Taylor Lewis, MD, Anesthesiologist

Finishing 2022 strong 💪🏻
•
•
3️⃣3️⃣ procedures today 😮‍💨
•
Couldn’t have done it without this great OR team!
•
•
See y’all in 2023 🎉
•
•
•
•
•
•

👻 Don’t let pain scare you from doing the things you enjoy!🎃
•
•
Strong day in the OR with a diverse case load of routine and advanced procedures 💪🏻
•
•
This patient is undergoing a spinal cord stimulator (SCS) trial to help with persistent back pain after multiple back surgeries. They will wear this device for 1 week as a “test” to see if it helps improve their pain/functionality. If so we will discuss more long term options at their next appointment!
•
•
•
•
•
•

⭐️TEAM LEWIS⭐️
•
•
These are the ladies that live in the trenches with me on a day to day basis - my job would be impossible without their hard work and commitment to our patients 🙌🏻
•
Iris is my lead medical assistant who interacts with patients on a daily basis to make sure our clinic runs as smooth as possible
•
Keke is my surgery schedule and insurance authorization specialist. She is in constant communicate with our operative patients after their visit to ensure the timely scheduling of OR procedures
•
Excited for what the future has in store for this group!
•
•
•
•
•
•

End of summer push 💪🏻
•
•
With summer vacation winding down patients are returning home with new pain or flare-ups of old conditions. No matter the issue, we are here to help!
•
•
•
•
•
•

💥 Minimally Invasive Sacroiliac Fusion💥
•
•
•
Sacroiliac (SI) joint pain is one of the most common causes of lower back pain - especially in patients that have had prior lower back surgery. Patients will generally describe a chronic, achey lower back pain that may also move into the upper portion of their butt cheek 🍑 SI pain is usually made worse with activities that require prolonged sitting (sedentary jobs, driving or flying long distances)
•
•
After conservative therapy (PT, NSAIDs) has failed we can look to simple X-ray guided injections of the SI joint. If these are successful certain patients may qualify for a much longer lasting form of SI joint relief via a minimally invasive fusion using an allograft implant 🤓
•
•
📸 1️⃣ - action shot 🔨 with X-ray images in the background
•
📸2️⃣ - picture of allograft implant
•
•
•
•
•

🔋 🚗 Battery Swap 🚗 🔋
•
•
Did you know that there are multiple types of spinal cord stimulator brands/batteries? As the technology in our field has progressed over time so have the treatment modalities available for patients with existing spinal cord stimulator systems
•
•
This particular patient had an older battery in place and was not getting the relief he had years prior🪫 After a few discussions in clinic we ultimately decided it was time for a battery change to something more advanced in order to further address his pain profile 🔧 💥
•
•
•
•
•
•
•
•

Our KSF offices we will remain open tomorrow, February 4, 2022 for those patients who have scheduled appointments.

Feel free to contact us by phone at (281)440-6960 or through our patient portal on our website www.ksfortho.com

Thank you and stay safe.
KSF Orthopaedic Center

🥷 2022: Year of the Contrast Ninja 🥷
•
•
•
Contrast dye is used in a variety of X-ray guided pain medicine injections to ensure patient safety and procedural efficacy (aka making sure you’re in the right spot 🎯). Once we are satisfied with our needle placement and the appropriate contrast pattern/spread we have the green light to confidently inject our medication mix 🚦
•
•
•
Every patient has their own unique anatomy, and thus their own unique contrast spread. It can’t always be perfect like you see in the textbook, but when it is you gotta yell out “put it on the fridge!”
•
•
•
•
•
•

✌🏻Peace out 2021, bring on 2022🎉
•
•
Feeling extremely grateful as I reflect on the past 12 months. I’ve been able to grow my practice and expand my general knowledge base as a clinical provider. I’ve had the opportunity to learn new techniques/procedures to provide for my patients. I’ve been able to develop professional relationships with even more colleagues in our tight knit pain medicine community.
•
•
Last but not least, I’ve enjoyed going to battle with ALL of my patients’ insurance carriers to get approval for appropriate treatment/therapies to improve their quality of life. Sad that it has to be this way, but I look forward to continuing the fight in 2022.
•
•
•
•
•
•

Last night I had the pleasure of connecting with the MD Anderson Pain Medicine fellows to provide helpful insight on navigating the private practice marketplace. When I was in training it was always helpful hearing from past graduates and learning from their success/mistakes in the early stages of their careers. It’s a privilege to now be on the other side of the table and pay it forward to these future pain practitioners - big things to come from this group!
•
•
•
•
•
•

💸DEDUCTIBLE SZN 💸
•
•
Medicine never stops but if there was a “busy season” in our line of work it’s definitely the end of the year. We refer to this as “deductible season” since a large amount of our patients have satisfied their insurance deductibles and are able to obtain very favorable out-of-pocket costs until everything resets on January 1st ⏰
•
•
This can lead to crazy long days in clinic and the OR but it’s worth every second helping patients get the most bang for their buck 👊🏻
•
•
•
•
•
•

🦴 Intercostal injections 🦴
•
•
The intercostal nerves live beneath each respective rib and supply sensation to your chest wall that wraps around from back to front in a ribbon like distribution. See pictures displaying ribs T1-T12 and the corresponding areas they supply sensation to (aka “dermatomes”)
•
•
These nerves and their associated sensation areas can be targeted by injection to help relieve acute chest wall pain (broken ribs, postoperative pain) or chronic chest wall pain (shingles, radiation therapy, chronic postoperative pain seen with chest wall surgeries such as mastectomy or thoracotomy)
•
•
Using fluoroscopy we place our needle on the lower portion of the appropriate rib and make contact with the bone to ensure safety and minimize the risk of complications. Once we know we are in a safe place, we carefully walk the needle off of the lower portion of the rib and slightly advance to the area where the intercostal nerve resides. At this point we confirm correct needle placement by injecting contrast and I looking for a spread pattern beneath the respective rib. After this is performed we then deposit medication around the nerve. In this picture we are directly beneath the 8th rib thus targeting the T8 dermatome area depicted on the later pictures.
•
•
If these injections are successful we can then submit for an ablation procedure of the respective nerves which will result in a longer duration of pain relief 💥
•
•
•
•
•
•

We hope you have a 'spooktacular' week!

💉 Occipital Nerve Injections💉
•
•
Occipital neuralgia is a commonly overlooked cause of chronic headache involving the neck, back of head and behind the ears. It can be caused by inflammation and/or compression of the occipital nerves which exit along the back of the skull along a ridge between the occipital protuberance (notch in the back of your head) and the mastoid process (area behind your ear)
•
•
After conservative measures have failed we can target the occipital nerves for therapeutic injection by guiding a needle along this ridge and depositing medication as we withdraw - essentially creating a “strip” of deposited medication mixture that should cover the nerves and provide relief 🎯
•
•
•
•
•
•

Mark your calendars! The Cy-Fair Health & Wellness Expo is just around the corner! It is such a pleasure for KSF to have an opportunity to visit with the communities we serve- hope to see you there!

⭐️ Procedure Day Spotlight: Ganglion Impar injection⭐️
•
•
This patient presented to my clinic with chronic coccydina - which is just a fancy doctor word for “tailbone pain” (word like this make that Med school tuition worth it, right? 💸😳)
•
•
After exhausting conservative modalities we decided to move forward with a ganglion impar injection
•
•
A ganglion of impar block is safe and easy procedure used to treat visceral, pelvic, ge***al, perineal and a**l pain. This injection is considered to be a type of sympathetic block that can be used in the treatment of sympathetically-mediated pain, pain secondary to malignancy, neuropathic pain and post-surgical pain. Patients who will benefit from this blockade will frequently present with vague and poorly localized pain in the “seat” region, which is burning in character and frequently accompanied by sensations of urgency with urination and/or defecation.
•
•
•
•
•
•

⭐️ Procedure Day Spotlight: Peripheral Nerve Stimulator⭐️
•
•
As an anesthesiologist and pain medicine physician I have the ability to utilize peripheral nerve injections to help determine if certain nerves can be targeted for long term relief of chronic pain 💉
•
•
If an initial diagnostic injection of a nerve with numbing medication provides substantial relief we can then place a peripheral nerve stimulator device to alter the activity/signaling of said nerve. The concept of altering the way a nerve behaves is referred to as “neuromodulation” 🤓
•
•
This particular patient had chronic pain sequelae following a shoulder replacement surgery. After successful diagnostic injections of the suprascapular and posterior supraclavicular nerves displayed tremendous pain relief we then targeted those same nerves with a peripheral nerve stimulator
•
•
•
•
•
•

⭐️Procedure of the week: Spinal Cord Stimulator Trial⭐️
•
•
Hands down probably my favorite procedure to offer my patients with chronic back/leg pain after prior back surgery that didn’t provide the results they were looking for. Here’s why ⬇️
•
•
Potential for *life changing* pain relief, especially if patients have been suffering from chronic pain for years 🙌🏻
•
•
The trial process only consists of 2 pokes for placement of the stimulator leads which are then hooked up to a disposable battery. Patients essentially get to 🚘 test drive🚘 the technology for 7 days and see what kind of relief it can provide for them. There is no commitment to any kind of surgery until after the trial - you get to try it before you buy it!
•
•
•
•
•
•

⭐️Procedure of the week: Sacroiliac Joint Fusion⭐️
•
•
I’ve posted about the Sacrolilac Joint (SIJ) before - inflammation of this joint is one of the most common causes of lower back pain that is extremely tender to touch and can have radiating features into the buttocks/lower leg
•
•
If initial therapeutic injections are helpful, but only for a short amount of time, we can look to minimally invasive fusion of the joint to help limit inflammation and pain indefinitely
•
•
This patient of mine had excellent relief from SI injections however the duration was short lived and we decided to move forward with fusion of the joint. Immediately post-op he was able to endorse > 90% relief of his pain and was already asking when we could get the other side setup for the same procedure 🔥
•
•


•
•
•
•
•

🥇 H-Town has spoken!! Best Pain Management in Houston 2021 🥇
•
•
Excited to announce that KSF Orthopaedic has been awarded the Houston Chronicle’s “Best of the Best” pain management practice for 2021. This award is based entirely on votes received by the general population in the greater Houston area 🙌🏻
•
•
Give us a call at 281-440-6960 to get the best pain relief space city has to offer 🚀
•
•
•
•
•
•