How is she different now then when you last saw her?

Dr. Mehta: When I saw her first she was very nervous sitting in her chair, not moving very much and actually a couple times looked like she was going to doze off because of the dose of medication. This is not somebody that is addicted to pain medication and so forth, this is someone that unfortunately needs a dose of medication to help her pain but is now reaching her side effects.

What kind of medications?

Dr. Mehta: Things like morphine and other morphine based pain medications. These are medications that when used in the right way can be helpful.

Who would this be helpful for and who would it not be helpful for?

Dr. Metha: The best candidate would be somebody that has pain going in to the extremities. So in the arms, in the legs, back pain with and neck pain. What has been studied are people who had surgery and still have residual pain. People who have something called complex regional pain syndrome--where the nervous system now actually is false alarming in simple terms and causing pain signals to fire even though nothing is really going on. Now, there are many pain physicians across the country that are actively studying using this for other things, such as chest pain when you’re already had stents and bypasses and still have residual chest pain, abdominal pain from pancreatitis, or having pain in the legs from poor circulation. These are things that are still very experimental and not been FDA approved. But again our hope is that somewhere down the road that these will prove to be effective.

Is this FDA approved?

Dr. Metha:  For the type of pain she has ,yes.

How does the procedure work?

Dr. Metha: It is very simple to do. It’s like having an injection but instead of putting medication we put a wire. There are no incisions and there are no scars. If for some reason the trial was not effective, they come in to our office and we pull the wire out and put a Band-Aid on it and there’s no lasting effect. The point I’m trying to get across is that there really isn’t a lot of downside to trying this.

How many people have you been involved with that have come in and it had no effect?

Dr. Metha: usually I‘d say about ten, anywhere from ten to twenty percent of patients will not have a response that’s favorable. Meaning it didn’t address their pain or they didn’t like that sensation. Again as we talked about, it changes from one sensation to another. But for the rest they’ve all gone on, eighty percent of patients go on and have a permanent implant.

Is it immediate relief?

Dr. Metha: It’s like a TV remote, you’re given a box and you turn it on and you can increase the intensity or decrease. Depending on the position you may change how much you need. There are companies out there like Medtronic, who currently is working on something that can actually sense position changes and they are using that for people who change when they’re seated versus standing up. The technology is ever evolving and we think that this is only going to grow in terms of the number of people that can actually benefit from it.

How about Kathryn?

Dr. Metha: She’s honest that her pain is not zero, but it was enough for her to get back to what she wanted to do in life. That’s the most important thing. We talk about pain scores ten out of ten versus five, everybody has their own subjective pain. But what I look at is what she’s able to do. Is she able to walk? Is she able to have her life back? That’s the most important thing and for her the answer is yes.

FOR MORE INFORMATION, PLEASE CONTACT:

Neel Metha, MD
(646) 962-7246

painmedicine@med.cornell.edu