Dijon: Pain Center at the University Hospital: New Premises and Even More Team Commitment
Philippe Husson, a 62-year-old resident of Belleneuve, has been suffering since 2021. "I was the victim of a road accident which resulted in fractures and a dislocation of my foot."
He now uses crutches to get around, and behind his good humor and optimism, one can see a life turned upside down and reshaped by his suffering. "I can't cook anymore because it involves standing, and I can't mow the lawn either. I'd like to do the same things I used to do, but it's impossible. I haven't gotten over it yet, just as I haven't really accepted my accident."
When asked where he stands on the pain scale, he smiles and explains: "This feeling is so personal, it doesn't make sense. My 6 won't be yours. I can tell you I'm in a lot of pain, but you'll never really understand what's behind it. A number isn't enough. What I can tell you is that you shouldn't withdraw into suffering, you have to be in the "doing" to overcome it."
Philippe Husson is being treated at the Pain Assessment and Treatment Center (CETD), which has recently moved to new, specially adapted premises at the Dijon University Hospital. He is also receiving care at the new day hospital created for the occasion.
Innovative techniques are offered, such as the administration of botulinum toxin and ketamine: "I had tried everything before: painkillers, therapeutic cannabis, hypnosis, patches, etc. Ketamine is what worked best for me. It blocks the pain signal from being sent to the brain. The pain is there, but it's silent, which allows me to go through the days without thinking about it."
Behind the active queue of around 1,700 patients a year generating more than 3,000 consultations, there is a multidisciplinary team led by Dr. Philippe Rault, anesthesiologist and head of the CETD: "Ten years ago, when I arrived, there was only one part-time doctor. Today, with this consolidation of activity in new premises, we have a much greater strike force than before and the capacity to refine care from the start for patients. We have five doctors, four nurses, two psychologists and three secretaries and we benefit from six consultation rooms and four day hospital beds..." At the same time, thanks to multidisciplinary consultation meetings, the CETD can receive help from colleagues at the CHU, "all specialties combined."
With 20% of the population suffering from chronic pain , the CETD's expansion was necessary. "Despite everything, we have more than a month of waiting and an uninterrupted wave of people to treat, the question is how we will deal with this flow in the future. We are talking about young people, between 30 and 50 years old, who only want one thing: relief so they can get back to work. Because behind the scenes, untreated suffering has a high cost for society."
I would like to do the same things as before but it is impossible.
“To treat, we start by telling the patient: ‘I believe you’”
Is the pain in the head?The complexity of assessing suffering lies in its uniqueness. "It's a cerebral construct, but be careful, that doesn't mean it doesn't exist," exclaims Dr. Philippe Rault, anesthesiologist and head of department. "Every day, we see people who are wandering. Their biology is good, their imaging too, and yet they're in pain and wonder if it's all in their heads. We have to start by listening to them and telling them, 'I believe you.'"
What if we could see pain?Recent research shows that pain can be seen on imaging, as explained by Dr. Catherine Doussot, an anesthesiologist and pain specialist at the CETD: "We can see where the pain message impacts the brain based on its intensity; we have described a pain matrix. Several areas are activated, affecting emotions, cognition, adaptation, etc."
Optimize supportDr. Paul Elhomsy is a general practitioner but later trained to become an algologist. "In my opinion, this should be better taught in the curriculum. There's too much of a tendency to believe that chronic pain is an extension of acute pain. This specialty requires a lot of time, which is rare in medicine (laughs). Suffering is multifactorial, and there's no miracle drug that can make it disappear. Hence the importance of the CETD's multi-professional approach."
Doctors more awareFor Dr. Catherine Doussot, the increase in the number of people suffering in recent years is probably explained "by better detection. This shows that doctors have more knowledge on the subject and do not hesitate to refer to this specific treatment. At the same time, we have practitioners and caregivers who are surely more attentive to these situations, more aware."
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