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Veract Clinic -Intractable Pain Program-Founded by Dr. Forest Tennant, MD., Dr.PH -Internal Medicine
Dr. Forest Tennant MD.PhD, founder and head of Veract Intractable Pain Clinic, has been treating pain for over 40 years. He has become the foremost expert in the country on diagnosing and treating centralized Intractable Pain. The most common reasons for seeking care at the clinic are: Intractable Pain, Palliative Care, most often caused by rare disorders and injuries. Some more commonly known rare disorders he encounters are: Arachnoiditis, Ehlers-Danlos Syndrome-EDS, Post-viral syndromes, Marfans and Reflex Sympathetic Dystrophy-RSD and CRPS.
Dr. Tennant has always maintained a small patient load, of approximately 150 patients, and only sees 10 patients per day so he can focus on individualized treatments and conduct timely research. The criteria for admission into the Intractable Pain Program he oversees is very strict. Each patients must retain their home state primary care provider. The combination of careful screening of each patient and the expertise of Dr. Tennant, has resulted in zero overdose deaths and zero reports of diversion of medications by patients.
He believes in treating the whole person and finding the root cause of pain, and ultimately striving for a cure. He continues to research and develop treatment plans that restore the lives of those suffering with Intractable Pain, giving them hope and many pain free hours.
Veract Intractable Pain Clinic has been the foremost center for treating Intractable Pain in the country. Patients and their family members travel from around the country to seek the expert care of Dr.Tennant.
Dr. Tennant is also a well sought-after teacher and presenter at various conferences throughout the country. He is editor Emeritus of Practical Pain Management journal, has published over 300 articles and research papers, and was awarded the prestigious Lifetime Achievement Award at PAINWEEK 2017.
He understands the scientific basis of those who are outliers due to genetic metabolic disorders, and will prescribe accordingly. One of Dr. Tennant’s main goals has always been to try to reduce each patient’s opioid medication use, by tirelessly researching new and innovative treatments in pain care. These protocols are individualized and treat the whole person, with the goal of homeostasis of all bodily systems, which includes restoration of deep sleep and quality of life factors.
Operation of the Clinic -Intractable Pain Program
-After thoroughly reviewing each patient’s history through previous medical records, the next and essential requirement for being accepted into the Intractable Pain Program by the clinic is that the patient must have centralized their pain, the pain has become severe and chronic, and that standard medical pain treatments have failed.
-Dr.Tennant conducts a thorough physical examination, and orders labs based on his physical findings and individual patient history.
-All state and federal paperwork forms are completed, including a REMS, patient consent for treatment with non-standard and opioid medications, and an Admission into the Intractable Pain Program form is filled out. All forms required by the State of California Opioid Guideline are completed, and as updates occur, they are added. Dr.Tennant keeps all records in an individual patient file.
-A family member is required to attend the clinic with the patient. The patient and family member are taught home treatment protocols including stretching to prevent contractures, optimal diet, home exercise plans, topical application of medications to relieve flares and control pain, comfort measures for pain flares and how to recognize a flare. Timely handouts and booklets on the newest and most up to date information on the patient’s disease process and treatment break-throughs are given out through the clinic.
-Dr. Tennant treats serious rare diseases, and often after these patients have been considered hopeless cases. He tries everything he knows to bring the patient back to a functional health state, and his methods are working. Often so-called- “experts” miss many obvious things.
-He gets to the root cause and disease process that often have a painful component, and has instituted protocols for neuro-genesis, recovery, that brings back quality of life and function to these patients.
-Every patient must have a referral from their home state physician. He is very willing to work closely with the patient’s PCP and teach them everything he knows about treating their rare disorder.
-He researches all the newest tests, and orders all labs, imaging and tests that are relevant at each follow-up appointment, to diagnose and track each patient’s progress including genetic, hormone and inflammatory marker testing.
First appointments with Dr. Tennant commonly occur over two to three days, depending on the severity of the case. Careful diagnostics are made and lessons on anatomy are given, including how the CNS functions, how centralized pain develops from these rare disorders and the role of microglial cell over-activation in this process, and the role of neuroplasticity. He explains carefully how all this causes the symptoms of fatigue, depression, mental dysfunction and over-stimulation of the autonomic nervous and endocrine system. This over-activation of the nervous and immune systems often leads to auto-immune syndromes. He teaches the important role of hormone replacement and timely analgesia as a component of symptom relief and neuro-genesis, and how this stabilizes the patient enough so that regeneration and stabilization of the patient can occur.
-Medication trails are done in the office and family members are instructed on safely storing medications at home.
-Family members are taught how to take at home blood pressure, pulse-oximetry readings, and how to detect adverse reactions to medications. All changes are to be reported to the doctor, so medication adjustments scan be made swiftly.
-Treatment plans and protocol follow-up instructions are given at each appointment. -Appointments are made monthly at first and when the patient is stabilized, with a working protocol, appointments then occur every three months for follow-up.
The 2014 CA Medical Board Guidelines are strictly followed by the clinic, as are the newest-April 2017- Opioid Prescribing Guidelines set forth by the Federation of State Medical Boards. The foundational and legal basis for treating Intractable Pain can be found in the California Pain Patients Bill of Rights and the California Intractable Pain Act.
Here’s a great article describing Dr. Tennant’s Clinic written by one of the co-founders of FIPR- Kristen Ogden -link below:
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