MeritCare Pain Management Specializes in Pain Relief

For Myrna Krogman, the low-back pain became so severe she could barely sit, stand, walk or even sleep. Unrelenting, the pain affected her everyday life. "It was the worst burning ache," says the 68-year-old from Ottertail, Minn. "I couldn't do anything around the house anymore - cleaning, cooking, even pushing a vacuum cleaner."

For Myrna Krogman, the low-back pain became so severe she could barely sit, stand, walk or even sleep. Unrelenting, the pain affected her everyday life. "It was the worst burning ache," says the 68-year-old from Ottertail, Minn. "I couldn't do anything around the house anymore - cleaning, cooking, even pushing a vacuum cleaner."

Myrna's long-standing pain stemmed from arthritis and spinal stenosis (a narrowing of an area of the spine that can cause painful compressions.) Surgery several years ago had helped, but in recent years, after trying various approaches and going to several doctors, nothing worked well. And she disliked the drowsiness caused by the pain pills.

A year and a half ago, thanks to her husband, Jack, she decided to try one more option – and it was the option that worked. Researching the Internet for back-pain remedies, Jack came across information about a new type of implantable pain-control pump called "intrathecal drug delivery." The system automatically delivers a small dose of medication to the precise area of the spinal cord where it's needed. MeritCare Pain Management in Fargo was the closest location to offer it. "That was a place we hadn't yet tried - we're really glad we did," says Myrna.

Under the care of Dr. Majid Ghazi, a board-certified, fellowship-trained specialist in pain management, Myrna underwent a thorough evaluation, including tests confirming she was a candidate for the treatment. Dr. Ghazi proceeded with the minor surgical procedure to implant the pain-control pump. About half the size of a fist, it's located under Myrna's skin on the left side of her abdominal area. A thin flexible tube - also located under the skin - carries medication from the pump to the site where it's needed. To this day, Myrna continues to get much-appreciated relief, returning to MeritCare in Fargo every three months to get the pump refilled with medication. "I can walk better, sit better, even stand long enough at the stove to brown a roast," she says. "It's wonderful to be without back pain."

It's worth seeking help
Myrna is grateful for the help she received, but many people with chronic pain never get to that point, as Dr. Michael Gonzales knows well. A board-certified physical medicine and rehabilitation specialist, he has more than 25 years' experience in chronic-pain management and now serves as the managing physician partner of Pain Management.
He and Dr. Ghazi devote their full-time practices to helping patients with chronic pain, working closely with a multidisciplinary team. The team combines the expertise of anesthesiologists, psychologists, nurse practitioners, nurses, physical and occupational therapists, exercise physiologists, social workers, nutritionists and other professionals as needed.

"Many times patients with chronic pain get frustrated and give up on finding help. Believing they just have to live with the pain, they get discouraged and stop seeking medical care," says Dr. Gonzales. "In the meantime, the pain continues to damage their quality of life, slowly eroding their ability to function. This can lead to depression, anxiety, changes in personality and shifts in family roles. A person who was the breadwinner, for example, may become disabled by chronic pain and unable to work. Chronic pain can have devastating effects, but it doesn't have to be this way. Our goal is to help people restore their function and improve day-to-day life."

From listening to treating
At MeritCare Pain Management, the goal of restoring function begins with the simple act of listening. "The most important step in treating chronic pain is to listen carefully to what the patient is telling us," says Dr. Gonzales. "Yes, the pain may be associated with an objective finding such as a spinal fracture, but what that person is experiencing is completely subjective. We listen carefully to the patient to better understand the pain, and we continue to listen in order to assess how the course of treatment is working."

MeritCare offers several types of pain management treatments. Examples of interventional treatments include the implantable pain pump, nerve blocks and spinal cord stimulators; examples of non-interventional treatments include physical or occupational therapy. Each treatment or combination of treatments is tailored to meet individual needs.

"One of the newer interventional options we're particularly excited about is radiofrequency treatment," says Dr. Gonzales. "In carefully selected patients whose neck or back pain has been resistant to other treatments, we have successfully reduced patients' pain by 50 percent or more, with relief lasting several months, even a year. It's been a very gratifying treatment, and one that can be repeated as needed." Available as an outpatient treatment at the Pain Clinic, radiofrequency involves the injection of an electrical field to inactivate a nerve. A mild sedative may be used during the treatment, and patients can typically resume their normal activities the next day.

For some patients, the only help that's needed is to get them started on the appropriate medication. "The newer medications, including some good non-narcotic options, have been very effective in controlling certain types of chronic pain, but often patients aren't aware of them," says Dr. Gonzales. "There's also the misconception that it's somehow wrong to rely on medication. In fact, the use of appropriate medication can be very helpful."

For more information
If you have pain that occurs on a regular basis (either continuously or nearly every day), and if the pain has lasted longer than the normal healing period for your particular disease or injury, consider MeritCare Pain Management. The specialized, dedicated team welcomes patients with any kind of chronic pain, including constant pain caused by arthritis or pain caused by diseases such as cancer. "No matter what the situation, we can help," says Dr. Gonzales. "We want our patients to get on with enjoying their lives rather than struggling with pain every day."

For more information or to make an appointment, please call (701) 234-7400.