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Dr. (Lt. Col.) Mike Gehrke of the 10th Combat Support Hospital in Baghdad discusses the merits of swift pain treatment.

Dr. (Lt. Col.) Mike Gehrke of the 10th Combat Support Hospital in Baghdad discusses the merits of swift pain treatment. (Anita Powell / S&S)

Dr. (Lt. Col.) Mike Gehrke of the 10th Combat Support Hospital in Baghdad discusses the merits of swift pain treatment.

Dr. (Lt. Col.) Mike Gehrke of the 10th Combat Support Hospital in Baghdad discusses the merits of swift pain treatment. (Anita Powell / S&S)

Dr. (Capt.) Ron White lays out the equipment used to administer painkillers to injured patients at Baghdad's 10th Combat Support Hospital.

Dr. (Capt.) Ron White lays out the equipment used to administer painkillers to injured patients at Baghdad's 10th Combat Support Hospital. (Anita Powell / S&S)

BAGHDAD — Seriously wounded patients at the U.S. military’s main combat support hospital in Baghdad can now take a little more comfort in their treatment, thanks to a militarywide medical program that focuses on swift pain treatment.

Anesthesia doctors at Baghdad’s 10th Combat Support Hospital say a complex new pain management program — which debuted in November at the hospital — will make a big difference to all who are injured in theater, many of whom pass through the hospital’s emergency room.

The 84-bed hospital manages a steady stream of wounded patients, as evidenced by the constant whir of medical evacuation helicopters buzzing in and out of the hospital’s landing pad. Patients, on average, stay about 24 hours before being transported out of the theater to Germany or the States.

“In the history of pain management in medicine, we have shied away from treating patients’ pain,” said one of the hospital’s three anesthesiologists, Dr. (Lt. Col.) Mike Gehrke. “There is a reason to treat pain. People actually recover faster. There’s a whole spectrum of why you would want to treat pain.”

The new system consists of a multi- pronged approach that includes localized nerve blockers to numb nerves in specific areas; the standard heavy-duty opiates; over-the-counter pain medication and anticonvulsant medications. In the long-term, patients also receive psychological counseling.

Another new feature at the hospital is patient-controlled analgesia, a hand-held pump that, at the push of a patient’s finger, delivers a small, safe dose of painkillers. The amount of painkillers administered over a period of time is limited to a certain amount.

Despite the delicate chemistry involved, the bottom line is simple: treating pain swiftly and effectively.

Doctors at the hospital say the patient-controlled pump is a new feature that may help patients on the long air evacuation trip out of Iraq.

“It’s never ever been fielded in the military environment,” said Dr. (Capt.) Ron White, a staff anesthesiologist.

The treatment may also lead to advances in medicine as a whole.

“Part of the things we’re defining here is pain control under transportation,” Gehrke said. “That’s not something that’s really been studied in the States.”

Gehrke said that medical studies have shown that early pain treatment does not lead to drug dependency or, worse, to long-lasting damage.

“People who have pain who are adequately treated do not become dependent on drugs,” he said. “If we under-treat their pain, and we hide those pain medications from them, and we make them hurt through theater and all the way home, we’re going to set them up for post-traumatic stress disorder.”

He also attested to the safety of properly administered nerve blockers, which enable the patient to remain conscious while their pain is treated in a specific area.

“Everybody has heard the urban legend of their sister’s husband’s cousin three times removed from Fourth Street who knew somebody who once had a regional anesthetic and was paralyzed from his waist to his eyeballs,” he said with a chuckle. “You can’t just go willy-nilly and stick needles in people. You only want to numb up what’s hurt.”

Both doctors are passionate about the new program, which they say has earned rave reviews — both physical and psychological — from all 10 patients who had been treated by mid-December.

“Patient satisfaction is infinitely higher,” White said.

Military medical officials at other facilities will also be tracking the program.

“That is just now going into play. We don’t have any data yet to say that these patients are doing better than other patients. That’s one thing we’re going to be evaluating,” said Air Force Dr. (Lt. Col.) Warren Dorlac, chief of critical care and trauma surgery at Landstuhl Regional Medical Center, Germany.

“What’s the number one thing people worry about when they’re going to die?” Gehrke said. “They’re worried that they’re going to die in pain. What they’re worried about is having to lie there in agony.”

Despite the immediacy of pain treatment, White added that the program has a more long-term focus.

“We don’t want these veterans to be like the Vietnam veterans,” he said. “The Vietnam veterans had poor pain control, poor psychological intervention, poor social support.

“Everybody has their passion,” he said. “We like to make people feel better.”


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