Pediatric Pain Management Program Nemours Childrens
SantanaRojas: Good morning. So there are two types of pain. There is acute pain, which is immediate pain after an injury. But if it lasts more than 3 to 6 months, that will be a chronic pain problem. And here in the program, that’s one of the criteria that we have â€“ it’s chronic pain for more than 3 to 6 months. Leslie Edwards, Mom: About two years ago, she laid down to take a nap one day. And woke up that afternoon and she said â€˜Mama, I just don’t feel good.’ And we put her in the shower and she just started screaming bloody murder. And she’s got juvenile rheumatoid arthritis, but she’s also got an amplified pain disorder.
SantanaRojas: She was not able to go to school full time, not dancing, no playing basketball. Savannah: When I first met Santana she asked me, â€˜Are you sure you want to do our program?’ And I told her â€˜Yes, because I want something to keep down the pain low and not me feeling it.’ Boris: Pain programs really have to be quite intensive in their approach. Most patients we’ve seen here have seen many providers in many different institutions. But what they haven’t done is come into a place where they’re seen day in and day out for a series of days up to a month long, focused directly on strengths and building back their capability.
SantanaRojas: It’s a three hour program. We have an hour of physical therapy, an hour of occupational therapy and one hour of behavioral therapy. There are together the emotional and the sensory component of pain, and you have to have a balance between those two. That’s why the behavioral component in our pain program is so important. Boris: So we teach kids how to understand how the pain signals in their body work and how they can overcome those signals. With Savannah we addressed everything from physical rehabilitation to the psychology of learning how to breathe in order to manage the pain and dampen the signals.
Kaylin Luu, LCSW: Savannah had created goals for herself to improve her mood at home, improve her interactions with her family, and definitely wanted to return to her sports and dance in school. Mom took her back to the Ronald McDonald House where they were staying and practiced their exercises all night and was ready for the next day. Savannah: Well they gave me this exercise. Just think of a place where you really want to be. And just forget about everything. Kaylin: We have weekly meetings with the team and then with the family.
So that they’re able to hear feedback from us, give feedback of their own and ask any questions so that we’re all on the same page and all treating the child effectively. Tim Finlan, MSM, MHS, OTRL: Savannah was at a point where she could exercise some, but then felt that that pain would come on after the exercise and be overbearing. So she stopped doing her exercise and stopped being involved in activities that she liked. Boris: Very often kids will come in with anxiety. They’ve been fearing discomfort day in and day out, and so they’re heightened in terms of feeling anxious. Tim: The first thing we need to do to break that cycle is get them moving again.
Seeing that patient over and over and over, you create a bond with that patient and a real strong trust with that patient â€“ which is really what we need to help push them to that next step. Leslie: They took a lot of time with her, with both of us, but especially her. Because this was our last hope. If this didn’t work, then we were just going to have to keep on the medicine and keep on with the pain and just kind of live life as best we could. Boris: Kids like Savannah, who is a brave girl, are classic for us. They’re kids who have been suffering, often in silence, for month after month after month.
And what they need is a place where, again, they can get a variety of professionals putting their heads together and creating an intervention plan tailored to their needs. SantanaRojas: You know my job is to have no â€“ zero â€“ pain in all my patients. So I’m going to do anything that is in my hands to figure out what’s going on to treat it. Kaylin: Some of our patients come in in a wheelchair because of the pain and are able to leave walking fully. Savannah: I am back to basketball. I really want to do softball. I’m going to dance a lot.
Chiropractor in Bellevue Reveals how his Treats Peripheral Neuropathy
Hey guys, welcome back. This is Kevin of Bellevue Pain Institute and today again we’re, as promised, we’re talking about the treatment for peripheral neuropathy or foot pain, numbness, burning, tingling, pins and needles. Basically what you’re looking at, is you’re looking at a red, infrared and ultraviolet light therapy boot. These boots are designed to stimulate the free nerve endings of the foot. In treatment, what you’ll see is the foot will be placed inside this boot, and will be wrapped around with a protective coating bag, and then what’s happening is each of these lights shines about a quarter size penetration into the skin so there’s overlap. There’s a hundred and ten laser diodes in each of.
The boots, the wavelength the computer will go through a series of seven different settings which change the wavelength from six hundred and sixty to nine hundred and ninety nanometers of depth penetration, wavelength size. Which basically has a resulting effect of stimulating the mitochondria in the nerve cell. With that nerve cell stimulation, the mitochondria are free or available to produce more ATP, otherwise known as Adenosine Triphosphate, otherwise known as nerve energy. Nerves have two jobs; number one job is to replicate, multiply and divide, as well as increase the information, the electrical impulse, input up to the brain. After twenty minutes dosage, then we go through all the different therapies that is required.
To stimulate these nerves and reconnect the, basically the nerves of the feet to the sensory cortex of the brain. Studies have shown that the primary symptomatology or the derivation of origination of peripheral neuropathy nerve pain is actually in the brain. The best analogy that science has come up with for sufferers of peripheral neuropathy is actually the same as, or same neurology, as phantom pain suffered by amputees. When the brain does an assessment of the body, it recognises that there’s less input from the feet, and the sensory cortex literally becomes hyperactive or hyperstimulated. Treatment of choice in the medical arena is your top five; Gabapentin, Neurontin, Lyrica, Topamax, Cymbalta basically a family of.
Antiseizure medications that are designed to turn down the sensory ability of your brain. Side effects of course will be memory losses, lack of clear mental control or power, you know, brain issues that way which none of us want but also, turning down that phantom pain in the brain from the neuropathy. At the Bellevue Pain Institute, we’ve been treating, successfully treating the symptoms associated with peripheral neuropathy and enjoy over a ninety percent success rate, meaning that over ninety percent of the people that come through our program, and number one qualify for care, and there’s a big stipulation there, qualifying for care, because if the peripheral neuropathy is too severe we just flat out.
Can’t take you because you can’t grow something from nothing. Ninety percent success rate with going through our protocols in as short as a seven to ten week treatment plan. Alright, encouraging times, encouraging things when we’re dealing with neuropathy, I look forward to teaching you more about it; last time we spoke about a tip with burning pain and doing a cold water soak, another great tip for those of your suffering from burning pain, that act as a bandaid but can give you some relief in the middle of the night, is simply taking a hairbrush (a highlydense bristled hairbrush) and tapping the skin of your feet and of your hands that will stimulate the free nerve endings and overwhelm the brain, dimming down.
Or dampening down the phantom pains, or phantom sensations of burning that you might experience at night, there’s your tip. Alright, Kevin checking out; live large at any age.