by Airman 1st Class Kyle Johnson
JBER Public Affairs
3/19/2015 - JOINT BASE ELMENDORF-RICHARDSON, Alaska -- It
was supposed to be a routine steroid injection, but before she could
depress the plunger, the electrocardiogram (or EKG) flatlined, telling
Air Force Maj. Nichelle Renk her patient no longer had a heartbeat.
Unable to flip the patient over - standard procedure to mitigate an
asystolic vasovagal reaction - due to the cramped room, Renk and her
team began moving equipment, Tetris-style, to shoehorn a gurney into the
Before they did so, the patient shuddered and came to.
It was a fairly common and potentially lethal complication; a puzzle demanding a solution.
"We are always looking for that and are very good at treating it if
something does happen," said Renk, a 673d Medical Group Pain Management
Clinic element leader and interventional pain management specialist.
The team's ability to work in the cramped conditions was a testament to
the quality of service the pain clinic offers, but the protocol was just
a bandage - the procedural room needed treatment.
So the pain clinic did what the pain clinic does. They solved the problem.
To increase the clinic's capacity and efficiency, they requested renovation, and enhanced both operating environment and staff.
They added two new operating rooms for procedures, one of which allows
medical staff to easily and quickly handle emergency situations. This
ensures maximum patient safety at all times - and increases the clinic's
operating space by a badly needed 25 percent.
Additionally, a new case manager, pain psychologist, and two licensed
vocational nurses joined to the staff, beefing up the total to 14
Renk said the goal is to have a staff of 22, but as they started with
fewer than a half-dozen, she is happy with the progress they have made
Whether the problem is a cramped procedure room or chronic back pain,
the JBER pain clinic pieces together solutions to new problems every
day, and sees more patients than any other pain clinic in the Air Force.
In order to be seen at the pain clinic, a patient must have been
experiencing pain for more than six months with little to no relief,
"When [patients] are here, they're happy, they're smiling, they're hopeful," Renk said. "That's the key thing."
"It was so painful to brush my teeth and put on my combat boots every
morning," said one patient in an Interactive Customer Evaluation
comment. "I am active duty, and 'down time' puts my unit and the mission
on hold. Dr. Renk took care of me so I can take care of the mission.
Words are not enough to explain how much relief I have right now. Thank
you all so much."
Because of positive feedback the pain clinic is receiving through ICE,
the clinic and its doctors have nabbed several awards since January.
"Sometimes we can only improve the pain for a period of time," Renk
said. "But our hope is to improve the daily experience of pain and
"Chronic pain is very different from acute pain," Renk said. "With acute
pain, there is something anatomically wrong, but with chronic pain,
there's actually a transformation to a disease of the nervous system.
Our job is to try to stop that process as best we can."
Renk said by offering a multidisciplinary approach to pain management,
the clinic has been able to treat patients very successfully with very
"We only have 22 percent of our patients on any kind of narcotics," Renk said. "The average [for a pain clinic] is 95 percent."
"Medication treats symptoms; we treat the problem." said Air Force
Master Sgt. William Lewis, flight chief for Anesthesia Services with the
673d Surgical Support Squadron.
However, puzzling out each patient's individual problem isn't a static process.
The staff members strive to treat every patient they see as an individual.
Underneath the medical gown is not just a patient with a problem, but a person in pain.
"We listen to your symptoms, perform an examination to identify exactly
what the issue is, and tailor a treatment plan specifically for that
problem," Lewis said. "That's what the pain clinic does."
Every person's problem is unique, and the pain clinic strives to offer a
unique solution for each individual - not by stamping a prescription
and sending them on their way.
"There's no right way to treat patients. Everyone's different," Lewis
said. "That's why we have a huge toolbox of options to offer patients."
By constantly looking for new tools to put in that box of treatment
plans, both inside and outside the hospital room, the pain clinic
strives to give patients their best hope for recovery.
"I think they sometimes come to us hopeless, and through encouragement,
giving them options and being positive, I think we're giving them hope."