Pain Management and Research Center Director
Dr. Yeon-Ray Wen
The 53-year-old of Mrs. Tseng underwent brain surgeries four times in a period of just six months due to complications after undergoing surgery for her crainiopharyhgioma in 2010. Not only has she developed cognitive and intellectual deterioration in addition to long-term disability, but she has also manifested degeneration, weakness, and spasm of the lower limbs, which are too painful even to be touched, leading to a difficult rehabilitation process. Fortunately, her husband has continued to accompany and encourage her and even brought her to the swimming pool to practice walking again, so she has not given up the rehabilitation. However, due to unrelenting and severe pain on both sides of the hip joints, she visited the Pain Management and Research Center, China Medical University Hospital (CMUH). There, Dr. Yeon-Ray Wen applied Cooled Radiofrequency to destroy the nerves over the joints through a highly selective approach, significantly improving the pain of her daily life so that she can continue her swimming pool training. What’s more, she can do stepper training twice a week at the Department of Rehabilitation to improve her quality of life even more.
Her husband Mr. Tseng said, “There are many levels of challenges in the disease waiting for us to overcome them.” His wife has developed such issues as urethritis, diaper rashes, and so on because she would resist pants and diaper changes due to the pain caused in her degenerative joints, which have severely impacted her daily care. Mr. Tseng has reviewed cases experiencing joint pain relief through rehabilitation in water, so he particularly looked for a swimming pool with an elevator facility and asked for special permission to allow his wife to rehabilitate in the pool with the lower water level for children. He was surprised to find that his wife may have recalled the childhood memories of swimming and thus agreed to enter the swimming pool. However, changing his wife into her swimsuit took almost one hour in the beginning because he needs to be careful to avoid pushing too hard and causing pain while holding his wife and getting her into and out of the water. In order to resolve the issue of pain over her hip joints, Mr. Tseng visited the CMUH Pain Management and Research Center to seek help. By way of the Cooled Radiofrequency, his wife’s pain was managed, and the previous inconveniences of her daily care were simultaneously resolved.
Director Yeon-Ray Wen indicated that Cooled Radiofrequency Ablation (CRFA) is especially good for some patients in the middle of suffering from joint pain for a long time but not yet requiring joint replacement. It’s also very good for elderly people with unbearable pain but that are not eligible for surgery. Through the special probe of the Cooled Radiofrequency, the nerves responsible for causing the pain over the joints can be ablated, but the original joint function of the movement can still be reserved. The effect of the treatment has even been seen in a 90-year-old grandma, who forgot to use her crutches or walker after accepting surgery. The technology can be applied on hip, knee, or shoulder joints, and many successful cases have already been accumulated.
Director Yeon-Ray Wen explained that pain is not just a common symptom of diseases; it could be the fear of the disease of someone for an entire lifetime. Chronic pain can imprint in the memory forever, and the sensitivity of the pain will influence other functions of the nervous system for a long time, causing anxiety, depression, insomnia, autonomic disorders, or even personality changes; therefore, the most direct way to restore health and prevent permanent nervous system disorders is to control the pain or remove the pain directly.
Director Yeon-Ray Wen explained that the objective of the treatment is to relieve the pain and regain function to improve quality of life, especially for neuropathic pain, i.e., postherpetic neuralgia, failed back surgery syndrome, trigeminal neuralgia, or complex regional pain syndrome, etc. The results caused by longtime severe pain, reflected not only the discomfort of the body but also the change of emotions and lifestyle. The pain department can help provide various analgesics, as well as all kinds of approaches for nerve ablation, destruction, or modification applied by specialists. These approaches may be unable to distinguish the different pains of the patients, but they can minimize the pain to enable patients to get their normal lives back with taking analgesics for a long time.
Director Yeon-Ray Wen states that the pain department of OPD does not only serve patients suffering from the end stage of cancers or severe neurological pain and is not just for dispensing morphine prescriptions. Recently, pain therapy in Taiwan has grown significantly and been making progress, especially in introducing invasive treatment techniques with the image guide. It has been getting more aggressive and popular; from the scalp to the sole, or from the skin surfaces to the viscera deep inside, all kinds of pain are included in the territory of pain management. The most important thing is that the concept of pain management has been turning to the recovery of body functions and the improvement of quality of life through pure pain relief.