Distinctly Montana Magazine

34 D I S T I N C T LY M O N TA N A M A G A Z I N E • W I N T E R 2 0 2 5 - 2 0 2 6 BENEFIS HEALTH SYSTEM FREE FULL-PAGE AD IN THE WINTER, 2025-26 ISSUE. CAN BE COMBINED WITH OUR OTHER FULL-PAGE AD IN THIS ISSUE TO CREATE A 2-PAGE SPREAD AT NO ADDITIONAL COST Orthopedic Surgeon Brings New Protocol to Benefis Helena Specialty Center Pain is a common concern when considering surgery. Likewise, pain control after surgery can also cause worry. Typically, post- surgical pain is controlled with narcotic pain medications — opioids like Percocet, hydrocodone, oxycodone, and others. Those medications carry concerns of their own. Opioids have been at the center of a substance abuse crisis in the United States, with their use tied to addiction and chemical dependency issues, overdoses, and deaths. Chase Dukes, MD, is a board-certified orthopedic surgeon at Benefis Helena Specialty Center and a proponent of a narcotic- free post-operative (post-op) protocol that allows his patients to recover without the use of narcotic-based pain medications. In fact, Dr. Dukes developed the protocol he uses now during his tenure in the U.S. Army in 2022. His concerns about the potential repercussions of opioid use led Dr. Dukes to research and investigate the true need for narcotic pain medications following most orthopedic surgeries. "The goal is to help people and make them better, not create additional problems for them," he says. "I thought, 'There has to be a better way.'" Advances in orthopedic surgical techniques and the increased use of multimodal pain control — a comprehensive approach to managing post-op pain and inflammation that includes multiple intervention techniques such as non-narcotic pain medications, strategic therapeutic icing, and medications that reduce swelling after surgery and bleeding during surgery — led Dr. Dukes to prescribe fewer and fewer narcotic pain medications following certain surgical procedures like total joint replacements, rotator cuff repairs, and anterior cruciate ligament (ACL) surgery. He notes that while narcotic medications have a role in the practice of medicine, they can cause issues such as nausea, constipation, itching, a reduced ability to breathe, sleep disturbances, and even delirium, especially in older adults. Discontinuing the use of narcotic medications after a procedure can even lead to an increased sensation of pain. "Ultimately, these medications bind to the mu opioid receptors in your brain and throughout your body, which control the sensation of pain," Dr. Dukes explains. "They don't do anything to actually prevent the cause of pain … so the question became, 'Does the utilization of narcotics do anything to affect patients' overall pain trajectory?' And the answer for most people is, 'No.'" Pain is a byproduct of inflammation, so the goal of Dr. Dukes' protocol is to mitigate and treat inflammation, and that makes patients feel more comfortable and able to participate in physical therapy. "You'll have less swelling and inflammation, you'll hurt less, and your early range of motion following surgery will probably be better," he says. That was the case for Jacob Reddick, a 44-year-old Helena man who had both of his hips replaced by Dr. Dukes. "I'd never had any major surgery in my life before that," he says. "I think the extent of my narcotic pain medication use was after I had my wisdom teeth removed." Jacob's mobility had deteriorated to the point that he couldn't run, carry things, or even bend over to tie his shoes. He knew he needed the surgeries, but he had heard negative things about surgery and the narcotic medications prescribed to control the pain afterward. Tackling Post-Surgical Pain Without Narcotics

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