Doctor Talks About Hockey Puck-Sized Pain Management

IU Health pain specialist Dr. Michael Dorwart offers an alternative to managing pain from pancreatitis.

It’s about the size of a hockey puck – or maybe an English muffin. And this small device can punch about as much power as a slap shot.

It’s called a pain pump and can serve as an alternative to other pain medications prescribed for pancreatitis.

“We rely on the GI physicians to make a diagnosis and initial treatment, but most of the time when the patient comes to me with that diagnosis we determine functional status based on pain – can the patient work, attend his child’s ball games, make a trip to the grocery story,” said Dr. Michael Dorwart, IU Health pain specialist. “It’s pretty much given that that their pain is worse than they want.”

Pancreatitis causes pain in the abdomen that can spread to the back. It can cause nausea and vomiting and may become worse during a meal. Gallstones, heavy alcohol use, a genetic disorder, or use of some medicines may bring it on. Typically potent narcotic medications are effective in controlling pain associated with acute pancreatitis.

It affects both male and females and Dr. Dorwart has seen patients between the ages of 20 and 60 years old. That can mean years of pain management.

The Indiana Chapter of the National Pancreas Foundation will host a free public event at 6:30 p.m. April 29 where Dr. Dorwart will present “Management of Painful Chronic Pancreatitis: Perspectives from an Advanced Pain Provider. The event will take place at University Medical Center, 550 N. University Blvd., Room 0633. IU Health gastroenterologist Dr. Jeffrey Easler will also be on hand to answer questions.

“The pain pump is an alternative means of delivering opioid medication. It doesn’t make you opioid free; it offers better efficiency and fewer side effects,” said Dr. Dorwart. Through a surgical procedure that last about 90 minutes, the pumps are implanted in the abdomen under the skin but outside the muscular wall. The pump is attached to a catheter that distributes the medicine directly to the spinal fluid, which is where opioid medications have their main mechanism of action as it relates to decreasing pain. The pumps are programmable and release and accurate dosage of pain medicine, and are refilled in the physician’s office about every two-to four months – a procedure that takes about five minutes.

“The biggest advantages are better and more consistent pain control, a lower risk of side effects than systemic opioids, and a low incidence of overdose from opioid medication,” said Dr. Dorwart.

— By T.J. Banes, Journalist, IU Health.
Reach Banes via email