| International Pain Foundation | www.internationalpain.org |
| Patient Advocate Foundation | www.patientadvocate.org |
| U.S. Department of Health and Human Services | www.hhs.gov |
| Substance Abuse & Mental Health Services | www.samhsa.gov |
| Social Security Disability Offices | www.ssa.gov |
| Medicare Office | www.medicare.gov |
| Medicare Rights Center | www.medicarerights.org |
| Cares Alliance | www.caresalliance.org |
| The Medicine Abuse Project | www.Drugfree.org |
| RX Assist | www.rxassist.org |
| Patient Physician Trust Partnership | www.pptp.org |
| Partnership for Prescription Assistance | www.pparx.org |
| Patient Advocate Foundation | www.patientadvocate.org |
| Pain Legislation | www.patientawareness.org |
| RX Safety Matters | www.RxSafetyMatters.org |
| Pain Advocacy Community | www.InTheFaceofPain.com |
| Suicide Prevention | 800-SUICIDE (784-2433) |
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Barby Ingle
There’s Such a Hysteria Going On When It Comes To Opioid Medication
by BarbyIngle
written by BarbyIngle
There’s Such a Hysteria Going On When It Comes To Opioid Medication
By Barby Ingle
A few weeks ago I got a phone call from a ‘pain patient’ who said he was from California. He kept referring to questions that didn’t make sense based on his reported pain story. He ended his phone call saying he needed me to make sure that everyone vote for (his candidate of choice). I laughed first as I don’t talk about where I stand politically and I really don’t care who anyone else votes for. I care about other issues such as access to proper and timely care for patients around the world. My verbal response was ‘I don’t talk about politics and I don’t promote any one candidate publicly or privately’.
One of the other things I did say to this caller was “There’s such a hysteria going on about those who have died from overdoses and from patients who feel that opioids are helping them but they have or may be taken away. We need to find a way to address prescription drug abusers and chronic pain patients at the same time. We cannot forsake one for the other.” I have made similar statements in other media interviews. The first part of my sentence has been used in recent AP stories that have run, leading me to believe either my phone was tapped, or this ‘patient’ was lying about who he was and he was trying to get quotes for his story. The thing is, I would answer the same to the patient as I would to the reporter. My beliefs are my own, no one can buy them. You could change my mind with new presented information, but you don’t need to pay me to change my mind, just show me believable evidence.
It’s like the doctors who call me saying, I have a cure. As soon as you say cure, I am not going to believe you. All means all and that is all, all means. So slow down track stars and check out why I think that there is a hysteria going on, both sides included.
I strongly believe that the patient and their properly licensed providers should be making the decisions for what is best for the patient. I also believe that we need better access to care. And as I state in my book Remission Possible; Yours If You Choose to Accept It, published in 2011, “opioids activate glia”. When you have a nerve pain disease like I do our glia is already activated due to neuroinflammation. Opioids make it worse, they make us not care, but they also make our condition worse on a neuroinflammation level. (You can look up Dr. Linda Watkins for more scientific explanation on this).
We need to use a multimodality approach to chronic pain management over monotherapy (one treatment type such as only using opioids). Having lived with chronic pain for nearly 20 years and 14 of which is having diagnoses including reflex sympathetic dystrophy, arthritis, TMJ disorder, hypothyroid, ischemia, seizures, and thoracic outlet syndrome I am pretty sure I know what living life with chronic pain is like. I have tried many different treatment options. I have avoided opioid use since realizing it didn’t help my severe nerve pain, it only made me not care. I found a way to go from wheels (wheelchair) to heels (walking). Am I out of pain? No, I am not, but I have found effective treatments that work for me to help management my pain, and out of the top 5, 1 is a medication, and it’s not an opioid or NSAID, both of which have caused me additional challenges such as OIC and internal bleeding.
I also advocate for other patients. In doing so, I have heard from thousands of patients (of the millions who do use opioids on a daily basis) who swear by two things. First, they have no other treatment options being provided or access to those options due to costs. Secondly, there is no other option that they have been able to try that is successful or as successful as the opioids they use daily to have some sort of improvement in their daily life.
I know that there is not good evidence – based on scientific scores either way. Every test, needs assessment, research study can be torn apart by the ‘other side’. For me it comes down to, if I have something that helps me live a better quality life and function better, I want to have access to use it. For me that was not opioids, but that doesn’t discount the millions who do say it is helping them live. Or even those who were denied access to care, (any care including opioids) and they decided to commit suicide, or those who have the addictive gene causing them to abuse medication and other things in their life, some to the point of losing their life. I have lost many friends to suicide and a few to addiction. For those who were in pain and could not get access to proper and timely care, I don’t blame them for wanting to go to heaven and be out of the daily pain we feel here on earth. It is not my choice, but I do understand how someone can get to that point and want to die because they are not being helped here on earth. For those who use illegal drugs (and if you are abusing prescription medication that is illegal mind you, according to our governing laws) there is help and hope for you as well. It is becoming more and more available over the recent years. I can’t watch TV on any given day and not see the advertising for the rehab centers and help for you once you are ready to get it.
So where do we go from here. I believe that we do need more cautious prescribing and in bringing the opioid crisis to an end for abusers of prescription medications. I believe that opioids are an extremely important class of medication, especially when used to ease suffering at the end of life and when used short-term for severe acute pain. I believe that we need more efforts in abuse deterrent options both in medications as well as in lifestyle changes such as mindfulness and psychotherapy for abusers. Will ADF’s and behavioral techniques stop abuse? No, if an abuser doesn’t have access to one they will find a way to get the chemical change they seek. But will it help, yes.
I also strongly do not support legal constraints on clinical decision-making. Again, I believe it should be between the patient and their providers as to the care they receive. I believe that opioid prescribing can be reduced by providing accurate information about medication risks and benefits. I hope that providing all humans with the information on medication risks and benefits and letting them and their provider make the choice will help stop the hysteria on both sides. I think that we all have more common ground and if we could find a way to help both abusers and chronic pain patients get the proper and timely access to the care that they need that (and all humans for that matter), that our goals would be accomplished faster and safer. Let’s not forsake one for the other.
As the president of the International Pain Foundation our goal is education, awareness, social events and access to care. I have never spent any iPain funding on giving it to any legislators or lobbyist. Our funds go to our awareness and education projects. Our access to care projects are not funded, it is all done on volunteer time, effort, energy and story sharing by patients. I am 100% volunteer as are all iPain board members, delegates, and volunteers.
For the past two years iPain has been focused on creating the Music Moves Awareness project to accomplish our mission. Over 95% of the raised funds in 2015-2016, were used on our Music Moves Awareness projects in 2015-16. You can see the music video and purchase the song HOPE IS TRUE at www.hopeistrue.org The Music Moves Awareness project involves featuring patient stories, (We have 24 featurettes with a variety of pain conditions and using many different treatment options), iPain Webinars, HOPE IS TRUE music video/song for the public, and the 12 steps to patient empowerment. You can check out GuideStar to see our 990’s – International Pain Foundation is a dba so you will find us under Power of Pain Foundation, Inc. tax id: 47-3080556.
International Pain Foundation (iPain) supports the notion that chronic pain is a real and complex disease that exists either by itself or it can be linked with other medical conditions. As a charity, it campaigns for effective pain care through an array of treatment options, which are widely inaccessible. It also underlines that chronic pain is an unrecognized and under-resourced public health crisis with devastating personal and economic impacts. Most importantly, it operates under the belief that allowing people to suffer with unmanaged pain is immoral and unethical.
Barby Ingle suffers from Reflex Sympathetic Dystrophy (RSD) and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics.
More information about Barby can be found on her website.
In no particular order, my bucket list. It is a work in progress… last update 9/10/2016
- Dance 6-eight counts with Paula Abdul choreographed by both of us together
- Get a reading from Tyler Henry
- Get my own car
- Get one my favorite groups (schroeder) to play at a celebration of mine or iPain
- Get iPain on the TV show like Apprentice as a charity a celebrity plays for to raise awareness and funds
- Go down one of the world’s longest zip lines
- Judge at a beauty pageant (possibly be in one for married women)
- Meet all three Kardashian girls (and tell them about iPain), especially Khloe’
- Meet Mark Cuban (tell him about iPain, and get his advise to go to the next level with it)
- Move to a house closer into phoenix area but I love just as much as our current house
- Publish 2 more book for a total of 10, by the age of 50 (already have RSD in Me, ReMission Possible, The Pain Code, The Pain Code Journal, Real Love, Wisdom of Ingle, and Aunt Barby’s Invisible Endless Owie, ImPossible)
- Renew my wedding vows in the Caribbean
- Ride in a hot air balloon
- See every circ du soleil show in Las Vegas
- Star in a National Commercial
- Take a ride on a fighter jet
Completed:
- Attend a class at Billy Blanks studio in Sherman Oaks, CA. While he is teaching and try to participate. 2016
- Run International Pain Foundation with my husband full time 2018
If Prince Had Gotten Proper Follow-Up, Could His Death Have Been Avoided?
by BarbyIngle
written by BarbyIngle
By Barby Ingle and Emily Ulrich
When Prince passed away I was dealing with some migralepsy seizures and knew that I wasn’t going to say this how I wanted to. I turned to another writer and iPain Delegate Emily Ulrich to help me get my idea out. We worked to get this published but editors didn’t want to put it out without a doctor or healthcare professional who would sign on and be interviewed about it. Since then I have been recovering.
Recently I reached out to a few doctors and a pharmacist that I am connected to in my real life world (vs e-connections). All of them had similar reactions. None of them disagreed with the thought I posed but they didn’t want their name on this article. The medication we speak of is important to the opioid abuse community AND anyone in the pain community who are going through an overdose for any reason. This is not meant as bad press about a medication whatsoever.
We need Naloxone available. We are all in agreeance on this fact. But there is another side to the medication that should be considered. Yes it can save your life if you are in a respiratory depression situation due to an overdose of opioids, but what follow up is being done with these patients who live on? We need to look at that part of the situation. I reached out to Emily to write this and do the research. She did an amazing job and although it is my observation I felt Emily deserves the credit for writing the piece at a time I couldn’t.
This article is meant to be an example that brings on a whole new idea. We need to talk about follow up care with our providers. We need to know how our medications work –the positives, negatives and full instructions to get on any medication and to get back off safely.
I now present Emily’s article –
I haven’t yet decided what to believe and what to disregard in the aftermath of Prince’s death. After pondering the many possibilities and questioning the inaccuracies and partial information provided by the media, I spoke with my friend, mentor, and President of International Pain Foundation (to which I am a Delegate), Barby Ingle. She posed a fact about the scenario, which I hadn’t thought of, and which has yet to be mentioned by anyone; the effects of the Naloxone, the “save shot” which had allegedly been administered to Prince, days before his death may have actually played a role in causing an overdose days later.
Naloxone (an opioid antagonist) is an immediate antidote to opioid overdose. It works by essentially re-awakening the Central Nervous System (CNS), which becomes severely depressed during opioid overdoses. The depression of the CNS is what causes overdose victims to develop hypotension (extremely low blood pressure) and slow to no breathing. Although the drug can literally be lifesaving, doctors and medical professionals have not been thoroughly educated about the semi long-term effects of the drug in patients who use opioid pain medicines regularly and legitimately to control chronic pain. So, when a patient is administered Naloxone, and is not informed about how it works, and the possible semi long-term effects of the medication on a cellular level. Most specifically, they need to know that it is actually possible for the drug to CAUSE overdose in patients who immediately resume their regular pain medication schedule and dosage, after having been given Naloxone.
To understand how and why this happens, we have to discuss pain on a cellular level. 90% of brain cells are called glial cells. These are the cells that, when activated, ”…may produce a number of pathologic sequelae in the CNS, including neuroinflammation, cellular destruction, GCD [glial cell dysfunction], stimulation of the sympathetic nervous system, and hyperarousal of the hypothalamic-pituitary complex. The memory of pain may be trapped, or centralized, in this pathologic process…” (http://www.practicalpainmanagement.com/pain/other/glial-cell-activation-neuroinflammation-how-they-cause-centralized-pain ).
In addition to causing pain when disrupted, “…glial activation contributes to a state of opioid analgesic tolerance,” (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1828713/ ). This explains, in part, why one’s opioid pain medication dosages are often titrated up over time, to accommodate the same pain as a lower dose once did. When Narcan is administered to a patient with a tolerance to opioid pain medications, the brain’s glial cells effectively re-boot, “Jane Loitman [2006] at the Washington University School of Medicine, St. Louis, Missouri, described 3 cases of refractory pain…in which she administered 0.6 to 1.2 mg naloxone IV that precipitated severe withdrawal. This was relieved within 20 minutes by readministration of opioid analgesics and, in all cases, the patients achieved greater pain relief than before the brief detoxification procedure and at lower opioid doses.“ (http://updates.pain-topics.org/2010/11/naloxone-reboots-opioid-pain-relief.html)
Essentially, what all this means is we need to ask if Prince’s alleged overdose COULD have been precipitated by the purported Narcan treatment, a few days before his death? If the “save shot” did essentially reset his glial cells, thereby significantly altering his tolerance and making it markedly lower; the Narcan shot could have put him at a fundamentally heightened risk for overdose. This is particularly true if he was taking regular high dose pain meds before, and automatically resumed the same high dosages after he received the shot. This potential explanation of the Medical Examiner’s report, which determined Prince’s cause of death to be “accidental overdose” must be taken into account as a potential reason for his overdose. It must also serve as a warning to the medical community and to high-dose opioid users, that in the case of overdose treated with Narcan, the opioid dosages following the administration of the shot must be adjusted to prevent additional accidental overdoses.
Barby explains this scenario by comparing tolerance to/dependence on opioids for chronic pain to the body’s adjustment to the desired temperature of shower water. “We get used to taking a shower at a certain temperature. In the winter you turn on the shower to the same specific spot on the dial for every shower, to get the desired temperature. Summer comes and all of the sudden, it’s too hot at that setting. The outside force of nature resets the inside temperature of our house and in doing so, changes the spot on the shower dial where the temperature is right for our desired comfort. Naloxone is that reset, it is a life saver in many overdose situations. Studies show us that opioids attach to the glia and Naloxone knocks the opioids off of the glia.” She goes on to say, “Naloxone is designed for addicts in an overdose situation not for use of chronic pain patients who use opioids daily. If Naloxone is given to a chronic pain patient such as in the case of Prince, providers have to remember to reset where the opioid using pain patient put the dial next time they take a shower. Or in other words, lower our dose as though we’re starting from the beginning, because our tolerance will be lowered like it’s suddenly summer again, and we don’t want to get burned.”
Barby Ingle suffers from Reflex Sympathetic Dystrophy (RSD) and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics. More information about Barby can be found at her website.
Emily Ullrich suffers from Complex Regional Pain Syndrome (CRPS), Sphincter of Oddi Dysfunction, Carpal Tunnel Syndrome, endometriosis, Interstitial Cystitis, migraines, fibromyalgia, osteoarthritis, anxiety, insomnia, bursitis, depression, multiple chemical sensitivity, and chronic pancreatitis. Emily is a writer, artist, filmmaker, and has even been an occasional stand-up comedian. She now focuses on patient advocacy for the International Pain Foundation, as she is able.
The information in this article should not be considered as professional medical advice, diagnosis or treatment. It is written by two pain patients who are not licensed or healthcare professionals. It is for informational purposes only and represents the authoress opinions alone. It does not inherently express or reflect the views, opinions and/or positions of any healthcare provider. Always talk to a licensed healthcare provider for proper healthcare needs you have questions about and be comfortable with any decisions you make for yourself.
There is absolutely no doubt in my mind that there is a lot of misinformation out in the pain community. I hear it in phone calls, emails, and see it on social media posts. Last week I was speaking to a woman who helped start a new fb group. She wanted me and International Pain Foundation to help support their upcoming survey after telling me it was just like the one the iPain and Pain News Network did together a few months back, but different. She asked if she could cite our results in the meantime to help get a legislative bill blocked. She said much more. I let her know as long as she cites our survey she could use our results. She went on to tell me that opioids had been made illegal in multiple states for everyone except palliative care patients. Knowing that this was not true, I asked which states. She named Virginia and New York as two of the examples. There is no such law that makes opioids illegal for all but palliative care patients in any state. I record most of my phone calls and when this one was done, I couldn’t believe what I had heard her say so I went back and listened again and again. Where does this misinformation come from? Its not helping.
If you have relapsed Chronic Lymphocytic Leukemia (#CLL), you can help forward medical research by participating in an important new clinical trial to test if adding an investigational medication (ublituximab) to ibrutinib (Imbruvica®), an FDA-approved treatment, improves outcomes for CLL patients with high-risk disease.
If you are interested, the full study details and eligibility criteria are listed here.
More about the study:
• The investigational drug is administered by infusion and the FDA approved drug ibrutinib is administered by oral capsules • This is a phase 3 trial • There will be approximately 330 participants in this trial
You or a loved one may be able to take part in this trial if you: • Are at least 18 years old; • Have been diagnosed with and received prior treatment for CLL; • Have relapsed CLL that now requires additional treatment; and • Have at least one high-risk genetic abnormality (your doctor or the study staff can help you determine if you have a high-risk abnormality).
Matching participants to trials is a critical problem facing CLL research. Can you help find new treatments for patients with relapsed CLL?
Please complete the online questionnaire to check if you’re eligible for the trial.
If you’re not familiar with clinical trials, here are some FAQs:
What are clinical trials?
Clinical trials are research studies to determine whether investigational drugs or treatments are safe and effective for humans. All new investigational medications and devices must undergo several clinical trials, often involving thousands of people.
Why participate in a clinical trial?
You may have access to new investigational treatments that would be available to the general public only upon approval. You will also receive study-related medical care and attention from clinical trial staff at research facilities. Clinical trials offer hope for many people and an opportunity to help researchers find better treatments for others in the future.
April 17 to raise awareness about hemophilia and other inherited bleeding disorders
by BarbyIngle
written by BarbyIngle
Join the World Federation of Hemophilia and all CureClick Ambassadors on April 17 to raise awareness about hemophilia and other inherited bleeding disorders. Globally 1 in 1,000 people has a bleeding disorder. Most are not diagnosed and do not receive treatment. Together we can change that. World Hemophilia Day provides an opportunity to talk to your family and friends, colleagues, and caregivers to raise awareness and increase support for those living with an inherited bleeding disorder.
Ever wonder, am I strong enough to make it on a trip out of town? In traveling nowadays, there are overcrowded terminals, flight delays, and security with which we have to contend. There are ways to make traveling easier and less stressful for chronic pain patients. My first suggestion is to pack your medications in a carry-on bag. If your luggage gets lost, you won’t have to worry about where or how to get your medications. As travel terminals are hectic and people are at a frantic pace, arriving early so you can go at a slower, more relaxed pace will make the hassles of dealing with disabilities manageable when traveling. Your goal is to make it to your destination on time, in a low pain level and in a good mood. When you decide to make a trip, it is best to plan ahead. I use the Internet to get destination information. I check out the floor plans of the airports I am coming and going from, and what types of foods are available in the terminals. I also request handicapped services from the airline, bus depot, car rental company, and hotel all ahead of time.
My mother is on oxygen and has had a few troubles traveling because of it. If you are on oxygen, let the airline know 30 days prior to travel or as soon as you know that you will be flying. In-flight oxygen needs to be prearranged, and there is typically a charge. Then call 24-48 hours prior to your flight to confirm the oxygen arrangements. At the airport, if traveling alone, bring tip money. I try to bring one-dollar bills and tip a dollar for each bag that I am assisted with, both when I am departing and at my destination. I also pay the person pushing my wheelchair one to two dollars for their assistance. I also have a scooter, so I do not always have to pay for the wheelchair assistance. It is not mandatory to pay for help; however, the person pushing you often works for tips only or tips with a low wage. Be sure to let them know if you want to make any stops to use the restroom or purchase food while they are assisting you. When they bring you to your gate, ask to be “parked” at the door or the start of the line. Make sure that the airline person sees you. If you sit off to the side, they may miss you, and you will not be able to take advantage of pre-boarding. If you need extra time and assistance, you may have a problem.
Typically, the flight attendant or ground crew comes over to me and moves me up in the plane if I have a seat towards the back, and they ask me if I need any assistance walking, or if I need an aisle chair to get to my seat. I do not tip the attendant who brings me down the jet way. When I pre-board, once on the plane, if I need to take medication or I am nauseated, I ask for a small glass of water. I also board with the first group, when they call for people who need assistance. If they do give you a small glass of water, they must take it back before the plane takes off; make sure you drink what you need when they give it to you.
Let them know while in flight if you need assistance in using the restroom or need blankets and pillows for comfort. When you arrive at your destination, stay in your seat until your wheelchair assistance has arrived. They typically ask you to wait until the other passengers unload so that you do not hold them up or so that they do not bump against you and it may cause you further injury. At baggage claim, if you are alone, ask the assistant to get your luggage and to bring you outside to meet your party. Once you are in a place you do not need assistance, give them their tip and thank them, so they may go help other travelers needing assistance.
I wrote this a few years ago but it all still applies today.
Colorado Department of Health Care Policy and Financing (adf review)
by BarbyIngle
written by BarbyIngle
March 21, 2016
Kelli Metz
Clinical Services Pharmacist
Colorado Department of Health Care Policy and Financing
1570 Grant Street
Denver, CO. 80203
RE: April 5 PDL Drug Class Review (Abuse-Deterrent Formulations)
Dear Kelli,
On behalf of thousands of Coloradans who live with life-altering and debilitating pain, we urge you to protect and enhance access to safe medications. It is critical that Colorado Medicaid cover the full range of treatments available for pain in the safest possible way which includes covering recently approved “Abuse-Deterrent Prevention” (ADP) formulations. This is incredibly important because there is a higher amount of abuse in the Medicaid population than commercial population.
Colorado presently ranks at the top of the list in terms of misuse, abuse, and diversion of controlled substances, particularly opioids. We believe anything that can be done to ensure safety and optimize efficacy of these medications should be strongly considered.
When prescribed and monitored appropriately, most patients do extremely well on these types of medications, and experience improvements in pain, function and quality of life. There are instances, however, where medications are used inappropriately. The disastrous consequences of inappropriate use can lead up to and include death. In fact, over 16,000 of roughly 22,000 prescription drug overdose deaths annually are associated with opioids.
The path to opioid overdoses, in many cases, begins with the misuse of prescription pain killers. These pills are most frequently passed along by family or friends or sold on the street and then crushed, melted or otherwise altered to get a more powerful effect. Over 70% of abusers of prescription pain relievers got them from friends or relatives. The slow release over time that occurs when the pill is swallowed whole – can be felt at once when the pill is altered for snorting or injection. A useful pain killer is thereby instantly turned into a potentially lethal narcotic.
While it is not possible to entirely eliminate this occurrence, It is our belief that abuse-deterrent formulations should be part of a multi-faceted approach to decrease abuse. Although ADPs do not prevent users from simply consuming too much of a medication, they may help reduce the public health burden of prescription opioid abuse in Colorado by making it harder to abuse in other ways.
The consequences of opioid abuse, including emergency room episodes, treatment admissions and overdose deaths are staggering and it is a behavior that is starting in adolescence.
- 1 in 4 teens reports having misused or abused a prescription drug at least once in their lifetime.
- Nearly two-thirds of American teens who abuse pain relievers say they got it from family members and friends.
- This behavior has deadly consequences: overdose deaths involving prescription opioids quadrupled over a decade from 4,030 deaths in 1999 to 16,651 in 2010.
- Due to the increase in prescription drug abuse, drug overdoses now exceed car crashes as the number one cause of accidental death in the United States.
The Food and Drug Administration (FDA) wrote in a 2013 ADP guidance for drug makers that the “FDA considers the development of these products a high public health priority.” In fact, in February 2016 the FDA announced that they will now mandate that any new opioid go before an outside committee of experts, unless the product has abuse-deterrent properties.
Additionally, a study published in the Journal of Pain Medicine found that the first ADP formulation of oxycodone was associated with a $430 million reduction in medical costs, an almost $100 million reduction in criminal justice costs and a $476 million increase in workplace productivity. Results such as these have prompted five governors, 29 attorneys general and 22 members of Congress to oppose the production of opioids without the use of ADP.
Colorado does not have ADP formulations available on their formulary even though 42 states currently do. A Medicaid patient must try and fail on an opioid without abuse-deterrent properties before they can get an abuse-deterrent medication, even if their physician feels that an ADP medication is best for the situation.
We believe in the sacred doctor patient relationship and request that Colorado have an ADP available for each class of medication. It is our hope that these issues be taken into consideration when Colorado’s P&T Committee meets on April 5. Should you have any questions please contact the International Pain Foundation at 480-882-1342.
Sincerely,
Barby Ingle
President
International Pain Foundation
Barby’s Bucket List Update… This is ongoing and ever changing as I grow and make accomplishments. I think it is important to have life goals and things that we can look forward to doing. I dont know what order these will happen but I am constantly working on accomplishing them in conjunction with my life purpose to be a Cheerleader of HOPE and a Dancer for LIFE. Follow along with me to see which ones I get to do next…
- Dance 6-eight counts with Paula Abdul choreographed by both of us together
- Get my own car
- Get one my favorite groups (schroeder) to play at a celebration of mine or iPain
- Get iPain on the TV show like Apprentice as a charity a celebrity plays for to raise awareness and funds
- Go down one of the world’s longest zip lines
- Judge at a beauty pageant (possibly be in one for married women)
- Meet all three Kardashian girls (and tell them about iPain), especially Khloe’
- Take a ride on a fighter jet
- Meet Mark Cuban (tell him about iPain, and get his advise to go to the next level with it)
- Move to a house closer into phoenix area or in Los Angeles.
- Publish 2 more books for a total of 10, by the age of 50 (already have RSD in Me, ReMission Possible, The Pain Code, The Pain Code Journal, Real Love, Wisdom of Ingle, Aunt Barby’s Invisible Endless Owie, and i’m Possible)
- Renew my wedding vows in the Caribbean
- Ride in a hot air balloon
- Run International Pain Foundation with my husband full time
- See every circ du soleil show in Las Vegas
- Star in a National Commercial