Pain does not normally incite laughter, but two Greenwood anesthesiologists are using a combination of humor and a new trend in medicine to help their ailing patients smile again.
The Greenwood Pain Clinic, run by Drs. David Madden and Todd Besselievre, offers for the first time in Greenwood epidural steroid injections to relieve chronic back and neck pain. The doctors opened the clinic in Greenwood Leflore Hospital's free clinic building in November.
For the treatment, a pain-reducing anesthetic and an anti-inflammatory steroid are both injected into the space between the spinal nerves and the vertebrae. The procedure, usually performed under sedation, eases pain caused by a herniated disc or a bone spur pressing on a nerve. It is virtually painless and leaves no lingering effects, Madden said.
"Most patients wake up and say, 'When are you going to do it,' and we've already done it," he said. "We take the fear factor out of it."
The secret to Besselievre and Madden's technique, however, is not sedation, which is optional. They primarily ease their patients' minds by "cutting up, carrying on and telling jokes."
"We're not making light of their pain, but everybody who comes in here is in pain, and we try to make it a pleasant experience," said Madden. "Some say we're the first people to sit down and act interested in their pain."
For patients too elderly to withstand the impact of intensive surgery or those who would rather not go under the knife, pain management is an effective alternative, Madden said.
Madden, 50, said most people will eventually need some kind of pain treatment during their lives. "Everybody over 40, especially when they approach 50, will have the same type of back problems. That's just a given," he said. "it's wear and tear whether from playing football, pushing a vacuum or carrying laundry," he said.
Madden himself has turned patient and sought the treatment for his back problems.
"I have a surgical back, and I've been able to not have surgery because I had four injections. I've been pain free for 11 months now," he said.
The treatment works on patients whose surgery did not alleviate their pain. Madden estimated that about 60 percent of the pain clinic's patients have had corrective surgery. "We offer them help to get better without additional surgery," he said.
Neurosurgeons sometimes send their patients for pain treatment to reduce the swelling and inflammation in tissues to facilitate surgical procedures.
Both Madden and Besselievre said doctors, patients and society in general have been skeptical of medication that relieves pain. People, they said, are afraid pain medicine might cause such side effects as addiction and impairment. The Greenwood Pain Clinic monitors patients to prevent those side effects, and Madden and Besselievre are trying to familiarize the public with this relatively new branch of medicine.
"We're not over here to addict people to pain medicine. We have a very regimented program," Madden said.
Besselievre added, "We do administer pain medicine for acute needs, but our goal is to get patients off pain medicine. We provide a regimen that is tailor-made for each patient."
The injections in no way alter or impair the recipients' state of mind, Madden said. "When patients leave here, they can go dancing or do whatever they want to because there are no physical limitations," he said.
A recent push by some anesthesiology schools and the national media is stressing the importance of recognizing and treating pain, Madden said. He was the first doctor on the Greenwood Leflore Hospital staff to ask for privileges in pain medicine.
Patients seeking a cure for their pain come from all over the Delta and some from as far as Oxford. Before the Greenwood Pain Clinic began operation, they had to go to Greenville, Jackson or Memphis. Now neurosurgeons from those three areas recommend patients to the Greenwood clinic, which sees about 250 to 300 cases each month.
Madden came to Greenwood almost two years ago. An emergency room doctor, he had gone back to school to learn anesthesiology at University Medical Center in Jackson. His wife and Besselievre's wife are both from Greenwood. Besselievre, 38, also went to anesthesiology school at UMC. He moved here and began practicing in August.
Besides epidural injections, the clinic provides other methods of pain management. Treatments include trigger point injections to relieve chronic muscle inflammation and S.I. joint injections to stop pain in the joint where the hip bone meets the pelvis.
The clinic also treats complex pain syndrome. Also called reflex sympathetic dystrophy, this condition happens after minor injuries to extremities and causes victims to lose control of their motor skills because of intense pain.
Said Besselievre, "Our goal is not only to improve pain but to improve the functioning level of our patients."
