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Reining in the pain

Advances in medicine help relieve the suffering Saturday, June 10, 2006
By Jamie Lampros
Standard-Examiner correspondent

Kelly Morrill doesn’t need a meteorologist to tell her it’s going to storm. Her health condition does it for her.

When the weather starts to get cold, Morrill, 41, of Layton, gets so much pressure in her head that it feels like it’s going to explode. She also has had problems with her gait, and with speech and numbness.

Her doctors diagnosed multiple sclerosis when she was 20 years old, but it turns out that wasn’t the problem.

“I had a lot of headaches growing up, but they got much worse after my first child was born when I was 25,” she said. “They get so bad sometimes that I can’t think or function. It’s like a war going on inside my head.

“When we are about two days away from a storm, I start feeling tremendous pressure in my head, and I know that it’s going to get cold. I’m always right.”

Morrill was eventually diagnosed with Arnold-Chiari malformation, a condition in which the cerebellum portion of the brain protrudes into the spinal canal.

“I have had numerous surgeries since then and have had shunts put in several times to help relieve the pressure, but I still have recurring pain and limited mobility. My joints hurt all of the time too,” she said. “It’s just become an everyday part of my life.”

Morrill said chronic pain is something that she probably will deal with the rest of her life. However, thankfully, because of so many advances in medicine, she said, there are things that help relieve her suffering.

For the past several months, Morrill has been treated at Lifetree Pain Clinic and Research in South Ogden.

“They have taught me that I don’t have to live in pain and that I can have a normal life. While I will always have pain, the severity has gone from a 10 down to about a 7 now.”

Morrill is being treated with a multi-modality approach.

“We are working with cognitive behavioral therapy, physical therapy, counseling and medication management,” said Cindie Dodenbier, an advanced practice registered nurse and certified family nurse practitioner at Lifetree. “Kelly also follows up with a neurosurgeon at the University of Utah.”

No reason to suffer

“Chronic pain, unrelated to cancer, affected 75 million people in this country in 2005, according to the American Medical Association,” said Dr. Bryan Peterson, an anesthesiologist at Ogden Regional Medical Center and Rocky Mountain Pain Clinic. “That is a huge number, but I think we are finally starting to get somewhere.”

People do not have to suffer, Dodenbier said.

“There are so many professionals who dedicate their time and talents to offering modalities and therapies,” she said. “It is a shame when someone is robbed of their future and potentials. Too many people are suffering, sometimes silently, with decreased quality of life and function.”

The definition of chronic pain varies according to the source, said Dodenbier.

“Primarily, it’s pain lasting greater than three to six months,” she said. Back injury, fibromyalgia, nerve conditions, degenerative joint disease, trauma from accidents and many autoimmune conditions can lead to chronic pain, Dodenbier said.

“We focus on interventional alternatives as well as the mainstays of chronic pain management,” she said. “There are so many pain medications available to help decrease and lessen suffering.

“Often, people stop at the very valuable but not benign options of nonsteroidal anti-inflammatory drugs. There are also many benefits to be claimed with appropriately dosed acetaminophen.”

Alternatives for relief

Besides traditional pain medication, Dodenbier said, those with chronic pain may also be treated with epidural steroid injections, nerve blocks, trigger-point injections and spinal cord stimulators.

Mental health and relaxation counseling, cognitive behavioral therapies and physical therapy may also be added.

Anti-depressants, anti-convulsants, anti-spasmodics, capsaicin and anti-inflammatory drugs can be used to block pain signals in the brain and provide relief.

Dodenbier said many people are afraid of filling their narcotic pain prescriptions because of the stigma of abuse and addiction associated with them.

Many of her patients tell “harrowing stories” of being mislabeled as addicts.

“Just by considering the ratios of valid pain patients to the people with true addiction issues, it is evident that, 90 percent of the time, a person seen at the pain clinic is not suffering with addiction,” she said.

Help from specialists

People with chronic pain see a variety of specialists as well, including neurologists and anesthesiologists.

“The most common type of pain is nociceptive, where the body is identifying ongoing damage to a site in the body,” said Dr. Navin Varma, a neurologist at the Center for Neurological Services in South Ogden.

As a neurologist, Varma sees a variety of conditions, such as headaches, neuralgias, back pain, arthritis and also the emotional aspects of chronic pain that include depression and anxiety.

“Pain is controlled by the brain/mind,” Varma said. “We do control our neurotransmitters, and we have exquisite control over these, much more so than medications ever will.”

While medications are often a first resort, Varma said, they have side effects and can worsen pain if used chronically.

He said exercise, meditation and relaxation exercises seem to modulate pain by helping to reset pain perception in some patients.

“Pain has many causes and there really is no single answer to treatment,” Varma said.

Keep trying

Julie Kellos, medical assistant at Skyline Pain Clinic in Ogden, said she tells her patients to use almost anything that will help, like hot packs, cold packs, hot rubs, massage therapy, yoga or visualization.

Because chronic pain is long-standing, Kellos said, patients are seen on a regular basis and followed closely.

“Chronic pain is an ongoing process and treatment isn’t an overnight thing,” she said. “Something that works wonders for someone else might not work at all for you, and we tell our patients to try to not get frustrated and to hang in there because eventually we will find that miracle for you, too.”

Morrill said she hopes more people will seek help for their chronic pain.

“You don’t have to live in constant pain,” she said. “Don’t make yourself have to sit around wrapped in a blanket. Don’t be tied up in the pain. Don’t put yourself through it. There’s too much help out there.”

SOURCE:- Ogden Publishing Corporation

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