Pain Awareness Month: an interview with Dr. James Jeltema in our Pain Management Clinic
September is Pain Awareness Month, an annual global campaign to help spread awareness of issues related to pain and pain management. This U.S. Pain Foundation initiative seeks to increase public awareness of chronic pain and the issues people with pain face. Dr. James Jeltema, Anesthesiologist serving in our Surgery Center and Pain Management Clinic, addresses some key issues with chronic and acute pain.
Q. Doctor Jeltema, Can you share a bit about your training and what led you to specialize in anesthesiology and pain management?
A. As a medical student, I did an anesthesia and pain management rotation early on in my 3rd year with a group in West Des Moines and fell in love with the specialty. I loved being an integral part of the operating room but enjoyed being more behind the scenes. I always enjoyed physiology and pharmacology which is a big part of our job to provide safe anesthesia care. I also enjoyed the change of pace doing pain management and have the ability to see patients on my own and help them with acute and chronic pain issues. I did my anesthesia residency at Michigan State and followed this up by completing a 1 year pain medicine fellowship at the Detroit Medical Center.
Q. Pain Awareness Month reminds us that pain is not “just part of life” and millions of people are living that way. What types of conditions or patients benefit most from pain management services? What are some options for treatment of those conditions?
A. Anyone can benefit from pain management services - both younger and old, acute and chronic conditions. The most common issues I see are related to the neck and back - arthritis in these areas and radicular issues are common chronic and at times, acute issues that we very commonly treat through medications, physical therapy, and various procedural interventions such as epidural steroid injections or arthritic joint denervation.
Q. How does pain management integrate with other areas of medicine and services at Orange City Area Health System (like physical therapy, counseling/behavioral health, sports medicine, clinical pharmacy, or dietetics/nutrition)?
A. While we usually focus on the unpleasant, physical aspect of pain, it really is much more than just that physical stimulus. There is much more at play and to properly help people and give them the best chance at improving, a well-rounded, whole person approach needs to be adopted. Most pain issues will benefit from learning exercises and stretches with physical therapy that are specific to your issue that can help you better care for and manage your issue both acutely and in the long run. Counseling and behavioral health are also vitally important as our mind plays a major role in the processing and our interpretation of pain. I could poke 10 people in the same place with the same sized needle and get 10 different pain ratings. The mind is very powerful and just as important to address when dealing with pain issues as the physical issues you are dealing with. Working with our clinical pharmacists is also very helpful to allow us to collaborate and figure out which medications work well for you and which ones may cause unwanted interactions. Another area that can be optimized is a person's diet. Moving away from processed food that tends to be more pro-inflammatory and towards more whole foods can sometimes be the thing that tips the balance for people. Working with our dieticians is another area we have to offer here. At OCAHS we have all the resources needed to help patients manage their acute and chronic pain issues.
Q. One focus of Pain Awareness Month is educating the community. What should patients expect during their first visit to our pain management clinic? How do they access the clinic and the services we offer?
A. During your first visit, we conduct a thorough history and physical exam focused mainly on your pain issues. Sometimes this includes getting imaging done prior to being seen or you may get some done during your appointment. While some people expect to have an injection the same day, we generally don't do that. The first appointment is an intake where you are assessed and if any sort of intervention is deemed necessary, we will contact your insurance to get authorization. You can access the clinic by talking to your primary care physician or calling in to the clinic and asking for the pain clinic.
Q. What message would you want patients and providers to understand about the value of pain management services?
A. We are here to help out if you have any questions or concerns on any patients, don't hesitate to ask. We are uniquely placed here to add value in this community specifically as patients normally would have to travel to Sioux City or Sioux Falls to see a fellowship trained pain specialist. We have that opportunity right here in Orange City.
