Managing chronic pain: Some things really do help
Their chronic pain may not go away, but they’ve found a way to fight through it and keep going
12:50 PM CDT on Tuesday, September 11, 2007
For the lucky ones, pain is a passing thing.
It’s a problem with a solution: Take the right medication; get on the right health and fitness program; wait for the wound to heal, the fever to pass, the bone to set.
But there are many for whom the aches, the stiffness, the sensitivity will never fully go away. It can be managed and minimized, but for people with chronic pain, life is a battle that requires constant vigilance, courage and a love of life that refuses to surrender.
Helping them in their journey is the growing field of pain management. We talked with four patients and their doctors and therapists about how to put chronic pain in its place and keep it from interfering with life. They shared their hard-won knowledge, which took a couple of them decades to acquire, about how essential it is to get the proper medical care, to consider complementary alternative therapies, to exercise even when it hurts and to draw on the emotional support of family and friends through the tough times.
Here are their stories.
A breast cancer diagnosis in 1996 was a shock for Bettye McQueen of Grand Prairie. But even the lumpectomy, chemotherapy and radiation did not prepare her for the pain that hit a year ago.
“I don’t have any movement in my left hand or my thumb at all. And the pain was so bad, I could hardly bear it.”
It turned out that she had developed lymphedema, a condition in which a body area collects protein-rich fluid that causes it to swell. It can be caused by trauma injuries, such as the surgery for carpal-tunnel syndrome that Ms. McQueen had just before the pain started. Breast-cancer patients are at particular risk if they have had their lymph nodes removed, as Ms. McQueen did.
She’s grateful, she says, for the Healing Arts Center at Harris Methodist Fort Worth Hospital, where she is learning the benefits of massage therapy, reflexology, lymphedema therapy and aromatherapy under the guidance of Ellen Kerr, a registered nurse and licensed massage and lymphedema therapist.
“It surprised me that the massage therapy, along with the lymphedema therapy, reduced the amount of swelling, which reduced the pain,” Ms. McQueen says. “I’ve been able to reduce the amount of pain medication.”
That’s given her hope.
“I’m feeling much better, and I’m hoping to get back 100 percent. They’ve told me they can’t make any guarantees. But along with the therapist and my faith in God, I feel I can get total use in my arm and hand again. I have the fighting spirit, and I intend to fight this.”
Study your condition: “There are women out there who don’t even know there is treatment for lymphedema. Consult with your physician on how to get relief.” She suggests seeking out complementary methods, “because sometimes we can help manage pain in different ways.”
Therapy is work: “You have to take on extra pain if you want to get better. I go to therapy every day, Monday through Friday. By the time I’m finished, I’m so wiped out I have to lie down and rest. But while it’s painful going through it, in the evenings when I sit down to rest, the pain isn’t there. I also have exercises they’ve given me to do at home. They’re painful, but I’m resolved to do them.”
Family support: “I have three nieces and a brother and friends. They have taken time off from work to take me to my treatments. You don’t know how that makes you feel that someone thinks enough of you to take time off from his job to take you where you need to be.”
Don Bell of Lucas has suffered from back problems for 35 years. As a young man, he compensated for spinal weakness by working out. But when he went into sales to support his wife and five children, the sitting reduced the muscles that had been keeping his back straight. He developed chronic pain syndrome and lumbar spinal stenosis – a narrowing of the back spinal canals that causes compression of the nerve roots. At age 40, Mr. Bell had the second of two back surgeries to alleviate the condition, but he was left with so much pain that he could barely get out of bed for the next two years.
“It became a depressing situation. You can’t sleep good, so you don’t care to go to bed,” he says. “Then it’s hard to face the day. The hardest part is that I had to stop being active with my kids, and I couldn’t carry any of my grandchildren. That’s a big part of my life I had to miss. That makes me ache.”
He suffered for years until someone at his health club advised him to look into pain management. Mr. Bell had never heard of that field. Then he met Dr. Jerry W. Lewis, a pain-management specialist at Baylor Regional Medical Center at Plano, who “turned my life around,” he says.
Dr. Lewis gave him injections that alleviated the nerve pain and told him he was a good candidate for a lumbar spinal-cord stimulator, which Mr. Bell had implanted in his back six months ago. The implant blocks the pain signal at the spinal cord before it reaches the brain, so the brain doesn’t recognize the pain. Mr. Bell says he feels 80 percent to 90 percent better. The stimulator also helped correct his posture.
“I used to have a walker to get from room to room, and now, I can walk throughout the house,” he says. “Recently, I was playing golf with my son. It’s the first time I’ve played golf in more than 10 years
“I love it,” he says. “I get to intermingle with all the teenagers. That’s an experience!”
Family helps: “I married a good woman. And all our children built homes around us. I have 13 grandchildren, and they like to come over on weekends. We’re so blessed.”
Take care of yourself: “I had to lose some weight and start exercising. That got me through several years. Now that I feel better, I can start exercising again, and I think I will be much better off.”
Embrace technology: “My wife got me a PlayStation for Christmas, and my grandsons and I really enjoy playing while I charge my bionic implant. I always keep this unit with me. I hook it around my belt like a cellphone.”
Bob Johnston first noticed that something was wrong during a trip from Oklahoma to the State Fair of Texas 28 years ago. His legs were cramping, and he struggled to walk.
He had no idea then that he had rheumatoid arthritis, a condition in which painful, widespread inflammation leads to an increased risk of heart disease and early death. And that it was going to get worse, a lot worse.
“I didn’t know what it was for a couple of months,” says Mr. Johnston, who now lives in Farmers Branch. “It just devastated me. Once you get in that cycle of pain, stress and fatigue, it’s real hard to get out of it. If you’re not seeing a good doctor who knows what he’s doing, and you’re not on good medication, it will drive you to despair.”
He consulted a series of doctors, some more helpful than others. Among “the others” was one who prescribed liniment used for racehorses. Mr. Johnston has tried various medications over the years and is very happy with the ones prescribed by Dr. Yijun Fan, a rheumatologist at Presbyterian Hospital of Dallas.
After a stroke in 2000, he followed Dr. Fan’s lifestyle advice, too. He had been a smoker, so he quit. He gave up red meat in favor of turkey and chicken. He retired, started exercising and began taking time to enjoy life. He recently returned from a cruise he and his wife took to celebrate their 25th wedding anniversary.
No doubt about it, he says, he feels better at 68 than he did at 45.
Get help: “You’ve got to find a good physician and have support at home, because you’re not going to always feel up to things. When you’re in pain, sometimes just putting on your pants can be a struggle.”
Don’t give up: “The alternative isn’t good. You can’t just sit there and feel sorry for yourself. I’m not brave, but I feel better when I get on the treadmill about 30 minutes every other day.”
It gets better: He retired six years ago, which, he says, reduced his stress level. That lifestyle change, along with giving up smoking, making more healthful food choices and exercising, has helped a lot. “I’ve been lucky,” he says, noting that it’s important not to give up, because by taking the right steps and getting the proper help and support, things can improve over time.
In March 2006, Megan Valdez twisted her ankle in gym class. But as the ankle healed, the pain got worse. She began using one, then two crutches. It hurt when air from a fan hit the ankle. Putting on her shoes and socks was excruciating.
Megan had developed complex regional pain syndrome. In the condition, diagnosed by the multidisciplinary pain-management clinic at Children’s Medical Center Dallas, the nerves don’t get the message that the injury has healed. Symptoms include swelling, a change in skin color, a change in nail and hair growth patterns and a cool temperature at the original injury site.
The diagnosis was a relief, the Lewisville teen says, because it meant that she would get help and had an answer for kids who teased her for making “a big deal” out of what they thought was nothing.
“I would cry a lot because it would be hurting,” Megan says. “People thought I was lying. I felt sad, and I would get mad because people were not believing me.”
Understanding the condition didn’t make the pain itself easier to handle, however. Dr. Alan Farrow-Gillespie at Children’s gave her spinal blocks and inserted an IV line for epidural injections when needed. After the hospital treatment, she struggled to do intensive physical therapy at Greater Lewisville Therapy Center for a year.
“I would always want to stop because it hurt so much. Sometimes, I was crying at physical therapy, but my physical therapist was very nice and would always make me laugh.”
It’s been hard, too, to accept that the pain will never fully go away. But Megan is happy because, on Aug. 20, she did something she never thought she’d do again. She ran a half-mile around her neighborhood.
“At the beginning, I thought I would always be on crutches. Now, I feel better about myself. I’ll be happy when I start school and can be in athletics because I love playing volleyball.”
Face it: At first, Megan wanted to do anything she could to avoid the pain, including exercises that made her foot hurt. But now she’s glad she persevered. And she’s made peace with it. “I’m OK with the pain. I can fight through it because distraction is the best thing for it.”
Love that bro: It’s hard when others don’t believe you. That’s why it means so much to have family members who understand. Megan’s brother, Mark, now 10, “was very supportive” and would get things she needed when it hurt too much for her to move.
Tough love helps: On orders from the doctor and therapist, Megan’s parents would touch her injured foot. “I would start crying, and they would keep doing it. My mother said it was tough love because they were trying to help me get better.”