Dr. Alyssa LeBel This is Me

Education

 View all 17 references Web References

1. 1. www.imagingpain.org

   www.imagingpain.org/team.html - [Cached]

   Published on: 7/7/2008   Last Visited: 7/7/2008

   Alyssa Lebel MDPediatric Imaging
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   Alyssa Lebel MDChildrens Hospital Medical CenterHarvard Medical School

2. 2. Use of Opioids (Narcotics) to treat RSD / CRPS in Adults and Children

   www.rsdfoundation.org/en/opioi - [Cached]

   Published on: 1/29/2005   Last Visited: 2/20/2008

   Dr. Alyssa LeBelNeurologistHarvard Medical School (Boston, Massachusetts, USA)
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   We have Dr. Alyssa LeBel from Harvard Medical School.What makes her rather unique is she's collaborated with some of the great people in pain.For example she was with Dr. Schwartzman for a while and they did that landmark paper on spreading RSD patterns.Now she is at Harvard working with another outstanding scholar in the field of pain as particularly as it relates to children, Dr. Charles Berde.She is doing some very important research on RSD in children.Dr. LeBel is primarily a Neurologist, but she is in the Department of Anesthesia because of her special expertise as it relates to the pharmacology and so forth in the area of Pain Management.Um, Dr. LeBel?
   
   Dr. Alyssa LeBel:
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   Dr. LeBel:
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   Dr. LeBel, thank you very much.
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   I listened carefully to Dr. LeBel's presentation and I would agree with her and most of it.I think the patients I've seen in Boston are similar to what we see here.This is a Tertiary Care Medical Center, so most of the patients that I would see in the clinic or for in-patient therapy are rather complex and might have failed therapy in other locations.
   
   We use a multi-disciplinary approach to the treatment of RSD.The primary tools are as Dr. Lebel said, physical therapy, behavioral intervention; and they will lead to an improvement in the majority of patients.
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   At this point, what I would like to ask Dr. LeBel to please standby. ...Dr. Lebel, could you please stand by here?
   
   Dr. LeBel:
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   We've heard a beautiful discussion of that with Dr. LeBel and Dr. Kost-Byerly about how they've tried to navigate in placing, positioning the opioid in the proper clinical context.
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   Dr. LeBel?
   
   Dr. LeBel:
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   Dr. LeBel:
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   Again, thank you Dr. LeBel.
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   Yes, I would agree with Dr. LeBel.I think although opioids are not the first choice of treatment for RSD / CRPS in children, they should be considered as a part of a pharmacological approach within a multidisciplinary management.I also couldn't agree more with Dr. Kiefer in Germany, Dr. LeBel, that more research is needed.
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   Dr. LeBel's References:
   
   Berde CB, LeBel AA, and Olsson G. Neuropathic pain in children.In Schecter NL, Berde CB, and Yaster, M,eds.Pain in infants, children, and adolescents.Philadelphia : Lippincott Williams & Wilkins, 2003; 620-641.
   
   Berde CB, Sethna NF.Analgesics for the treatment of pain in children.N Engl J Med.2002; 347, 14:1094-1103.
   
   Lee BH, Scharff L, Sethna NF, McCarthy CF, Scott-Sutherland J, Shea AM, Sullivan P, Meier P, Zurakowski D Masek BJ, and Berde CB.Physical therapy and cognitive-behavioral treatment fo complex regional pain syndromes.J Pediatrics.2002; 141:135-140.
   
   Robowthan MC, Twilling L, Davies, PS, Reisner L, Taylor K, Mohr D. Oral opioid therapy for chronic peripheral and central neuropathic pain.New Engl J Med.2003; 348, 13:1223-1232.
   
   Truong W, Cheng C, Xu QG, Li XQ, Zochodne, DW. m Opioid receptors and analgesia at the site of a peripheral nerve injury.

3. 3. ADVANCE for Nurse Practitioners | Editorial

   nurse-practitioners.advanceweb - [Cached]

   Published on: 1/28/2005   Last Visited: 5/9/2006

   "Children present with a different clinical profile, and therefore differ in their responses to functional training and other treatment approaches," notes Alyssa LeBel, MD, an associate in pain medicine and assistant professor of anesthesia at Harvard University Medical School in Boston.
   
   For the most part, this difference is a positive one."Children can be more responsive [to interventions] than adults, perhaps because adults can display more complex nervous system involvement and can be more skeptical about therapy approaches," LeBel says.
   
   But locating the root cause of the pain can be problematic."Chronic pain in children is the result of a dynamic integration of biological processes, psychological factors and sociocultural context considered within a developmental trajectory," according to the American Pain Society.2
   
   Clinical diagnoses are just as varied.Under the somewhat pliable definition of pediatric chronic pain unrelated to a specific event, the most common conditions are persistent headaches, back pain, abdominal pain, chronic regional pain syndrome (CRPS), fibromyalgia and persistent musculoskeletal pain of unknown etiology, says LeBel.