Courtesy Texas Health Spine and Orthopedic Center
It seems as if every day there is another media story about the dangers of patients becoming addicted to pain medicines. This typically occurs after surgery when the patient is recovering from the procedure.
One Dallas joint replacement surgeon, Dr. Kwame Ennin, with Texas Health Physicians Group, who practices at Texas Health Spine & Orthopedic Center, has developed a medication strategy that is designed to reduce the incidence of this addiction to prescription drugs.
Dr. Ennin is a specialist in total joint replacement surgery and sums up his approach to medicine by noting; “I help people get back to doing things they want to do by removing the pain––the barrier––that prevents them from having a good quality of life.”
Patients Addicted to Pain-Killers
“One of the issues endemic to medicine is having patients become addicted to these pain-killers,” Dr. Ennin says. “This is partially due to the nature of these medications, where the medicine itself is addictive. The medicine affects the brain chemistry of the patient. In other situations, the patient might have a predisposition to becoming addicted. These people are at greater risk.
“We physicians are also somewhat culpable in this epidemic of medical addictions, because we have dealt with these people’s pain by passing out these medications.
“One of the ways I have dealt with this problem is by taking pain very seriously,” he notes. “We have developed a very well-planned, multi-modal pain reduction plan that we use with our post-operative patients.”
A Unique Three-Pronged Approach to Pain Management
Dr. Ennin helped develop a regimen for his surgical patients which helps reduce the number of medications needed after the surgery is completed.
“We have a much better understanding of what pain really is,” he says. “Although our brains subjectively experience pain in a particular, specific way, what we’re doing is interpreting several different inputs in the same manner. Our multi-modal pain management system works because we treat pain from the various perspectives.
“We treat pain immediately before surgery––before any incisions are made. The patient is given a cocktail of medications to be taken by mouth that treat pain from several different perspectives. One is an opiate and another is an anti-inflammatory medication. Finally, there is a nerve-type medication which treats the nerve component of pain. All of these medications work synergistically.
“During the operation, we use an injection, which is a combination of medications that treat pain from two different perspectives. An important component of that injection is a numbing medication, similar to what dentists use to numb the gums during a dental procedure. This is formulated to last for about 72 hours.
“During the surgery, we use ‘IV-Tylenol,’ which is the same Tylenol that one can purchase over the counter, except this is formulated to allow us to deliver it intravenously. When traditional Tylenol goes through the liver, it is metabolized in part and its potency is decreased. By giving it in the form of an IV, that potency is not affected in any way. That has the effect of decreasing post-operative pain.
“In the post-operative phase, we give patients a cocktail of medications, where opiates are used as the last resort. It is not uncommon for our patients to avoid taking the opiates entirely after surgery because they don’t have to. However, if they need it, it’s there for them.”
When Joint Replacement is Needed
Dr. Ennin’s orthopedic practice involves replacing human joints with artificial joints. Typically, a patient begins thinking of undergoing this procedure when their pain is intense.
“What I do is all about quality of life,” he says. “If your quality of life is poor because your knees or your hips hurt, that’s when you should start thinking about joint replacement. If this pain is causing you to miss important events or an outing that you had previously enjoyed because you are afraid of a walk of a few hundred yards, you should seriously consider your alternatives.
“One of the ways we can help you is by managing your symptoms, rather than operating. The first way we typically approach knee and hip pain is through non-operative pain management. If you have arthritis in some form, we try to manage it without surgery. If this arthritis is so severe that we can’t manage it, that’s when we think of knee or hip replacement.”
To contact Dr. Ennin, call Texas Health Spine & Orthopedic Center at 1-888-608-4762. To learn more, visit www.texashealthspineortho.org.
Physicians employed by Texas Health Physicians Group practice independently and are not employees or agents of the Center or Texas Health Resources.