Ep. 327 Building a Pain Interventions Service Line with Dr. Stephen Hunt
BackTable Vascular & Interventional29 Maj 2023

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. 33 Building a Comprehensive Vein Practice with Dr. Brooke Spencer

Ep. 33 Building a Comprehensive Vein Practice with Dr. Brooke Spencer

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/tNgPeU Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome.

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Ep. 32 Building an Interventional Oncology Program with Dr. Zaetta and Dr. Stanton

Ep. 32 Building an Interventional Oncology Program with Dr. Zaetta and Dr. Stanton

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/a114SU Interventional Radiologist Dr. Julie Zaetta and Oncologist Dr. Julie Stanton discuss the essentials of building a successful Interventional Oncology program, including the importance of a multidisciplinary approach.

8 Sep 201835min

Ep. 31 Cosmetic IR and Marketing Tips with Dr. Aaron Shiloh

Ep. 31 Cosmetic IR and Marketing Tips with Dr. Aaron Shiloh

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RKhFhu Dr. Aaron Shiloh of PA Vascular Institute discusses his experiences adding Cosmetic IR procedures to his practice, as well as some essential online marketing strategies for IRs.

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Ep. 30 Transradial Access: Basic to Advanced with Dr. Aaron Fischman

Ep. 30 Transradial Access: Basic to Advanced with Dr. Aaron Fischman

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o72eK3 Our interventional radiologist guest Dr. Aaron Fischman gets into the details of his technique, equipment and tips/tricks for transradial access, as well as its advantages in a variety of IR interventions.

26 Juni 201847min

Ep. 29 Interview with Interventional Initiative founders Isabel Newton and Susan Jackson

Ep. 29 Interview with Interventional Initiative founders Isabel Newton and Susan Jackson

An interview with Interventional Initiative founders Isabel Newton and Susan Jackson taking us through the journey behind the awe-inspiring Without A Scalpel documentaries, including some funny stories and more exciting things to come.

17 Juni 201837min

Ep. 28 Advanced Enteral Access with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Ep. 28 Advanced Enteral Access with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/q7wJPr Dr. Jeffrey Chick and Dr. Ravi Srinivasa discuss what inspired them to start IRAD Lab, their advanced enteral access techniques, as well as a new technique for closing EC fistulas with laser!

7 Maj 201831min

Ep. 27 Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson

Ep. 27 Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/cGcyzt Our latest BackTable podcast on an exciting new therapy for osteoarthritis of the knee- Geniculate Artery Embolization! Our guests Dr. Ari Isaacson and Dr. Sandeep Bagla discuss their experiences and the immense potential this trans-arterial treatment has for management of people suffering from OA.

13 Apr 201843min

Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Dr. Christopher Beck and Dr. Jason Iannuccilli discuss radial vs femoral access in IO procedures, including the pros and cons of both, and a very informative "how I do it" for radial access by Dr. Iannuccilli.

30 Mars 201844min

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