TRAVERSE CITY — A professional state association recently honored a Munson Medical Center pharmacist for his expertise in pain management.
Honoree Terry Baumann said he measures medication success by how well a patient can function in life, rather than aiming to control the pain completely.
“There’s got to be balance between ability to function and being over-sedated,” said Baumann, Munson Medical Center’s pharmacy manager. “We now know prescription medications are the most highly abused drugs in the country. So we need to take extra care in how we assess patients who have chronic pain.”
Baumann received the Professional Practice Award from the Michigan Society of Health-System Pharmacists at the group’s annual meeting. He is recognized at the state and national level as a pain management expert and has lectured across the country.
Baumann became interested in treating chronic pain during his residency in the early 1980s when end-of-life cancer patients weren’t treated well for pain, he said.
Over the ensuing years, he saw the pendulum swing in the other direction: physicians began adopting an aggressive pain management approach not only toward the dying, but the population at large.
“It’s become a perfect storm. We have patients in pain who could benefit (from opioids), but we have a larger and larger population who are abusing them,” he said.
Now the pendulum is swinging back toward a more conservative approach, he said.
Baumann said his own epiphany toward pain management came in the 1990s while working with a man who while hunting broke bones in his back after falling out of a tree stand. Medication eased the pain, but not all of it; increased dosages didn’t seem to help. But the man eventually felt good enough to hunt again with his cross bow.
“When that happened, he became engaged in life again,” Baumann said. “I believed his pain meds allowed him to do that, but increasing them wasn’t making it much better. If we keep throwing drugs at those in chronic pain, it doesn’t seem to help their function at all.”
Baumann works with a Munson team of physicians and nurses to maximize pain relief for patients with a minimal use of opioids. Dosages depend on a number of factors, including a patient’s prescription drug history and respiratory risk. Nurses advise patients of their “functional end point,” whether it’s getting out of bed or walking down the hallway, he said.
Baumann said part of his job is to lower a patient’s expectations about the level of pain to expect so they don’t over-medicate.
“I tell them, ‘it’s still going to hurt’, and it’s a hard thing to tell somebody,” he said.