Easing life’s burdens
Wednesday, June 29, 2005 10:36 AM CDT
The Edmond Sun
Patients sometimes cry when Dr. Gretchen Wienecke listens to their concerns and tells them she believes their accounts of pain.
“They’ll tell me, ‘Nobody believes me that I have pain,'” said Wienecke, an OU Physician on staff at Edmond Medical Center with a focus on pain management. “To help them to some degree is pretty gratifying.”
She has an office in the Edmond Regional Medical Building and conducts procedures in the hospital. Her residency in anesthesia was completed at Tufts University Medical School in 1994. Then she entered private practice in South Dakota for a few years before moving to Oklahoma to further her education by becoming board certified in pain management in 1998.
Pain management is a marriage of interests for Wienecke. She gets to place needles for injections of anesthesia while overlapping in neurology.
“My dad was a psychiatrist, there’s a lot of psychiatry in pain management and a lot of neurology.”
Bringing patients comfort and relief is a personal reward.
Many of her patients come to her after enduring intense pain for several years without successful medical intervention, Wienecke explained.
Most frequently, Wienecke alleviates the painful symptoms of pinched nerves due a herniated disc or the narrowing of the lumbar spinal canal, a condition known as spinal stenosis.
“Nobody has seemed to be able to do anything,” she said of their past surgeries.
“There are very few cures so it’s frustrating also because I hardly ever see someone that gets 100 percent relief of their pain.”
Epidural steroid injections are common means of treating back pain due to a bulging disc or spinal stenosis. A small bit of steroid is inserted to calm inflammation anywhere in the epidural space from the lower back to top of the neck.
Periodic injections also can help numb arthritic pain in back joints.
“We usually do it again to make sure they really and truly are getting relief because there’s a big placebo effect where you can stick a needle in anywhere and they’ll say it’s gone,” she said.
“If you do it twice and they get pretty good relief, then we can proceed to something where we try to destroy that nerve.”
Complex regional pain syndrome is often associated with an injury. Patients complain of burning sensations after their symptoms have healed that are worse than the initial injury.
To alleviate this, a sympathectomy will block the nerves associated with pain without any numbness.
Invasive pain relief procedure include implanting tiny, electrical units to stimulate the spinal cord. The devices are implanted near the spinal cord to produce a tingling in the legs or arms.
“What it tends to do is block the pain signal,” Wienecke said. “The spinal cord is so busy sending the tingling signals that it blocks out the pain signals from getting to the brain. It doesn’t fix anything,”
Also, intrathecal pumps can provide prescribed amounts of morphine or other drugs for pain treatment.
A new drug made from killer sea snail venom is beginning to be used with the intrathecal pumps.
“I was actually part of the big (drug) trial (as a researcher) in Tulsa several years ago and it has just got FDA approval,” she said. “It looks like it’s going to help.”
The future of pain relief beckons with more procedures done in a less invasive manner than what has been used.
Treatment is already available for compression fractures that elderly people often get. A needle can be injected into a bone, injecting bone cement.
“That’s gotten some pretty good reports on it so far,” Wienecke said.
She also expects greater demand for pain relief as the baby boom generation ages.
Seventy-six million people born between 1946 and 1964 are approaching old age in the United States.
In eight years, the oldest of the baby boom generation will be 67 years old.
“More and more arthritis, especially, we will see as the baby boomers age,” Wienecke said.
Meanwhile, Wienecke enjoys her practice at Edmond Medical Center.
For a physician, EMC makes a physician’s practice “very easy,” she said.
“The staff here is very attuned to patient care,” she added.
“My patients that have been to several different places often comment on how nice it up here. … It’s very peaceful. There’s not a lot of hub-bub and commotion.”
(Features Editor James Coburn may be reached via e-mail at jcoburn@edmond sun.com.)
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