Thursday, February 23, 2023

Sanderson Tower Adds Pain Clinic for Children

Annie Oeth penned the following essay for UMC. 

Kaeden Thigpen’s right foot hurt so much that the high school student couldn’t wear a shoe.  He has a chronic pain condition called complex regional pain syndrome.

For Bentonia resident Charley Shiers, 10, a fall while playing left her with back pain.

Hevyne Hinton, 14, of Hattiesburg has chronic pain resulting from amniotic band syndrome deformities that required a leg amputation below her knee.

Chronic pain may not seem like a condition of childhood and adolescence but studies say up to a third of children suffer from pain lasting three months or longer.

Treating pain in children is the focus of the transdisciplinary pediatric pain clinic opened at the Kathy and Joe Sanderson Tower at Children’s of Mississippi. The clinic is the first of its kind in Mississippi and the 56th in the country, said anesthesiologist and pediatric pain specialist Dr. Veronica Carullo, who leads the clinic team.

"The number of specialty-trained professionals in children’s pain management is still low,” she said, “but there is a growing awareness of the specialty and growth in the number of training programs.”

In addition to caring for patients at the Sanderson Tower, the team also sees patients who experience pain resulting from underlying medical conditions such as sickle cell disease or cancer at the Center for Cancer and Blood Disorders at Children’s of Mississippi and at the University of Mississippi Medical Center’s Center for Integrative Health in Ridgeland.

“Treating children’s pain makes an enormous difference in their lives,” Carullo said. “Their participation in school, family life, activity level and ability to relax can all be adversely impacted by pain.”

Children’s pain can be the result of an injury or conditions ranging from arthritis to headaches.

Some patients experience discomfort from primary pain disorders such as complex regional pain syndrome (CRPS). “Some of the pain we see is occurring in otherwise healthy children,” Carullo said.

CRPS results in pain and sensitivity in a particular spot of the body. For 16-year-old Kaeden of Hattiesburg, that spot is the top of his right foot. With hopes of going to Xavier University after high school graduation next year, Kaeden wants to ease his pain.

“I’m seeing good results so far,” he said.

His mother, Desshondra Walker, agrees. “The pain clinic has allowed him to start feeling like a normal teenager who deals with pain. He is now able to wear a shoe after not being able to for almost a year. They are teaching him ways to deal with the pain through different techniques, medicine and therapy.”

The clinic's team includes Carullo, psychologists Dr. Cindy Karlson and Dr. Hannah Ford, physical therapists Tara Husband, Annie Reiher, and Rachel Dear, and RN-care coordinator Shannon Armstrong.

The multidisciplinary approach to children’s pain treatment reflects the different factors relating to pain, Carullo said. For instance, Charley comes to Children’s of Mississippi for physical therapy and cognitive behavioral therapy to ease her persistent back pain.

“Pain treatment is not only pharmaceutical,” Carullo said. “Physical therapy can reduce pain and increase function, and cognitive behavioral therapy can treat pain and the stress, anxiety and depression that can come with it.”

Psychological intervention is essential in the treatment of chronic pain, said Ford, associate professor and director of the psychology residency program at UMMC.

"Out of all the treatments we have for chronic pain, cognitive behavioral therapy (CBT) has the most evidence,” she said. “Psychology isn’t just helpful in treating the psychiatric comorbidities, like depression or anxiety, that often occur with pain but is also helpful in treating the pain itself.”

CBT is a discussion-based therapy that helps patients identify and change negative thinking.

“The way I will often talk with patients about this is to give the analogy that pain is like an alarm system,” Ford said. “It tells us that something is wrong — our body is being harmed in some way. When we have chronic pain, our body continues to sound this alarm, even though we are not being acutely harmed. We need to help retrain our pain system to reduce these ‘false alarms’ and help patients to recognize that hurt does not necessarily equate to harm.”

CBT “involves making changes to the way we think about our pain, learning strategies to turn off this physiological alarm system, and also making behavioral changes to support a healthy lifestyle,” Ford said. “We practice lots of relaxation skills that are aimed at regulating our autonomic nervous system response, turning off that fight-or-flight response. Patients also learn cognitive strategies to change how they think about pain. We also work together to gradually build up activity to improve functioning and promote healthy behaviors. Our goal is not only to reduce pain, but more importantly, to improve functioning.”

Children’s of Mississippi physicians say the pediatric pain clinic is helping children with chronic pain enjoy fuller lives.

Patients with sickle cell disease get multidisciplinary care for chronic pain at UMMC’s Center for Integrative Health in Ridgeland, said Dr. Melissa McNaull, professor of pediatric hematology and oncology.

“Knowing that 30 percent of adults with sickle cell disease live with chronic pain, our goal is to intervene early and break that cycle,” McNaull said. “We see just four patients in an afternoon clinic because it is very time intensive. I evaluate the patients for their sickle cell disease management, Dr. Carullo does a thorough pain history and explains to the patient and family the nature of chronic pain, how it starts, what keeps it going versus what can break the cycle and sets out a treatment plan.”

Karlson performs a comprehensive pain psychology evaluation and introduces cognitive behavioral therapy, and Dear performs a comprehensive physical therapy evaluation. Patients also get a dietary plan since some foods can promote more inflammation.

Follow-up pain management care for chronic pain from sickle cell disease and cancer is offered multiple times each month at the Center for Cancer and Blood Disorders at Children’s of Mississippi with Carullo, Karlson, and nurse coordinator Shannon Armstrong.

“This is convenient for our patients and their families,” she said, “because they are coming to the place they are familiar with and can get all of their care in one place.”



Anonymous said...

At least he qualifies for what is now referred to as Medical Cannabis.

Anonymous said...

Sorry, but these kids aren't helped by your favorite dope. Your poor lifestyle choices are not an opportunity to groom a new generation of slackers in the naive and self serving belief in something that is harmful as a "cure."

But, please regale us with anecdotes of how Mee Maw's arthritis and sleep patterns have been dramatically improved by her nightly torching of a huge one. Right.

"Even though pain management is one of the most common reasons people report for using medical marijuana in the United States, there is limited evidence that marijuana works to treat most types of acute or chronic pain."

Isn't it enough to lose 100,000 folks a year to "pain" meds and addiction without encouraging a placebo value Drug for young people??? Jeezus Christ.

Like Jackistan need mo weed. Dripping in blood from weed's biggest consumers, who can hardly read and write. SMH.

Anonymous said...

You clearly have no medical knowledge.
It is important to interrupt pain and get ahead of it.
Doctors have known this for lots longer than you've been on the planet.
And, I would remind you that long before we had a significant drug problem in this country, prescribed pain meds did not result in addiction. And, they still don't when taken as prescribed unless...oh...the drug company lied to doctors about how much could safely be prescribed. Or did you not read any news about that?
If your grandparents are still lucid, and especially if one of them has a Purple Heart, they can tell you they were prescribed addictive drugs for pain when they broke their bones or needed lots of stitches or for after any surgeries. Even the boomer hippies who experimented have a low drug addiction rate. For one thing, drugs aren't cheap and we were , like most used to be, rational and responsible. And, we didn't have criminals lacing drugs with toxins to get their jollies. But, when it's " all about me" and the courts are overburdened with nonsense lawsuits, criminals ( white collar crime and violent) are happy.
When a family can't get treatment for members they know are dangerous, insanity runs rampant.
Try to have your perspective be broader than the end of your nose.

Anonymous said...

Got to get them hooked as early as possible.

Anonymous said...

@ 8:45

So what is the other option? To have babies and small children writhing in agony?

God I HOPE you didn't reproduce

Anonymous said...

@12:27 from 8:45 I did reproduce and my kids have never been charged with a crime. They are college educated and married to the opposite sex. They hold positions in their church as well as being productive members of society. They were not subjected to drugs at a young age to combat all of these new illnesses kids today seem to have. They were taught right from wrong and respect for others at a young age and none of my grandkids are taking the kiddy medicines that are being dispersed at the corner clinics.

Anonymous said...


12:37 here, all of these things I have deep respect for, but you do realize that you are talking about a pain management clinic......these children don't have coughs, and colds these babies are seriously ill and in significant pain.

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