Urologist Dr. Jennifer Anger from the UCLA Diagnostic Center and Dr. Phil discuss ways to treat 19-year-old Katherine’s chronic pain.
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Dr. Phil Discusses Ways to Treat Katherine's Chronic Pain Dr. Phil: In my understanding this way, the good news is that your kidneys and your bladder looked completely normal. You have a very small stone that is probably not causing any discomfort at this point and may never even when it’s passed because it’s really small and you do have an ovarian cyst but it seems to be normal and probably cyclical, so that’s really good news. Okay, Katherine questions from you and then I want to add a few thoughts to see what you guys think. Katherine: Since we’ve ruled out the kidney stones and ovarian cyst, I guess my question is what is the next step if I do have a chronic pain disorder or nerve disorder, what would be the next thing that we would do? Dr. Phil: First of, Katherine anytime you find someone with a chronic pain syndrome and you can’t find any structure in the body either muscular or skeletal or neurologic or whatever that explains it then you have to go through some other considerations. And one of those is malingering. Do you have someone who’s just making up their pain for attention? And I have to tell you that in my opinion, this is just an opinion based on my history with you across time, I certainly don’t think that this is a malingering situation. I mean for a young girl to go through an appendectomy to help sell her story would be really, really, rare so I think you have to rule that out. No not at all, but I will tell you this that depression and stress can certainly aggravate a pain syndrome in a major way. In fact, neurologic pain and depression shares some of the same neurological pathways and neuro transmitters, Dr. Anger what do you say on all of these? Dr. Jennifer Anger: I agree with you, she was not looking forward to the cystoscopy procedure and most people don’t and so I don’t think malinger would go through that type of evasive testing. It’s fortunate because a lot of the good medication that we used to treat chronic pain falls in the class of tricyclic antidepressants so it can address both components. Dr. Phil: But I do think that it would be appropriate to have a pain specialist get involved to manage this and talk about dealing with it. Katherine, I think what we’re saying is we’ve ruled out what was a great concern to you so you should take a huge deep breath and say “Thank God for that.” And now let’s start talking about treating what I’ve believed to be a very real pain syndrome with her. Dr. Travis Stork: So Katherine, we want to help you move forward with Dr. Anger’s recommendations what we are going to is we’re going to set you up with pain management specialist, Dr. Marla Goldeb she’s actually in your area and she’d agreed to work with you until you have real relief from this pain. Katherine: It’s amazing, thank you so much. Thank you and your team so much and thank you Dr. Anger and Dr. Phil. I appreciate everything you guys have been doing for me. Dr. Phil: And I think in a very short period of time, we’re going to see some real improvement with this based on the good diagnostic work that Dr. Anger’s done and the work that the pain specialist is going to begin with you right away. So we are on the road to recovery here, Katherine. Dr. Travis Stork: Thanks to you again Dr. Jennifer Anger as well as the team of UCLA who’d took Katherine under their wing. So Katherine thank you so much for joining us and we’re going to follow your story and your progress at home if that’s okay with you. Katherine: Thank you so much. Dr. Travis Stork: And Dr. Phil as always, it’s been a pleasure.