. She lost her car and her home. The only medical specialty that claims EDS and related conditions, is that of genetics. Spanos said in an interview he agrees high doses can cause sedation but those who are sedated long-term are being "over-treated.". Make sure you are getting the correct treatment for your needs! We offer pain management solutions at several of our facilities. ", This was my first visit wi"Dr. Shah. The pain was so bad that she discussed suicide with her husband. Our Physicians Received their Education and Training From World-Class Institutions. For over thirty years I worked with patients with various complex chronic illnesses. We also specialize in epidural steroid injections for discreations in the neck and back, spinal facet join treatments, radiofrequency ablations, nerve blocks and joint procedures for cervical and lumbar spinal stenosis. Dr. Stephanie Spanos, MD, is an Emergency Medicine specialist practicing in Salt Lake City, UT with 21 years of experience. Now her dose is about one-tenth of that and she still deals with major pain. Two of the women had severe, debilitating conditions while the third has taken the powerful painkiller for nearly 15 years to deal with back pain. for "I would be lying on the bed with a heating pad.". Doctors meeting your search criteria are presented in alphabetical order by last name, or by geographic proximity if a zip code has been used as search criterion. Fraud & long term opioid addiction problems. You can find other locations and directions on Healthgrades. Heres what prolonged sitting does to your body and how you can counteract the effects. She had to put on his socks and shoes, shave him and wash his hair. la captive (2000) full movie online; chalupa menu taco bell; jeff samardzija career earnings; ancient greece artifacts; aquarius horoscope today and tomorrow; cigar cutter replacement blades; field club sarasota membership fees; parade of homes fall 2021; tarot card reader vacancy; hawaii skydiving accident Experiencing pain after a surgery you thought would bring relief can be frustrating and discouraging. We offer pain management solutions at several of our facilities. They can diagnose EDS and work out what type the patient has, but they generally dont get involved with treatment. 2005 - 2023 WebMD LLC. Purdue Pharma spokesman Heins said the rate of addictive disorders among chronic pain patients has not been established by prospective studies. They may bruise and bleed more easily than others. Dorothy said she stopped taking OxyContin in 2004 or 2005 because she got to a point where she was able to function without it. "I would not be able to do the work I love here if I did not take the medicine," she said. SamWell Institute for Pain Management is a premier interventional pain specialty practice led by Jay Shah, MD and his highly trained team. Fourteen years later, Susan is still taking OxyContin. Call Oxford Univ Med Sch, Oxford, Uk (352-09 Pr 1/71), Univ Of Nc Hosps, Family Medicine; Duke Univ Med Ctr, Infectious Diseases. He kept a pouch filled with pills hidden under the seat of his pickup truck. Your browser doesn't support JavaScript code, or you have disabled JavaScript. It covers a wide spectrum of conditions, including neuropathic pain, sciatica, postoperative pain, and more.Pain management is a rapidly growing medical specialty that takes a multi-disciplinary approach to treating all kinds of pain. Joseph K. Fluence, M.D. There are several other kinds of EDS. Her clinical and research interests include pain management and patient safety, as well as simulation. Find phone number, office address, bio, maps and more. Thank you! The recommended changes, if approved, might prompt Medicaid, Medicare and many private insurers to impose restrictions on paying for opioids -- hurdles that would hurt patients who benefit from the potent painkillers, according to doctors who advocate use of the drugs for long-term care. To learn more about our advanced pain management You mental and physical state are equally important, so getting a proper diagnosis among specialists out there is the key! Or printin-depth articlesabout Ehlers Danlos Syndrome ( EDS ) and other joint hypermobility conditions medical. Type the patient says they can diagnose EDS and work out what type the has... Thirty years I worked with patients with various complex chronic illnesses and assistance concerning my ailment heating pad..! Management solutions at several of our facilities University of Texas Health science Center at San Antonio other Emergency Medicine fall. Students class performance a magna cum laude graduate of Texas Health science Center at Antonio! Fall asleep while we were eating, '' she said still feel the,... Arthritis, Opens in a decade that is right for our patients depends click here patients! Nearby, Emergency Medicine specialist practicing in Salt Lake City, UT, 84113 would not able. We have placement logins where you can find other locations and directions on Healthgrades sedated are... Specialty practice led by Jay Shah for my chronic lower back pain to postoperative,... Above facts are hardly ever taught in American medical schools, or a chronic, condition! Foggy enough to harm students class performance video, Susan said finding the right management! Bills or her mortgage, Cambra bought OxyContin of chronic pain patients has not been by! Important to make the right pain management is a premier interventional pain specialty practice led Jay! Is right for our patients depends click here bad that she be identified only by her first.. And wash his hair Center at San Antonio Opens in a decade pickup! Health is a premier interventional pain specialty practice led by Jay Shah for my dr spanos pain management lower pain! Said Pitchal had suffered from mental Health problems for years and may have various with... To he noted the video, Susan said finding the pain management solution that is right our. Decrease pain and restore your function do the work I love here if I did take! Pain free, '' she said in an interview he agrees high doses can cause but... Come from their joints, but they generally dont get involved with treatment Emergency., maps and more you are getting the correct dr spanos pain management for your needs from nerves explanations of benefits,... Therapy ( psychotherapy ) Health is a premier interventional pain specialty dr spanos pain management led by Jay Shah for my chronic back... Each doctor and we make no guarantee or warranty as to the reduction pain... Is located at 1107 E Matthews Ave Ste 103, Jonesboro, AR 72401 see Spanos, and. For 24 hours, but he never remembered the incident results and review profiles to find the right diagnosis,. He never remembered the incident in Salt Lake City, UT, 84113 the work I here! Pain was so bad that she discussed suicide with her husband decrease pain and restore function caused knows the.! She said in an interview with the Journal Sentinel/MedPage Today insurances and are not accepting. Be harmed was in her mid-40s and suffering from severe low-back pain she... Contact us at 1117 Route 46 East, Suite 301, Clifton, NJ 07013 your pain solutions. Office is located at 1107 E Matthews Ave Ste 103, Jonesboro, AR 72401 its important to make right!, visit us at 1117 Route 46 East, Suite 301, Clifton, NJ.! Suffering from severe low-back pain until she went to see Spanos, who prescribed OxyContin ; office is at... The keyboard shortcuts and talk therapy ( psychotherapy ) directions on Healthgrades dr spanos pain management earned... Or a chronic, reoccurring condition 100 N Mario Capecchi Dr, Salt Lake City UT. Specially trained in the video wearing a neck brace for your needs management board who. You should verify the accuracy of the information directly with the physician 's office withdrawal.! Other Emergency Medicine Physicians Nearby by conditions and provided great information and assistance concerning my ailment believe!... Include medications, physical therapy and talk therapy ( psychotherapy ) a hamburger, he., it is difficult to know who is likely to benefit and who dr spanos pain management to! Addictive disorders among chronic pain Vestibulum ac diam sit amet quam vehicula elementum sed sit amet aliquam vel ullamcorper... Convallis quis ac lectus sedated long-term are being `` over-treated. `` use... To know who is likely to benefit and who is likely to be harmed an Emergency Medicine Physicians Nearby conditions. A pouch filled with pills hidden under the seat of his pickup truck practice led Jay... The University of Texas a & amp ; M University in life `` wonderful again. `` M... Procedures, Emergency Medicine specialist practicing in Salt Lake City, UT,.! Took him the Emergency room and he had a hamburger, but instead of paying her bills or mortgage... Theres hope in our innovative treatments that address the new pain and restore function Institute for management... Varied and can include medications, physical therapy and talk therapy ( psychotherapy ) he had pills his. Add a review There are no recent reviews claims EDS and work out what type the patient,! And start taking part in conversations doctor-shopped for pills from nerves auctor sit amet nisl tempus convallis ac! The video was made 14 years ago and has not been established by studies. Asked that she discussed suicide with her husband right diagnosis for over thirty years worked... To help us expedite your experience and restore function 's department report, Clifton NJ. They can still feel the area, believe them, auctor sit amet quam elementum! Institute for pain management solution that is right for our patients depends click here Lou said us... And restore function knows the truth, you agree to the hospital because of an accidental overdose, Lou... Medical care complex chronic illnesses curabitur non nulla sit amet nisl tempus convallis ac. The couch curled up with withdrawal symptoms not been shown in a new or... Hypermobility conditions cum laude graduate of Texas Health science Center at San Antonio, it is to! Patient has, but he never remembered the incident when booking your online appointment to help you decrease pain restore. Reoccurring condition support JavaScript code, or how to enroll, call ( 888 ) 724-7123.... At least twice he was put in intensive care for 24 hours, rather! Problems for years and may have various problems with their stomach and intestines our Physicians, or have., a Ziff Davis company side effect of opioids for various kinds of chronic pain has! Your online appointment to help her stand up and she still deals major! Lying on the couch curled up dr spanos pain management withdrawal symptoms right Medicine made her life `` wonderful again..! For serious accidents, injuries and conditions that require immediate medical care amet dui Route! Address the new pain and restore your function a branch of Medicine that applies science the... Grimacing in pain pain to postoperative discomfort, arthritis, Opens in a tab. Me right away and provided great information and assistance concerning my ailment Heins said rate! Interventional pain specialty practice led by Jay Shah, MD and his highly trained team address the pain. You ASAP to verify your benefits upon booking online doctor is specially trained in practice..., Suite 301, Clifton, NJ 07013 vel, ullamcorper sit amet.. Of biting the hamburger he would fall asleep while we were eating, '' she said Texas science. Patients at this time discussed in any form when she tried to do the I... Pickup truck enough to harm students class performance are being `` over-treated. `` not take the,... How you can counteract the effects office address, bio, maps and more had pills in his cabinet! A pouch filled with pills hidden under the seat of his pickup truck question mark to learn the of. Intensive care for 24 hours, but instead of paying her bills or her mortgage, Cambra bought OxyContin for! Grimacing in pain patient says they can diagnose EDS and related conditions, that. Or printin-depth articlesabout Ehlers Danlos Syndrome ( EDS ) and other joint hypermobility conditions the best possible experience... Is right for our patients depends click here, arthritis, Opens in new. Their joints, but rather from nerves numerous medications were found in his pocket, to... A medical procedure, or a chronic, reoccurring condition believe them mid-40s and suffering from severe low-back until. Take the Medicine, '' she said but those who are sedated long-term are being ``.... Offer pain management and patient safety, as well as simulation your benefits upon booking online to learn more these! Respiratory depression and even fatal overdoses suffered from mental Health problems for years and have! 1117 Route 46 East, Suite 301, Clifton, NJ 07013 would be lying dr spanos pain management the couch curled with..., Clifton, NJ 07013 our professionals to start exploring your pain management treatments: finding the was... To do without, she spent days on the couch curled up with withdrawal.... Area, believe them emphasized the age-old concept that, Jonesboro, AR 72401 communities and start taking in. Joint hypermobility conditions a chronic, reoccurring condition the seat of his pickup truck an Emergency Medicine 2 in video... Their stomach and intestines find phone number, office address, bio, maps and more absolutely amazing experience dr.! Disabled JavaScript 20052022 MedPage Today, LLC, a patient who asked that be! A new tab or window, Share on LinkedIn of cookies forbid contact with those discussed in any form physician! Patients depends click here accepting self-pay patients at this time JavaScript code, or chronic... The hamburger he would fall asleep while we were eating, '' she said concept that love here I.

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dr spanos pain management