Portland Pain Solutions - Portland, Maine

02/13/2025

We're open all day today. If you need to reschedule there will be no fee.

07/24/2024

At Portland Pain Solutions, we do a procedure called stellate ganglion blockade, mostly for PTSD, anxiety, and hyperarousal- but also for pain and long COVID. I have noticed overlap in responses between these different groups, and found the following case report interesting. The investigators performed what's called "hydrodissection" (basically expanding a group of tissue layers with injected fluid) of the vagus nerves bilaterally and had a remarkable result that echos some of what I see with stellate blockade (a very similar procedure). I have a few candidates in mind to try this with.
https://www.cureus.com/articles/266241-a-novel-ultrasound-guided-bilateral-vagal-nerve-hydrodissection-with-5-dextrose-without-local-anesthetic-for-recalcitrant-chronic-multisite-pain-and-autonomic-dysfunction?fbclid=IwZXh0bgNhZW0CMTEAAR0QPBpDbC7zY00M5IlyucaMill0MPMdB5gU50Y0COsTM0in69paMXxiKIg_aem_dp3GoNFZa0E0Lq0li5B4oQ #!/

Chronic pain is a complex condition that often poses diagnostic and management challenges due to its multifactorial etiology. This case report describes a 49-year-old pastor who presented with a three-year history of chronic pain affecting multiple sites, including the neck, bilateral shoulders, tho...

04/28/2024

Our website was down, but back up now. For the techies, somehow the PHP version got auto-updated beyond the capabilities of the site. A simple downgrade to the PHP fixed it.

04/04/2024

For those still on the schedule, we are open today and will be here for you.

03/24/2024

I have received confirmation, we do have power, so Portland Pain Solutions will be open Monday morning.

02/17/2024

Happy Presidents Day Weekend! I'm out of the office until 2/26, but Patty will be around a few hours each day for scheduling and admin needs.

01/29/2024

We are open today!

01/25/2024

We're open today with no delays. The main roads are fine, although be careful on the side streets and our parking lot.

12/10/2023

Happy holidays! Our office will be closed for Christmas week from 12/25-12/29. Slots are filling up fast the next two weeks, but we'll be back as of 1/1/2024.

08/13/2023

It's our second birthday at Portland Pain Solutions, and time for another blog post. I talk about my approach to pain, but with a special emphasis on treatment of anxiety, PTSD, depression, and centralized pain disorders. Stellate ganglion blockade and IV ketamine are discussed. I also provide my personal recipe for building a quiet mind. If you've ever wanted to get started with meditation, but found it confusing- try this. Thanks for reading!

03/26/2023

Got Cigna? This article was shared on a physician board I read. Prior-authorization for medical procedures is a hot topic these days, and there is currently a push in Congress to "do something". Prior-auth is an infuriating process that consumes hours of administrative time and seems designed to wear down both doctors and patients until they give up. And as it turns out, that's precisely what it's designed to do. Have a read! I can guarantee the process is the same for every commercial insurer.

Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.

03/19/2023

Ketamine therapy has been in the news a lot lately. We've been using it to help patients with treatment-refractory depression for almost two years, and now have consultative relationships with a wide range of mental health providers throughout the state. Here's what one recent patient had to say about her treatment last fall:

"I felt a difference immediately after my first ketamine infusion- a lifting of the depression, anhedonia, and the dark cloud of hopelessness. Most importantly, thoughts of su***de dissipated to zero. The effect was quite remarkable. It lasted about four months, and I feel like I'm ready for another treatment."

We know from the medical literature that about 70% of patients with refractory depression respond to ketamine. A lot of patients ask us about the differences between the various forms- lozenges, nasal, intramuscular, and IV. Without a doubt, IV and IM have the best bioavailability. So these will give you the greatest chance of success. Where IV really shines is in patient comfort. Because it's easily titrated, we can start very gradually and work within the bounds of patient tolerance and safety, while still maximizing the dosage for optimal effect. The downside is that IV ketamine therapy is time and resource-intensive, so it's not cheap, and insurances generally do not cover it. You will find that costs vary from $400-800 per treatment session. We want to make IV ketamine therapy a possibility for as many patient as possible, so we work hard to keep our rates competitive. We're always happy to discuss the procedure with interested patients, so feel free to email or call us anytime!