October Newsletter 2010

Retired California Prison Warden Finds Persistence Can Be the Answer to Pain

Raymond Ramirez has some salient advice for other pain patients: Don't give up the first time you hear a doctor say "there's nothing more we can do."

For years, Raymond listened to the stories of murderers, terrorists and life-long criminals. Before retirement, he had served as an associate warden in the California Department of Corrections and Deputy Commissioner on the Parole Board, seeing inmates with life sentences. But when it came time to find a doctor to listen to his story of debilitating pain, he fell short until he saw the staff at Twin Cities Pain Clinic.

"From the very first visit, I felt like Dr. Will listened. He looked over all my reports and we had a good talk,” said Raymond. "He helped answer a lot my questions and my wife, Barbara, and I marveled at Dr. Will's abilities.”

Raymond Ramirez showcases a picture painted by his mother. Before receiving a neurostimulator from Twin Cities Pain Clinic, Raymond was extremely limited by his chronic pain.

Raymond had been looking for answers to his persistent pain for three years. It started with leg pain in 2006, first the right and then the left. He received the diagnosis of degenerative disc disease and began an endless series of procedures that never brought anything more than temporary relief - surgery, water therapy, acupuncture, and injections. "It got worse. My pain was a 9 or 10 at times. I could barely walk hunched over with a cane and finally I wasn't leaving the house for anything other than doctor visits for more than a year,” said Raymond. One doctor even told him there was nothing he could do or even suggest. "Your hope goes out the window and it's difficult to move on from there,” he added.

At Twin Cities Pain Clinic, Raymond was considered a candidate for neurostimulation therapy, a battery-powered device that interrupts the pain signals to the brain. "I felt the difference right away. This small device has a tremendous amount of technology packed into it."

Raymond had the neurostimulator permanently implanted in July 2009 and has had no complications. His pain hovers around a level 5 and can be helped with additional pain medication if needed. The best part is that he's able to walk, ride in a car comfortably and even fly. "I never would have been able to do this last year. It's a gift from God,” said Raymond.

To learn more about the neurostimulator and other pain management procedures and physical therapy practices, please click here.

Measuring Your Pain: How Doctors Standardize the Subjective

Pain is - in its nature - a personal experience. Though it has a definite physical cause, your pain is as subjective as your emotions and identifying its root cause can be difficult without a concrete method of defining it.

For your doctor, measuring a patient's pain is as difficult as it is for the patient to describe it - and fortunately, there are a number of ways around it. By using predefined pain scales, physicians can acquire a more accurate picture of their patients' pain levels, form a better diagnosis, and ensure that they prescribe the right treatment.

Most chronic pain patients are familiar with the "0-10" pain scale. Patients are asked to rate their pain level on a scale of zero to ten, with zero representing "pain-free" and ten representing the highest level of pain imaginable; the test is simple, non-specific, and often the most effective and accessible way to reach a patient. Some doctors favor more complex methods of assessment, such as the McGill Pain Questionnaire - a series of specific descriptors that ensure an accurate picture of the patient's pain experience.

While these pain scales are useful for assessing most adults, children - and some disabled adults - require nonverbal methods of assessing pain. Most children over six or seven can be evaluated using the "0-10" pain scale, but young children of speaking age may require the Wong-Baker Faces pain scale - a series of ten drawings of human faces requiring the child to indicate which face best describes his or her pain. Doctor observation is an option for younger children and adults unable to communicate their pain verbally - the Faces, Legs, Arms, Cry, Consolability (or FLACC) scale makes use of visual and behavioral cues to measure pain.

Often physicians will ask their chronic pain patients to record their pain levels daily or during certain tasks using a Visual Analog Pain Scale on a scale of zero to ten. Varying situations - such as an emergency room visit versus a monthly appointment with a pain specialist - require different methods of analysis, and having an effective method of measuring pain makes the diagnosis more accurate. For a chronic pain patient, being able to communicate pain levels in a medically standardized way opens a world of opportunities in pain management - and in life.