Rising above the pain: alternatives to opioids

March 22nd, 2018
Patrick Gaines crouches on a knife-edge ridge during a peak climb. He uses climbing, running and alternatives to opioids to cope with chronic pain.
Climbing Colorado’s toughest peaks has helped Patrick rise above chronic pain from a spinal tumor. Photo courtesy of Patrick Gaines.

First came the spinal tumor.

Doctors successfully removed it and Patrick Gaines, 50, recovered from temporary paralysis that had incapacitated him from the neck down.

Next came excruciating pain that never goes away.

Patrick Gaines with his young son in the hospital after he had to have surgery for a spinal tumor. When Patrick was using alcohol and marijuana, his son told him he had to stop.
Patrick in the hospital with his son after he had to have surgery for a spinal tumor. Photo courtesy of Patrick Gaines.

“It feels like my skin has been lit on fire and I’m putting it out with dry ice,” Patrick said.

To cope with the pain, Patrick tried a variety of medications including opioids. The side effects were terrible. He couldn’t function in a job he loves. After months of suffering, Patrick turned to binge drinking and marijuana after work to try to check out and dull the pain.

But then his son, Christopher, who was only 14 at the time, spoke up.

“He came to me and said, ‘Dad, I can’t come home and find you dead.’”

Patrick’s heart broke that day.

But his devastation sparked determination.

“Superman’s cape came off,” Patrick said.

‘Pain inevitable, suffering a choice’

Always a hero and role model for his son, Patrick knew he needed help standing back up after a hard fall.

He immediately checked himself into a rehabilitation program his insurance covered in California.

Empowered upon his return, Patrick started using healthy alternatives to cope with his pain.

“In rehab, I learned this isn’t about battling the pain. It’s about carrying it. Pain is inevitable, but suffering is a choice,” Patrick said.

Patrick Gaines sits on a couch in his psychologist's office at the UCHealth Center for Integrative Medicine, where he uses alternatives to opioids to treat pain.
Patrick Gaines uses alternative therapies to cope with non-stop pain. Here, he does a session with Meredith Shefferman, his psychologist at the UCHealth Integrative Medicine Center.

Now he’s back to doing sports he loves including ultra marathons and challenging peak climbs in the Colorado Rockies. To cope with his pain, he has embraced several alternative treatments including biofeedback, acupuncture, Reiki, meditation and EMDR, which stands for Eye Movement Desensitization and Reprocessing. Patrick also focuses on eating well, exercising regularly and doing regular one-on-one and group therapy.

In his journey to heal without pain medication, Patrick receives critical help from Meredith Shefferman, PhD, his psychologist at the UCHealth Integrative Medicine Center in Denver’s Stapleton neighborhood.

She said Patrick is remarkable.

“He’s such an inspiration,” Shefferman said. “The amount of pain he’s carrying could be debilitating, but he’s found many ways to cope with it. He shows that you can live a happy, healthy, productive life even with pain.”

Brain tumor crushed the spine

Patrick’s ordeal with chronic pain began in 2014. He had played Pop Warner football as a boy. Since then, every once in a while, he’d get a quick jolt of pain in his neck like a pinched nerve. It always went away, so Patrick didn’t think much of it.

One night, the divorced dad was home alone when the pain in his neck hit him. He grabbed a bag of frozen peas and lay down. Patrick fell asleep, but woke at 11:30 p.m. unable to move anything on his left side. He was petrified that he was having a stroke and called 911.

Patrick is the executive director of the Gates Center for Regenerative Medicine, a research center at the Anschutz Medical Campus that supports scientific breakthroughs in stem cell therapies.

While Patrick would have chosen to go to UCHealth University of Colorado Hospital close to his office and where he knows many doctors, he lives in the Ken Caryl Valley, so paramedics rushed him to the closest trauma ER. Doctors there determined that he wasn’t having a stroke. But, they found a tumor called a hemangioblastoma that was crushing his spinal cord. By 6 a.m., Patrick was in surgery. In order to remove the tumor, doctors had to cut some nerves.

Patrick Gaines runs with mountains in the background. He does ultra-marathons in Colorado and around the world. Running and other alternatives to opioids help him cope with pain.
Patrick Gaines during one of his ultra-marathons near Leadville, Colorado. Photo courtesy of Patrick Gaines.

After an eight hour surgery, Patrick was relieved to learn that the tumor was not cancerous. But about a month later, the unrelenting pain began. Doctors told him that the tumor and the surgery to remove it had left his spinal cord injured.

“I was very scared. It’s intimidating when something like this invades your body,” he said.

Doctors expect his spinal cord to gradually heal over about 10 years, but in the meantime, Patrick faces non-stop suffering.

“It’s roughly a third of my body on the left side down to my toes. Deep tissue massage is incredibly comforting, but water, clothing and light touch is painful 24/7,” Patrick said.

“I was prescribed opiates, anti-seizure drugs and anti-depressants. On my own, I was supplementing those with marijuana and alcohol.”

By August of 2015, Patrick checked into rehab.

The philosophy at the program he attended was to introduce patients to as many alternative therapies as possible and let them find methods that provided some relief.

“Every day, we did Reiki, cranial-sacral therapy, yoga, Pilates and meditation. We were able to access the gym and work with a Native American healer. Their philosophy was, here’s a host of non-invasive, non-narcotic modalities. Let’s help you find what works for you.”

Alternatives to opioids: training the body to calm down

Shefferman has reinforced all of the methods that worked best in rehab for Patrick and has continued to teach him new techniques.

An alternative to pain medications that she says works for many people is biofeedback. She uses a method called HeartMath.

“It’s an evidence-based approach for training the body to relax,” Shefferman said.

By hooking a small sensor from Patrick’s ear to a computer, she can monitor variability in his heart rate and help him increase his awareness of how stress affects his central nervous system.

“We can train our bodies to calm down. With the biofeedback sensor on, you can see in real time how stress is affecting the body. Then I can teach relaxation and emotion-shifting skills, and you can literally watch your body begin to relax,” Shefferman said.

Biofeedback works well for people who are dealing with chronic pain and anxiety disorders.

Shefferman said pain serves a biological purpose.

“It’s an alert system for the brain to signal that something is wrong. It’s usually an indicator of illness or injury. Then that triggers a stress response,” Shefferman said. “It’s the body’s way of trying to solve a problem.”

When a person like Patrick is perpetually in pain, the system goes into overdrive.

“It’s fatiguing for our body to constantly be in a stress response or fight-or-flight mode,” she said. “That’s where biofeedback is very effective.”

Shefferman said Patrick came to her with a lot of meditation and mindfulness skills that he had been practicing for years.

“The biofeedback was really helpful in showing him how meditation could affect him in real time. I taught him additional breathing and emotion-shifting skills so he could learn how to cultivate positive emotions,” she said.

“He could then see on the screen how it was helping his body calm down,” Shefferman said.

Short-term therapy, long-term benefits

Providers at the Integrative Medicine Center provide patients with short-term treatments. The idea is to teach patients new skills in a handful of sessions that they can then keep practicing on their own. The Center accepts patients with most major health insurance plans.

“We try working with patients no longer than six months because we want our patients to learn the skills they need to take their health back into their own hands” Shefferman said.

The Center also offers classes like a 6-week mindfulness meditation class that proved invaluable to Patrick.

Patrick Gaines poses on a rocky outcropping on a Colorado peak. He has used alternatives to opioids and exercise to cope with chronic pain.
Patrick Gaines enjoys one of his peak climbs. Photo courtesy of Patrick Gaines

He also worked on another therapy with Shefferman called EMDR, a method that works well for people with a history of trauma and post-traumatic stress.

EMDR is tied to the rapid, darting eye movement that we all have when we are in the most restful phase of sleep, known as the REM phase. Our eyes move from side to side as our minds and bodies restore themselves.“The two sides of the brain are communicating with each other and processing the events of the day. REM sleep helps your brain process all the events that have happened,” Shefferman said.

When people experience traumatic events, their brains have trouble processing and storing away those memories. The trauma remains so vivid that it can keep causing fear and pain years later.

EMDR can help patients process the trauma and properly store it away.

During the treatments, patients hold paddles in their hands. Shefferman asks them to think about a traumatic memory and try to figure out where they feel it in their body. Then Shefferman can send signals through the paddles that stimulate the two hemispheres of the brain to communicate with each other and reprocess the traumatic memory. Research has shown that EMDR can be highly effective for trauma survivors like military veterans and victims of sexual violence.

“Patrick’s pain started with a brain tumor. The surgery then was traumatic. We’re working on the PTSD from that,” Shefferman said.

‘Time to run again’

Among the many tools Patrick taps to overcome his pain is intense physical activity.

Following the surgery, Patrick went to see Dr. Venu Akuthota at the UCHealth Spine Center.

While Akuthota couldn’t offer a miracle cure for the nerve damage Patrick had suffered, he did ask a critical question.

“He said, ‘I know you’re in pain. Tell me about your life before this happened.’”

Patrick runs and uses alternatives to opioids to cope with chronic pain. Here, he is running in the mountains with a barn behind him.
Running in the mountains is a beautiful distraction. Photo courtesy of Patrick Gaines.
Patrick immediately told Akuthota about his love for running and being in nature.

“It’s time for you to do that again,” Akuthota said. “I see the light inside of you, Patrick, Right now, it’s dim because you’re in pain and you’re afraid. But your body is strong, so its time to look beyond the physical symptoms and brighten your light. It’s time to run again.”

In his 30s and 40s, Patrick had done ultra marathons around the world from Colorado’s famous Leadville 100 to races in Nicaragua, Italy and France.

One of his favorites is called the San Juan Solstice. It’s a stunning, high-altitude race that weaves 50 miles through Colorado’s most rugged mountain range, the San Juans.

So many runners want to do the race every year that the organizers hold a lottery.

Inspired by Akuthota, Patrick decided to try to get a spot in the race in the summer of 2016. He scored an entry, and, to his surprise, he did better than ever.

“I ran that race faster than I’d ever run it before. That was not my goal, but I finished in 13 hours,” Patrick said.

Patrick was selected to compete in the San Juan Solstice and will run it for the fourth time in June 2018.

A ‘beautiful distraction’ in a garden of 14ers

While he’s running, his pain persists. But, as endorphins flood his body, and he revels in the views around him, Patrick literally rises above the pain.

“Running is a beautiful distraction,” Patrick said. “It’s very rugged. There are about a dozen river crossings and a good portion of the race is up on the Continental Divide above treeline. The whole thing is beautiful. It’s a 14-er garden down there.”

Patrick loves communing with nature.

“It’s an opportunity to lose yourself and be embraced by your surroundings,” he said.

Patrick’s job supporting stem cell research and therapies keeps him busy. The aim of the Gates center is to create a world where we can teach our bodies to fix themselves with stem cell therapies rather than having to rely on drugs or surgery.

A giant tree made of art sprouts on a wall at Patrick Gaines' house. He uses art along with other alternatives to opioids to deal with chronic pain.
Along with running and alternative therapies, Patrick also uses art to cope with his pain. Here, he has created a large tree on a wall in his home. Photo courtesy of Patrick Gaines.

If Patrick’s having a rough moment during a busy day and needs to tap some relaxation techniques, he lays down on the floor of his office, uses his backpack as a pillow, and transports his mind to a calmer place.

“I can get a restorative session in as little as 90 seconds,” Patrick said.

He can’t wait for the day – hopefully less than seven years from now – when his nerves have healed themselves and the pain will go away.

Until then, he’s grateful for all the help he has received and the critical lessons he’s learned.

“If you fight with pain, it wins. It will always fight back,” Patrick said.

Strange as it seems, he’s learned to make peace with his pain instead.