Do you have the “pain face?” Do you know someone who has the “pain face?” That is the look on the face of someone suffering from lower back pain and for many the associated pains in the extremities. I know what that face looks like because I saw that face in the mirror every morning for many years. I don’t know where I got it. Could it have been inherited? No way to know since I was adopted.
Could it have been from years of shoveling snow where I grew up in Rochester, New York or years later when I lived in Wisconsin? Could it have been after years of lifting patients when I worked as an orderly in a hospital while I was in college? Or could have it been my shoveling ten yards of dirt here in Eugene from my driveway into a wheelbarrow to my back yard for 8 hours to replace washed away topsoil? I guess the answer is all of the above. I’m sure they all contributed to my L-5 S-1 disc being jammed into the nerve root of the sciatic nerves of both legs. It started with some numbness in both feet and accelerated to numbness and pain in the left leg from the knee down and the right foot.
I went to my doctor who sent me to physical therapy. It helped a lot early on, but over the years the pain got worse. I was checked out by a Neurologist and a Neurosurgeon, but was told at the time there was nothing that could be done. I would have to wait until it got worse or the science would improve to make it possible to fix what was wrong. When it would “act up” I would take pain killers and go to physical therapy. It took more years until the sciatic nerve in my left leg started firing and causing paralyzing pain. We tried a little physical therapy which didn’t help and I was sent to a pain specialist. The pain medication Dr. James Kassube gave me eased the pain to a more tolerable level, but it wasn’t enough. After some spinal injections that didn’t have much effect I was sent to a Neurosurgeon.
On February 28, 2012 Dr. Jonathan Sherman,Neurosurgeon from Keiper Spine, performed a spinal fusion that took away all back pain and the lightning-like left leg sciatic nerve pain. All it took was a small incision in my lower back, two rods, a net, some cadaver bone in place of the disc, and 6 screws. Dr. Sherman explained that my healing could take up to a year from the surgery date to be as good as I would get. The surgery was 100% successful, but the nerve damage that caused the numbness pain I already explained was not going to get any better as I found out one year later. We tried more spinal injections and they seemed to have no effect on the pain. I was still taking the pain killers which helped, but only made the pain livable.
Dr. James Kassube, pain specialist, then told me there was one more thing we could try. The last option before having to wear a pain pump for the rest of my life is a neurostimulator. You may have heard of a TENS Unit which is an external neurostimulator connected to the body with glue-on electrodes. It sends a signal through the affected part of the body and tells the brain to think of that instead of the pain. He explained that we would perform a test for a week to see if it would help ease my pain.
Dr. Kassube surgically implanted two wires along my spine about 3/4 up my back with a cable to an external control box. (see the two black areas that were connectors to the external control box.) Jeff Bailey patient representative from Medtronic, the company that makes the implantable device, worked with the doctor and they woke me up to turn it on to test it. It felt like bubbles flowing up my legs. Then it was back to sleep and to recovery. After a week of healing time they turned on the stimulator and my pain was practically gone. If you get a 50% reduction in pain you qualify to have the full implant surgery. I couldn’t believe it. I had 100% relief. You have to know that I was still taking pain killers, but before the implant they relieved some of the pain and left me with the rest. The doctor was just as happy as I was and took out the temporary wires 3 days early due to the connectors pulling loose and shorting out. He said the test was a success and scheduled surgery for about a week or so later.
He surgically implanted new leads and the controller/battery pack (just above rt. buttock) with minimal incisions. There were no guarantees that the final implant surgery would work exactly as well as the test. We waited for another week to turn it on. One hitch, the anchor that was supposed to hold the leads (wires) in place from the bottom pulled loose and when the stimulator was activated it bubbled in my chest not my legs. Another quick surgery allowed Dr. Kassube to pull down the leads that crept up my spine and re-anchor them. It worked fine from that day on. Depending on how high the stimulator is set the battery in it might need to be charged more often. I keep the charging system plugged in the wall outlet. When I need to use it I unplug it and strap the charging unit against the skin over the implant site. In about three hours it’s completely charged and I’m ready to go.
My life has changed immeasurably because of the neurostimulator. As I have been dropping the pain meds I’ve had to turn the stimulation up. Now I’m off the painkillers completely and still doing well. I have the stimulator turned up pretty high because the pain level still tries to increase. It’s like it knows I’m not taking the pain killers and it is now able to increase at will. Once my body gets more used to the stimulation I will be able to turn it down to a more normal level. When the settings have stabilized I will go into the office and Jeff Bailey will input the settings for when I sit, stand, and lay down. Then he flips a switch, so-to-speak, in the implanted unit and it will change settings automatically depending on whether I am standing, sitting, etc. The miracle in my life continues. What should you do if you have serious back pain and/or the associated leg pain? Dr. Kassube recommends that you see your primary care physician first, even if you don’t have to get a referral for insurance purposes, and have them refer you to a pain specialist that they trust. That way there is a good flow of information between your doctor and the pain specialist.
I’ll bet you are wondering what kind of success rate Dr. Kassube has attained. He told me it’s 90% for success of the test implant and also 90% for the final implant surgery. Why such a high success rate? Dr. Kassube told me it is because he chooses his patients very carefully. He won’t do the test implant unless he is quite sure the patient would benefit from the procedure. And the same goes for the final implant surgery.
Back to the Medtronic company for a technical update. Jeff Bailey told me that Medtronic has developed a special MRI machine. You see, I can’t have any kind of MRI without removing the wires and battery/control device (oh, the rods and screws in my lower back make that even more impossible. Medtronic has conditional approval from the Food and Drug Administration (FDA) for a new MRI machine that can perform x-rays of the head and neck only without taking the wires out. No one else can do that yet. A final word from Jeff who’s advice is “not to overplay the outcomes until the patient has been tested.” Each patient can react in their own way to the various therapies offered including the neurostimulator.
I know some of you will remember the “6-Million Dollar Man” TV show. There are moments now when I feel just like Lee Majors’ character who had super-human skills. I’m just glad I can stand, sit, walk, or lay down without being in serious pain. My main reason for telling my story is to let you know that help is available and not to give up. You may not qualify to have a neurostimulator, but in most cases there is help out there to give you at least some relief.
Let me know what you would like me to talk about or explain. You can email me at: [email protected].