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Ease Their Pain

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DANVILLE & CYNTHIANA Pain travels. And now, so do the doctors of Bux & Bux Pain Clinic.

Three days a week, providers from the Danville-based group travel to Cynthiana to operate a pain clinic located within Harrison Memorial Hospital.

In the summer of 2015, Anjum Bux, MD, who operates Bux & Bux Pain Clinic with his father Madar Bux, MD, was approached by Pain Management Group (PMG), a pain clinic management partner with Harrison Memorial Hospital in Cynthiana, Ky. PMG was looking for a provider to run the pain clinic. Bux accepted that role. “We are operating 3 days a week in Cynthiana and doing everything including epidural injections, joint injections, spinal cord stimulators, intrathecal pain pumps and medication management,” says Bux.

“We get patients from Georgetown, Harrison County, and even Lexington. Again, it gives us the opportunity to spread out and expand our services to different areas. There certainly is a need in the area,” Bux says, noting that they already see over 1,000 patients in Cynthiana.

One of the newest members of the Bux & Bux Pain Clinic group is Cristina Lamar, DO. She works in Cynthiana on Mondays and Fridays and operates out of Danville the rest of the week at the Bux & Bux Pain Clinic. Lamar joined the practice in mid-August of 2015 after completing her fellowship through the University of Kentucky (UK) at Good Samaritan Hospital. A native of Georgia, Lamar completed her undergraduate work at the University of Georgia before attending the Philadelphia College of Osteopathic Medicine in Georgia. Lamar, whose husband is from Harrodsburg, Ky., completed her residency in anesthesia at UK.

Lamar’s interest in pain began even before medical school when she was a medical assistant at Atlanta Orthopedics. There she assisted Dr. Amy Lang, who was fellowship-trained in pain management, and introduced Lamar to that field.

“I always kept that in the back of my mind going into medical school,” Lamar says. “I saw their practice style, their level of enjoyment with their career, their ability to appropriately manage personal lives with career. I saw that it would also enable me to be part of my community, being able to return patients to function with minimal pain and able to get back to their way of life and improve their quality of life. That was always something I wanted.”

Lamar’s doctor of osteopathy training allows her to bring a different approach to evaluating her patients and understanding how disease, dysfunction, and disorder in one part of the body affects another part. “Osteopathic manipulative medicine can also be applied in pain medicine in various ways, especially in patients with myofascial pain syndrome,” Lamar says. She adds that manipulative medicine can help with muscular pain, spasms, and inflammation, as well as gentle manipulation of the arthritic joints or joints that are out of place and out of alignment.

A high percentage of the patients coming to the Bux & Bux Pain Clinic suffer from conditions such as complex regional pain syndrome, back pain, and compression fractures. These are often candidates for intrathecal pain pumps.

“It’s great to learn from Dr. Bux as he does so much of the pain pump insertion and implantation,” Lamar says. “He does this in combination with a surgeon, so the procedure itself becomes much quicker for the patient.”

The pain pump itself represents a significant improvement in pain management for many patients who come to the clinic with a history of taking pain medicine orally and have developed a dependency or have suffered other side effects. “It can be challenging when new patients come in already on many different medications,” Lamar says. “They become tolerant of these medications. Our goal is to help patients transition, using a multi-modal approach, which may include a pain pump to help minimize what they are taking by mouth and diminish the side effects of what they have been taking.”

Because of the potentially negative side effects of high doses of opioid pain medications, Bux & Bux Pain Clinic operates with a low-dose opioid prescription philosophy. The preference instead is to focus on the patient’s overall condition and look for other means to pain reduction.

“Our goal is to make sure that they have been appropriately rehabbed in physical therapy and that we have tried to optimize their pain intervention,” Lamar says, adding that a multimodal approach can better serve the patients’ lifestyle necessities. “A lot of our patients have severe depression and anxiety. That’s all part of chronic pain. Many of our patients are younger and have families and are figuring out how to take care of their family while suffering from pain. Being a mom myself and imagining what they are going through provides that much more of an incentive to get my patients out of pain.”

New methods to achieve that goal are here or are fast approaching. Ultrasound-guided joint injections and ultrasound-guided neuraxial techniques can help improve accuracy in administration of targeted pain blockers.

“There are going to be advances in the spinal cord stimulation technology in the type of leads that are going to be used and the type of pain that can be covered,” Lamar adds. “I’m excited to learn more about these and the ultrasound-guided techniques.”

Kyphoplasty, infusing cement into the vertebral structure to restore it to its prior height, will soon be added to the procedures offered by Lamar and Bux.” Kyphoplasty works well for patients with lumbar compression fractures from osteoporosis and pain from cancerous tumors on the spine,” says Lamar. “It provides immediate pain relief.”

“With new techniques and treatments for chronic pain,” Bux says, “we look forward to employing a multi modality treatment approach to help people better manage their pain.” Expanding services throughout Central Kentucky, Bux and Bux Pain Clinic continues to employ a family type atmosphere in treating their patients providing better options in dealing with their chronic pain.