PREVAILING OVER PAIN

HIV/AIDS doesn't always kill, as it once did. The latest advances in drug therapy have added years to some patients' lives. But the down side is that patients often suffer excruciating muscle and nerve pain.

    Managing that pain usually involves seeing a number of specialists, from physicians and physical therapists to psychiatrists. Richard T. Jermyn, DO, an associate professor at UMDNJ-School of Osteopathic Medicine (SOM), developed and directs a pain center specifically for HIV/AIDS patients, which houses all these specialists under one roof.

    SOM's Comprehensive Pain Center at Voorhees uses a multi-disciplinary approach to pain control. It is the only center of its kind in southern New Jersey and Jermyn says probably one of only a few in the tri-state area. " Each person responds differently to various treatments," Jermyn explains, "so we use whatever combination is best for each patient." That combination can be comprised of oral medication, physical therapy, massage therapy, biofeedback and intensive pain counseling. Experts also teach breathing techniques used to decrease pain, which patients can then do on their own at home.

    Depression and/or anxiety, often side effects of constant pain, and drug and alcohol addictions, common among HIV/AIDS patients, are also addressed at the center by psychiatrists and detox counselors. And if an assistive device is needed, such as a walker or wheel chair, the center works with insurance companies or other providers to get the equipment at an affordable price.

    "A hallmark of HIV/AIDS is nerves dying off, beginning in the feet and slowly moving upward," explains Jermyn. "As patients lose sensation in their feet, they often bang them and consequently injure them. We fit them with orthotic shoes that are usually a great help."

    Each patient is discussed at weekly team meetings, and together specialists decide on future treatment. This eliminates disjointed care and duplication of efforts, Jermyn explains, which often occurs when specialists are scattered.

    Research is also a priority at the center. The physician and his colleagues are currently doing two studies: one on the effect of exercise on pain, and another on the effects of depression on pain. They recently completed a study on electroacupuncture, a technique that involves placing low voltage electrical stimuli over acupuncture points. They found that it helps reduce peripheral nerve pain of HIV.

    Jermyn says besides helping patients, the center is also working to educate the public. "Because HIV/AIDS patients are just beginning to live longer, most people don't realize the extent of the pain that accompanies the disease," he says. "The World Health Organization states that HIV pain is as significant as the pain of cancer." The education started with SOM medical students and residents rotating through the center. Basic researchers and representatives from several pharmaceutical companies also spend time there. "We want to get the word out that these patients need our help."

    The ultimate goal is to get the patients back into the workforce. "This is a very young population that wants to contribute," Jermyn says. "If we can help them do that, the center will have paid for itself in value."