WIPM Newsletter

WIPM E-Newsletter Co-Editors Lisa R. Kroopf, MD Jolene Smith, DO

Message from the President

“I’m so excited to announce the launch of The Society of Women Innovators in Pain Management (WIPM). WIPM was founded by a small group of female who recognized the under representation of women in the field of pain management. The goal of this organization is to be a stand alone entity who can act as a collective voice for women in pain management. Please go to our website. We are awaiting our 501c3 status in order to take funds. However, please enter your contact info and we will invoice you once we can accept payment.”

Click here for a special message from Dr. Jessica Jameson, MD

Dr. Jessica Jameson, MD President, WIPM

www.wipmsoc.org

WIPM Annual Conference

We are pleased to announce the practitioners, scientists, and engineers. Inaugural Annual Society of Women We will provide a forum to interact and Innovators in Pain Management (WIPM) discuss evidence-based to Conference. improve the quality of care and access to care for patients. Industry partners The conference will consist of leaders in and exhibits are an important part of our the field of pain management coming meeting’s success and benefit both the together to discuss advances in the attendees and companies who choose field and to encourage women to take to participate. We anticipate in excess of active roles in leadership and research. 100 clinical providers specializing in pain Event panelists will share their training management, interventional pain and professional experiences with event management, and neurosurgery to attendees and engage participants in attend. We welcome professionals further discussion of these topics. The interested in the field of pain medicine event will conclude with a networking who support our mission. reception. Networking and discussions will be enhanced with the addition of surgeons and professional women of Register Here other supporting industries sharing their experiences and providing attendees PLANNING COMMITTEE with roadmaps for career and Jessica Jameson MD, FASA professional development. Helen Blake MD Lisa Kroopf MD The meeting will take place in Coeur Madi Schnur MD, MBA d’Alene, ID July 24-26, 2020. Our goal is to present cutting edge information to

In the News

Marijuana (cannabis) legalization is A recent Boston Globe article discusses sweeping across the nation. Twelve the possible implications of perioperative states (including Washington DC) have cannabis use. Check it out here. legalized cannabis for adult recreational use, and many more have The review referenced in the Boston legalized cannabis as part of medical Globe article is here. cannabis programs. Our patients are increasingly turning to cannabis to treat Information about each state’s medical pain, insomnia, anxiety, and a host of cannabis laws and regulations can be other conditions. Patients are also viewed below in a map from Marijuana becoming more open to disclosing their Policy Project (MPP). cannabis use.

NANS 2019-20 Board of Directors Election is Open

On behalf of WIPM, we would like to individuals with current NANS invite all active members of NANs to membership are eligible to vote in the vote. The election is open until Janu- election. Check your email for the official ary 17, 2020, at 5:00 pm CDT. Two very ballot. Click on the links below to review accomplished women are running for their statements. Director-at-Large positions. Only

Susan Moeschler, MD Stephanie G Vanterpool, MD, MBA View Info View Info

If you have any questions or you experience any difficulties, please contact Rachel Parks at [email protected] or call the NANS Office at (847) 375-4714.

Case Report

Percutaneous peripheral nerve stimulation for analgesia following total knee arthroplasty

Left knee: Trial Implant Right Knee: Permanent Implant

In the face of the growing opioid underwent bilateral total knee epidemic, pain physicians are arthroplasties (TKA), which did not increasingly turning toward new significantly improve her symptoms. The interventional techniques for pain patient underwent diagnostic genicular management. The evolution of nerve blocks to the superior medial (SM), innovative Neuromodulation therapy superior lateral (SL) and inferior medial targets is improving outcomes for some (IM) genicular nerves with a small volume patients with chronic joint pain. of local anesthetic, reporting 80% pain Peripheral nerve stimulation (PNS) is relief, temporarily in each knee. She then emerging as an effective modality to underwent a peripheral nerve stimulator target pain of peripheral nerve origin. trial of the SM and IM genicular nerves PNS employs a minimally invasive for each knee, reporting 90% pain surgical implantation of electrodes relief, followed by permanent implant at near a target nerve to directly treat the the IM nerve for each knee. The surgery source of ongoing pain signals. was performed with a minimally invasive Ultimately, PNS has proven to reduce technique under monitored anesthesia pain symptoms, improve function and care, which allowed for a relatively easy improve quality of life measures. The and quick recovery compared with a TKA following is a case report of a patient surgery. with ongoing chronic severe bilateral knee pain following knee replacement The patient was followed at regular surgery. intervals post-operatively. She reported improvement in her daily function, which The patient is a 65-year-old female with she attributed to an increased standing a history of rheumatoid arthritis who tolerance and improvement in presented with chronic progressive ambulation. She continues to report 70% bilateral knee pain due to osteoarthritis. pain relief overall and continues to enjoy She reported progressively worsening being more physically active. Peripheral joint mobility, pain with standing and nerve stimulation is a novel approach to walking, decreased exercise tolerance, the treatment of chronic knee pain and and difficulty climbing stairs. She had may be employed as an alternative to undergone extensive conservative intra-articular steroid injections, management including physical genicular nerve radiofrequency ablation, therapy, TENS unit, intra- articular and in some cases, knee replacement steroid injections, and pain medications surgery. including opioids. Eventually she

by Lisa R. Kroopf, MD

Research Feature

Erika Petersen, M.D., Selected to Lead National Clinical Trial on Painful Diabetic Neuropathy Read the article here.

Member Achievement

Dr. Vanila Singh was an Instrumental Leader in Development of the 2019 Pain Management Best Practices Inter-Agency Task Force

Click here for Best Practices Pain Management report

Dr. Vanila Singh is an American Her work earned widespread praise from , educator, policy maker, and the public and private sector across all patient advocate dedicated to public disciplines – such as with the American health and currently tackling one of the Medical Association, the Association of nation’s most widespread, expensive, American Physicians and Surgeons, the and devastating epidemics of our time: Human Rights Watch, the Department of the opioid and greater drug Veterans Affairs, the American Society of epidemic. As a double-board certified Interventional Pain Physicians, the faculty physician in both anesthesiology American Association of Poison Control and pain medicine, she is an expert in Centers, the American Society of understanding the underlying Hematology, the American Academy of mechanisms of complex acute and Pain Medicine, and the American Acade- chronic pain. Dr. Singh has spent over my of Orthopedic Surgeons. 15 years at the School of Medicine as a Clinical Dr. Singh has served in various Associate Professor where her practice leadership capacities and has spoke focuses on regional anesthesia with a extensively to various professional specialty in advanced ultrasound-guided organizations around the country procedures. including the Boys and Girls Club of America, STEM initiatives, panels on In 2017, Dr. Singh was appointed by the women in leadership, and patient White House to serve as the Chief advocacy groups. She has served as Medical Officer of the Department of Vice President for the National Physicians Health and Human Services (HHS) in Council on Health Policy, as a Delegate the Office of the Assistant Secretary for and IT Subcommittee member for the Health (OASH). She was later Medical Association, as an concurrently appointed by the Assistant editorial board member of the Pain Secretary for Health as the Acting Physician Journal, on the board of the Regional Director for Region 9 (CA, Santa Clara County Medical NV, AZ, HI, and the Pacific Islands) and Association, and as a member of the served dual leadership roles through her Scientific Planning Committee for the HHS tenure. American Society of Regional Anesthesiology. She currently holds a In her role as the U.S. Department of Pain Fellowship appointment at the HHS Chief Medical Officer, Dr. Singh Walter Reed Military Hospital in was integral in shaping the Bethesda with DoD. Dr. Singh is Department’s opioid policy passionate about advancing recommendations. She served as individualized, patient-centered care; Chairperson of the highly regarded Pain improving clinical outcomes; and Management Best Practices Inter- empowering patients through education, Agency Task Force, for the CARA health policy, economics, and medicine. Legislative Act of 2016, where she brought together and led 29 expert Task Dr. Vanila Singh, MD, MACM Force members in pain medicine, addiction, mental health, minority Recent Articles published by Dr. Vanila health, Veterans’ health, as well as Singh, MD, MACM professional medical organizations representatives and respected members The Emerging Role of Toxic Adulterants from FDA, CDC, NIH and others. in Street Drugs in the US Illicit Opioid Under her leadership, the Task Force Crisis - Vanila M. Singh, Thom Browne, submitted a comprehensive Report to Joshua Montgomery the U.S. Congress on May 30th 2019, that received over 150 endorsements Following massacre of Americans, we from various stakeholder organization, need a new strategy to defeat drug included over 500 scholarly references cartels and 10,000 public comments, and utilized machine learning to analyze new and emerging trends in the pain management landscape.

Helen Blake announces the bookstore release of her book Move Freely: Get Your Life Back After Injury.

Buy your copy here.

Paperback copies available in injuries. It is an exceptional resource bookstores now. This book inspires to educate your patients about patients to rise above chronic pain and behavioral changes they can make to outlines a plan to recover from painful improve their pain without medications.

QUIZ

1. A 79 year old female patient is admitted to the hospital for intractable pain secondary to metastatic breast cancer. You are consulted for pain management options to aid her ability to discharge from the hospital.

Currently receiving intravenous hydromorphone. Chest x-ray shows mild basilar atelectasis. GFR is 65. Electrocardiogram shows heart rate of 79 with non-specific T-wave changes and a QTc interval of 475.

What pain medication should be avoided? a.) Morphine b.) Oxycodone c.) Fentanyl d.) Methadone

2. An 82 year old male stepped off a curb awkwardly and felt a sudden pain in his low back. He cannot sleep due to the pain. He also notes radiating pain into his groin and anterior thigh. Currently on hydrocodone which makes him dizzy and constipated. Lumbar x-rays show a compression deformity of L2 resulting in 50% height loss. What is the next best step?

a.) Bipedicular kyphoplasty at L2 b.) Lumbar CT scan to evaluate fracture c.) Lumbar MRI d.) Switch hydrocodone to oxycodone

3. In reference to the above question, what MRI sequence identifies acute vertebral body fracture?

a.) STIR b.) T1 c.) T2 d.) FLAIR

QUIZ Answers 1. D https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940069/ 2. C https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899533/ 3. A https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899533/ www.wipmsoc.org