NV Advanced Pain as Seen on Nevada Business Chronicles
You're. Watching Nevada business Chronicles. Take, a journey with us to see the innovative businesses that, put Nevada, on the business map. Connecting. You with the businesses events, and organizations that. Bring innovation and, prosperity to. The Nevada area please, welcome your host Mitch, Berney. If you. Have chronic pain you want, to sit down to pay attention to this episode we're, here at Nevada advanced pain specialist, with dr. Mary Z and dr., Patterson, thank you so much for having us here today yeah thank you for making it thank, you for being here this. Facility, has made an impact on so many lives in our community I cannot, wait to show people what goes on here come, with us thank you good tour let's go. Tell. Me a little bit about Nevada advanced Pain Specialists, what you do here and what inspired, you to open the facility so. I moved to the Reno Tahoe area back, in 2007. And, at that time I realized that there was a lot of patients here with chronic pain, statistically. If you look at it a hundred million Americans, suffer from chronic pain on a daily basis, at. That time I saw that this community had a lot of those patients and I. Decided to create a comprehensive pain clinic to help address their needs and, hopefully give them their lives back dr.. Murray's joined the practice in. 2014. Because. I knew I needed good help to allow, our clinic to see more patients that was a great fit for me we do have a different background and, what we do we do, our fellowship. And interventional, pain management both of us with, two, different, backgrounds to, make sure that we can offer the best technology. And treatment to our community, we've combined our specialties, we. Are ultimately trying, to use the biopsychosocial, model, to. Treat. Every, single patient that comes through our doors and. What that means is that we try to you, know address any physical, problems they may have any. Psychological, problems they may have and on, top of that use interventions. To treat their underlying pain issue and hopefully make them a better person, in whole, providing. The best care plus, also educating, them so we are very much involved in R&D. And education. When we see patients here we, initially want to start out with a simplest, solution. To treat their pain and that, would involve active, treatments, such as physical. Therapy behavioral. Health, in massage. Therapy our. Goal is to comprehensively. Treat their pain using those modalities in hopes, that we can solve their issue is the. Easiest way possible, something. That people need to understand, about your Center, is that. You are. Prone. On opiate, pain treatment, options first, that's. Right yeah that's right when. We talk about conservative. Treatments, and minimally, invasive treatments, we have different modalities, hands-on a manipulation. Technique, using, detains unit for the patient or conditioning. For muscle and also, real are in process of adding virtual training, as a physical, medicine rehab, doctor you, know when I interview, the patients at the initial consultation I can't, tell you how many times I heard that the patient has tried. And failed physical, therapy in the past but, when I really delve into it you. Know they had the wrong, type of physical therapy, and so, that's. Why we. Like to work with a therapist, who actually puts their hands on the patient's does, a lot of you, know manipulation. Strain. Counter, strain techniques. Myofascial. Release. Not. Just therapeutic, exercise, you, know we're.
Not Trainers. You know if you want to go get training and you got to go to the gym and work with a personal trainer they'll tell you what exercises, you need to do but. Here you actually need the hands-on, care, in order, to feel better to. Do exercises. To get that conditioning, and training in beforehand, and, some. Of our patients they want to be conditioned, to what, they used to do for, work wise they had an injury for example so. I want to make sure that what type of job they do have and we can get there if the job requires them, to walk. Half a mile we, have that ability, to, get them after the right therapy, just to make sure that they are able to do what they're asked. For in their daily job. Overall. We try to individualize, the treatment. Not. Every. Form of physical therapy is going to benefit, each individual, patient so, you need to find the right modality, the, right therapy. At the right time to treat that person. We, realize that over the last decade. Opioids. In the United States have led to an epidemic plus. They're, not really treating the actual problem, they're just masking, the patient's pain issues and, so here, we try to look at doing other treatments, that actually can treat the problem not, cover it up and that's, why we use these other minimally, invasive treatments, to, address patients, before we consider putting them on opiates that's. True and also, our state of Nevada has the fourth highest rate of death, from opiate overdose, so, our. Neighborhood. Has been hit, so badly by opiate, crisis and this, is our commitment to our community, to make sure we, do have safe alternatives, for opiate to, treat them yes. Unfortunately. All. Patients. Aren't going to get better with conservative, care and that's. Why doctor and Murray Z and I did. Interventional, pain fellowships, so that we can offer patients procedures. To alleviate, their pain the, first step of doing that is getting a thorough. Physical. Examination, and, then having some imaging, of that area to see if there's, abnormalities. That correlate, with what we're hearing and seeing, the. Next step at that point then would to diagnostically. Block, those, structures, that we see and see, if the patient's pain goes away. In. Order to do that diagnostic. Or therapeutic treatment, that. Would do we, use the image, guidance, for, every patients. We have in practice that can include, x-ray. It. Can include the ultrasound. And in some situation, we use the nervous stimulator because.
We Want to make sure that when we do the treatment we, do it right and we find. And identify. This structure, that we, are targeting and. Also, helps us to avoid from structures. That we don't want we don't want to hit that in there if we need to stay away from the artery, or vein and, that image. Guidance, helps, us to get there and provide, the best safe treatment, once. We have an idea diagnostically. What's going on with the patient and, we'll bring them into this room this room is our, fluoroscopic. Guided. Procedure. Room and we'll. Set them up with interventions. To. Try to treat their pain, and. This can be as simple as a. Facet. Joint cortisone, injection, a. Epidural. Steroid, injection. It could be a. Shoulder. Hip. Or knee. Injection. Or. If you. Know we do those procedures, and the patient doesn't get better then we can look at doing simple. Surgical. Implants. To help the patient a couple of the things we have here our pain, pumps in spinal. Cord stimulators, pain, pumps. Help. You, know more, global, pain it. Can be used to help spasticity. Chronic. Non-malignant pain. Or. Even patients, dying of cancer, to help give them pain relief for the remaining time that, they have spinal. Cord stimulators, are better for regional. Pain kind. Of help in patients you know if they have neck or arm pain or back and leg pain we. Can use those to help out it's, also important, to know that pumps. Typically. Help, mechanical. Or neuropathic. Pain but. Stimulators, really only help with neural, Pathak pain. The. Beauty of what we do is typically. We have a chance to test them and diagnose. Them by. Doing, some type of procedures, beforehand many. Of the patients you know they've had back, surgeries, before in the past but never had a chance to try out a surgery. Before having you surgery and hopefully they. Benefit, from it with what we do we are able in majority. Of our procedures, to test that beforehand, to identify, the right patient, and that, makes us different from other, type of procedures. That can be offer out there for, example the pain bob the patient, can come and have a single, shot injection. Of the medication. That we think it's right for the patient and we. Document, the patient response, from we do physical therapy maybe after, we use it in patients who do have the server pulses the spasticity, or they, have a stroke, inducer specificity, we may use baclofen, so, we do a physical, therapy beforehand and after hand and see how much of relaxation. Improvement. In their functionality. Of the mussels baguette and then if they're a good candidate would proceed spawn, occurs simulator would do the same thing who placed them temporarily, and they just everything that stays outside, did go home they, lived their normal life and they, get a chance to test it for seven to ten days if, that helps them that's, when we offered them the permanent, so we are confident, they can benefit from the device because, they had a chance to test before him it's important for patients to know that a trial where.
They Get to try these out you know it only takes us a couple minutes to do a pump. Trial a spinal. Cord stimulator trial only takes ten or fifteen minutes and there, it's done with local anesthesia. Patients. Awake talking, to us laughing, joking it's, really not painful at all and, just, like dr. Murray Z said it, they, know the benefit and if it if it helps them then we can actually then set them up for our surgical procedure that takes us 30 minutes or an hour at most to. Have these implanted, underneath the skin to give them pain relief for the rest of their lives our. Goal in this practice, to offer none or create. Alternatives, for the patient to benefit from but, we have situation, that few patients may exhaust, all options and, then. Opioid becomes, the only option for them but. We take that very seriously, come with us I'll show you how we treat those patients. We. Took the time and made the, investment, to, make sure that we do, urine, drug screening, and have, the best technology, available to. Assess our patients, for, several reasons one, make. Sure our patients being compliant they're taking their medications as prescribed, to. Make. Sure our patients aren't diverting, their medications, ie, meaning, they're selling them to the black market within our community, and three. Making. Sure our patients, don't have a. Substance. Abuse or misuse problem, meaning, that the medications, were prescribing, they are misusing, them or are, taking illegal drugs at the same time we. Want to make sure that our patient, is safe, plus, we have some, patients. That they're, not here to get better to here just to abuse the system they, are here to take advantage of what we can do for the patient to help them this, is one of the tools that we. Use, to identify those. Patients, along, with the psychological. Testing, that we do to, make sure that our patients are safe and do get the best treatment as a, person. Living in this community I want, to make sure that I provide, a, care. That I can be proud of and. Not worry that I'm contributing to the problem pain. Psychology. Is a, big. Component of our treatment because. Some patients they don't have the, insight, if the, anxiety depression. Presenting. Itself but. Pain or their, pain is a, result. Of their, anxiety and depression, at, the initial appointment, we do two things one, would be we give patients an online, psychological. Assessment, that, psychological. Assessment, also includes, the opioid risk tool the, opioid risk tool will tell us of a patient is mild. Moderate. Or high risk for using opiates on the front-end the, other thing that we do is we get a random drug screen we're. Able to find those results, to see exactly what the patient has in their system, that. Tells us if the patient is compliant with medications, have been taken from somebody prior to seeing us or, if they're using illegal drugs that. Would preclude them from being a good opioid, candidate, the, top two reasons why patients come to see us are for spinal pain and chronic, migraines, I'd, like to touch on chronic migraines for a second because, we have found that Botox can. Significantly help, patients and we've been doing it for five or six years how. Does Botox. Help, migraines, it's. Funny that you ask a lot of people wonder the same thing because they've always known about, it being for cosmetic, reasons for.
Chronic Migraine it does two things one it. Stops. The nerves around. The head to neck area from releasing nerve neurotransmitters. That can potentiate a migraine. Attack and, two, it, relaxes, the muscles in that area just think what happens when you when you do have pain you you, tighten up and so the muscles, in that area if they're relaxed can no longer do that we, have by, relaxing the muscles around the head and neck area we. Can either, prevent, the, onset of a migraine or two, if they do have, a migraine, it'll, make it not last as long for the patient that's, proven by studies so, we know that those patients, those. Muscles, they have, in the shoulder, around the neck the, neck frontal, area they, all trigger. For migraines, so if you relax those muscles right. Back of the shoulder get, the forehead, this side they, can benefit, from that, relief to, have the less of a migraine, attacks procedure, as simple as well it. Only takes about 10-15. Minute office visit and. It's done every three months, patients. Completely, benefit, sounds. Like they can get a little. Other. Cosmetic. Benefit, out of it as well at the same time I'm sure that's a little bonus always, joke with my patients, that the next time I see and they'll look younger as well I joke. With them that have this side effect as it can't frown anymore, so. They laugh but the main the main goal is to treat the, pain. What. Are the treatment options do you offer here one. Of the treatment options that we do here is varicose, vein ablation, we have so many patients that come to our practice, complain, of restless leg syndrome the, component, of soreness, in their legs being, fatigued, in their legs and we do multiple, studies it's just not coming from the back it's, not the nerve damage then, we realize that this is because of they have disease drains the, varicose, vein so, those lanes are not diverting, the blood back. To the heart so it stays right there that can cause pain for them so, one of the treatments that we do is to, get. Rid of those bad things, those disease thing to. Use. The radiofrequency and, to, cauterize same so then. Would divert the blood into, healthy, veins and. Back to the heart back to the heart that's that's true beforehand. We also have, a certified. Vascular tech who, does the ultrasound, for us and, to. Identify the patients, who have. Suffered. From backless, Lane treating. Spinal pain is very complex, as you, can see there's a lot of structures that go into making up a spine. As we. Get older our bones. Get thinner when. Our bones get thinner it can lead to a condition called osteoporosis, a. Consequence. Of osteoporosis, is you can develop a spinal fracture one. Of the treatments that we do here at Nevada advanced pain specialists is that, we can put cement in those fractures, to, make the patient's pain go away Wow. It, is a great treatment for the patients because it's one of the, treatments, that when, we get it done patients, get relief right away this. Is the one that typically, when they come out of the procedure room the, pain is gone or almost very minimal, that's, one of the way we know that children also was effective, for them or not, that's. Amazing, yeah, they. See somebody come in in English and walk out pain-free is, an amazing experience as a physician, to see, if. One would have it with that cancer patients who do have lesions in their bone and those. Lesions are cancer lesions and, they cause pain we can literally can go into that structure, of the bone and burn. Those lesions. And fill, that with cement that's, just one of the other treatment. Options we do have when, it comes to kyphoplasty. How. Does cognitive. Behavioral. Therapy. Get. Mixed in with pain, management. So. Far what we know about pain, we, know that pain has two components, one the emotional, part and one is the physical part so the emotional part can present itself with depression, anxiety so. The patients, who are in pain, they, can become depressed and anxious over, time it's. Important, for us to, identify these patients, and to.
Intervene, Very soon, to make sure that their, physical pain, is addressed as well, as their emotional part of the their, pain is addressed but, also we, do have some patients, who, have, depression, and anxiety but. They manifest, themselves with, pain they come and dig you. Know complain, of pain but. In deed, the problem is because they are depressed or anxious we. Do have tools here and pain psychology, we have counselors, on board to. Tackle and address every, one of these issues, so. Somebody, that's been in a car, accident for an example got seriously hurt has real, pain, but. At some point in time the pain goes away but the brain doesn't realize. That. There's, no pain left and they still feel pain there. Are multiple patients, that can be involved in a car accident and, heal but that accident, becomes, part of their identity especially. The pain portion, these, patients, if the. Pain goes away they have no further identity, so consciously the patient doesn't even realize that, they are doing this so, we can't physically. Treat, the pain we, have to treat it from, a psychological standpoint, to. Get that, emotional. Distress. Or, suffering. To, resolve, before the patient will feel better and you certainly don't want to do procedures on somebody that doesn't need one, absolutely. Correct because. We know they're not going to get better they're not going to improve problem, is somewhere else so it's coming from their emotional. Anxiety that they have depression it's, interesting to know they. Don't have insight which, one, is the problem as long, as there's a train on that rail, track that's, all brain cares, about so, that train, can carry depression, or it can carry pain, the, outcome, can be the same and brain, does not have the insight so, that's why we introduced that pain psychology. Into it to, identify, and break that insight back to the patient really important, and something I wouldn't have considered probably not all that common but you still have to look for it correct. And that's why part, of our initial assessments, we screen, every patient. To see if there's any underlying, psychological, factors. That, may be contributing to the patient's pain that's. True Samantha. What brought you to Nevada advanced pain specialist, I was referred here by the VA after the VA couldn't, help me anymore so dr., Patterson, and was able to help me what, happened to you and I broke my ankle when I was in the army and I, developed a nerve damage first. Of all thank you for your service what. Type of pain were you in and what we're able to do here to help treat you I was an extraordinary pain, my day-to-day was miserable I can function, it, was horrible, dr.. Patterson was, able to relieve my pain about, 90%, so. My, quality, of life is so much better so. You broke your ankle it, heals, yet you're still left with real. Pain. What. Did they do, treatment wise to alleviate, that you're, right after breaking. A bone you think it would heal but after, four years on active duty without, actually getting a, real. Medical treatment, for my ankle I, when. I got out of the military I, came to, see dr. Patterson. And he put the spinal cord stimulator in my spine the implant, and I knew right away that I, loved. It I wanted it in me and I wanted it to fix, me on, a scale of one to ten what kind of pain were you in I was. About. A ten in most days as, soon as you tried, the implant. What was the pain oh it relieved it's about a 1 what. Things you're able to do today that you weren't able to do is I can go hiking I, can go running I can, stand for long periods of time I, got. To wake forward this past weekend, I haven't done that in years, Wow yeah, so. A life altering mm-hmm, is wonderful. Steve. I understand, that you're a patient at Nevada advanced pain specialist, tell, me a little bit about how, you got here what happened. For. About 15. Years I had been bouncing, around from, pain specialist, pain specialist, with absolutely. Very. Minimal, results, you. Had gone through some, surgeries, as a matter of fact prior to coming here, approximately. Five, spinal. Fusions, and. Even. After, those you were still in pain and taking a lot of medications, for that tremendous. Amount, of pain. Bilaterally. Throughout. My hips down, my legs up. Into my spine I couldn't. Walk I couldn't go grocery shopping so, yes I was before, you got here you were taking about how many pain pills a month between, 300.
And 350. Opioid. Tablets, so months and then, when you met doctor, they're easy what happened he changed my life he. Implanted, a intra, 3 perl drug, implant, into me which reduced. My opioid. Pain medications. To where I'm only down to 2 a day now, unbelievable. And then you also had a stimulator. Implanted yes. He also in. February. Of 2014. Implanted. As st. Jude's neuro stimulator, which. Works wonderful, what, things can you do now that you weren't able to do in the past. Sleep. Wow, that's a big one huh, I can. Go grocery shopping with, my wife so, she doesn't have to carry that load all by herself no more I can ride a bicycle I. Can. Get out and go to the park I can, play with my kids I can, do just about anything, that, a normal uninjured. Person, can now it probably goes without saying you'd recommend other people that are trying to manage their pain now or, that. Are finding, themselves in need of pain management to come to Nevada advanced pain specialist, before. I, came, to dr. new easy I had. Given up on life and, anybody. Who, has. That. Type of pain. Constant. Chronic pain and is, looking for. Some. A new way out I had strongly. Advised to come talk to dr., Marie Z or dr. Patterson, at Nevada advanced pain specialist so happy you're able to do the things that you weren't able to do before and thank you for taking the time to share that with us thank you Jeff what caused. You to seek. Out dr.. Patterson at Nevada advanced pain specialist, well I'd been suffering. From low back pain with radiation, issues. Down my legs. Received. A mailer. From, the clinic about a spinal cord stimulator, which was news to me, went. To the seminar on that and thought, okay let's proceed, had. An initial consultation, in. Addition, to the spinal cord stimulation, another. Option presented was what's called ablation, therapy, and, you wound, up trying both first, the spinal, cord stimulator, which had some success correct but, then you went. On to the ablation. Therapy and, how did that work the, ablation was great in. And, out not much problem, as far, as being. Under. The knife if you will simple procedure and I've, been able to sleep much better don't. Wake up two or three four, times a night trying, to turn over without screaming. And then. Made it through ski season, up at Mount Rose as well as now starting, to get out on the golf course well that's fantastic being, able to enjoy life that's been great Danna I understand, that you were in a lot of pain when you came here and taking, a lot of medication, for that man correct when. You first came in you. Had to have people help you come in here yes. I have. Been with, a cane or a walker or, a wheelchair. For. Many years and that and the day that I first saw doctor never easy was I was, actually using my walker so I could get from one room you know to another, and, that, and he was so concerned. He. Had people around me because I was just so wobbly and he, was so afraid I was gonna fall over. And. They examined, you correct. And found, that you might be eligible for, other treatment, he, offered me a spinal stimulator, and then he explained, to me what it was and that we could put a temporary, went. In to see if it actually worked so. I thought about it and we decided we were going to go ahead to see if it worked, and that, and so it was, a procedure, done in his office I went home and the. Very next day I wanted. To make sure that. This was going to work so, I actually stopped. 60. Milligrams of morphine to see how much pain I was going to be in with the spinals and I, wasn't in any pain, for. The first time, and, that. And so the next time I saw dr. new easy we. Decided, we were going to go ahead and go I'd be a good candidate, for this, system, and so. I guess, less than a month later I was actually in, and, we put the stimulator, in. And, it, has, been phenomenal. First. Time in 40, years that, I am, pain-free. A very, large point, of the day now. Well. What. About the pain. Medications. Are you still taking any well, I was, taking, a hundred, and eighty milligrams. Of morphine a day, and that, still kept me in a pain of about seven, or eight every. Day because, I just didn't want to continue adding, on, and on and so, I've. Actually gotten, down today. Where, I can take anywhere from thirty to forty, five milligrams, a day and, I. Am pain-free. A good part. Of the day what types of things you're able to do now that you're able, to clean, or cook like any normal, woman could. And that and. So I noticed. That I was able to start doing things around my home and I was able, to start walking with no aid whatsoever and now, I'm use my 60s, then I'm riding a bicycle, again it, sounds like your, life no, no I got, a life, there's a huge difference I didn't, have a life before I was in bed 22. To 24, hours a day this. Is the first time, I've.
Actually Had. Results. That. Worked. Fantastic. I'm sure people watching right now are asking. How they can get hold of you they can find it said five five seven eightt Longley. Lane our, phone number is seven, seven five two, eight four eight, six, five zero or. They can find us on the web at envy advance, pain comm I'd, encourage all of them to go to our website to, learn more about us see, the procedures, that we do and follow, us on social media thank. You so much if you about joining us and having us here thanks. For being here. I, thank you thank you for, more, information on, this guest or to see this show in its entirety visit nvbusinesschronicles.com. While, you're there you can watch all of our past shows on the Chronicles page, and stay connected with us by following us on our social media. You.