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"Pain management anesthesiology from acute pain therapies we're talking about spinal cord and peripheral nerve stimulation basically ways to control pain in the spinal cord in the back his weight control chronic pain through a spinal cord intervention or or stimulation I mean it's very important if you have chronic pain I mean you can control five percent of it that's a big relief definitely people forget her all right let's see what Dr Julian has to say which general Kelly Dr Julian welcome health talk thanks for joining us how are you I'm good how are you this morning I'm doing great let's let's talk about kind of your practice I always liked our listeners to kind of find out our guest with the do care what their interest is and how you got interested you're trained anesthesiologist working in his affairs a pain intervention correct give us a little background on you okay great so and Christina Julian I'm an anesthesiologist and I've done tele shipped in interventional pain management so I put primarily focused on the treatment of chronic pain via procedures to be a medications the injections I'm currently at a private practice in Bellevue Washington were cut acute pain therapies and I'm partnered with another instance Yala just to see a specialist in regional anesthesia which means that he does a lot of alter sound guided injections his name is doctor Zachary fescue and I've been there for about a year now well you know I think our listeners are thinking a lot of people would assume when you hear the word anesthesiologist I think the perception is you as a physician spend your time in the are putting people sleep right that's what you do you put people sleep for surgeries but really I mean it's more into a broad kind of discipline you just talked about your partner doing regional pain management you do spinal cord pain management let's talk about that area and how it evolved can you give us the genesis of pain management with anesthesiology right so correct there are different specialties that go into pain management I think an anesthesiologist to go and interventional pain management is kind of a natural progression because as the anesthesiologist we do a lot of hands on procedures in the operating room and we use a lot of ultrasound guidance in X. ray guidance to do those procedures so it's just kind of a natural progression for us to transition from the operating room into an outpatient procedural based practice because we have a lot hands on experience with that we we we talked about in the past with other providers interventional medicine in mental pain management and you just use the term alter sound guided procedures maybe set that up I know on the radio maybe could describe what that means to our listeners because you're looking through an old some machine guiding your needle if it were if it is or the injection site so you have a lot of good information now verse maybe thirty years ago when I was we kind of just did it by palpation and feel and knowledge to talk about all to sound guided interventional medicine okay yeah years ago I mean most of these procedures were just done with feeling you know feeling for bland marks and everything was done blindly but now we have with technology we have alter some guidance and we also have X. ray her fluoroscopic guidance so ultrasound guidance is you know what we used to did take pictures of the bed intense right fetuses when they're in the month mother stomach gets on a probe that we place on the patient and we can see the different layers of muscle the different layers of tissues the bone so we can actually identify the exact nerve that's our target alternatively I use X. ray guidance and in addition to alter some guidance X. ray guidance just basically shows me the bonus and then anatomically I know where to go in relation to those bounds to do my injections to help with that pain condition of the patient is having so this is obviously this technology in this uses obviously increased the accuracy and and in the injection site in getting right to the problematic area is that fair to say absolutes increased accuracy and it's increased efficiency and it's increased safety because we can actually see where we're going and we can avoid the things that we want to avoid like blood vessels we can avoid actually touching the nurse which we don't want to do because that would damage there so absolutely it's made our our job a lot easier and a lot more beneficial for the patient it what is your area we talked about spinal cord pain is kind of the air you focus on maybe talk about what that what is that mean to our listeners spinal cord pain spinal cord pain is basically when there's narrowing of the spinal canal this putting pressure on either the spinal cord or the exiting nerve roots and that can cause a variety of symptoms it can cause numbness and tingling in the hands and feet can cause electrical shock like radiating pains into the extremities it can cause weakness because the nerves and the spinal cord."

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