An Independent supplement by medIAplAnet to usA todAy spinal stenosis Interstitial cystitis ClICK dancing with the stars empowering patients to ReAd judge Carrie Ann Inaba with the tools to take About shares her story control SLEEP

September 2012 chronic pain Finding Power over Pain Singer Paula Abdul opens up about life with Reflex Sympathetic Dystrophy Syndrome Photo: f Photo: oX

“As an athlete, pain is inevitable.” NFL Wide Receiver Laurent Robinson tackles a discussion on concussions.

Certifi ed Registered Nurse Anesthetists Alleviating Pain for 150 years www.aana.com 2 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy chaLLEnGES In 2011, the Institute of Medicine released a report on a medical condition that affects 100 million Americans and costs more than $600 billion dollars annually, more than heart disease, cancer, and diabetes combined. Yet few Americans are aware of this We recommend Be an advocate. condition and medical professionals receive little training in its treatment. Bill Walton talks about managing chronic back pain Be part of the solution. The invisible medical disorder pAge 10 he condition is Living with pain skills, and much more. The goal Take action TODAY with chronic pain, Pain may be invisible, but its of pain management is to restore defined as pain impact on the person is over- quality of life and level of func- a pain advocacy resource that persists whelming. It affects one’s abil- tioning while reducing the sense chronic Pain, 1st edition, sePtember 2012 beyond the ity to think clearly, complete the of suffering. that provides inspiration, expected heal- basic tasks of daily life, hold down Publisher:Gina Lafleur [email protected] pain-related news, ing period for an a job, or have any quality of life. Raising awareness Business Developer: Janel Gallucci illness or injury or pain from any People with pain are stigmatized Unfortunately, most health [email protected] downloadable materials T Designer: aran Kim source that goes on for three or and isolated. Left untreated, pain care professionals have little Managing Director: Luciana colapinto more months. One of the most will not only destroy the person knowledge in pain management [email protected] and tools to inform and Penney Cowan Editorial Manager: sara Quigley misunderstood health care issues with pain, but too often the fam- Founder, executive director, because it is rarely part of their [email protected] empower people with pain, health care today in spite of its prevalence ily, as well. American Chronic pain Association training. People too often are left Contributors: Paula abdul, Pat anson, and cost, pain is invisible, unde- During the month of Septem- to their own devices to manage faye brookman, maggie buckley, professionals, caregivers and other tectable on x-rays, blood tests, or ber, we work to raise awareness “unlike most their pain. Penney cowan, carrie ann inaba, barby ingle, nelly nitram, Ziv m. Peled, cindy concerned individuals. any other measure. and understanding of chronic medical conditions The good news is that it is pos- riley, Laurent robinson, Jill smits, bill sible to live with chronic pain. It Walton, Lynn Webster, s. tim Yoon, with specific causes, barbara Zarnikow chronic pain does requires a coordinated approach drawing on the skills of a multi- Distributed within: IntheFaceofPain.com/USAToday not lend itself to a Usa today, september 2012 disciplinary team on which the this section was created by mediaplanet ‘cure.’” person with pain plays a vital role. and did not involve Usa today or its editorial departments. 1/3 With more awareness and educa- oF aMeRICanS Visit the app store on your smartphone, pain. Unlike most medical condi- tion about chronic pain among CLICK THE ADS SUFFeR FRoM tions with specific causes, chronic professionals, people with pain, TO LEARN MORE download a QR Code Reader and scan SoMe FoRM pain does not lend itself to a and the public, we can reduce the this barcode to explore pain advocacy “cure.” economic impact of this invisible fofoLLoWoW UsUs on facebooK & tWitter! resources now! oF PaIn facebook.com/MediaplanetUSA Rather, chronic pain must be epidemic and help to restore the twitter.com/MediaplanetUSA managed using an interdisciplin- lives of the millions who suffer mediaplanet’s business is to create new ary approach that includes medi- daily. customers for our advertisers by providing cation, physical therapy, counsel- Penney Cowan readers with high-quality editorial content that motivates them to act. ing, stress management, coping [email protected]

www.PurduePharma.com

A service of Purdue Pharma L.P., Stamford, CT 06901 I003-01 08/12 4 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy An independent supplement by mediAplAnet to usA todAy septembeR 2012 · 5 inSpiraTion inSpiraTion

patient education: Filling your toolbox ■ Question: As an athlete, ■ Q: What pain did you Laurent how do you manage pain? experience due to your ■ Answer: As an athlete, concussion? I live with Ehlers-Danlos “Keep a pain journal sleep hygiene, nutrition, massage, pain is inevitable. The game of ■ A: It felt like I was dreaming Syndrome (EDS), a genetic meditation, distraction, acupunc- Robinson, football is a contact sport and you at first —I didn’t know where connective tissue disorder to help you gather ture and prescription pain medica- are going to get hit and pushed I was. A few days after that that causes painful joint information to share; tions. Combining these tools pro- Jacksonville around. You have to continue to concussion, I had some dislocations. vides the most powerful pain relief get up and line up for the next headaches and mild neck pain. where it hurts, when because each one chips away at the play. ■ Q: Why is it important to As a child, I relied on adults to it hurts and what pain a little bit. Jaguars’ ■ Q: What is your experience you that people learn to take speak for me to access medical makes it feel better.” Your first tool in advocating for with concussions? concussions seriously? care. Health care providers did yourself is communication. You ■ A: I have had a few ■ A: It is important for players Maggie Buckley wide receiver, not believe me when I said I hurt are the expert on your unique body. concussions throughout my to take concussions seriously Volunteer Patient advocate because I didn’t have the words or Always be respectful and clear in football playing career. My first because of the long-term effects knowledge to adequately describe dangling hammers. I am battered viders respectfully and commu- your descriptions, expectations weighs in on one in the NFL was my rookie after our playing careers are the pain. As I grew older, it became and aching all over.” That is the nicating clearly has helped me and requests for treatment. Keep year versus the Colts on a slant over. The more you know about clear that I needed to learn anat- language it takes for others to fill my pain management toolbox a pain journal to help you gather pattern where the corner hit me concussions and safety now, the omy, medical jargon and much understand. with treatment options and cop- information to share; where it concussions so hard, the ball flew up, and the better your life will be in the long more to advocate for myself. Working with health care pro- ing techniques, including exercise, hurts, when it hurts and what pass was intercepted. I had to run. Sadness, anger, calm… emotions makes it feel better. Chronic (per- go to the sidelines and perform tiPs alone don’t make the point that sistent) pain is a multi-faceted all the necessary tests. After a nelly nItRaM EDS causes pain. Just saying, “I’m ■■ create a daily activity sleep, money worries, and condition that requires a multi- quarter, I was able to go back in. [email protected] in pain,” is not enough. To fully checklist to help you to see even the weather. a pain modal approach. Use a pain scale understand, health care provid- where you are having difficul- log can help you track the and define what each level means ers need to know where it hurts, ties with everyday activities. everyday things that have an to you. Be patient as you try differ- how long it lasts, what causes pain ■■ Prepare for each healthcare impact on your pain. ent treatments on your journey Absolutely indispensable to flare, and how the pain feels visit by tracking any new ■■ Follow-up from your to identify which combination of app for people (burning, aching, heavy). Advocat- symptoms or improvements visit. it is important that after options work for you. Eventually, with chronic pain. ing for me means saying, “Mov- since your last visit. your appointment with your your toolbox will be filled with var- ® Award-Winning! ing my body feels like I’m walk- ■■ Create a pain log. many doctor you follow through with ious pain management tools too. 5-Star iPhone app. ing through a tropical storm on a things can affect your pain. what was discussed during Know listing ship with bags of pebbles when a is too ChronicPainApp.com these can include stress, your visit. Hit A Leader in Postacute strapped to my feet while wearing MaggIe BUCkley SoURCe: aMeRICan ChRonIC PaIn aSSoCIatIon a jacket hooked with a thousand [email protected] Hard. Brain Injury Rehabilitation. The streets aren’t the only Shockbox ® place kids find drugs. Football Helmet Sensor Sends an immediate alert to a Smartphone Sometimes they find them right at home. that a player has experienced an at risk hit which may result in a concussion. For over 30 years Centre for Neuro Skills (CNS) has been recognized What can parents do? You have much more influence on your children than Used in Pro and High School Football. as an experienced and respected world leader for providing intensive you think! They watch what you do and adopt your values. Even though they Keeps track of hits to the head. Endorsed by Laurent Robinson post acute community based brain injury rehabilitation. With facilities pretend that they aren’t listening... they are! For more information about how you Better Way Back in California and Texas, CNS’ highly trained staff offers outcome can help prevent prescription drug abuse, visit www.SafeguardMyMeds.org. 9.75 x 2 inch driven medical treatment, therapeutic Educate yourself • Keep medications in a safe place • Dispose of old or unused medications properly rehabilitation and disease management Apps Available for | Blackberry iPhone & Android services for individuals recovering from acquired and traumatic brain injury. For additional information about CNS, go to theshockbox.com /ImpaktProtective neuroskills.com or call us at 800.922.4994. www.PurduePharma.com A service of Purdue Pharma L.P., Stamford, CT 06901 www.safeguardmymeds.org 6 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy nEWS

For Certified Registered Nurse Anesthetist Jackie Rowles, developing a comprehensive treatment program for pain management is crucial, no matter the patient.

facts certifiedre gistered pain knows no boundaries nurse anesthetists

(crnas) at a Glance vide diagnostic and therapeutic write prescriptions in his state. ■■ tYPes of Pain Nurse anesthetists have injections which are sometimes treated bY crnas He points out, “In the 30 years been providing anesthesia care done using fluoroscopy or ultra- I’ve been doing anesthesia, I’ve to patients in the United States sound visualization. seen the profession go from a for 150 years. “To watch someone’s pain certificate program to doctorate ■■ CRNAs are anesthesia pro- lessen to where he/she can level. We’re taught techniques in NECK PAIN HEADACHE fessionals who safely adminis- become more active and involved placing epidural catheters to take SHOULDER ter more than 33 million anes- in life again because their pain PAIN mom’s pain away during labor thetics to patients each year in has been managed enough to and delivery or post-op pain in a POSTHER- the United States. get them back to work, or allow MUSCLE/ PETIC patient having abdominal or joint ■■ CRNAs are the primary Janice J. Izlar, CRNA, DNAP them to play with their children TENDON PAIN replacements.” president, AAnA PAIN LOWER providers of anesthesia care or exercise again, is just amazing. BACK Kane adds “These homegrown PAIN in rural America, enabling “CRNAs administer more than 32 HIP PAIN New Englanders are blind when healthcare facilities in these “I care for teens, students, execu- million anesthetics to patients it comes to the letters after my medically underserved areas tives, farmers, construction each year in the U.S. and are the name. They live in a world where

to offer obstetrical, surgical, workers, professional athletes, primary provider of anesthesia SCIATICA doctors are few, and to get their pain management and trauma mothers, fathers, retirees, nurs- care in rural America, according care they see Physician Assistants stabilization services. In some ing home patients, and disabled to Janice Izlar, President of the and Advanced Registered Nurse STUMP PAIN PERIPHERAL states, CRNAs are the sole pro- patients. Pain knows no boundar- American Association of Nurse VASCULAR Practitioners.” viders in nearly 100 percent of ies.” Anesthetists. In fact, nurses were DISEASE TENDONITIS the rural hospitals. Rowles, a longtime registered the first professional group to ■■ According to a 1999 report nurse, works at Meridian Health provide anesthesia services, as far from the Institute of Medicine, Group in Carmel, Indiana and back as the 1800’s. anesthesia care is nearly 50 has specialized in chronic pain CRNA John Kane runs a pain times safer than it was in the management care for 10 years. As office in Wolfeboro, New Hamp- SoURCe: aMeRICan aSSoCIatIon CIndy RIley oF nURSe aneSthetIStS early 1980s. a trained CRNA, Rowles can pro- shire and has the authority to [email protected] ■■ Managed care plans recog- nize CRNAs for providing high- quality anesthesia care with Managing Pain, BUiLding reLaTionSHiPS reduced expense to patients and insurance companies. The ■■ Question: How can a nurse ground, with smoke coming out ments, resulting in considerable Flachmeyer, an avid fisherman cost-efficiency of CRNAs helps anesthetist make a difference of my clothes. It was extremely pain. We’ve been treating him and hunter says, “The difference control escalating healthcare in a patient’s life? painful. “ with cervical epidurals with good going to Brian is like night and costs. ■■ Answer: by providing pain Flachmeyer spent nearly a year success.” day. Within ten minutes of the ■■ According to a recent sur- relief while also forming a recovering, and was fitted with Bradley, who works at a practice first shot, I had no pain at all. Plus, vey, nine out of 10 Americans personal relationship. prosthetic arms. He eventually focusing on disc herniations, spi- I can go ten miles from where believe it is crucial that Medi- found work in the security field, nal stenosis and facet disease, says I live for treatment. Otherwise, care protect patient access to It was a Good Friday Dan Flach- married and raised three children. most of his patients are referred I’d have to travel 110 miles to get pain management delivered by meyer will never forget. Just But in 1999 he fell on a job site and to him for treatment from local treatment. Brian also has a great CRNAs. 14-years-old, he was trying to suffered a serious neck injury. It orthopedic spine surgeons and bedside manner and answers ■■ A minimum of 7-8 years of remove a fish hook from a power wasn’t until he met CRNA Brian neurosurgeons. all my questions. I trust him, education and experience are line using a stack of aluminum Bradley, years later, that he truly “The work is very rewarding. because he knows what he’s required to become a CRNA, tent poles. found relief from the pain. Chronic pain management pro- doing.” and 40 hours of continuing “ The pole hit the line and I lost Bradley explains , “Dan wears a vides me with the ability to estab- education is required every two both my arms and some toes, “ prosthesis that crosses his neck. lish relationships. I get to know years for recertification. explains the 46-year-old Montana The pressure on his neck broke the patients and their families on CIndy RIley [email protected] [email protected] native. “I was smoldering on the down some of the spinal seg- a much more intimate level.” 8 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy An independent supplement by mediAplAnet to usA todAy septembeR 2012 · 9 nEWS doCTorS SaY new geneTiC TeST CoULd insiGht revoLUTioniZe Pain ManageMenT Physicians at the forefront The art and science of pedic surgery, physiatry, and PGT testing patients who seem to have the same pharmacogenetics in pain manage- Helping patients psychiatry are at the forefront of Millennium is one of the nation’s back problem. One patient would ment. The study, which will encom- “I think we’re still very early in the treating these patients. But no largest urine drug screening com- need 50 mg of morphine a day and pass more than 30 trial sites in the game in understanding which pain management matter the specialty, we have the panies, but PGT is a saliva-based the other would only need 10 mg. It United States, will evaluate the genes you should test for that will same goal, to provide patients in test — designed to detect genetic didn’t make any sense, really.” relationship between a patient’s make a difference,” said Harry pain with a safe and comprehen- variations in enzymes that influ- genetic variations and clinical out- Leider, MD, chief medical officer of Three years ago following shoots of major medical centers The line has to be found sive yet individualized treatment ence how a patient’s metabolism Pharmacogenetics comes. Ameritox. “There aren’t many stud- a stroke, Rick Fraum and are staffed by physicians between those who need the program. processes opioids. That informa- Tennant believes PGT testing will “Individual genetic differences ies out there that will really support experienced excruciating uniquely qualified to treat issues medications and those abus- Chronic pain not only debili- tion will help physicians modify give physicians an extra tool that in medication metabolism can that if you test for this gene, it will pain in his wrist. After such as chronic back pain — one of ing them, added Bogema. That’s tates each individual sufferer, dosages, anticipate side effects or will help them prescribe opioids significantly impact the efficacy of help you make a decision about how consulting with his family the biggest maladies. “Typically where monitoring comes in. But but also significantly affects our Pat Anson Lynn R. Webster, MD, editor, national pain Report practitioner who couldn’t change medications for patients to tailor therapy for a patient.” you find a group of physicians the screening and testing must president-elect, American Academy society and our economy. The who don’t respond well to opioid But Forrest Tennant is convinced solve the issue, Fraum coming from different specialties be done with experts and with the of pain medicine medical cost of pain care and the One doctor calls it the therapy. “by identifying patient- the time has come for genetic test- sought treatment at a pain such as anesthesiologists or spine right tools since even tiny varia- economic loss related to disabil- “Holy Grail” of patient drug The company first introduced specific drug metabolism, ing. management clinic. and back specialists,” said Stuart tions can yield false results. One third of Americans suffer ity and lost wages and productiv- therapy: a genetic test that PGT to a select group of physicians “This is going to be a godsend. For Bogema, Jr. a toxicologist who Pain management clinics are from the debilitating effects of ity ranges from $560 billion and can tell physicians why in June and is now expanding its pharmacogenetic testing the first time, we have scientific, Of the 100 million Americans suf- consults to pain management also becoming a great choice for chronic pain which not only $635 billion, excluding military some patients react poorly use to other healthcare profession- can potentially pave objective tools at our hands that we fering from some form of pain, providers. “Pain treatment has those in need since more and prevents them from working, service members and older adults or differently to opioid als who want to incorporate the the way for personalized can use to justify regimens that are estimates are that at least half are grown into a specialty.” more are taking all of the services but also from engaging in the living in long-term care such prescriptions. emerging science of pharmacoge- Angela Huskey, pharm.d., Cpe, odd and to help our patients,” Ten- living with chronic pain that, like Pain management clinics fuse in house, according to Michael normal activities of daily life. as nursing homes, where the netics into their practices. Associate Vp, Clinical Affairs, millennium medicine in the field of nant says. Fraum, halt them from enjoying art and science. The art is the Bartlett, director global financial This number includes patients known presence of painful condi- laboratories; Research scientist, Some believe it could revolution- “I’ve been waiting 30 years to millennium Research Institute; American pain management...” daily activities. knowledge of the physicians to services at Thermo Fisher who who suffer from spine, head- tions is very high. ize the field of pain management do this kind of testing,” said For- society of pain educators Industry pain According to research from prescribe a mixture of treatment said clinics now have the cutting ache, facial and arthritis pain, as Physicians should be dedicated educator of the year and result in more effective care of rest Tennant, MD, a longtime pain Peter D. Hart Research Associates, ranging from meeting with psy- edge equipment and have brought well as members of our return- to their patients, but also advo- chronic pain patients. physician in the Los Angeles area. more effectively. medication therapy in pain care. By read more 40 percent of those with severe chologists, physical therapists, testing in house to keep costs ing military, over half of whom cate on their behalf for better care Millennium Laboratories Tennant has long suspected that “Right now I’ve got an awful massage therapists and even down and provide speedy moni- and more research so that their identifying patient-specific drug ■■ National Pain Report pain have made appointments report suffering chronic and announced the launch of its phar- genetic differences in patients lot of questions that I don’t have metabolism, pharmacogenetic test- nationalpainreport.com with specialists and seven in 10 acupuncturists. The team puts toring and treatment. persistent pain. quality of life can be enhanced. macogenetic test (PGT) during influence how patients respond to answers for. But at least we’re ing can potentially pave the way for Americans feel pain research and together a pain management plan Physicians from a variety of We owe them nothing less. PAINWeek in Las Vegas, a national opioid treatment. starting,” said Tennant. personalized medicine in the field management should be one of the that also involves strict monitor- specialties, including anesthesi- conference attended by nearly “A few years ago, I became aware Last month, Millennium of pain management,” said Angela medical community’s top few or ing of pain medications since ology, internal medicine, neurol- lynn R. weBSteR, Md 2,000 frontline practitioners in the that there was something differ- announced the start of a large Huskey, associate vice-president of Pat anSon top priority. many of these — specifically opi- Faye BRookMan ogy, neurological surgery, ortho- [email protected] field of pain management. ent about patients. You take two clinical study examining the use of Clinical Affairs at Millennium. [email protected] The pain clinics are often off- oids—can be addictive. [email protected]

confirmation monitoring tools Pain management is hard enough for patients—it shouldn’t be hard for the lab too. From drug screening and monitoring to results confi rmation, labs rely on Thermo Scientifi c solutions to achieve the highest storage and preparationlevels of productivity and confi dence in results. Whether your lab is small or large, our technical and business solutions—from immunoassays, consumables, instruments and software to fi nancial and compliance services—enable your business to better serve patients. for managing pain therapies screening • explore Thermo Scientifi c solutions at thermoscientifi c.com/painmanagement sample collection painmgmt_horiz_7.indd 1-2 9/10/12 10:08 AM 10 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy An independent supplement by mediAplAnet to usA todAy septembeR 2012 · 11 inSpiraTion inSiGhT Take CONTROL of your BACK PAIN Q & a Bill Walton, the basketball great who played under overcoming spinal stenosis S. Tim Yoon John Wooden at UCLA has never forgotten the game that AND take control MD/PhD Q: Who are the best understand what it’s like to be in associate Profes- wrecked his back — and changed his basketball career and life. neWs in brief sor, director of candidates for this, and pain. As a dancer, I loved my body. of your LIFE clinical research, Understanding TENS department what would you warn I don’t mean the way it looked, of orthopedic against? but the way it worked. It was my Devices for lower back pain surgery, emory University A: It is extremely important engine, my base, my source of In basic terms, electrotherapy to note that the vast major- everything. When I found myself in uses electrical energy to address ity of patients with chronic BaCK in THe gaMe pain 100 percent of the day, unable medical conditions ranging Q: What exactly is low back pain should not have to even go for car rides without from edema to incontinence. It minimally invasive spinal surgery. In fact, I spend “i had lost everything. But now i’m back excruciating pain, I hated my is also used as a method of pain surgery? a great of time counseling body. It was a terrible feeling and management, and can be deliv- A:Minimally invasive spi- patients against spinal surgery in the game. There is hope.” it caused a bit of depression I think. ered via a transcutaneous elec- nal surgery is a cutting-edge especially for chronic low back restriction.” At least his troubles would be over. I was sad that my body was letting trical nerve stimulation (TENS) technology that is a potential pain. However, patients with Carrie Ann Inaba He eventually transitioned into Finally, at the age of 56, Bill Judge, dancing with the stars me down. And I could tell people device. treatment option for spinal dis- low back pain need to be evalu- a broadcasting career, where the submitted to back surgery after got bored of having to leave places Simply put, TENS distracts orders, as well as chronic back ated by non-surgical special- constant travel (200 nights a year trying various non-surgical treat- ■■ Question: What are some early if they were with me because I patients from pain by caus- and neck pain. The goal is very ists (primary care physicians, New FDA cleared technology physiatrists, neurologists, etc.) on the road) compounded the prob- ment options. In February 2009, he unique challenges you have was hurting so badly. Or I could see ing a tingling, pulsing sensa- much the same as any tradi- for the management of lower tional spinal surgery, which is who should determine whether lems with his aching back. underwent a minimally invasive faced as a dancer with they just thought I was overacting. tion. James W. Matheson, PT, back pain! to decompress pinched nerves the cause of the low back pain is “I lived in this increasingly surgery. spinal stenosis? MS, says, “A TENS unit utilizes ■■ ■■ and remove bone spurs that can correctable with surgery. These unbearable world of pain and dis- “I just wanted my life — any life— Answer: Because of where my Q: Why did you decide to a counter stimulus of electri- Wireless handheld remote press on the nerves or to fuse causes include isthmic spondy- ability,” he said. “I ate my meals on back,” said Walton. After his sur- spinal stenosis is, it’s up high in my tell the world about your cal stimulation to interfere or control…control your pain the lolisthesis (a slippage of the ver- painful spinal segments. the floor, face down. I couldn’t get gery, he was amazed by the relief neck, I have been told not to dance, spinal stenosis? mask painful stimuli.” instant you need it! tebra), severe forward bend of sleep. I couldn’t get dressed.” he experienced from his excruciat- punch, or get into a car accident ■■ A: I decided to share it because Q: What are some of the the spine (typically due to pre- At one point, feeling like there ing nerve pain. because I could easily become I don’t think a lot of people know Uses No wires, bulky back wraps, vious surgery), severe scoliosis, advantages of minimally was no hope, Bill stood atop a tall “I began to do things again I paralyzed. Because of the whiplash what spinal stenosis is. And I think According to Christopher or belts…a back pain device and some spinal stenosis (nerve invasive spine surgery Bill Walton bridge and contemplated jumping. hadn’t been able to do in years, like designed to fit your lifestyle root pinch). Patients with these element being so dangerous for me, they suffer needlessly because they Proulx, DC, MS, TENS can be versus other traditional PHOTO: BARRY GRIMES put on my own shoes and socks and I don’t do any partnering dancing. don’t know about it. If I help make used to address both acute and diagnosis could become candi- Thin, lightweight, flexible, and surgical options? bend over and pet the dogs,” says So I hope that people are not people aware of it, and it helps chronic pain. And while it does dates for surgery but only after discreet…so comfortable you A: Minimally invasive surgery In January 1974 when playing Walton. offended when I decline a request ease the pain of one person, I have not treat the mechanism of failing other conservative treat- forget you are wearing it! is a way of making the surgery ment modalities. Minimally Washington State, Bill was “low- Today, the basketball great has a to dance with them. It’s because helped and that’s important to me. pain, it can help patients under- less destructive to the soft invasive spinal surgery tech- bridged” by an opposing player that message for anyone contemplat- I don’t want to end up paralyzed. take other therapies. Easy to use and operate tissues of the patient. It also niques can be used to reduce flipped him upside down on his ing minimally disruptive spine ■■ Q: How do you empower “For some chronic patients, reduces the overall time for the recovery period in many ■■ Q: What advice would you yourself as a patient? the patient to recover, as well back, sending him falling hard to surgery. “I had lost everything. But it may be uncomfortable to patients who need surgery, but give to others who also want ■■ A: as reduces the amount of pain the wooden floor. now I’m back in the game. There is I ask tons of questions. I perform therapeutic exercise not all patients. Each case will “I broke two bones in my spine hope.” to pursue their dreams but also take notes. Words I don’t due to pain,” says Proulx. “But the patient experiences post- need to be evaluated by an expe- that night, and things were never suffer from pain? understand, I write them down with the use of TENS, they may surgery. Some of the other rienced surgeon. benefits include: reduced blood the same for me again,” he recalled. ■■ A: You know your body best, you and I Google them. I also go to chat be able to perform therapeutic loss and scarring, improved Bill received treatment but was have to listen to it when it speaks boards and read blogs of people exercise to progress their con- function, and smaller surgical still not his best. “It was always to you. Don’t wait until it’s yelling who have similar conditions. If dition.” The World’s First incisions. nelly nItRaM [email protected] there,” he said. “That pain. That at you. Hear the whisper of pain they suggest a medication, I read True Wireless TENS for Back Pain discomfort. That limitation. That [email protected] first, then go easy, slow it down a all the side effects and check to Advances bit, don’t push yourself into a pain make sure it’s the right medication TENS is evolving to become To order or for more info contact your situation. If you want relief and for me. The doctor doesn’t know more user friendly and cost healthcare provider, local independent pharmacy want to continue doing what you everything about me so it’s my job effective. Proulx says if technol- or visit www.coreproducts.com/WiTouch love the most, you have to seek out to inform him of everything I think ogy and accessibility advances ADVANCING WWW.NUVASIVE.COM or call 800-365-3047 SPINE SURGERY the remedies that work for you. is important. And then double continue, its usefulness will check. It’s my health and my body increase. “It’s not a magic bul- Our commitment to Speed of Innovation®, Absolute OUR CORE INNOVATIONS INCLUDE: ■■ Q: Did you ever have —not theirs. They are experts but let, but can be used to improve Responsiveness®, and Superior Clinical Outcomes • Maximum Access Surgery (MAS®) Platform moments where you felt you I’m the one who has the ultimate movement, which in turn ® has propelled NuVasive® as an industry leader and • Safe and Reproducible Lateral Access Surgery Solution (XLIF ) needed to defend yourself • Nerve Avoidance Monitoring System (NVM5®) say on what I am going to do for improves therapy, activities of revolutionized how spine surgery is performed. • because others didn’t A growing number of Biologics, Cervical and Motion treatments. daily living, and quality of life.” To learn more about Hollywog or Preservation Products understand your invisible JIll SMItS WiTouch, visit hollywog.com 7475 Lusk Boulevard, San Diego, CA 92121 1.800.455.1476 illness? [email protected] ■■ [email protected] Made in the USA © 2012. NuVasive, Inc. All rights reserved. , NuVasive, Speed of Innovation, Absolute Responsiveness, M5, NVM5, and XLIF are registered trademarks of NuVasive, Inc. A: ALL THE TIME! People don’t ©2012 Hollywog 11S.1044 0912 12 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy An independent supplement by mediAplAnet to usA todAy septembeR 2012 · 13 nEWS

don’t miss Some have compared it to a urinary tract infection that never goes away. Barbara Interstitial Cystitis (IC) is a debilitating medical condition that Zarnikow tion continued to worsen, and co-chair, can go untreated for years. board of I quit working for a year due to directors, interstitial the severity of my symptoms. I cystitis rarely talked about my condi- association tion, even to my husband. He was shocked to hear that I was Finding hope: in pain every single day. This The journey disease was negatively impact- Living with interstitial cystitis (ic) through pain ing every aspect of my life

My journey with Interstitial Finally, a diagnosis “Patients often state it feels like back to living a productive life,” Dr. Whitmore points to a 42 Cystitis (IC)began in 1995. I woke One day my internist recom- they have ground glass or a hot Evans explains. “While there’s no -year-old female, with 20 voids a up one day feeling like I had a mended that I make an appoint- poker in the bladder,” says Robert clear cut way to cure this disease, it day, five trips to the bathroom at very bad bladder infection. The ment with a urogynecolo- Evans, M.D., Associate Professor can often be controlled.” night and discomfort with a full terrible burning felt like my gist, who formally diagnosed of Urology at Wake Forest Baptist Unfortunately, only 50 percent of bladder. Her pain was severe , she bladder was filled with acid or me with interstitial cystitis. Medical Center. “The symptoms of IC sufferers tell their doctors, and feared for her job, and had sexual broken glass. Tests at my doc- Though getting diagnosed pain, urgency and frequency don’t many health care providers don’t secondary pain. Through stress tor’s office showed no signs of didn’t relieve my pain, I felt improve with antibiotic or over- ask,” says Kristene Whitmore, management, bladder instilla- an infection. I was baffled asking relieved to finally have a name active bladder therapy. It’s more M.D., Medical Director of the Pel- tions, physical therapy and trig- my doctor how I could be in such for what I was going through. commonly seen in women than vic and Sexual Health Institute at ger point injections, she improved pain and not have an infection. I have not been cured, but men, but can occur in all ages.” Drexel University College of Medi- dramatically. She was eventually The pain continued and my my symptoms continue to be The chronic bladder condition cine in Philadelphia. “The quality promoted and is sexually active. urinary frequency increased. I helped with medication, dietary affects 4 to 12 million Americans of life is worse than diabetes, and According to physical therapist was going to the bathroom at restrictions and yoga. Physical and might be caused by a deficit in the pain is worse than arthritis. Bernadette Kamin, “Most IC suf- least 40 times a day. Halfway therapy and cauterization of the bladder lining layer. Thirty percent have neuropathic ferers are in pain 24/7. IC patients through a less than 20 minute ulcers have also been very help- “There are many options avail- pain, which is a more severe type are frustrated, sleep-deprived, commute to work, I had to stop ful. I have learned to advocate able, and most patients can find a of pain, and can become incapaci- depressed and some have contem- at a hotel and run in to use their for myself and to talk with oth- treatment that will help them get tating.” plated suicide.” restroom. Road trips meant stop- ers about my condition. facts Kamin says it’s important to ping at every rest stop. Going to empower patients with tools to a concert meant standing by ■■ 100 million = number of diagnosis of ic. gain control and better manage the doorway so that I could use americans who suffer from ■■ in the Us, the mean yearly their symptoms on a daily basis. the restroom as often as needed chronic pain, of those 12 million costs for treating ic are more They may include a home exercise without climbing across a row of may have interstitial cystitis. than double those of other program, relaxation and breathing people. ■■ ic can affect anyone. Women, patients. techniques, proper posture and Over the next five years, I men, and children of any age or ■■ Pelvic pain resulting from body mechanics, along with blad- saw many urologists and tried race can develop ic. ic can be so severe that many der retraining. numerous different treatments. BaRBaRa ZaRnIkow ■■ on average, it may take up to people with ic abstain from all During this time my condi- [email protected] five years to receive a correct sexual activity. CIndy RIley [email protected]

So You Have IC, Now What? Newly Diagnosed Tool Kit: Interstitial Top Questions IC Patients Ask • Top Treatments for IC Cystitis Visit: www.ichelp.org/NewPatientToolkit Association 14 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy inSiGhT

Paula Abdul talks pain, support, and hanging in there. Drug-free therapy for don’t miss BeTTer daYS advanceded pain managememanagement Turning Pain into POWER Ten years ago, I was in a minor car accident. Those eight sec- aHead onds changed my life trajectory - Non-invasive and has brought me to a place ■■ Question: What are some of the pain I was dealing with at the in life I never saw for myself. I unique challenges you time. Honestly, there were some - Painless learned motivational skills as have faced as a celebrity very dark days; however, the people a cheerleader growing up, but with Reflex Sympathetic that loved me unconditionally are - Drug-free never knew how much more I Dystrophy Syndrome (RSD)? still in my life supporting me today. would learn after developing ■■ Answer: Regardless of my Reflex Sympathetic Dystrophy “celebrity” status, I faced two major ■■ Why did you decide to tell Syndrome (RSD). challenges: isolation, and the the world about your RSD? Through my motivation for quest for knowledge about what ■■ A: The assumptions being a cure, I am turning pain to was happening with my body. The made about me were just so off POWER! How am I doing it? truth is, it’s a complicated disease to the mark. I felt like I was already I am taking life moment by explain to people. At the end of the fighting the pain… did I want to moment. I believe in myself. I day, the people who really love you start fighting people’s perceptions, have a goal of motivating oth- hang in there, and I’m so grateful too? My appearance on Dr. Oz was ers through my actions. I know for the people that hung in there so freeing—for the first time I felt firsthand how hard it is to con- with me. like I was understood. The whole - Brachial Plexus Neuropathy tinue looking for relief, perfect experience of sharing that with the answers, and then coming up ■■ Q: You continue to do world was truly liberating for me. I - Phantom Limb Syndrome against healthcare profession- what you love every day, felt like I could give back to all the als who blow you off or do not despite the challenges people who so generously shared - Pudendal Pain believe what you are saying posed by your chronic pain. a wealth of information with me. could actually be what you are What advice would you give I felt like I could help give them a - Postherpetic Neuralgia (PHN) experiencing. to others who also want to voice, and create more awareness.

As I search for a cure, I have pursue their dreams but I want to encourage people that X

Fo - Post-surgical Neuropathic Pain become my own best advocate. suffer from pain? there really are better days ahead,

I feel strongly about sharing ■■ A: Look, I can only speak from and to hang in there. oto: pH the knowledge I have learned so my own place of pain. It was that everyone can be their own imperative for me to constantly - Chronic Neuropathic Pain best advocate. Even after seeing check in with myself, and to be nelly nItRaM over 100 healthcare profession- clear on what pain I was feeling. Of [email protected] als, having major surgeries I did course, I encourage people to do as - Visceral Pain not need, complications such as much research as much as possible. rsd facts internal bleeding, medication That has been invaluable to me. interactions, kidney stones, Really take the time to inform ■ burning pain is the hallmark million americans with rsd. tumors, and so much more — I yourself, and try to connect with symptom of rsd. feeling as if ■■ rsd was first diagnosed over Competitive Technologies, Inc. did not give up or give in! I was what’s going on in your body. you are fire and can’t put out it 150 years ago by dr Weir mitchel tested to my limits and real- out. a military surgeon in the civil war. ® 1375 Kings Hwy. East ized they are past the boundar- ■■ Q: How important is ■■ anyone can get rsd (all ■■ there have been over 20 CALMARE having a support network to ages, races, and both men and names for this condition includ- ies I placed on myself. I had to Pain Therapy Treatment become the Chief of Staff of my you? women). it affects females 3 to 1 ing rsd, crPs, causlagia, 203.368.6044 ■■ own medical team. If I can do it, A: Before I actually learned what over males . Polytrama neuropathy. it is ® anyone can. the correct medical diagnosis was ■■ one limb will be a few degrees most commonly known as rsd, www.calmarett.com for what I was experiencing, it was different then the other . reflexs ympathetic dystrophy. BaRBy Ingle very difficult for people to fully ■■ there are approximately 10 [email protected] understand and accept the severity 16 · septembeR 2012 An independent supplement by mediAplAnet to usA todAy An independent supplement by mediAplAnet to usA todAy septembeR 2012 · 17 nEWS THe BaTTLe oF THe Migrane:

The NHF advocates for those experiencing headache, employing the most effective idenTiFYing, TreaTing, and means to disseminate information and knowledge about headache. www.headaches.org Moving Forward

Dr. Ziv M. Peled nose, toes, and head and neck temple if those areas are involved. tiPs peripheral nerve area can be irritated or pinched, During surgery , the surgeon finds and plastic FCI continues to advance its goal surgeon which can cause people to become the nerve and removes a little bit to develop and execute programs symptomatic. No one knows why of muscle or connective tissue to dedicated to addressing the root this happens to some people and create space for the nerve so it is no causes of Fibromyalgia and Chronic Fatigue Syndrome. not others. As far as we know, it’s longer pinched. ■ Question: What is a just bad luck. There’s not much you www.fibrocoalition.org migraine? can do to prevent it or treat it with ■■ How can a reader find a ■ Answer: A migraine is medications or a lifestyle change. specialist? thought to be some type of ■■ A: This is a subfield of plastic chemical imbalance, usually ■■ How do you diagnose surgery with only about a dozen in the central nervous system pinched nerve as a cause? people specializing in it. Google of the brain. nobody really ■■ A: The process begins with a “migraine surgeries” in your region. knows what the chemical complete history and physical Anyone who is also a member of ■ see a headache specialist imbalance is. this explains exam. Be sure to bring your any the American Society for Peripheral or neurologist if your pain Improving the lives of millions why there are many different previous imaging studies (e.g. Nerve practices regularly and changes or you have a of women who experience headache lasting more than vulvovaginal pain or painful medications and treatments an MRI of the brain) in for your should have the proper credentials. sex through education, support, for migraines. 35 million consultation. During the physical You should see a neurologist for 72 hours. research and advocacy. people have migraines. exam, if the tender areas are found a comprehensive workup before www.nva.org For many of those people, corresponding to potential areas seeing a specialist. You will want a ■■ Keep a headache diary. the medications and other for nerves being pinched, that can migraine diagnosis and an MRI to tracking changes in diet, treatments aren’t effective. be good clinical evidence that a rule out herniated disc, arthritis, hydration, and sleep can pinched nerve is the culprit in your aneurism, or a brain tumor. Only help identify your triggers. ■ Why do peripheral nerves case. You can then use Botox to relax when all the other modalities have matter? the muscles pinching the nerve or failed do you want to consider ■■ try complimentary Putting an end to the neglect, ■■ dismissal and discrimination A: There’s a theory that a local anesthetic if appropriate. If surgery. therapies. many people find faced by women suffering from migraines are not a problem in your surgery is required, it is performed yoga or massage therapy help chronic pain. central nervous system, but rather a as an outpatient and through a 5-6 reduce the frequency of their www.EndWomensPain.org problem in your peripheral nervous cm incision (in the back of the neck) dR. ZIv M. Peled headaches. system. The nerves that go to your or a smaller incision in the front or [email protected]