Ep. 327 Building a Pain Interventions Service Line with Dr. Stephen Hunt

Ep. 327 Building a Pain Interventions Service Line with Dr. Stephen Hunt

In this episode, host Dr. Michael Barraza interviews Dr. Stephen Hunt about building a pain practice, including his nerve ablation technique, how to obtain referrals, and why it is one of the most rewarding procedures that he does. --- SHOW NOTES We begin by discussing what caused Dr. Hunt to start building a pain service. He was treating many patients with lung cancer, and he saw so many patients toward the end of their life. What they wanted was to reduce their suffering due to pain. He saw what was being offered for them, which was opioids, but this caused them to be disconnected from their families at such an important time in their life. He knew he could offer nerve blocks and ablation, so he began educating himself. As he learned about different blocks, he adapted them to create his own technique. Pretty soon, word got out that he was doing this, and he started getting referrals from oncologists. Soon after this, thoracic surgeons and breast surgeons began referring to him for post-thoracotomy and post-mastectomy pain. Next, radiation oncologists referred their patients with radiation necrosis of the ribs, and orthopedic surgeons referred patients to him for pain from musculoskeletal metastases. For his technique, he often starts with a test block using bupivacaine and triamcinolone, which prolongs the effect of the bupivacaine and provides relief for around two weeks. For the ablation, he does the block in the same way, waits 15 minutes, and then injects ethanol to ablate the nerve. Some tips he has learned for celiac ablation are to ablate the retrocrural splanchnic nerves, because they feed into the celiac, and you will get a better result. Other areas he commonly ablates are intercostal nerves. For these, to avoid devastating paralysis from damage to the spinal cord, he always orients his needle lateral and stays at least two inches away from the spine. He advises those new in pain interventions to remember your anatomy. In radiology, we learn it all, and if you remember these nerves, you will be able to help a lot of people with their pain and decrease their suffering, making an enormous impact on someone’s quality of life. --- RESOURCES PIGI Lab: https://www.med.upenn.edu/pigilab/ Twitter: @PigiLab @md_rogue

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Ep. 68 RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla

Ep. 68 RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla

Dr. Jason Levy and Dr. Sandeep Bagla discuss palliative treatment of bone metastases with radiofrequency ablation, as well as recent results from the OPuS One trial.

15 Kesä 202040min

Ep. 67 Locoregional Therapies for Bridging to Transplant in HCC with Dr. Alex Kim

Ep. 67 Locoregional Therapies for Bridging to Transplant in HCC with Dr. Alex Kim

Interventional Radiologist Dr. Alex Kim and Dr. Christopher Beck discuss the utility of different locoregional liver therapies in bridging HCC patients to transplant.

8 Kesä 202047min

Ep. 66 Treatment of Endoleaks (Part II) with Dr. Saher Sabri and Dr. Sabeen Dhand

Ep. 66 Treatment of Endoleaks (Part II) with Dr. Saher Sabri and Dr. Sabeen Dhand

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IvRKl0 Dr. Sabeen Dhand and Dr. Saher Sabri discuss their various approaches to treating Type 2 Endoleaks.

2 Kesä 202034min

Ep. 65 Treatment of Endoleaks (Part I) with Dr. Saher Sabri and Dr. Sabeen Dhand

Ep. 65 Treatment of Endoleaks (Part I) with Dr. Saher Sabri and Dr. Sabeen Dhand

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zw5KJW Dr. Sabeen Dhand talks with Dr. Saher Sabri about diagnosis and treatment of Endoleaks after EVAR placement. This is part one of a two part series on Endoleaks.

27 Touko 202029min

Ep. 64 Bridging to Transplant for HCC with Dr. Jennifer Berumen and Dr. Isabel Newton

Ep. 64 Bridging to Transplant for HCC with Dr. Jennifer Berumen and Dr. Isabel Newton

Transplant Surgeon Dr. Jennifer Berumen and Interventional Radiologist Dr. Isabel Newton discuss the treatment of HCC and the importance of multi-specialty collaboration in bridging these patients to successful liver transplantation. Special discussion was given around this HCC consortium article in Annals of Surgery: https://pubmed.ncbi.nlm.nih.gov/30870180/

21 Touko 202050min

Ep. 63 IR Identity and Turf Wars with Dr. Eric Keller

Ep. 63 IR Identity and Turf Wars with Dr. Eric Keller

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/48hidj Dr. Eric J. Keller from Stanford Medicine Department of Radiology provides insight from his studies on the IR Identity, as well as his research on perceived turf wars between specialties.

11 Touko 202050min

Ep. 62 Protect Yourself Before You Wreck Yourself with Dr. Mina Makary

Ep. 62 Protect Yourself Before You Wreck Yourself with Dr. Mina Makary

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xsBt1Y Special guest Dr. Mina Makary from The Ohio State University Wexner Medical Center discusses the need for better awareness and protection from the serious harmful effects of chronic low dose radiation, which can sometimes require change in institutional culture. An extremely important occupational health issue!

27 Huhti 202026min

Ep. 61 Physician Burnout with Dr. Jeff Chick and Dr. Jacob Bundy

Ep. 61 Physician Burnout with Dr. Jeff Chick and Dr. Jacob Bundy

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/nl8ZgW Dr. Jeffrey Chick and Dr. Jacob Bundy discuss the results of their recent study in April JVIR on rates and major contributors to Physician Burnout in IR, how they compare to other specialties, and how to prevent it in your own career.

13 Huhti 202033min

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