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Southern DHB Persistent Pain Service

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    The Persistent Pain Service is an outpatient service made up of specialist healthcare professionals experienced and trained in the management of long term pain conditions. Persistent pain is classified as pain that has lasted more than three months and can affect all ages. At the moment all clinics and education sessions are held in Dunedin Hospital, although telehealth is available for some follow up care.  It is really helpful if before being referred to the Pain Service you ask your referring doctor to include your email address or you contact the Pain Service secretary to give your email address if you have one.

    When the Pain Service receives your doctor's referral you will be sent a questionnaire. If your email address has been supplied this questionnaire will be emailed to you, if not it will be posted.  If you have access to the internet you will find it much easier to complete the questionnaires on a tablet, laptop, PC or mobile phone via  a personalised link to a website.  The paper copy posted in the envelope provided is acceptable, but slower to arrive at the Pain Service. Your referral is triaged when all the information is received.  These questionnaires are used in many pain services across New Zealand and Australia. As well as contact details the questionnaires give us  information about how long you have had pain, how it started, and baseline information of how it has affected your lifestyle and wellbeing. These questionnaires are part of a holistic assessment process using internationally recognised validated assessment tools and form part of your clinical assessment. If, for whatever reason, you have difficulty filling out the questionnaire, please contact the Pain Service administrator. It is also really important that you provide  details of all  medications. The questionnaires need to be returned before your referral can be triaged. 

    As well as gathering information to help the clinicians choose appropriate strategies, in the long term as all the major Australasian Pain centres gather the same outcome measures the Dunedin Pain Service, results can be benchmarked by similar services to ensure it provides the best care.  This enables the service to have strong quality assurance measures.

    The Dunedin Pain Service has treatment approaches that are evidence based and in line with worldwide trends in pain management. The mixture of specialised professionals provides a holistic approach to managing pain which can affect many aspects of a person’s life. The aim of the service, where possible, is to guide the client towards independent management of their pain condition and to enable them to have a more fulfilling life.

    Usually rehabilitation strategies are as important or more important as medication approaches so education is provided in both individual and group settings. All suggested interventions are discussed with the client to enable them to make an informed choice of direction.

    The Pain Service team is innovative and keen to explore international advances in pain medicine and pain management, so from time to time new approaches will be tried or offered.

    The Pain Service team comprises  pain medicine specialists and allied health professionals (Clinical Psychologists, Physiotherapists and an Occupational Therapist).

    Management of complex pain problems requires a multidisciplinary approach to:

    • prescribe and adjust medications
    • provide education about the nature of the problem
    • provide rehabilitation to improve quality of life and performance of daily activities. 

    The Persistent Pain Team

    • Luciana Blaga, Senior Occupational Therapist
    • Tracey Hogarty, Physiotherapist
    • Wendy Lockhart, Physiotherapist 
    • Vandana Kapur, Clinical Psychologist
    • Dr Naomi White PhD, Clinical Psychologist
    • Specialist consultants below

     

    Practitioners

    • Dr David Jones

      Anaesthetist
    • Dr Paul Templer

      Anaesthetist
    • Dr Charlotte Hill

      Anaesthetist
    • Dr Maartje Tulp

      Anaesthetist
    Procedures

    Understanding Pain - Videos

    Brainman Understanding Pain in Less Than 5 Minutes

     

    Brainman Chooses

     

    Brainman Stops his Opioids

    What to Expect at Your Pain Clinic Visit - Brochure

    Patient Education Programme - Brochure

    Driving and Strong Medications for Pain Control

    If you drive you may be concerned about safety. Please read this carefully, it will help you to decide.

    How Pain Medicines Affect People

    Strong pain medications affect each person in a different way. Strong pain medications make some people drowsy and reaction times can be slowed. This may be worse if you take other medicines or tablets that also cause drowsiness, or if you drink alcohol. Some medications can affect your eyesight.

    Pain medicines commonly prescribed to control pain include:

    Anticonvulsants 
    e.g. gabapentin (Neurontin, Neupentin), sodium valproate (Epilim) carbamazepine (CBZ) pregabalin Tricyclics and similar
    e.g. amitriptyline, doxepin, dothiepin, nortriptyline, venlafaxine Opioids
    e.g. codeine, tramadol, DHC Strong opioids
    e.g. methadone, fentanyl, buprenorphine, morphine (m-Eslon, LA Morph, RA Morph, Sevredol) oxycodone (Oxynorm /oxycodone CR, Oxycontin)   Others
    e.g. clonidine, baclofen, flecainide

    These are only some of the medications. Brand names change from time to time so check with your doctor, nurse, or pharmacist whether your medication is in one of these categories.

    Advice about Driving if you Take Strong Medications

    General health, past exposure to medications, weight, and medication taken for other conditions can cause different responses to medication. Strong medications to control pain should not affect your ability to drive after you have had time to adjust to them. However, it may take you some time to adjust to side effects affecting your ability to drive. If you are driving when on medication you should:

    Avoid driving if you experience drowsiness, dizziness, feel unsteady, have blurred vision, or when your doctor advises you not to. Reassess your ability to drive if you are prescribed medication for another health condition, or obtain them from the chemist e.g. hay fever medicine. Make sure your reactions have not been slowed. Not drink alcohol or take non-prescribed strong drugs, e.g. cannabis. They alter your tolerance to prescribed medication and lower your ability to drive safely. Your ability to drive safely on days when you take extra (rescue) doses of strong pain relieving medication will be impaired, e.g. Oxycontin, Oxynorm, Sevredol, oral morphine. Generally this would NOT be a safe situation for driving.

    You have a responsibility to remain safe when driving. It is important for you to regularly reassess your ability to drive. If poor co-ordination, or concentration affects your ability to do household and other tasks, you must not drive.

    Restarting Driving

    When you are confident that your medication is not causing side effects such as drowsiness, dizziness, feeling unsteady, or blurred vision, you can start driving.

    A close friend or family member may help you decide if you are ready to drive. Judge your ability to drive on how well you are managing to cope at home.

    Make your first trip:

    short on roads you are familiar with at a time when traffic is not too busy.

    You may find it helpful to have an experienced driver accompany you to begin with in case you find that you are unable to complete your journey.

    New Zealand Transport Agency (NZTA)

    You do not need to inform NZTA that you are starting a strong pain medication. However, there may be other information about your illness that the NZTA needs to know. If you are concerned, the NZTA can advise you about this.

    Car Insurance

    You may need to inform your motor insurance company about your current state of health and what medication you are taking.

    Each insurance company is different. Check your insurance policy or discuss your circumstances with your insurance company to be sure that you are covered.

    Your medical specialist or your GP can help you decide when it is safe to drive. If you have questions about the information in this leaflet please don’t hesitate to ask a member of the Pain Service.

    How to Contact the NZTA

    Telephone number for licensing enquiries: 0800 822 422

    Have your driving licence number available.

    Website: www.nzta.govt.nz


    Drivers and Vehicle Licensing
    AA Building
    450 Moray Place
    PO Box 5245
    Dunedin

    Victoria Arcade
    44 Victoria Street
    Private Bag 6995
    Wellington 6141

    Charges

    The Persistent Pain Service is funded by the Ministry of Health so no charges apply. However the Persistent Pain Service is not contracted by ACC so patients under the care of ACC need to be referred to an ACC provider.