Dr. Mahesh Menon

AREA(S) OF INTEREST:

Chronic Neuropathic pain, Spine Pain, Cancer Pain, Interventional pain management, Ultrasound in pain medicine, Palliative care
ACUTE PAIN SERVICES (outpatient and inpatient: Pain less than 1 month's duration, For patients with pain after surgery, accidents, injury , For sports injuries
CHRONIC PAIN SERVICES (outpatient and inpatient): For patients with pain lasting more than 3 months’ duration and not responding to illness, Chronic backache Pain due to lumbar disc disease ("spondylitis") Knee pain Shoulder pain Pain due to nerve injury (Neuropathic pain) like diabetic neuropathy, post herpetic neuralgia, pain following spinal cord injury or trauma Persistent post-surgical pain Fibromyalgia

TREATMENTS/PROCEDURES OFFERED:

Ultrasound guided Nerve blocks for chronic pain, Platelet rich plasma injections for knee pain, plantar fasciitis and other musculoskeletal pains, Radiofrequency for back pain, with Cooled radiofrequency for Sacroiliac joint pain, Knee pain, shoulder pain, Spinal cord stimulation, Intrathecal drug delivery device implantation and Neuromodulation, Image guided foraminal epidural steroid injections and nerve root injections for arm and leg pain caused by pinched nerves, Cancer pain blocks, Ultrasound guided injections for athletes and non-athletes for shoulder, knee, wrist and other joint and muscular pains

NAME OF INSTITUTE(S):

• MBBS, Lokmanya Tilak Municipal Medical college and General hospital
• MD, Anesthesiology (Gujarat University)-awarded highest marks secured by a candidate in the examination
• Singapore General Hospital, Singapore: Fellowship in pain management
• Indian association of palliative care: Certificate in palliative care (IAPC)
• European diploma in pain medicine (EDPM) awarded by the European pain federation: The first doctor from India to receive the award

Training

• Training in Pain Medicine Training in Palliative Care Advocacy for Patients and Caregivers in Palliative Care

FELLOWSHIPS:

• Fellowship in Pain Management (Singapore)
• European Diploma in Pain Medicine (European Pain Federation) EDPM (EFIC)

2019

• Faculty at the 3rd Update in Lung Cancer -Year End Review 2019
• Faculty at the India Pain Update 2019, an international academic event organized in New Delhi for pain education.
• Faculty at the Indian Society of Anesthesiology annual conference 2019, for the pain management workshop organized in Bengaluru.
• Presented work done in a complex case at a poster presentation at the European pain congress organized by the European Pain federation in 2019 at Valencia, Spain.
• Faculty at the Indian society for study of pain (ISSPCON 2019) organized at Bengaluru, India.
• Invited External examiner for MD Palliative care assessment at Tata Memorial hospital, Parel.
• Speaker in Advocacy programs on “End of life care in India” for General physicians, specialists and palliative care professionals.

2018

• Awarded the prestigious European diploma in Pain medicine (EDPM) by the European pain federation. The European Pain Federation EFIC is a multidisciplinary professional organisation in the field of pain research and medicine, consisting of the 37 chapters of the International Association for the Study of Pain (IASP®), which are the IASP approved official National Pain Societies in each country. First doctor from India to receive this award

2017

• Faculty at the International conference on recent advances in pain, organized at Pune.
• Faculty at the Education in Cancer pain organized at Tata Memorial hospital in Mumbai.
• Faculty at the national conference of the Indian society for the study of pain (ISSP) organized at Jaipur.
• Trained at the EPEC-INDIA train the trainer program in pediatric palliative care at Coimbatore, an education program on palliative and end of life care.
• Started the first Indian pain training fellowship IAPM (under the Indian society for study of pain) in Kokilaben Dhirubhai Ambani hospital and medical research institute, Mumbai.

2016

• Participated in the national palliative care training program held in Delhi. Organised by AIIMS and the Asia –pacific hospice network as a part of the ministry of health and family welfare's National palliative care program.
• Faculty for the national conference of the Indian society for study of pain, Indore Trained at the EPEC-INDIA train the trainer program at Pune, an education program on palliative and end of life care.

>2015

• Winner of travel scholarship to Copenhagen, Denmark at the annual meeting of the Multinational association for supportive care in cancer.
• Faculty for the International conference on recent advances in pain management, Kolkata, India
• Faculty for the National conference of the Indian society for study of pain at Chennai
• Faculty for the Golden jubilee conference of the Western India regional orthopedic conference organized by the Bombay orthopedic society, Mumbai

2014

• Faculty in the CME "Clinical Update on Burns", held at the National Burns Centre at Airoli.
• Training Faculty at the Traveling Pain School, an educational initiative to educate undergraduates about Pain Medicine.
• Certified for training by the ANZCA- Australian and New Zealand College of Anesthesiologists.
• Organising faculty, National Conference of Indian Society for Study of Pain at Mumbai.

2013

• Faculty at ISSPCON organized by the Indian Society for Study of Pain at Nagpur.

2012

• Faculty at Association of Regional Anesthesia (AORA) National Conference at Coimbatore
• Faculty at 5th CIPM (Comprehensive Interventional Pain Management) Workshop held in Mumbai
• Faculty at AIPMR (Ashirvad Institute of Pain Medicine and Research), Mumbai, in a course on Introduction to Pain Management.

2011

• Faculty at Bengaluru for the SAARC Association of Anesthesiologists for Chronic Pain Workshop

Dr. Mahesh Menon is one of the pioneers in pain medicine who has contributed to the development of pain medicine and palliative care as a specialty in Modern medicine in India. He specialized in this branch after his post-graduation in Anaesthesiology. Chronic pain is any pain that lasts longer than 3 to 6 months.

Dr Menon moved to this branch when he realized the severity of the problem faced by patients in India requiring pain relief and palliative care.  He holds a prestigious Clinical Fellowship from the Pain Management Centre at Singapore General Hospital - accredited by the Australian and New Zealand College of Anaesthetists (ANZCA) Faculty of Pain Medicine. He has visited reputed Pain Centres in the United States as an observer and is actively pursuing excellence in Palliative Medicine.

He has background work experience in Neurosurgery and was involved in Family Practice which has added broader dimensions to his clinical approach in treating patients with chronic pain.

He has presented several talks on this subject, and demonstrated advanced pain interventions at various conferences and scientific meetings. He is a strong advocate of pain relief as a basic human right, and is involved with several scientific bodies and organizations to this end.

He aims to promote awareness regarding the burden of suffering patients with pain, and the use of rational, evidence based techniques to address these problems in patients with a spectrum of illnesses that cause pain.

In addition, he strongly promotes pain relief and quality of life in patients suffering from Cancer in all stages of the illness. He has been a Faculty in several National and International conferences in Pain medicine. He has delivered talks in Orthopedic Conferences, and Cancer conferences and other specialty meetings, and is a Training Faculty at the Traveling Pain School, an educational initiative to educate undergraduates about pain medicine.

He is a certified trainer in the Education in palliative and end of life care (EPEC- India) program. He has won a travel scholarship to participate in the Multinational association for supportive care in cancer meeting held in Copenhagen in 2015. He has represented Kokilaben Dhirubhai Ambani hospital at the national training program endorsed by the Ministry of health and family welfare held in Delhi in 2016 to promote palliative care for patients suffering from cancer in India.

He has continuously expanded his scope of services and initiated training programs and lectures for doctors from all disciplines in this subject.

In addition to his interest in pain medicine and palliative care, he is socially active in promoting care for the elderly. Other areas of interest  include playing the Tabla (an Indian classical music percussion instrument), writing blogs and poetry and performing in stand-up comedy.

KDAH Experience

The Pain Management Clinic and palliative care services at Kokilaben Hospital are led by Dr Mahesh Menon who is an Anaesthesiologist by training but exclusively practices Pain Medicine and palliative care. He has an Advanced Fellowship in Pain Medicine from Singapore.

Since he set up the Pain Management Clinic at Kokilaben Hospital in 2011 more than 10000 patients have been treated here. Currently every month more than 300 patients are seen and 50 Complex Pain Management Procedures done. Around 70% of these procedures are for spine related problems (*Backaches).

Advanced Procedures done at the Pain Management Clinic include

• Intrathecal Morphine Delivery Device Implantation (Intrathecal Pump- IDDS) for advanced cancer pain and Baclofen Pumps for Spasticity
• Ultrasound Assisted Caudal Epidurals
• Ultrasound Assisted Stellate Ganglion Blocks
• Ultrasound Guided Subacromial Bursa, Knee and Soft Tissue Injectionsfor wrist, elbow, shoulder pain, knee pain, hip pain and ankle pain
• Ultrasound guided injections for muscular pains
• Third Occipital Nerve Radio Frequency Ablation (RF Ablation) for Cervicogenic Headaches
• RF Ablation for Facetogenic Low Back Pain
• RF Ablation of the Trigeminal Ganglion for Trigeminal Neuralgia
• Neurolytic Blocks for cancer pain
• Pulsed Radiofrequency (pRf-DRG) for Neuropathic Pain
• Cooled Radiofrequency and platelet rich plasma injections

Long Term Success Rates (internationally defined as a 70-80% reduction of pain, decrease in requirement of painkillers and return to normal life) are around 75% for patients. Some procedures like epidural steroid injections depend on underlying patient factors. We see a lot of patients here who clearly require surgery, but wish to go for Injections to avoid it and as a step down option. The success rate in these patients is close to 70%. Radiofrequency Ablation (RF Ablation), and Knee Joint Injections are more definitive and carry a close to 90% success rate in the long term.

The department is now in the process of integrating pain medicine and palliative care services in the care of every patient to ensure a pain free hospital stay. This is part of a national training program and in keeping with standards for palliative care recognised by international oncology associations.

Dr Menon has been instrumental in coordinating and integrating the palliative care services with oncology and the hospital is the first private hospital in Western India to be accredited in 2018 with the ESMO designated centre of integrated oncology and palliative care.

Publications

• Menon M. Role of physiotherapy and alternative therapy in cancer pain management. P 1149. In “A textbook of Clinical oncology in the Indian context.” Ed. Dr Suresh Sanchetee.
• Chutatape A, Menon M, Fook-Chong S, George JM. Metabolic and endocrinal effects of epidural glucocorticoid injections. Singapore Med J. 2019 Mar;60(3):140-144.
• Menon M et al. Continuous Cervical Epidural Analgesia in Metastatic Spinal Cord Compression. Indian J Palliat Care. 2016 Oct-Dec; 22(4): 507–510.
• Radhakrishnan M. Chronic Pancreatitis.Chapter 34.p 286-292. in Textbook of Pain Management. Ed Joshi M. Paras Medical publishers
• Radhakrishnan M. Ganglion impar block.Chapter 83.p 664-667. in Textbook of Pain Management. Ed Joshi M. Paras Medical publishers.
• George JM, Menon M, Gupta P, Tan MG. Use of strong opioids for chronic non-cancer pain: a retrospective analysis at a pain centre in Singapore. Singapore Med J. 2013 Sep;54(9):506-10.
• Menon M. Gabapentin in the treatment of persistent hiccups in advanced malignancy.Indian J Palliat Care. 2012 May;18(2):138-40.
• Vas LC, Pai R, RadhakrishnanM.Ultrasound Appearance of Forearm Muscles in 18 Patients With Complex Regional Pain Syndrome 1 of the Upper Extremity. Pain Pract.2012 Apr 11. doi: 10.1111/j.1533-2500.2012.00539.x.
• Sharma A, Pandey AK, Radhakrishnan M, Kumbhani D, Das HS, Desai N. Endoscopic management of anal protrusion of ventriculo-peritoneal shunt. Indian J Gastroenterol. 2003 Jan-Feb;22(1):29-30.
• Pandey AK, Sharma AK, Diyora BD, Sayal PP, Ingale HA, Radhakrishnan M. Inadvertent insertion of nasogastric tube into the brain.J Assoc Physicians India. 2004 Apr;52:322-3.

Professional Memberships

• International Association for the Study of Pain (IASP)
• Multinational Association for Supportive Care in Cancer (MASCC)
• Indian Society for the Study of Pain (ISSP)
• Mumbai Pain Group
• Indian Association for Palliative care (IAPC)
• American Association of hospice and palliative medicine (AAHPM)
• Asia Pacific Hospice Network (AHPN)
• Association of Medical Consultants, Mumbai( AMC)