Does your multidisciplinary program work well for treating chronic pelvic pain? Is Dr. Levey available after hours if I have an emergency? Dr. Levey suggested I see a psychologist who specializes in pain management; does he think I am crazy? I see a doctor who specializes in either herbal medicine, traditional Chinese medicine, or another form of complimentary and alternative medicine; should I tell Dr. Levey about this? How are antidepressants used in the treatment of pain? Does Dr. Levey participate in research? Does Dr. Levey operate with other doctors? I have fibroids and my gynecologist told me I need a hysterectomy - are there other options? I have heavy bleeding and nothing seems to work - what can I do? Does your multidisciplinary program work well for treating chronic pelvic pain?
A recent internal quality review (October 2003), revealed among all - comers patients with chronic pelvic pain, the average time for >50% pain relief was 208 days. Seventy percent of patients were able to reach this level.
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Is Dr. Levey available after hours if I have an emergency?
Yes, either Dr. Levey or another physician is on call 24 / 7. Call (646) 290 -9560 leave a message on the after hours line. Dr. Levey or the covering physician will be paged immediately.
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Dr. Levey suggested I see a psychologist who specializes in pain management; does he think I am crazy?
No, Dr. Levey, and many other pelvic pain specialists who practice evidence based medicine, understand the need for multidisciplinary care. They also understand that it is a normal response to have depression and anxiety when you have chronic pain.
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I see a doctor who specializes in either herbal medicine, traditional Chinese medicine, or another form of complimentary and alternative medicine; should I tell Dr. Levey about this?
Yes, Dr. Levey takes the whole picture into account and enjoys working with other practitioners. Remember, there is evidence in the scientific literature that some remedies may actually be harmful and others may have negative interactions with Western medications. It is best if Dr. Levey knows about everything you are taking.
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How are antidepressants used in the treatment of pain?
The tricyclic antidepressants can provide relief for some neuropathic pain, particularly pain that the patient describes as burning, tingling, numb, painful to a light touch or like pins and needles. Amitriptyline (Elavil), desipramine (Norpramin), and nortriptyline (Pamelor) are the most commonly used. Start with 25mg per day. Typically, these medications are increased by 25mg every 3 days until the patient has pain relief or encounters unacceptable side effects. The maximum dose is 150mg per day.The selective serotonin reuptake inhibitors (e.g. Prozac, Paxil, Zoloft.) do not appear to be effective for neuropathic pain. However, if patients are depressed, relieving depression may also help to relieve their pain.The tricyclic antidepressants may also be helpful for neuropathic pain that is lancinating, shooting, or radiating, and can be tried if anticonvulsants prove ineffective.
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Does Dr. Levey participate in research?
Yes, as physicians in an academic center, we do research that will ultimately lead to more effective therapies for patients with chronic pelvic pain. You may be asked to participate in such a study. You have no obligation to do so. Click here (this is the link to the research page) if you would like to learn more about Dr. Levey’s current research or here (this is the link to the page with the “other important research) to learn about other important research in pelvic pain.
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Does Dr. Levey operate with other doctors?
Dr. Levey will be performing your procedure with the assistance of a resident physician. If you are having an in- office procedure such as the Thermachoice, Essure, or hysteroscopy, then Dr. Levey will be the only doctor in the room.
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I have fibroids and my gynecologist told me I need a hysterectomy - are there other options?
Of course there are other options. In my experience, most women who are told they require a hysterectomy for fibroids would actually benefit from medical therapy or a safer and less invasive surgical option that preserves their uterus.
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I have heavy bleeding and nothing seem to work - what can I do?
There are always options for heavy uterine bleeding. These do not have to include hysterectomy. Dr. Levey is a national expert in the management of abnormal uterine bleeding and can work with you to find the safest and best medical or surgical option.
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