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Tulsa pain management : Ep-7 Part 5

I think the Tulsa pain management have a shoulder injection. Am I going to be off work. Can I go right to work.

Yeah I think you should be able to go back to work because the relief should be continuous instantaneous. And typically we don’t offer sedation because it’s such a quick and easy procedure so the patients yet they can go back to work after that I called the Tulsa pain management I had pain what do we offer for hips.

So again the hip is as multiple components a hip you know you could be as like jongg which is classically not the hip and strike back. We have also the throat cancer or bursitis Burswood at the side of the thigh that that is not per say the hip joint is outside. But you know a lot of patients call it the hip anyway and of course there’s a real hip joint which is a ball and socket joint deep in the groin. So we do injections for you as eigene. We use x ray for this for the cantor Bursey injection. Usually we just do it without the aid of X-rays because it’s fairly superficial and of course the hip joints are deep joint so we use x ray for those of us so we can inject into that square like join the greater cancer birth as well as the actual hip joints. Again we use steroids and a numbing medication.

OK. And it’s also a Tulsa pain management and a lot of patients have knee pain. Well what can we offer for any.

Knee pain. You have arthritis. We can offer a steroid and a local anesthetic injection. I use it in the X-rays some of the right to do it without X-ray guidance. Now if the patients respond to the steroids that we can do the injections every two to three months. If the patient has does not respond to the steering injection or the effect is just to short term what we can do is we can inject this medication called ortho viste out of his that is the tradename. They see what it is. It’s basically the same component that a natural joint lubricants made off. So basically we replace the the joint lubricant with something external. It’s a very thick gel like liquid. We do the injection ball three times every week. Well one week parts to fill up the joint stays. We need a pool for that so that also takes a little bit of you know some work to get it approved for it. So to repeat again we do the injections and we also do the auto visitation in in patients layman’s term we call it the injection.

OK. That’s also Tulsa pain management. We offer an intrathecal pain ponse.

So I think that means the spinal fluid you know in the spinal fluid space so what it is is is a pump that delivers medication directly into the spinal cord. This is where all the nerve fibers can and we get process you know in the spinal cord and sent up to the brain.

So by blocking the pain receptors in the spinal cord we can circumvent the. Defects of the liver see on the drug or the gastrointestinal tract because when you take a drug early it gets metabolized. And finally the final amount that actually reaches wild card is actually mind you compared to what you’ve taken orally. So by delivering the Medicare directly there is a more predictable response and you get the drug where it is needed. So you avoid a lot of side effects because you know you don’t get this going to your brain or to your gut to slow down your cause constipation in the case of a narcotic. So typically we put the cath catheter right the plastic very thin plastic tubing plus silicon tubing into the spinal cord right fluid and so and we can actually get into a pump that’s implanted under the skin. So we do use sort several indications so drugs can use the ones that are kind of morphin or Baclofen which is the muscle relaxers. Patients with cerebral palsy with previous stroke or spinal cord injury and they have really tight muscles as a result from that injury. So these back know a lot of patients you know they can’t take a lot of action because back and because of the side effects it’s too sedating it causes dizziness so we offer this.

To patients. Who can’t tolerate their own version of the medication.

So we feel to pump it back often and then we program it to run a second dose and we can increase or decrease the dosing the patients respond if it’s too much but it gets a little bit too loose then we can back off a little bit. It’s not. Now we can always bump up the dose. So back then is is one of the routes we can use the other drug that I use in the past. This is morphine. So instead of having to take morphine all the time with delirium morphine continuously into the spinal cord. The dose of use is typically very very low because obviously you know you don’t have to account for metabolism at the liver or the gastrointestinal tract. So for patients who typically offer it to patients who have cancer pain because because you know that the requirement for for pain medication is very high for these patients it’s hard for them to take a lot of pain meds can cause a lot of constipation. No it isn’t. So by bypassing all that we do live indirectly we can do the very high doses to treat the kinds of pain as it progresses. I also use Nikonov type which is training is called Prialt which is a medication that is a non narcotic a pain medication it acts on non narcotic receptors. It’s unique in that way because it won’t have the side effects of narcotics like sedation dependence tolerance addiction or constipation. Tulsa pain management ┬áSo typically we do it.