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This week’s Making Rounds spotlights Jocelyn Bush, an interventional pain specialist at the Center for Pain Management, where she treats chronic pain patients with a range of approaches from epidurals to peripheral nerve stimulators.
Bush spoke to Healthcare Brew about misconceptions in pain management, and why she finds it fulfilling to work in the field.
This interview has been lightly edited for length and clarity.
What is the Center for Pain Management, and what do you do there?
It’s a physician practice; there are eight of us, and we’re all anesthesiologists who have done pain fellowships. I’ve been at the Center for Pain Management for 15 years this summer, and I’m a treating physician here.
We treat all manners of pain: We treat the most common, which would be discogenic pain, meaning from a disc herniation…and pain from metabolic problems, such as diabetes. Or some sort of neuropathic pain, where [patients] have a damaged nervous system, and people who’ve had pain from post-surgical issues or just from daily wear and tear of our bodies.
We do interventional procedures from as minor as a little trigger point injection—which would be a little injection of local anesthetic into a muscle or tissue—to epidural injections and all types of spinal interventions, to minor surgeries such as implanting stimulators and pain pumps, and to minimally invasive surgical procedures to improve pain.
What would you say is the biggest misconception people have about your job?
People think all we do is give narcotics. I don’t think narcotics in general are bad. If they’re used appropriately and prescribed by the appropriate physician and monitored, they help people regain their lives. But we actually investigate our patients by taking a really thorough history about what their pain complaint is, what they’ve tried, what they haven’t tried, what things have worked.
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The other misconception is that all we do is needle sticks. We actually implant peripheral nerve stimulators. We can stimulate a nerve in your knee after you’ve had a knee replacement [for example]. I have several patients who I’ve put implants in who have been able to lose hundreds of pounds. They’ve been able to get married. I’ve had people who have traveled the world. I have people who have started their families. I have people who have met new loves in their lives. It’s fun—I get to be part of all of it.
What would you say is the most fulfilling part of your work?
I herniated my first disk when I was starting my pain fellowship at 30 years old. Three days later, the pain kicked in, and it felt like there was a blowtorch going up my leg. I don’t think I had ever had pain like that before, and so it changed how I saw my patients, and I sympathized more. I think that made me a better pain doctor.
The fulfilling part of my day is when I see people who think they’re at the end, and there’s nothing there. They’re like, “I’m never going to get better.” And then I tell them that little tidbit about me…and tell them I understand that fiery pain. That’s the most rewarding part: I let them know that this is where you can be you, and I’m going to figure out something to help you.