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Living without Pain

Kristina Lopez, age 50, has been struggling with back pain since 2002. Diagnosed with a compressed disc, she underwent three back surgeries to alleviate the chronic lower back pain she was experiencing, but they were unsuccessful.

Over time, enjoying a walk, riding in the car, shopping, and even dinner with friends became almost impossible. Seeking solutions, Kristina met with numerous pain management physicians who prescribed several options including physical therapy and injections. Unfortunately these treatments didn’t help. She was prescribed a variety of pain medications which would either be increased or substituted with another medication altogether, depending on the physician. At one point, Kristina was taking five different medications, several times a day, including Morphine and Vicodin.

In 2010, while suffering from a serious case of strep throat, Kristina’s husband, Orlando, took her to the emergency room where her condition was deemed serious enough that she was admitted to the hospital. Unfortunately, Kristina had not brought her pain medications with her and living in a rural area, they were quite a distance from home. The physicians at the hospital were unauthorized to prescribe or dispense the medications that Kristina took for her pain which meant she would have to go without them. Within a few hours, as she began to go through horrible physical and emotional withdrawal, it became apparent to Orlando; the chronic pain was significantly impacting Kristina’s life and the medications had completely taken her life over.

“Each time we would see a new pain management physician it was like they were playing poker and the chips were the medications,” Orlando states. “After the initial consultation, they wouldn’t even lay a hand on her to examine her. Instead they would just write another prescription and toss it across the desk, increasing the dosage amount, the quantities, and even give her completely different medications to take. It wasn’t helping the pain—it was just masking it.”

Orlando knew his wife desperately needed help. After her stay in the hospital, he contacted their family physician, begging him to talk to Kristina about the seriousness of the situation.

“My doctor was firm and direct,” Kristina explains. “He bluntly told me that if I didn’t get off of these powerful medications, I would end up like Michael Jackson, Anna Nicole Smith and Elvis, rolled into one. I knew deep in my heart he was right. Additional surgeries were not an option and the pain medications, no matter how many I took, were not helping. I was running out of options. My doctor told me I had two choices: Find a place to detox or enroll in Marianjoy’s Integrative Pain Treatment Program to get help for the chronic pain condition and rid myself of the medications.”

Kristina began to research facilities but was unable to find one that could treat both her chronic pain and medication issues. She then made an appointment at Marianjoy.

On her first visit to the Integrative Pain Treatment Center, Kristina and Orlando met with the case manager who explained the concept of the 21-day outpatient program. After being accepted into the program, she then met with the medical director of the program, Dr. Jeffery Oken, who performed a thorough physical evaluation and helped her set her goals.

“I had high expectations and an equally high level of commitment entering the program,” acknowledges Kristina. “Their approach is integrative as there are many facets to the program and a variety of components that go into your care. I wanted to get as much out of the psychological sessions as I did out of the physical therapy sessions. But my personal goal was to get completely off the medications.”

Almost immediately, the intense work began.

“What was amazing to me was that in the initial visit with her physical therapist, she immediately identified that Kristina’s shoulders and her hips were out of alignment,” Orlando explains. “The therapist didn’t have results from any of Kristina’s MRIs or X-rays in front of her. She concluded this just by touching and evaluating her. We both wondered why none of the other doctors or therapists had ever discovered this. She gave Kristina some exercises to help her adjust her posture, balance and stance, and others to help her strengthen her core. There was progress almost immediately. It was incredible.”

“They gave me a number of strategies to help with the pain,” she notes. “For example, we live quite a distance away and have over an hour drive to get to the program. They suggested I give myself an extra 15 minutes for travel. Halfway through the trip, I stop, get out of the car, walk around and stretch to help me tolerate the ride - a coping technique known as ‘pacing.’ Something so simple has made a tremendous difference.”

It was two weeks into the program that Kristina called Orlando on her way home from the program, crying.

“In these past eight years, it wasn’t at all unusual for me to get a phone call from her at some point during the day, upset and crying because of the amount of pain she was in,” Orlando explains. “So I’m immediately thinking the worst, like she’s quit the program. Once she composed herself a bit, she told me this was the first time in eight years that she didn’t have any back pain. They were tears of happiness! I wasn’t prepared for this phone call. I knew at that moment, a window had opened for her and she was coming through it—and that she’d never go back again.”

Kristina explains further. “I had realized the previous day that I wasn’t feeling the usual nagging pain in my back. It was almost too good to be true so I didn’t say anything to anyone; instead I just held my breath, waiting for it to return. I went to the program the next day and still no pain. I couldn’t believe it!”

Two and a half weeks into the program Kristina conquered another milestone; she had weaned herself off several of the medications except for the Morphine and Vicodin. Two weeks after completing the program, Kristina would be completely off the Morphine. Because of its withdrawal symptoms, she has struggled with quitting the Vicodin completely but continues to work with her family physician in slowly lowering the dosage. She hopes to be completely free of it in the early months of 2011.

“My life is so much fuller now,” confirmed Kristina. “Orlando gave me a plastic toolbox that I would use to carry my pain medications in case we got stuck somewhere and couldn’t get home in time for my next dose. Now, my ‘toolbox’ is these two binders that I’ve filled with hand-outs of the exercises, stretches and psychological tips I received while in the program that help keep me healthy and pain free. I am diligent about my stretches and exercises as I know it’s the key to keeping me moving.

“I came to Marianjoy with a myriad of issues that needed to be addressed. They in turn used an integrative approach to help me heal. They taught me how to pace myself, plan ahead, and gain control of my activities. Now my quality of life is incredible.”

Orlando agrees. “Prior to the program, we would go to the store and in 15 minutes, she’d be asking me for the car keys so she could go lie down or I’d have to get a power scooter because she couldn’t walk any further. Two weeks into the program, we were out at the store and became separated. Eventually, I realized quite a bit of time had gone by and that she hadn’t approached me to say she couldn’t walk any further. Instead, after looking around for her for a few minutes, I realized that the woman who was pushing a cart a few aisles down from me was actually my wife. I honestly didn’t recognize her. She was standing straight up, in complete balance, walking confidentially. It was amazing to see!”

Kristina has accomplished three personal milestones since leaving the program. She went peach picking in Michigan—enduring the long ride there and back as well as the physical activity of picking the fruit. She also went to a marching band competition recently and sat on the hard, uncomfortable bleacher seats for hours, experiencing no pain. Her final milestone though was a long time coming.

“We went camping on our 26th wedding anniversary,” she says, tearfully. “We really enjoy camping and it was the first time in over 15 years I was physically able to go.”

Asked how the Marianjoy program was different then the other programs she had tried, Kristina doesn’t hesitate.

“First, Dr. Oken has a vast knowledge and expertise in the field of pain management. The nursing education I received was also wonderful. I learned more about my body than I ever knew before. And having the psychological component allowed me to get feedback on my concerns and issues. For instance, they helped me realize that the medication and the downtime I was giving myself weren’t helping; it was all actually working against me. Finally, the therapists taught me so much and encouraged me. When I was receiving therapy it was very evident that during my sessions, I was their sole focus. I had not experienced that before. It was evident that they really wanted me to get better and succeed in the program.

“Working one-on-one with each clinician was wonderful but where I received the most benefit was in the periodic meetings we would have together called staffings,” she continues. “My care team would talk about my progress, including any challenges I was facing as well as identifying and praising my successes. It was in these meetings that I saw my whole journey of recovery come together—the physical, psychological and practical—and was able to see how all the pieces fit together in making each goal more attainable. This was one of the biggest differences I saw in Marianjoy’s programs from the other programs I had been in. The staffings were very important to my healing.”

Once Kristina is no longer taking the Vicodin, she will return to see her therapists for one final check-up to ensure that other issues related to her physical pain have not surfaced.

“There were some lucky convergences that allowed me to be successful,” she continues. “It was the right program, the right team of professionals, and the right time for me. I was committed and I really needed this program to work. Prior to entering the program, I had done a self-evaluation and I had to really think about what I wanted to do with the rest of my life. Being in pain and using medication to mask it was no longer an option for me.”

For those looking for a pain program, Kristina offers this advice. “Even though you think you’ve tried everything and the doctors have convinced you that you’re as good as you’ll ever be, try this program. Go in with an open mind and open heart and give 100 percent. You have a chance to make your life better.”

 “I know one thing for certain,” confirms Orlando. “They gave me my wife back.”

Kristina welcomes comments or questions about her story. She can be reached at