Make Pain a Thing of the Past – md – Physician Partners of America

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Interviewer: I’m sure a lot of you out there know it well. You’re in mental pain, which causes physical pain which, in turn, causes more mental distress. It’s a vicious cycle. When does it end? Dr. Jorge Leal from Florida Pain Relief Group joins us now to talk more about this. Dr. Leal, great to have you here.

Dr. Leal: Thank you.

Interviewer: Oftentimes, when you have people come in that are just mentally and physical exhausted because of their pain, is it sometimes because of something that’s happening inside their minds?

Dr. Leal: It is very common that you see a lot of mental abnormalities in people who suffer with chronic pain. It is sometimes difficult to tell which one was first, but you have to definitely emphasize both aspects. The physical and emotional aspect of pain and suffering are intertwined. Not infrequently, people that suffer from chronic pain also suffer from sleeplessness. And if you don’t sleep well, your day does not go well and your pain can be intensified by the lack of sleep, lack of concentration, anxiety, causing a release of catecholamines which basically are adrenaline. Response to chronic stress can also make you more sensitive to pain, more susceptible to pain and it just, indeed, becomes a vicious cycle.



Interviewer: Can depression cause pain too?

Dr. Leal: It can intensify pain and sometimes it is associated with chronic pain, very commonly.

Interviewer: So what’s more important? Treating the mental side first or treating the physical side first?

Dr. Leal: Well, you have to treat both. One without the other will not be effective so you have to emphasize in treating both aspects of the pain experience, the psychological aspect and the physical aspects as well.

Interviewer: I’m curious to know how you go about that.

Dr. Leal: In our center, we have a comprehensive approach to the treatment of pain and we identify, by certain psychometric tools that we have available, to gauge when is someone susceptible to psychological problems. We identify if they have any kind of depression or any other psychological condition that might interfere in the management of pain. And we identify it, and then we seek appropriate treatment in terms of referral to the appropriate mental health specialist, counseling and so forth.

Interviewer: I think it’s important that you mention a lack of sleep can cause all of these problems. That it’s not necessarily something wrong with your brain, it’s something physically that’s happening to you and then it’s affecting your whole body.

Dr. Leal: Absolutely. And as you will know, this is very common in our day of life. Lack of sleep is extremely common and has tremendous negative consequences in our health. It’s now becoming more and more talked about, and we have to deal with that. That being said, pharmacological treatments for insomnia are fraught with their own problems, including addiction to sleep aids. So a very good sleep hygiene is extremely important and we do emphasize that in our practice.

Interviewer: And you can help people get off the pills and figure out a great way to just remedy their sleep.

Dr. Leal: Indeed.

Interviewer: Okay. Good stuff. Dr. Leal, thank you very much. You can visit their website,  or give them a call at 844-KICK-PAIN to schedule your same-day appointment. We’ll be right back with more Daytime, so don’t go away.

Interviewer: Sadly, getting cancer at some point in your life is all too common in this country, but the pain from cancer doesn’t have to be. Dr. Rudy Gari is here from Florida Pain Relief Group to talk about this, as well as pain that can persist even after cancer is gone. Dr. Gari, great to have you back.

Dr. Gari: My pleasure, Thank you.

Interviewer: Let’s talk about this. How many patients who have gone through cancer, have been treated, still have pain afterward?

Dr. Gari: Well, unfortunately…fortunately, if they’ve been treated and cured, that’s a great thing, but a lot of times that cancer can spread to different nerves and can cause damage to some of those nerves, so it can leave a long-lasting painful injury even after you’ve been very blessed by having the cancer cure.

Interviewer: Okay, so what are some kinds of different cancer pain that people experience?

Dr. Gari: So, basically, cancer pain is associated with any type of cancer that ends up affecting the organs, your nerves, anything like that. In fact, my first patient that I had after I finished my training out of medical school in residency was a patient that was dying of cancer, and I remember her vividly because she came to me and she said, “Doctor,” say says, “I’m going to die, but my mother died of the same thing. She had breast cancer. All that I want to do is, I don’t want to die in pain.” So I said, “You are not going to.” She was referred to me by an oncologist. Most oncologists, if not all of them, they do a great job of taking care of that pain, but there are some patients that, after medications, you’re still going to, you might have some pain, and she said, “I just want to be able to spend my last days without pain.” We ended up putting in something called a morphine pump implant that allowed medications with a very small amount of morphine to go into the spinal cord that actually gave her pain relief.



Interviewer: So, apart from this morphine implant pump, and which helped her immensely, what else do you have out there to treat this pain?

Dr. Gari: Well, we have everything. So, we have every possible tool that’s available in the field today, including allografts, stem cells, nerve blocks, medications, physical therapy, things called radio-frequency. We can do what’s called cryotherapy. We can burn the little nerves out that are causing pain. We can put in something called smogra stimulators, morphine pumps. There is an incredible amount of tools available to physicians like myself that specialize in pain management to be able to treat cancer pain other than just giving medications.

Interviewer: Why are they experiencing this pain?

Dr. Gari: Well they experience this pain because of the fact that, just think about it, if you hit your nerves, it’s painful. So that cancer can spread, and it can spread and it can cause a distension of different organs. It can cause…it can impinge on the nerves. It can cause significant pain.

Interviewer: Okay, so for anybody out there’s who’s watching right now, who’s going through this, there’s definitely relief.

Dr. Gari: We can help you, yes, absolutely.

Interviewer: Okay, Dr. Gari, thank you very much. The Florida Pain Relief Group even offers same-day appointments. You can visit their website, or give them a call, 844-KICK-PAIN. Dr. Rudy Gari, great to have you back.

Dr. Gari: Thank you.

Interviewer: We’ll be right back.