Emily Ullrich✊🏾✊🏼✊🏽✊🏿

Proud nasty woman. LIZIBERAL. Progressive. Atheist. No Bitcoin. Married. 98% straight 100% #NOH8 #nobullying My god is walking around Savannah, Georgia dressed as a pharaoh.

@ChadDKollas @Lavishlyhers Something in the ether today, I dare not hypothesize. BUT, I came to they bird site to share THE BEST narrative meme I’ve seen..but bf I could, I was hit THIS MASTERPIECE on the same topic. Both full chest, 10 toes down! The 2 together could be our answer facebook.com/share/v/1H7tnS…

I am officially on my last nerve today with medical disinformation on opioid therapy and pharmacists who are at the peak of the curve that describes the Dunning Kruger Effect (original paper from 1999 can be found at pubmed.ncbi.nlm.nih.gov/10626367/). Here are the facts about opioid therapy: 1) The @US_FDA has approved opioid analgesics as safe and effective when prescribed appropriately for moderate-to-severe pain. Because they are safe and effective when prescribed appropriately for moderate-to-severe pain. 2) It is ethically impermissible to deprive patients from an established therapeutic benefit in a randomized, placebo-controlled clinical trial (RCTs); after a drug has been proven effective, studies that examine its long-term effectiveness should involve randomized comparisons to other drugs, such as in Enriched Enrollment Randomized Withdrawal (EERW) studies. Critics who wrongfully insist that we must have RCTs to justify the use of Long-term Opioid Therapy (LTOT) are either disingenuous or they are woefully uninformed (again, see the Dunning-Kruger Effect). 3) According to FDA Postmarketing Studies (PMRs) on opioid therapy, the prevalence of addiction in patients taking opioids for pain - operationalized BROADLY by the @US_FDA as patients meeting DSM-5 Criteria for moderate-to-severe opioid use disorder (OUD) - is approximately 1.5%. The prevalence of alcoholism in adults using ethanol is about 10% and the prevalence of tobacco addiction in adults who smoke is about 60-80%. Again, critics who refer to the risk of opioid addiction as "high" either lack the knowledge to appropriately contextualize that risk (Dunning-Kruger again) or they are disingenuous. 4) Buprenorphine is indeed a useful medication for treating both chronic pain and OUD, but it is too early to label it as the drug of choice for cancer pain or chronic, non-cancer pain. The largest review of buprenorphine in palliative care [Thakkar, et al. J Pain Symptom Manage. 2025 Dec 29:S0885-3924(25)01016-4] "found consistent evidence that buprenorphine was comparable to other full opioid agonists when used as both a short-acting and long-acting analgesic for palliative care patients. It also did not display significant differences in risks of adverse effect." Additionally, the authors observed, "While buprenorphine’s superior safety profile, particularly its lower risk of respiratory depression and overdose compared with full opioid agonists, is well established in the literature, none of the included palliative care studies reported on respiratory depression." Given this, it is also premature to conclude that buprenorphine is truly a safer option for LTOT than other full-acting opioids (FAOs); although that argument is a rational one, it remains unproven. 5) There is a substantial and growing body of evidence that suggests that abruptly discontinuing LTOT or reducing opioid doses too rapidly may cause patient harms including uncontrolled pain, mental health crises, increased risk of self-harm or suicide and increased risk of overdose from illicit fentalogues (See, for example, Oliva et al. BMJ. 2020 Mar 4;368). Discussions about reducing opioid dose or transitioning to buprenorphine should include a comparison of these risks versus the risks of LTOT. Additionally, clinicians must transition from a recovery model of illness to a model that acknowledges that some patients have PERMANENT, INTRACTABLY PAINFUL conditions that justify the use of LTOT under the ethical principle of double-effect. 6) The systemic vilification of opioid medications that began with the 2012 PROP Petition to the FDA on Opioid Labeling occurred - at least in part - to support large-scale multidistrict litigation (MDL) against opioid manufacturers and distributors. Many of the medical experts involved these lawsuits inappropriately influenced federal opioid policy despite having undisclosed financial and professional conflicts of interest that should have disqualified them from participating in the policy creation process [see Kollas CD, Boyer-Kollas B. Chapter 15: Laws and Policies Affecting Pain Management in the United States. Bonica’s Management of Pain, 6th Edition (James P. Rathmell JP, Edwards RR, Gilligan CJ). Wolters Kluwer, 2026, ISBN: 9781975222369. In press for Fall 2026]. 7) Ultimately, all pain care should be individualized and compassionate, make use of evidenced based treatments (that use both medication and non-medication-based approaches) and, when appropriate clinically, may include opioid therapy with a focus on optimizing therapeutic benefits while mitigating risks of both long- and short-term side effects, including the risk of OUD; patients with OUD or opioid addiction should enjoy the same level of access to individualized, compassionate care as patients with chronic pain. That level of care is detail-oriented, time-consuming and professionally challenging - but all of our patients deserve nothing less.

@JazzmondL85 That’s right mama! You never know when the game will change and the hand you were dealt is exactly the wining one! Glad to see you are inching toward feeling better while ALWAYS looking like a QUEEN!

I could not choose the cards I was dealt but I can choose to keep fighting. #Chemo day #75 #Chronicpain #Lupus can I get a heart for hope? ❤️

@Samanth18984539 @ThePOTSPostman Same

@eullrich11 @ThePOTSPostman Yeah.. some of the worst appointments I've had are with OBGYNs.

What’s the most “this can’t be real” moment you’ve had during a medical appointment or procedure? Mine was during a tilt table test. The doctor walked in, diagnosed me with POTS mid-exam and then told the nurse to keep me upright for another 20 minutes.

@Samanth18984539 @ThePOTSPostman Wow. The stories we have from the Drs & Nurses meant to be administering specifically women’s healthcare.

@ThePOTSPostman Being cornered in the bathroom by a nurse when I went to give a urine sample and being told I had been SA and was making up symptoms. I had a tumor on a nerve. Also was told by the same office, I could get an appointment sooner if I got pregnant. I wasn't in a relationship.

@MichaelAgwuart This is the shiz! Where can I see your work?

Not to brag, but i made this artwork completely from electronic waste

April Fools as Groundhog day when you live with #ChronicPain

@JazzmondL85 Sending love and gentle hugs!❤️‍🩹

I’m Pain big time. Please pray! 🙏🏾

@PainSteals @cpso_ca WOW. What if the family requests an autopsy??

So, if the MAID patient doesn't die quickly and painlessly, but is unable to clearly direct the physician to intervene on their behalf, the doctor cannot act to alleviate to patient's suffering in the event the death is prolonged or horrific? What dark evil is this @cpso_ca

@ChadDKollas The title sounds familiar…I think I may have read it, but maybe I need another round to refresh my memory!

@eullrich11 Stephen Crane. The Red Badge of Courage. (Read it as a junior in high school).

“The red sun was pasted in the sky like a wafer….”

My BFF of 25yrs lives 5min away but if going to happy hour, I’m never gonna see her or the rest of my group. Being a disabled chronically ill Lefty who’s an empath is traumatic right now…I’m sure there’s a joke in there somewhere.🤔😁😜

@JaymetheRN 🫰🫰🫰🫰🔥

Have you ever titrated vasoactive drips, managed lines, pumps, mediastinal tubes on a fresh open heart patient? I have. The Nurse manages life for many & THAT deserves more respect. We don't just wipe butts. 🙌🙌

@Breelee420 You are the SHIZNET!!

Take responsibility for yourself and your kids. Stop punishing everyone else because you are a dumbass who makes poor choices

Pain Management is a MESS. It’s only causing HARM by taking away the only meds that WORK. It’s time to fix this disaster the Government and Addiction Industry made.

@PendleWitch_ @DocPriyamMD @DrLizaMD I’m so glad you found answer!!

I’m sorry to hear that. I have had some eye problems that were originally diagnosed as dry eyes but were actually a corneal dystrophy. I had surgical treatment for that and eye problem is gone. Mine was pretty bad and went on for years as no-one spotted it until an optician did when it had got really bad and was affecting vision. Eye irritation, felt like something was in eye. Soon learned that rubbing the eye to try to get it out made it worse. Mine was in the eye not the eyelids/lashes though

The "Headache" that kills in 24 hours.🧵 As a doctor, this is the one diagnosis that genuinely scares me. Bacterial Meningitis doesn't give you days to "wait and see." It gives you hours. By the time you realize it's not just a flu, it’s often too late. 👉Stop scrolling and memorize these 3 clinical red flags: 1. The Fused Neck: This isn't a "stiff muscle" from sleeping wrong. If you have a fever and literally cannot touch your chin to your chest - that is Nuchal Rigidity. It’s an emergency. Period. 2. The "Glass Test" Rash: If you see tiny purple pin-pricks on the skin, press a clear glass firmly against them. If the spots don't fade/disappear under the glass, your blood is leaking. That’s Septicemia. Run to the ER. 3. Agonizing Photophobia: It’s not just "bright lights are annoying." It’s a physical, painful wince at a smartphone screen or a bedside lamp. 👉How to actually stay safe? 1. Mask up in crowds: It’s a respiratory drop infection. If there’s an outbreak in your school/hostel, a mask is your best friend. 2. Stop sharing everything: Vapes, spoons, water bottles, cigarettes. If their saliva is on it, the bacteria is on it. 3. Hygiene: Wash your hands like your life depends on it. 4. Vaccines: Check your records for MenACWY/MenB when you have a minute. It’s the ultimate insurance policy.

@JazzmondL85 You poor sweet sis! You can’t get a break!!!

Good morning it’s #Chemo day #62 I have a #Dental appointment deep cleaning & #Rootcanal today! Extra antibiotics required a hour before since I’m immune compromised please pray for me #Team @JazzmondL85 💜🦋 $JazzmondLove85

@zoomafrika1 @PhoenixGirl73 What her name? I love thus!! I want to interview her for a documentary I’m working on!

First female Ngoni chief in Malawi ends child marriage. She has broken up 850 child marriages in three years. ✊🏿

@Breelee420 OMG, girl this scared the crap outta me! But I must admit, now that I know you’re okay I gotta say you look beautiful and peaceful!

2004. T1-T12 Harrington rods OUT after 11 years (93) I woke up HOT and Hives head to toe, Allergic to Dilaudid. I was 23 and wasn’t over prescribed Opioids. See that face, that’s literally ☹️. Fentanyl was then used successfully.

@ChadDKollas @bbkollas Gorgeous! I love the beach by moonlight…as long as I’m covered in mosquito spray!!

Last night’s moonrise, captured by @bbkollas…

@ChadDKollas This is set up to trick people (like everything else R’s lobby for…This CAN NOT PASS!!!

The SAVE Act: Rules for thee, but not for me... 😡