Hello, I am Dr Gaillard
and I am the Medical Doctor responsible for the pain consultation at the Pôle Santé Sud in Le Mans
The Pain Unit of the Pôle Santé Sud has existed for many years
it involves the multidisciplinary team and is led by doctors
so there are four of us to run the structure and to run the structure and
in fact, not everyone works at a full time equivalent
so in total this represents 1.2 full-time equivalent doctors
Then we have three nurses who represent 2.7 job equivalents
we have a full-time equivalent psychologist
and then we have a hypnotherapist at 0.2 full time equivalent
In terms of care, we start of course with consultations consultations involving the nurse and the
and then a care plan is developed for each
patient which can combine TENS (skin electrical stimulation)
which can combine applications of Qutenza and Capsaicin patches
who can be referred to anaesthetists who will
perform infiltration procedures, for example,
hypnosis is also offered to patients and we have contacts to enable people
to learn to let go through sophrology, through meditation...
rTMS stands for Transcranial Magnetic Stimulation. It is a device
that we have had since 2016. We are in line with the experience of the
Brétéché Clinic in Nantes which has had a machine since 2009
The main indications here are fibromyalgia and neuropathic pain
with roughly a queue of 180 to 200 patients per year
and with a number of sessions of 2000 to 2500 sessions per year - less with COVID
We make an assessment after ten sessions and we see whether the patient responds to the technique or not
and then we decide on maintenance sessions or not, depending on the patient's response.
An annual survey is also carried out a satisfaction survey
which is not a clinical study as one might conceive it
and we still have 70% satisfied patients
by rTMS with an overall improvement quality of life.
These are patients who ask us again for maintenance sessions
which can be a problem when you when you have too many maintenance sessions you have
difficulty in getting places for new patients.
What is important in the care is the fact that it is
multidisciplinary care, and therefore to be able to talk about the patient around
of the file and to exchange, including with the psychologist.
Another therapy that can be offered to patients is spinal cord neurostimulation
therefore not practised directly in the centre
but in the clinic we have two doctors who perform neurostimulation
and after having a multi-professional meeting,
a decision is made whether or not to implant spinal cord neurostimulation.
Another important element is that we do not treat pediatric pain
and we do not treat cancer pain is not done
We will also be able to offer infusions with hospitalization
either as an outpatient or in a medical ward and we can do
Ketamine infusions or Xylocaine infusions.