In Search of the Best Pain Clinic in L A: Temporary Catheters

By | February 8, 2013

With a temporary catheter and this external pump a cancer patient's pain can be relieved while the diagnostic workup proceeds.

With a temporary catheter and this external pump a cancer patient’s pain can be relieved while the diagnostic workup proceeds.

A theme that we have dealt with over and over is that for the best pain clinic in Los Angeles, calendars and clocks are less important than patients. Yesterday afternoon an old patient Vera (not her real name) came to see me in the Burbank of complaining of upper abdominal pain, which radiated to her back. I was surprised to see her although I was not surprised by her complaint because I had heard through the medical grapevine that Vera had been diagnosed with advanced pancreatic cancer over a year ago. Vera looked well, albeit thin and in pain. She had had surgery for her original tumor and had done well. She had begun to experience pain and weight loss about 6 months and had consulted a number of physicians including her internist and oncologist, but the workups had been “negative”. Being the distrustful guy that I am my staff and I obtained all of the old records and just as I had expected her pancreatic tumor had been a low-grade cystic malignancy, which had been incompletely excised due to bleeding. Furthermore the previous CAT Scans were really not negative, but rather nondiagnostic, since the radiologist had in each case commented on not being able to adequately visualize the previous surgery area. I spoke with the patient and told her of my concerns that the tumor had returned, but that further studies were necessary. Instead of being upset she seemed almost relieved that the cause of her pain would be found. I also told her that I saw no reason to wait for the new studies before treating her pain. We discussed putting in a temporary intrathecal drug delivery system (IDDS) with a trial intrathecal catheter attached to an external pump. If a treatable cause of her pain were to be found the temporary catheter could simply be removed. The patient agreed and within a half an hour the catheter was in and her pain was gone. An hour later Vera was discharged from my office, pain free for the first time in 6 months.


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