September and the cooler autumn air stirs wistful feelings for Kim Dahl. Until three years ago, Kim drove a regular school bus route in Anoka, a job she loved. On August 1, 2007, a day no one will forget, Kim's life changed. She was driving a school bus filled with children on a field trip when the bus crashed in the I-35 Bridge collapse. With a broken back, Kim managed to keep her foot on the brake while 52 children and staff escaped through the emergency exit. While she has become a national hero, Kim's physical condition will never been the same.
Kim had been dealing with debilitating chronic back pain for two long years before she sought treatment at Twin Cities Pain Clinic. Her goal was to get off the high-dosages of medication that were causing her to feel drowsy and unable to move through the day. After trying a few different options, Dr. Andrew Will, TCPC's Medical Director, put Kim on an intrathecal pain pump trial.
The impact of the bus slamming into the rising piece of bridge caused her vertebrae to compress in the thoracic or upper spine very close to her diaphragm. Dahl also had two large disc herniations that led to more severe leg and back pain. Dahl already had had back surgery to fuse part of the spine, months of physical therapy, and she tried radiofrequency to disrupt the spinal nerves - and yet her pain persisted. “It hurt like heck," said Dahl, who admitted to growing angry with her slow recovery. “I was realizing that I would never be able to drive bus again, but I still wanted to be able to take care of my kids, cook their dinner, do my own laundry and garden. I love my flowers," said Dahl, 33, who resides in Anoka.
Kim Dahl (far right - pictured here with Nurse Practitioner Molly McNaughton and TCPC Medical Director Dr. Andrew Will, M.D.) has her intrathecal pain pump refilled at Twin Cities Pain Clinic every two months.
The intrathecal pain pump appeared to be the answer for Kim's unrelenting back pain. “It delivers medication directly into the spinal fluid at the source of pain. Unlike oral medications, this delivery method puts the medicine just where it's needed without affecting the rest of her body," said Dr. Will. The lower dosage required for good pain control with the pain pump can be as little as 1/300 of the standard oral dosage.
The pump has reduced her pain so that Kim has returned to her garden this summer. “I still feel some pain, but the pump does take the edge off so I can do some of my daily activities again without feeling tired or sick," said Kim.
 The intrathecal pain pump has two implantable components: an infusion pump and an intraspinal catheter. The pump is placed in a subcutaneous pocket, while the catheter is inserted into the intrathecal space of the spine, tunneled under the skin and connected to the pump. Medication can be delivered at variable rates. Parameters are set on the pump by authorized medical staff and locked so no patient could ever deliver more than a set amount in a 24-hour period. “We may set it up so a portion of the medicine is delivered at a constant rate and then we have Kim's pump set so she can give herself five boosts per day, also called a “bolus," and she can control that with her remote control," said Dr. Will.
“If I know I will be doing a lot of laundry or gardening, I'll give myself a boost of medicine," said Kim. “I'll never be able to drive a bus again because my back can't tolerate the vibratory motion. And I'll miss Waite House Summer Kids and my yearly school route, those kids were like my own kids," said Kim, who is a mother of three. “I don't think of myself as a hero. I was very thankful I kept my composure to land that bus safely. I did what any parent, school bus driver, or any normal person would do."
To learn more about the intrathecal pain pump, treatment options with a physical therapist, or back pain Minneapolis pain patients can visit Twin Cities Pain Clinic online - or call to schedule a consultation.
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In the medical and psychological communities, the idea that a sick person's mental status and stress-coping mechanisms affect their body is hardly new. Years of studies have demonstrated the power of the mind in healing the body: keeping an optimistic attitude lessens chronic pain and speeds recovery. Some studies suggest that optimism boosts the immune system - preventing disease and helping the body recover from illness faster - and a recent Mayo Clinic study even shows that people with an optimistic outlook live 20 percent longer than those who see the glass half-empty.
For chronic pain patients, there are obvious health benefits to being optimistic - but is your personal attitude and outlook on life really something you can control? Can you actually turn years of pessimistic and depressed thoughts upside down during a time of such great challenges for your body and your mind?
Yes.
Many lifelong pessimists fall into a behavior pattern called learned helplessness - a sense of a complete lack of control over one's life, or that one's actions are futile and will have no effect on the outcome of a bad situation. In a way, the patient has “given up" on changing his or her situation. First theorized by psychologist Martin Seligman in the late 1960's, learned helplessness is an all-encompassing life outlook that affects the way an individual copes with emotional as well as physical pain: uncontrollable bad events disrupt a person's ability to adapt to stress, while controllable bad events can be changed or avoided (making them less stressful).
Chronic pain patients often fall into this pattern because they begin to see their pain as an uncontrollable event. Without the comfort or hope of relief, pain patients can easily fall into depression, reject the support of loved ones, or abandon their search for solutions. It's important to stay positive by remembering that treatment centers - such as Twin Cities Pain Clinic in Edina, Minnesota - provide a wealth of innovative treatment options and programs for managing chronic pain. The “helpless" coping style is learned - and it's possible to retrain your outlook by disputing your own views (“Is there really nothing I can do about my pain?"), building a support network, and actively looking for a solution to your problem.
Don't let pain control your life - or define who you are.
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