Last Week On The Chronic Pain Service

Although this chronic pain management rotation has been very relaxed, the month overall has been very hectic with my fellowship interviews. Many days I’ve had to catch flights immediately after work or, even better, come to work after returning to Houston well after midnight (…delayed flights… 😡 ). I’m just thankful that the attendings have been very flexible and understanding of my limited interview day options. 🙂

I’ve come to enjoy performing interventional pain procedures (facet joint injections, medial branch blocks, epidural steroid injections, sacroiliac injections, etc.) due to the instant gratification they can often provide patients. This joy is instantly relayed to the provider, especially since we’re able to care for our incredible veteran population in such a profound manner.

The clinic side is much slower paced as we perform thorough histories and physical exams to identify the most likely etiologies of pain. Is this primarily a myofascial type of pain where physical therapy has a prominent therapeutic role? Or is it a multilevel radiculopathy caused by severe kyphoscoliosis which may benefit from steroid injections or surgery? Pain is such a complex spectrum, so managing these chronic patients can prove to be challenging yet very rewarding.

VA Pain Clinic exam room

With a few days left before I start three grueling months of pediatric anesthesia, I’m hoping to finish this rotation on a strong note! 🙂

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