My journey with chronic pain

Contributed by: Sara Gilbert Nadler-Goldstein
Reviewed by: Elsbeth McSorley, MA

 

When one lives their life on a daily basis, no one would ever imagine in the course of a second it would change forever. I never thought that I would be victim of those very words. On May 24, 2003 I was in a car accident on a parkway and rear-ended by two separate cars with two separate impacts. That day changed my life forever. I had been a medical social worker for well over fifteen years spanning the scope of practice from the acute care hospital setting to acute rehabilitation and then in a skilled nursing facility. I practiced in the role of case manager and discharge planner. I knew how to navigate the medical system for others. However, you never think that you are going to be the patient.

What followed was a year filled with many doctor appointments spanning various fields of medicine including neurology, orthopedics and pain management. I did receive two epidural injections, and that did not provide the necessary relief that I needed. In March 2004 I saw my neurologist and had an MRI. The results showed that my back was seriously injured and that I should go to Columbia Presbyterian Medical Center (Neurological Institute) in New York, New York.

At that point in time what followed was that I was given the name of world renowned neurosurgeon Dr. Paul McCormick, Director of The Spine Center at Columbia Presbyterian Neurological Institution. Little did I know this was the beginning of my good fortune. On March 30, 2004 my mother accompanied me to the Neurological Institution where I had undergone this consultation. The surgeon told me that I had a herniated disc and that it was affecting various nerves in my spine. He even showed us a model of the spine and explained the intended surgical procedure he was to perform. I arranged to have my spinal surgery at Columbia Presbyterian on April 12, 2004.

After the surgery Dr. McCormick monitored my physical healing as well as my emotional well-being. It was recommended by my neurosurgeon that several months after surgery, I should see a pain management physician. He was recommending this level of care for me as well as educating me on the role of a pain management. He was most detailed in his explanation about chronic pain. At that point in time I was not ready to accept that chronic pain would be part of my life. I thought I could heal myself by means of medication as well as physical therapy. Dr. McCormick said that he would give me time to come to terms with this information of my diagnosis of chronic pain.

During that time period I tried physical therapy as well as medications however there was no improvement in terms of my pain. I was most desperate at this point to accept that I needed help. In May 2005 I contacted Dr. McCormick’s office and was provided with the name of a highly regarded pain management physician at Columbia Presbyterian that he wanted me to see, Dr. Michael L. Weinberger. Dr. Weinberger is the Chief and Director of the Pain Management Department as well as Palliative Care.

At that point little did I know that this was the beginning of my good fortune. In June 2005, when I presented myself to Dr. Weinberger at The Pain Center I told him that I was in desperate need of help and he was my last hope. I told him that I wanted to lead a full and normal life that consisted of no pain medications. After a thorough examination was completed, films were reviewed, and all my medical records, Dr. Weinberger immediately presented me with a plan of care. He suggested that I consider a spinal cord stimulator as a modality for dealing with my chronic pain. That day he sent me home with a video tape and reading material about spinal cord stimulation so that I could learn about this possible treatment option. In the meantime, he put me on a regime of pain medications to determine if that would help.

On my follow-up visit several weeks later I reported that these pain medications were sedating me as well as leaving me with no desire to eat. They also made me feel so dizzy that I could not drive my car and I needed to be able to drive. At that point the decision was made to go ahead and start the process for a spinal cord stimulator which is an implanted and is connected to leads and electrodes and targets the areas of pain with a vibrating, tingling sensation. Instead of the brain perceiving pain, it alternates the brains signal from pain to a tingling, vibrating sensation in the affected nerve areas. The process was completed over the period of several months, beginning with a psychological evaluation and then proceeding with the trial.

My trial period was in October 2005 with Dr. Weinberger he did an excellent job in mapping out my areas of pain prior to the trial. After the surgery for the trial, I remember being in the recovery area crying out of happiness that for the first time I was not in pain. I was then instructed to test the device out at home for a week because the leads were not permanently implanted and I was given a hand held device similar to that of a remote control. I was instructed to journal my pain levels for a week. A week later I returned to see Dr. Weinberger and his team of fellows and residents. I stated that I had greater than 75% pain relief and if this could be duplicated for the permanent implantation then I would like to proceed with this method of treatment. I was most determined as Dr. Weinberger knew to lead a full an independent life and to be able to drive to Long Island where my mother resides.

In December 2005 I had my permanent implantation of my spinal cord stimulator with Dr. Weinberger. I am most grateful to acknowledge that my goals were achieved not to be on any pain medication, and to be living a full and normal life, engaging in all kinds of activities for well over seven years. This past December, the day before the date of my initial implantation, I went into Columbia Presbyterian to have surgery with Dr. Weinberger to replace the battery for my spinal cord stimulator as it had reached its end of life. I am fortunate to say that I have my new battery now and am able to do my daily spinal exercises which Dr. Weinberger says are important for maintaining a strong and healthy back. This even includes going to the gym several times a week pain free!

Dr. Weinberger has given me the most important gift and that is my ability to lead a full and normal life. It is important that the patient have an open and honest relationship with their pain management physician as well as all the healthcare providers working on the patient’s behalf. I was most privileged to have that level of care, and continue to receive that level of care nine years later. Dr. Weinberger is caring, compassionate, and understood the complexities of my medical conditions. He is an excellent listener and understood what my goals were and continues to understand my goals to this day. His clinical excellence made these goals a reality for me. In addition, Dr. Weinberger understands me as a whole person. That is significant in your treatment because mental health affects your medical health, your outlook for the future, and how you will live your life.

This past May 2013 was the ten year anniversary since the accident and in June I celebrated my 50th birthday. I could not have reached these milestones in my life without the care and compassion that Dr. McCormick, Dr. Weinberger, and Dr. Blanco have displayed over the years. Every day when I use my spinal cord stimulator I reflect to how grateful I am for this special gift. As of June 2013 I have been under the care of Dr. Weinberger for eight years and whenever I thank him at an office visit, through a note, or during a telephone conversation, his reply to me is always the same. He says, “Sara you did all the work.” I always say to him that I could not do the work unless a good foundation was built, and most certainly he built this foundation for me.

The last ten years have not been easy for me. There were many surgeries and I had to learn to live life with a new normal. As a patient you must stay resilient, strong, and want to be well. Dr. Weinberger knows as well as Dr. McCormick, and Dr. Blanco, that my gratitude runs deep and I have a very positive outlook for the future.

 

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