Managing pain at home

By Karen Abernathy - bio | email

More patients are living with less pain after major surgery, and getting home sooner, thanks to pain management at home. It's a trend that getting patients back on their feet faster.

Chuck Short is a sportsman who loves shooting at the range, but a shoulder injury threatened to take that hobby away from him. He thought that a total shoulder replacement would mean months of recovery, starting with several days in the hospital hooked up to powerful pain meds. Typically, the surgery puts patients in the hospital for three to five days. But Chuck was on his way home about two hours after the operation.

"I was really amazed that he said that I was going to be home the same day," Short said.

Now, more and more doctors are saying there's no need for most people to spend so much time in the hospital, or to take narcotics. That's because they are putting the power of pain management in the patients' hands.

Before surgery, Chuck was fitted with a home pain catheter. Doctors insert a tiny plastic tube near the nerves that feed the shoulder. It's connected to a pump that holds a safe amount of Novocain.

Dr. Randalll Malchow is the Director of theRegional Anesthesia and Acute Pain Fellowship at Vanderbilt University Medical Center in Nashville, Tennessee.

"Patients can dial back the local anesthetic on their own," Malchow said. "If they're not numb enough, they can go ahead and increase the rate on the pump so it infuses a continuous Novocain, a long-acting Novocain, through the pain catheter."

"It's just like going to the dentist. You're totally numb," Short recalled.

Patients wear the pump for three days, then pull it out themselves and continue pain meds.

"We feel if we can aggressively treat their pain for the first 72 hours or so, that the pain diminishes every day thereafter," Dr. Malchow said.

Doctors say it reduces the need for narcotics and cuts a hospital bill by as much as $10,000.

Chuck was pleased with his surgery, and the pain treatment at home.

"Much, much better than staying in the hospital."

Chuck even found a way to get back to the range sooner.

"Kind of taught myself how to shoot left-handed."

And now he's well on his way to full recovery.

Doctors say the pump holds exactly the right amount of Novocain to prevent overdose. The home pain catheter can be used for shoulder, elbow, wrist, knee and hip replacements.

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