Tag Archives: TENS

Partners in Pain

By: Jana Christian

I met my husband, Don, over the phone six and a half years ago. At the time, I was living with a woman who was an old friend of Don’s family. Don had called this woman and left several messages. I subsequently called him back to tell him that his friend was out of town. We talked and talked. I read him my poetry. We shared our histories. We cried. We ended up talking for four hours and made arrangements to meet for breakfast the next morning.

We met, we clicked..we meshed; we had so much in common ñ chief among those things was the fact that we had matching injuries. Ruptured discs at C5-6,C4-5, C3-4, C2-4, and L5-S1. Also, Carpal Tunnel Syndrome and lots of chronic pain to boot. A match made in Heaven.

We had found our soulmate; someone to identify with, and we married thirty-five days later. Call me crazy, but that’s the way it happened. We couldn’t have found each other soon enough. Both of us were in a self-destruct mode, due to years of chronic pain, and had pretty much given up on hope.

My husband went through six doctors and two unnecessary surgeries before I met him — only to finally find out he had the largest herniated disc at L5-S1 that the doc had ever seen. At first, this last doctor accused Don of just looking for pain killers until he finally did an MRI and apologized to him with tears in his eyes..told Don he couldn’t believe he was even walking with such a large ruptured disc. His first surgery was at age 27. Since then, it’s been a never-ending saga of repeated surgeries, accusatory doctors and staff in emergency rooms..on-going agonizing pain with no relief, and finally acceptance. People just can’t understand. It’s not their fault..too bad they can’t walk in our shoes.

It is SO debilitating living this existence of constant pain 24/7 with another person suffering the same fate. Unless you have it, there’s no clear-cut way of explaining the way it alters your life. But I’ll try.

When someone says they’re in pain, just because they happen to be coiffed and buffed on the outside, does NOT mean you could ever get in touch with the pain going on inside their bodies. I wish people would have more empathy, but how could anyone know, if they’ve never experienced it?

I’m exhausted from feeling as if I have to explain my every activity to people who tell me “Gee, you look fine”. I tell them “You wanna see my X-rays”? That usually does it. One day out of seven you just might get a spurt of actual energy (don’t blow it), if you’re lucky. You race around and try to do it ALL, because for five days, your back and upper body have been useless, and now you feel guilty for not doing enough around the house.

Last week my husband and I cleaned six small windows. With his neck and shoulders (two shoulder replacement surgeries, two discectomies in his neck, and eight other surgeries), and my neck and arms (two Carpal Tunnel release surgeries last year), we had to hang low for three days, we were so exhausted.

I’ve been studying chronic pain for quite a while. I got a kick out of discovering the 3 “s’s” of chronic pain. SADNESS, SLEEPLESSNESS, and SUFFERING. I say they should add another ‘s’ for SUICIDE. Not much to look forward to.

My husband kills me. He drags his body around and tries to always be productive. He pushes himself to the point that it makes me crazy because I worry about his health, and angry, because who has to listen to him groan the next day? You guessed it. But as he likes to say, “I’m not giving in to this”. He works like a dog on our yard and garden, practically drags his hind legs, but dammit, he gets it done. He’s been such an inspiration to me, when I want to give up.

For months when both my neck and back were ‘out’, I couldn’t sit, I couldn’t bend, NOR lie down and couldn’t sleep for five nights in a row sometimes and was totally losing it. I took to my bed and wanted never to emerge. If not for Don, I might still be there. Pity party’s over.

Meantime, now instead of sleeping and watching the world go by, I try to make my fingers do the talking, tho’ I can’t type for long periods or very fast (used to do 90 WPM), but doing it piecemeal is better than not at all. I’ve started yoga, because the chronic pain manuals tell you to stay in constant motion, and if I’m not in constant motion, I can only think and feel PAIN, so that’s a new behavior I’ve been doing.

We are blessed with a TENS (Transdermal Electro-Neuro Stimulator) which gives some minor temporary relief, but we maintain our constant pain with prayer and marijuana (WHEN or IF we can afford to buy it) PRIMARILY (see attached article written for Marijuana.com). We used to use alcohol for pain, only to produce more pain in other areas..so that’s out. Then there were narcotics from our doctors..Closest stuff to heroin you can get, and guess what?? No relief, so what’s the point? Gives you an idea as to the intensity of the pain.

We’ve been to physical therapy with maybe some temporary relief..done the pain clinics, been on the traction table, been through surgery, had injections, heat, pain rubs, Reiki, not to mention hypnosis, all with few, if any, results. My plan at first was to just give up if there’s no relief. But today, I know there are people out there with a MUCH worse situation than my own. I’m working on acceptance now..acceptance that my condition IS WHAT IT IS. And acceptance of the fact that I’m my own best doctor, that my pain WILL get worse, that surgery is not an option I’m willing to try on my neck just now after the nightmare stories I’ve heard (the worst ones from my husband), and acceptance that I’m not getting any younger. With these truths in mind, I’m trying to heal from the inside out starting with my attitude. All I have is today, so I better not waste a minute of it.

Today we’re watching the birds in our back yard. It’s an activity which produces much relaxation, and a positive attitude. I’ve been making them my focus, as it’s an activity I can say is very productive. I try to rise each morning with the best outlook I can muster. Some days are a wash. Other days, I actually love life. I’m practicing an attitude of gratitude as I battle my way to freedom from pain..

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You are the expert of you

“You are the expert of you,” says Krista Brecht, a nursing and chronic-pain specialist at the pain centre. “You come with a suitcase filled with things that can be helpful, like the professor who devised a way of working on a computer while lying down because sitting was too painful. We help you to identify those things and help you to become more self-reliant.”

Today Berardinucci undergoes physiotherapy regularly, meditates or relaxes in a hot bath about five times a week and makes a point of walking daily. Some relief came when surgery reduced pressure on her spinal cord. She’s also been given morphine and a drug cocktail that features a new anticonvulsant, a recent addition to the pain centre’s treatment arsenal. As her pain has become more tolerable, her interest in life has been renewed.

An early proponent of biofeedback and of morphine for noncancer pain, the pain centre is constantly in search of new tools. Anticonvulsants used to combat epilepsy and small doses of tricyclic antidepressants, for instance, have proven useful for many patients.

“Scientific research into pain,” says the centre’s Gary Bennett, “is one of the most productive areas of neurological research right now.”

The pain centre is currently setting up a one-year pilot study about the potential benefits of smoking marijuana for chronic neuropathic pain. “We do not recommend cannabis to patients, but we have had good reports from patients using it for neuropathic pain,” says Dr. Mark Ware. “We would be interested in the possibilities of cannabinoids in the management of pain once clinical trials are completed.”

According to the most recent Health Canada numbers, 786 Canadians are legally permitted to possess marijuana, of which the majority (about 600) can also grow it for their own use. Former pain centre neurosurgeon Dr. Joseph Stratford says, “I know of patients whose lives have been changed for the better by smoking marijuana.”

Encountering patients at the centre with intractable phantom-limb pain after amputation impelled one young doctor, Joel Katz, to see if administering a local anesthetic as well as a general one during surgery could prevent pain. Previously, Melzack, Katz and Terence Coderre had studied the effect on animals and discovered that local anesthetic protects the body from postsurgical pain. A general anesthetic alone does not.

Convinced by their results in both animals and people, a growing number of anesthesiologists now use local anesthetics as a preemptive strike against postsurgery pain.

When Dr. Mary Ellen Jeans saw how some of the centre’s patients were aided by acupuncture—which stimulates major nerves—she began to test a noninvasive treatment involving electricity, called transcutaneous electrical nerve stimulation (TENS). Today hundreds of people undergoing physiotherapy benefit from TENS. Patients affix electrodes to painful areas or at nerve points, then switch on a mild battery-powered electrical current from a device that can slip easily into a pocket. Milena Svraka, 52, was referred to the clinic after being mugged one night by two men, one of whom punched her in the face and dragged her across the pavement by her right arm while the other kicked her in the legs and body. She didn’t go to emergency because nothing felt broken but visited her local clinic the next day. The doctor said her muscles were strained and prescribed a few days of rest.

Back at work, Svraka couldn’t ignore the pain in her back, neck, right shoulder and arm. Determined to find out what was wrong, she saw a variety of medical practitioners, and still got no relief. When she couldn’t stand the pain any longer, she revisited the clinic, where her doctor recommended she take an indeterminate sick leave.

Svraka, who had travelled widely and rarely taken a sick day, now felt confined to the house. “Pain changes who you are. I wasn’t up to being jostled by people on the bus or metro. I was in so much pain, I just wanted to curl up and have it stop.” On a neurosurgeon’s referral, she was directed to the pain centre.

After a consultation, Svraka was put on a low-dose antidepressant, tried traction therapy—used to relieve joint compression, promote soft-tissue stretching and improve circulation—and began treatment with TENS. “I started feeling warmth returning to my arm right away,” she says. She used the arm more and began to regain the ability to turn her head from side to side—something she hadn’t been able to do in years.

She has since added everyday chores to her list of what is possible—such as stirring pots and peeling vegetables—and continues to use her TENS machine daily, affixing electrodes to her arm, neck and shoulder areas. The gentle pulse emitted releases endorphins, relaxes the surrounding muscles and seems to close the gateway to her pain.

Today her pain is a bearable three or four on a good day. “I can do things I love again, like gardening and going for walks.”

Linda Chown had successfully blacked out the memory of a bicycle accident she had at age nine, when she flew over the handlebars facefirst into a telephone pole. Her two front teeth remained embedded in the pole, and she endured four years of treatment to restore them. When, as an adult, she began suffering unrelenting face pain and severe migraines, a friend suggested she try osteopathy. While being given a facial treatment, she suddenly recalled the accident, and the shock and pain came flooding back. Later, when the nearly unbearable pain wouldn’t go away, she was referred to the pain centre.

A psychologist, Ann Gamsa, was called in and worked with Chown on many personal concerns, including her failure to remember much for a period of time after her accident. Seeing that her difficulty in expressing certain feelings was likely a factor in her pain, Gamsa helped her patient look at the accident and its aftermath, discussing the shame, anger, fear and pain it caused. The intensive work, along with medication and coping strategies, sharply reduced Chown’s suffering. It also left her grateful that not only her body but her mind was treated, too.

Today other pain centres across Canada follow the MUHC Pain Centre’s proven formula of combining physicians with varying specialists. But much remains to be done in educating the world about pain.

“There are still many practitioners who blame the patient,” says Gamsa.

“That is useless, unfair and wrong.” Despite a stack of research supporting the use of opioids such as morphine to relieve long-term pain and research that proves pain sufferers rarely become addicted, many doctors are still unaware or unconvinced.

“Montreal is light-years ahead of us in Ontario,” says anesthesiologist Dr. Ellen Thompson. “Under the rules of our College of Physicians and Surgeons, any doctor can refuse to treat a patient with opioids.”

Still, in the medical world, little is known about most forms of chronic pain. Researchers have only recently begun to study the differences between chronic pain and the passing pain that accompanies a broken arm, a heart attack or surgery. Work has also shown that unchecked pain changes the body at the cellular level, creating conditions that can continue to cause pain even after tissues have healed or disease is conquered.

As yet there is no magic bullet for the treatment of chronic pain. Researchers have been looking for safer and more effective alternatives to morphine and other related opioid analgesics for more than a century. In the past decade, they have developed a new series of drugs called delta opioid receptor agonists. “These drugs mimic the effects of chemicals already found in the body, and studies suggest they may be effective painkillers without producing morphinelike side effects,” says Steve Negus of the Harvard Medical School.

Researchers are also assessing the usefulness of new creams, exploring whether genes predict pain sensitivity and looking into theories that, down the line, could stop pain before it starts.

Says Milena Svraka: “I went to the MUHC Pain Centre to find a better treatment and what I could do to help myself. I found out that a good day can be a miracle. Simply having less pain can be a miracle.”