( Mentions CMT) Pain management focus of institute

[Guest guest]

Pain management focus of institute

By VICKI ROCK

Daily American Staff Writer

http://www.dailyamerican.com/articles/2007/08/13/news/news821.txt

Everyone has felt pain at one time or another, but people feel pain

differently.

The common pain scale is zero to 10, with zero being no pain at all

and 10 being the worst pain a person ever felt or can imagine

feeling, said Joltes, acute pain services coordinator,

Memorial Medical Center, stown.

" What may be a four for me may be an eight for you, " she said. " It's

different between individuals. Men and women process pain signals

differently. It's very tough to compare. "

Acute pain is that felt immediately after trauma or surgery. Chronic

pain is that which has lasted six months or more. An estimated one

in five Americans suffers from chronic pain.

When people have chronic pain their physicians may refer them to the

P. Murtha Neuroscience and Pain Institute, stown. About 80

to 85 patients are seen at the institute daily.

" Some people feel pain to such a degree that they call us daily, "

said Moran, associate director of pain and neurology services

at the institute. " Others we only hear from when they have their

appointments. What one doctor said is `Pain is whatever the patient

says it is.' "

When someone is feeling acute pain, physicians may prescribe a nerve

block, which can be pinpointed to the nerves closest to where the

trauma or surgery occurred, Joltes said. It is also possible for

chronic pain, such as occurs with cancer, fibromyalgia or trauma, to

have acute exacerbation.

" Our goal it to make treatment seamless - to begin pain management

after trauma or before surgery - and to follow up after the patient

is discharged from the hospital, " Moran said.

The acute pain service at Memorial Medical Center has a multi-

disciplinary team of doctors, nurses and pharmacists. In addition to

nerve block, epidural steroids and oral medications, there are other

treatments, including radiofrequency to destroy nerves if other

treatment options fail.

The institute has programs in pain management, neurology, physiatry

(doctors who specialize in rehabilitation), headache and balance

disorders and neuromuscular disease.

Conemaugh Health System also has specialty clinics that combine

traditional care with complementary therapies, including

acupuncture, relaxation, aquatic therapy, aromatherapy and massage

therapy. They are available to people with chronic neurological

conditions, including post-polio syndrome, Charcot-Marie-Tooth

disease, Parkinson's Disease and Lou Gehrig's Disease.

" We don't expect to make them pain-free, we expect to make them more

comfortable, " Joltes said. " That is why we say pain management, not

cure. "

" It is such a good feeling when someone comes in and says their pain

is gone, or is now more livable, " Moran said.

Inflammation has a lot to do with pain, Joltes said. Different

people produce different chemicals in the body, so some will feel

pain more intensely or for a longer time. Depression is also a

factor, Moran said. Someone with chronic pain may feel depressed,

but medications for depression often help relieve pain as well.

Psychological counseling may help as well.

Because of Defense Department funding, the pain institute also

partners with Walter Army Medical Center. Lt. Col.

Chester " Trip " Buckenmaier, M.D., an anesthesiologist at Walter

, is one of the principal investigators in pain management for

the military.

More than 90 percent of wounded soldiers in Iraq and Afghanistan

have survived - the highest survival rate in American history - but

they are suffering loss of limbs and severe head wounds.

Buckenmaier has expanded the regional concept in pain management to

field hospitals in Iraq and Afghanistan, Joltes said. The thinking

is to make the patient comfortable with nerve blocks immediately in

the field hospitals, then continue the treatment as they are

transferred to Landsthul Regional Medical Center in Germany and then

to Walter . That initial treatment is also helping prevent

phantom limb pain.

Dr. Tretter at Memorial Medical Center has been doing a trial

study of patients who need to have a limb amputated. He starts the

block medication 24 hours before the surgery. That helps prevent

phantom limb pain. Pain management also begins before cancer surgery

and total joint replacement.

" There are different theories as to what causes phantom limb pain, "

Joltes said. " There has been a dramatic insult to the nervous

system - a loss of limb - that it takes time for the brain to remap.

We've talked to patients who say their foot itches, after it has

been amputated. Because of our affiliation with Walter , we are

on the cutting-edge of anesthesiology and pain management and we're

a rural area hospital. And we're helping to come up with better

treatment for soldiers. "

The main thing to remember is that a person doesn't have to live

with pain, she said.

" There are places to go and people to talk to that will help improve

your quality to life, " she said.

" We've come a long way in the treatment of pain, but there's still

work to be done, " Moran said.