November 15, 2000
Clinic deals with pain on a daily basis
Munson Pain Clinic offers relief for chronic suffers
By Carol South
Herald contributing writer
"You get to the point where you think life is not worth it."
Reflecting on the chronic, severe pain that took over her life seven years ago, city resident Harriet Wood found life had become unbearable. Despite her strong faith, supportive family and myriad church and community activities, constant back pain had derailed her life and threatened her very spirit.
Wood, 73, has spinal stenosis and the protective tissue between her vertebrae have deteriorated, causing the bones to rub directly against one another. For three years, she and her doctors tried all sorts of medications, procedures and therapies; none of them worked. For three years, she watched her life and all she loved about it slip away as she was consumed by pain.
In 1996, Wood's doctor referred her to Munson Healthcare's Pain Clinic. There she learned of a new procedure that installed a pump under the skin to feed painkilling medications continuously into her system. Suddenly, there was light at the end of the tunnel.
"Without the Pain Clinic, I was almost suicidal, all I could think of was Dr. Jack," Wood recalled. "You think this is something that never happens to you, but this was something that crept up on me, just got worse and worse and worse."
She had the surgery, after passing the clinic's stringent counseling and testing requirements. These steps ensure that all other avenues of pain relief have been explored and that the patient will be able to handle disappointment if the pump does not help, which happens in some cases.
Since her surgery installing the pump, Wood has most of her life back. Pain is no longer a constant, debilitating companion and she can once more participate in life. Standing too long or making beds can bring on the pain, but for most of the time, most days, she is relatively pain free.
"Now I can do almost everything," Wood said. "I don't think that people believe that you can have that much pain and still go on living, you wonder yourself."
The pain pump is the last resort for people in chronic pain for which nothing else has worked. According to Dr. Michael d Rosayro, medical director of the Pain Clinic, the growing medical subspecialty of pain management takes a multi-faceted approach to managing ongoing, debilitating pain. In fact, by the time most patients come to the Pain Clinic, they have lived with so much pain, oftentimes for years.
As with other medical conditions, the first step is to diagnose what is causing the pain. In some conditions, such as arthritis, a diagnosis is clear; in other cases the cause may be more obscure and require extensive testing. Injuries, deterioration, aging or disabilities can all contribute to chronic pain.
Finding a diagnosis, however, is not a guarantee of stopping the pain. In chronic conditions, there may be limited treatment options but clinic staff work closely with patients to alleviate as much pain as possible.
"A lot of conditions are not reversible so you are faced with managing pain," said Dr. d Rosayro, a doctor for 32 years who has worked in pain management for 20. "When we talk of chronic pain, we mean pain that persists after the expected normal recovery period. In other words, if you fall and fracture your wrist you expect it to get better after three or four weeks. But if pain persists and other changes occur, then that is chronic."
The clinic staff creates an individualized treatment program for each patient, combining a multi-disciplinary approach of medication, nutrition, relaxation techniques, physical therapy - including aquatic therapy and massage - and psychological counseling.
Clinic staff point out that pain does not discriminate by age, gender or cause. They have patients ranging in age from their teens to their 90s, all coping with chronic pain. The clinic, which opened in 1995, serves more than 3,000 patients every year, with approximately 160 new patients a month.
"Part of it is to get the word out to colleagues about pain management," said Dr. d Rosayro.
Emotional support and coping skills are crucial to chronic pain management. Many patients with chronic pain are also depressed, some severely like Wood, because of years of suffering and loss. They may be unable to work, facing financial crises or have lost relationships, children, their house or car due to the pain. Antidepressant medication and counseling will help them cope with these changes.
"Until you work in this specialty, you have no idea what pain does to a patient," said Beth Schmidt-Starks, a registered nurse at the clinic. "Men can't be fathers and women can't be moms if they are in pain. Chronic pain affects the whole family."
Staff at the Pain Clinic address these social and emotional issues as an integral part of their treatment program.
"Adjustment varies by a person's personality and by the amount of loss," said Dr. Vince Cornellier, staff psychologist at the Pain Clinic. "Pain is very problematic, it is a physiological signal they have to get used to. In a big way, I help them readjust to life with pain."
"I see a lot of courage every day."