99 episodes

David Rosenblum, MD, creator of PainExam.com and Director of Pain Management at New York Based, AABP Pain Management discusses Pain Board Review and issues relevant to pain physicians.

Marketing, practice management and Board Prep are discussed. For more information and CME Credit's go to PainExam.com

Also, be sure to check out Dr. Rosenblum's children's book: Welwyn Ardsley and the Cosmic Ninjas: Preparing your child and yourself for anesthesia and surgery.

Available at Amazon.com and www.MyKidsSurgery.com

PainExam Podcast David Rosenblum, MD

    • Health & Fitness
    • 4.1 • 28 Ratings

David Rosenblum, MD, creator of PainExam.com and Director of Pain Management at New York Based, AABP Pain Management discusses Pain Board Review and issues relevant to pain physicians.

Marketing, practice management and Board Prep are discussed. For more information and CME Credit's go to PainExam.com

Also, be sure to check out Dr. Rosenblum's children's book: Welwyn Ardsley and the Cosmic Ninjas: Preparing your child and yourself for anesthesia and surgery.

Available at Amazon.com and www.MyKidsSurgery.com

    Interventional Psych and Pain? The Stellate Ganglion, Scope of Practice, Ketamine & Magnesium and more!

    Interventional Psych and Pain? The Stellate Ganglion, Scope of Practice, Ketamine & Magnesium and more!

    Dr. Rosenbum discusses Interventional Psychiatry, the role of Stellate Ganglion Blocks in PTSD, Ketamine Infusions for Depression, and the role of Magnesium as a co-factor in ketamine infusions.  Other Announcements from NRAP Academy:
    PainExam App almost ready  Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org

     
    Live Workshop Calendar
     

    Ultrasound Interventional Pain Course Registration 
     

     
    For Anesthesia Board Prep Click Here!
    References
    https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full
     
    References
     
    Górska N, Cubała WJ, Słupski J, Wiglusz MS, Gałuszko-Węgielnik M, Kawka M, Grzegorzewska A. Magnesium in Ketamine Administration in Treatment-Resistant Depression. Pharmaceuticals (Basel). 2021 May 3;14(5):430. doi: 10.3390/ph14050430. PMID: 34063604; PMCID: PMC8147622.
     
    https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.513068/full
     
    https://www.sutterhealth.org/services/behavioral-health/interventional-psychiatry
     
    Hanling SR, Hickey A, Lesnik I, et al
    Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial

    Regional Anesthesia & Pain Medicine 2016;41:494-500.
     
    https://www.psychiatrist.com/jcp/oral-ketamine-for-depression/

     

    • 17 min
    Rudy Malayil, MD WVSIPP President, Stellate Ganglion for Hot Flashes and more!

    Rudy Malayil, MD WVSIPP President, Stellate Ganglion for Hot Flashes and more!

    Dr. Rosenblum interviews West Viriginia Society of Interventional Pain Physician's President Rudy Malayil, MD and discusses the upcoming WVSIPP meeting in April 2024 as well as Dr. Rosenblum's upcoming ultrasound course. 

    Rudy Mathew Malayil, M.D., completed his internship in General Surgery at New York Presbyterian/Cornell Hospital in New York City, followed by residency training in Physical Medicine and Rehabilitation at New York University Medical School. Dr. Malayil further completed a Pain Medicine Fellowship at the Albert Einstein School of Medicine at the Beth Israel Medical Center Campus in New York City. 
    After training he went settled in West Virginia and eventually became the president of West Virginia Society of Interventional Pain Physicians and started private practice Pain Management 360.
    https://pain360.org
    https://www.malayilmd.com
     

    Ultrasound Interventional Pain Course Registration 
     

     
    For Pain Management Board Prep Go to:

    References
    https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full

    • 23 min
    Rethinking Hip Pain: PNS, Biologics and Cryoablation

    Rethinking Hip Pain: PNS, Biologics and Cryoablation

    In this episode, Garden City (long island) based Pain Physician, Dr. David Rosenblum explores Peripheral Nerve Stimulation, Biologics and Ablations for hip pain.
    He reviews a case report of a 67-year-old female with a history of a mechanical fall causing injury to her lumbar spine and pelvis resulting in hip and pelvic pain is presented. The patient had hypertrophic non-union of the right iliac wing fracture and displacement of the pubic symphysis and right sacroiliac joint. Medications were not effectively managing her pain, so she sought treatment at a pain management clinic.
    The patient underwent diagnostic obturator and femoral articular nerve branch injections, as well as a middle cluneal nerve steroid injection, all guided by fluoroscopy and ultrasound. She experienced improvement in her pain following these procedures. Subsequently, she had a peripheral nerve stimulator (PNS) trial and underwent implantation of leads targeting the right middle cluneal nerve and right obturator and femoral articular nerve branches.
    The patient reported significant relief in both the posterior and anterior distribution of her pain. Her activities of daily living improved, and she was able to sleep without pain after the PNS implantation. The successful use of combined fluoroscopy and ultrasound in targeting the specific nerves and replicating the patient's pain distribution before permanent PNS implantation is highlighted in this case.
    Additionally, the show notes mention an events calendar located at this link: https://www.nrappain.org/pages/ultrasound-course-calendar.
    Upcoming Course schedule for NRAP Academy includes the following events:
    Ultrasound Guided Pain & Regional Anesthesia Course in New York City on February 10, 2024. This course will cover nerve blocks, joint injections, and more. Attendees will have the opportunity to scan live models after the didactic session.
    MSK Pain & Regional Anesthesia Course in Miami, Florida on February 18, 2024. This course will focus on ultrasound-guided nerve blocks and MSK (musculoskeletal) pain management.
    Ultrasound Guided Pain Course in Key West, Florida on February 23, 2024. This 4 CME (Continuing Medical Education) course will cover ultrasound-guided nerve blocks, MSK, PRP (platelet-rich plasma), BMAC (bone marrow aspirate concentrate) targets, and regional anesthesia.
    Regional Anesthesia and US Guided Pain Management Course in New York City on March 9, 2024. This course will provide training in ultrasound-guided interventional pain management and regional anesthesia.
    Ultrasound Guided IPM (Interventional Pain Management) Course in West Virginia on April 14, 2024. This course is part of the Appalachian Regional Spine and Pain Meeting and will be conducted by NRAP Academy. It will focus on interventional pain management using ultrasound guidance.
    Regenerative Pain Medicine Course in New York City on May 4, 2024. This course will cover PRP (platelet-rich plasma) and other regenerative pain medicine techniques.

    In addition to the live training, attendees will receive bonus material including access to the On Demand Ultrasound Guided MSK Interventional Pain Management Course, a course workbook and certificate, post-course guidance and discounts, and the opportunity to join the mailing list for calendar updates.
    Please note that these course details are subject to change, so it's recommended to visit the NRAP Academy website for the most up-to-date information.
    Reference
    Fu E, Elsharkawy H
    #35977 Peripheral nerve stimulation implant for chronic post-traumatic hip and pelvic pain
    Regional Anesthesia & Pain Medicine 2023;48:A193.

    • 17 min
    Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves: Journal Club

    Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves: Journal Club

    Painexam Podcast Show Notes: Journal Club on "Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves" Special Thanks to Robert Stall, MD
    Introduction: Welcome to another episode of the Painexam Podcast! In today's journal club edition, we delve into a fascinating study by Dr. Joel E. Pessa on cerebrospinal fluid (CSF) circulation in human nerves. Background: The study addresses the growing evidence of CSF circulation in human nerves and its implications in various conditions encountered by plastic surgeons. Conditions such as nerve transection, stretch injuries, and peripheral neuropathy may be related to dysregulation of the CSF system. Methods: Dr. Pessa and his team developed the ventricular infusion technique using buffered saline in 2017. The technique was applied to eight fresh cadavers before dissecting the median nerve. Fluorescent imaging and nanoprobe injections were combined with ventricular infusion in selected specimens. Results: The eight cadaver specimens (six female, two male) aged 46–97 underwent successful ventricular infusion. Ventricular cannulation was performed successfully using specific coordinates. Results suggest that CSF flows in neural sheaths, including pia meninges, epineurial channels, perineurium, and myelin sheaths (neurolemma). Conclusions: Ventricular infusion and nanoprobes effectively identify CSF flow in neural sheaths of human nerves. CSF flow in nerves is described as an open circulatory system occurring via channels, intracellular flow, and cell-to-cell transport associated with glial cells. Neural sheaths, including neurolemma, may play a role in glucose and solute transport to axons. The techniques showcased in this study can be utilized in anatomic dissection and live animal models and have been extended to the central nervous system to identify direct ventricle-to-pia meninges CSF pathways. Significance: This study opens new avenues for understanding the intricate mechanisms of CSF circulation in neural tissues. Plastic surgeons and researchers can benefit from these techniques in studying and addressing conditions related to CSF dysregulation in nerves. The findings have implications not only for nerve-related conditions but also for broader applications in the central nervous system. Closing: Thank you for joining us on this insightful journey through Dr. Joel E. Pessa's study. Stay tuned for more engaging discussions on pain management and neurology in future Painexam Podcast episodes! Reference
    Pessa JE. Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves. Plast Reconstr Surg Glob Open. 2022 Feb 17;10(2):e4126. doi: 10.1097/GOX.0000000000004126. PMID: 35198353; PMCID: PMC8856590.

    • 11 min
    Ultrasound Guided Nerve Blocks in the Treatment of Headaches

    Ultrasound Guided Nerve Blocks in the Treatment of Headaches

     
    Exploring the Role of Ultrasound in Headache Evaluation and Treatment
    A Journal Club based on Dr. Andrea Trescott's article: 
     Ultrasound for evaluation and treatment of headaches. Anaesth Pain & Intensive Care 2017;21(2):241-253.
    Click Here to Claim CME for reflecting on content presented in this journal club.
    David Rosenblum, MD

    Accepting New Patients
    Patients Interested in scheduling a consultation with Dr. David Rosenblum can call 
    516 482 7246 (Garden City) or 718 436 7246 (Brooklyn)
    In this Podcast, Dr. Rosenblum discusses patient's in his practice who responsed to ultrasound guided nerve blocks in the treatment of headaches.  He discusses the use of ultrasound injections as opposed to medication to manage the pain and references Dr. Trescott's comprehensive article on the various nerves and clinical presentations of headaches related to terminal nerve entrapment or irritation. 
    Dr. Rosenblum discusses
    Supraorbital Neuralgia Auriculotemproal Nerve Anatomy Clinical presentation Interventional Pain Therapies Summary of Dr. Trescott's Article and Key Points:
    Headaches, affecting 28 million people in the US, pose a significant burden on society in terms of medical costs and lost labor. They are complex neurologic disorders with diverse origins and causes. Headaches are often viewed as the primary pathology, but they are fundamentally a symptom. Understanding them is an evolving science, and their patterns can be recognized for effective diagnosis and treatment. In 2003, Pareja et al proposed the term "epicrania" for headaches triggered by extracranial causes, suggesting a link between intracranial components and extracranial nerves. Peripheral Triggers and Plastic Surgery:
    Plastic surgeons noted relief of migraines through corrugator muscle resection and botulinum toxin injection, indicating peripheral headache triggers. Severe migraines post-head or neck injury may have an extracranial origin, suggesting peripheral nerve irritation. Traditional migraine medications may offer modest relief. Primary treatment involves inhibiting nerve irritation through interventional pain techniques, turning off the pain origin and associated migraine centers. Ultrasound Advantages:
    Evaluation and injection of nerves have traditionally used landmarks and fluoroscopic images, but ultrasound offers unique advantages. Nerves often travel with arteries, potentially contributing to "throbbing" pain. Ultrasound provides a more precise and dynamic visualization of these structures. Exploring Extracranial Causes:
    The International Classification of Headache Disorders (ICHD) categorizes headaches as primary or secondary. While valuable, it broadly defines peripheral nerve contributions as "Other Terminal Branch Neuralgias." The study of extracranial peripheral nerve entrapments and dysfunction reveals overlap between ICHD-defined headaches and potential nerve entrapments causing these pain patterns. Collaboration with disciplines like pain management enriches the understanding and treatment options for headaches. Conclusion:
    Headaches, often seen as isolated intracranial phenomena, may have extracranial triggers. Understanding and treating these triggers, especially through ultrasound-guided techniques, present a promising avenue in headache management. NRAP Academy also offers:
    Board Review Anesthesiology Pain Management Physical Medicine and Rehabilitation Regenerative Medicine Training  Live Workshops Online Training The Virtual Pain Fellowship (online training program with discount to live workshops)  
    Private Ultrasound Training Available
    Email Info@NRAPpain.org
    Reference:
    Trescot A. Ultrasound for evaluation and treatment of headaches. Anaesth Pain & Intensive Care 2017;21(2):241-253. Publication Details:
    Received: 15 Aug 2015, Reviewed: 2 Jun 2016, Accepted: 28 Jun 2016. This podcast explores the dynamic relationship between intracranial and extracranial factors in headaches, shedd

    • 21 min
    Intra-articular & PENG Phenol Injections for Hip Pain- Journal Club

    Intra-articular & PENG Phenol Injections for Hip Pain- Journal Club

    Phenol in the treatment of Hip Pain
     
    Bonus CME Available ($15 Processing Fee)
    The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/wo9gDI
     
    Dr. Rosenblum discusses the use of phenol injected into the pericapsular nerve group, hip joint and outcome a isolated case reports.  Also discussed, phenol, its mechanism of action and a refractory case of neuralgia paresthetica.  Pain from hip cancer, pain from DVT and IPACK or articular branch of the tibial nerve block discussed for knee pain. 
     
    Dr. Rosenblum discusses his ultrasound training programs, the migration of the PainExam platform to the new NRAPpain.org website and offers a testimonial from a previous ultrasound course from the student who inspired this podcast.
     
    Patients interested in scheduling a consultation with Dr. Rosenblum can call 516 482 7246 or 718 436 7246

    For our Live Course Calendar, Click here
     
     
    Board Prep for PM&R, Pain and Anesthesiology Boards
     

    References
    Monagle, John; Ee, Joanne1. Treatment of chronic hip osteoarthritic pain with intra-articular phenol. Indian Journal of Pain 27(1):p 41-43, Jan–Apr 2013. | DOI: 10.4103/0970-5333.114866 
    Marcio V. Pimenta, Amanda T. Nakamura, Hazem A. Ashmawi, Joaquim E. Vieira, Hermann dos Santos Fernandes,
    Ultrasound-guided pericapsular nerve group and obturator nerve phenol neurolysis for refractory inpatient hip cancer metastasis pain: a case report,
    Brazilian Journal of Anesthesiology (English Edition),
    2021,
    Rocha Romero, A., Carvajal Valdy, G. & Lemus, A.J. Ultrasound-guided pericapsular nerve group (PENG) hip joint phenol neurolysis for palliative pain. Can J Anesth/J Can Anesth 66, 1270–1271 (2019). https://doi.org/10.1007/s12630-019-01448-y

    • 20 min

Customer Reviews

4.1 out of 5
28 Ratings

28 Ratings

davermac ,

fantastic podcast

I used PainExam for my boards and MOCA
I passed, no problem

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