HIS AIM--NO PAIN

Posted on: 11/19/2008

One of Florida's foremost pain management physicians helps patients

from Profiles, January 1997

Todd B. Jaffe, M.D., seeks solutions to help chronic pain sufferers be more functional and independent; for those with acute pain, such as cancer patients, his treatment objective is to relieve their pain yet enable them to remain awake and alert. "My mission is increasing my patients' quality of life through management of pain," says the founder of Brevard Pain Management, Inc. The main office is at 1832 Garden Street, Titusville,Dr. Jaffe's specialty includes two invasive procedures: intraspinal drug infusion therapy, in which an implanted pump delivers very small doses of morphine through a catheter to the spinal canal, and spinal cord stimulation, involving implanting a low voltage power source and a catheter in the epidural space to produce electrical impulses which can control pain.

Results can be dramatic. One patient, treated with 1/4mg of morphine a day, was pain free with no side effects or impairment of reaction time four days later. Though results are not always so dramatic, Dr. Jaffe says, "I love to see people who had lost hope smile again, free from pain." Recently, Jaffe saw a testimonial to the benefits of pain management. A female patient with lymphoma already spread to other parts of her body came to the office in a wheelchair. After he implanted the morphine pump, she took a trip out west on a motorcycle with her husband.

Dr Jaffe's career began in anesthesiology and evolved into pain management as he realized the differences he can make in the lives of patients with chronic or acute pain. "I've got a gift with a needle in my hands; it goes where it's suppose to go," he says. "Accuracy reduces the pain of the procedure and the infection rate, resulting in fewer complications and better patient compliance."

His career has been devoted to disciplines that use needles. He decided initially on anesthesia as a specialty, and developed an interest in regional anesthesia, entailing nerve blocks for surgery. Then medical science discovered that morphine in the epidural space is 10 to 100 times more potent than when it's taken orally, without putting people to sleep. Jaffe has also pioneered the use of using smaller needles to inject patients, causing less tissue damage and often getting better results. Demand for his skills quickly grew as other invasive procedures were developed to manage pain. He started practicing acute pain management in 1983, followed two years later by chronic pain management, at a time when pain management was unheard of as a medical sub-specialty. He moved into pain management full-time in 1992.

Dr. Jaffe was among the doctors who took and passed the first certification exam offered by the American Board of Anesthesia. Currently, less than 20 doctors are board certified in pain management in the State of Florida through organizations recognized by the American Board of Medical Subspecialties.

Jaffe is helping change those numbers. He is developing a curriculum for a family practice rotation for the University of Miami, where, beginning either in January or July 1997, resident doctors may receive a session of study and experience in pain management.

His father, a pediatrician, teaches pediatrics to family practice residents at the University of Miami, and is credited with inspiring his son's drive in the medical profession. The younger Dr. Jaffe remembers meeting people out in public who knew his dad, and marveling at the respect his father had earned. He also remembers his grandfather's experience with colon cancer. "He took no medication and remained clear and awake, maintaining a lot of dignity till he died," Jaffe says. "That made a lasting impression." Dr. Jaffe believes chronic low back pain is one of the biggest areas of treatment, followed by headaches. He thinks cancer pain ought to be closer to the top, but a fear of drugs and addiction discourages many patients from seeking help. Narcotic addiction is almost unheard of in the treatment of cancer pain according to Jaffe. Patients using intraspinal drug infusion therapy don't become addicted because the morphine dose is so small. They don't get addicted because they use morphine to control pain, not for emotional gratification, which is what usually results in compulsive drug-seeking behavior. "When I can make them more functional and a little more independent," he says, "I have achieved a lot."

One of Jaffe's goals is to provide treatment so effective his patients don't have to keep returning for pain management. Another goal is to see that everyone needing treatment receives it. "I see patients denied care because of insurance coverage, and it bothers me that we can't take care of everybody," he says. "Research is incredible, and down the road we are going to be so specific and potent, there won't be any reason not to treat everybody."

Dr. Jaffe has earned the reputation of prominence in the area of invasive procedures with new techniques, and looks forward to adding two to four associates, enabling him to devote more time to his specialty.

He has admitting privileges at Parrish Medical Center in Titusville. Among his professional credentials, Jaffe was one of the first physicians to obtain a certificate of Added Qualifications in Pain Management from the American Board of Anesthesiology. He is a past president of the Florida Academy of Pain Medicine.

In his spare time, he golfs and plays the piano, paints and cooks. He credits both parents for inspiring his work ethics and wants to instill those values in his sons, Philip, 13, and Aaron, eight, who have expressed their desires to be doctors, and take over his practice if he ever retires.