{"id":23896,"date":"2019-05-07T12:26:22","date_gmt":"2019-05-07T18:26:22","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=23896"},"modified":"2022-09-06T08:12:25","modified_gmt":"2022-09-06T14:12:25","slug":"overcoming-pain-with-help-from-the-house-of-healing","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/overcoming-pain-with-help-from-the-house-of-healing\/","title":{"rendered":"Overcoming pain with help from the ‘house of healing’"},"content":{"rendered":"
<\/div>
\"This
Carey Robinson says the decision to remove opioids from his life has given him a renewed outlook. Photo by UCHealth.<\/figcaption><\/figure>\n

Chronic, endless pain overwhelmed Carey Robinson.<\/p>\n

It gripped his mind and paralyzed his body. It prevented him from doing what he loves. It threatened to change his life.<\/p>\n

\u201cHad I not sought additional help and learned there were other ways to manage my pain besides opioids, I\u2019d still be on them and in a rut,\u201d said Carey Robinson. \u201cI was so fortunate to have care providers who treated me as a human being, not a paycheck or a reason to come to work. We became a team, and together, we\u2019ve worked really hard to get to this point.\u201d<\/p>\n

Lingering pain<\/strong><\/h3>\n

Robinson, 61, lives in Kremmling, Colorado. He\u2019s been in the restaurant and food industry since he was 15.<\/p>\n

\u201cIt\u2019s a creative outlet to some extent,\u201d he said. \u201cI\u2019m a musician, too, which gives energy. I can create in both areas.\u201d<\/p>\n

But being creative while dealing with pain can be difficult. A car accident in the 1980s left pain that lingered for 30 years, and a more recent fall compounded that pain.<\/p>\n

\u201cI fell down some steel and cement stairs until boom, there I was on my tailbone,\u201d said Robinson. \u201cI fractured my coccyx (tailbone) and have been in living with the pain ever since. It hurts to sit and lay down.\u201d<\/p>\n

Having taken opioids to manage his pain from the car accident for some time, he figured that\u2019s what he had to do to deal with the pain.<\/p>\n

Frustrated, however, with the care provider he\u2019d been seeing for some time, Robinson decided to make a change and made an appointment with Dr. Brian Siegel<\/a> at UCHealth Pain Management Clinic in Steamboat Springs<\/a>.<\/p>\n

\u201cIt wasn\u2019t that far from Kremmling, and I got in relatively quickly,\u201d said Robinson. \u201cThey accepted the medications I was on, so it was a good transition.\u201d<\/p>\n

Understanding pain<\/strong><\/h3>\n

During that first appointment with Siegel, Robinson shared his medical and medication history. At that time, Robinson was taking two long-acting pain medications, four short-acting pain medications, ibuprofen and a muscle-relaxer.<\/p>\n

\"This
Dr. Brian Siegel is pain management physician at UCHealth Pain Management Clinic in Steamboat Springs. Photo by UCHealth.<\/figcaption><\/figure>\n

\u201cWhen we first see a patient, we ask about their current pain scores on a scale of 1-10, as well as their level of function,\u201d said Siegel. \u201cWith some patients, even over the course of time, their pain scores don\u2019t go down even with increased medication and their functionality doesn\u2019t improve. That\u2019s when we know the medication isn\u2019t doing an effective job of managing the pain. This certainly seemed to be the case with Carey.\u201d<\/p>\n

Siegel said chronic and acute pain, both of which Robinson was dealing with, are different beasts.<\/p>\n

\u201cOne reason people have chronic pain is because of unresolved trauma pain,\u201d he said. \u201cOftentimes, there is something traumatic in the patient\u2019s past \u2013 be it a car accident, a physical injury or even an emotional situation \u2013 that is too severe to overcome. When we\u2019re able to zero in on what that traumatic event is that is causing the patient pain, we can begin to look at whether medication is an effective way to manage the pain. We\u2019ve learned over the years that opioids, alone, really shouldn\u2019t be used with chronic pain, because they\u2019re not getting to the root of the pain.\u201d<\/p>\n

Siegel coordinated Robinson\u2019s next appointments and follow-up care with Stace Toye, a certified physician assistant, and Amy Goodwin, a licensed professional counselor and behavioral health counselor at UCHealth Pain Management Clinic.<\/p>\n

\"This
Stace Toye is a certified physician assistant who was part of Carey Robinson’s care team. Photo by UCHealth.<\/figcaption><\/figure>\n

\u201cThe positive energy I experienced with Stace and Amy was great,\u201d said Robinson. \u201cEveryone in that office has the same upbeat attitude to a certain degree. It spreads like wildfire, in a positive way.\u201d<\/p>\n

Robinson quickly developed a level of trust and confidence in Toye and Goodwin over the course of multiple appointments.<\/p>\n

\u201cAmy made me feel like someone cared about what I was dealing with,\u201d said Robinson. \u201cI became comfortable with her quickly and felt secure enough to open up to her about my family of origin and my past. It got to the point that I could say anything to her and it wouldn\u2019t be taken the wrong way. And I got a big hug every time we met \u2013 that was a big deal for me.\u201d<\/p>\n

Goodwin said Robinson was very curious and interested in exploring the different sources of pain and stress in his life.<\/p>\n

\u201cHe was vulnerable with me in acknowledging his stressors and was willing to process through them with me,\u201d she said. \u201cThe better we can manage stress, the better a patient can become at managing pain.\u201d<\/p>\n

\"This
Amy Goodwin is a licensed professional counselor and behavioral health counselor. Photo by UCHealth.<\/figcaption><\/figure>\n

According to Goodwin, there are two pathways for pain messaging in the body. One pathway goes from the injured tissue to the brain, where it gets interpreted for intensity. The other pathway communicates how bad the injury is and sends signaling back down to the tissue. The intensity of pain is influenced by regions in the brain that regulate for \u201cvolume control.\u201d These regions can increase or decrease the intensity and amount of pain experienced. The volume control valve is influenced by both physical and emotional pain messages.<\/p>\n

\u201cWe try to work on both pathways,\u201d she said. \u201cThe tissue injury needs to be stabilized and addressed. Additionally, we also need to turn down the brain\u2019s response to the injury. Your body\u2019s distress signaling is the same no matter the source of pain, tissue injury or emotional distress. The better someone becomes at managing stress and distress, the better the person is able to manage their own pain.\u201d<\/p>\n

Forward progress<\/strong><\/h3>\n

Over the course of appointments, Goodwin and Robinson\u2019s conversations changed from talking about pain being a symptom of an injury to more awareness of the tissue injuries and how they impact the patient\u2019s life. Robinson began to understand his pain in a different way.<\/p>\n

\u201cCarey was a complex pain patient, with multifaceted injury sites in his tailbone, back and wrist,\u201d said Goodwin. \u201cIn talking about his current regimen, he began to recognize that opioids are dangerous and can affect and exacerbate deterioration in other areas of his life. The pain was impacting his ability to work and be a musician.\u201d<\/p>\n

\u201cHe consistently reported to me at our visits the frustration of inconsistent and ineffective pain relief with his medications, said Toye.<\/p>\n

In meeting with Toye, someone who Robinson says he hit it off with \u201clike peanut butter and jelly,\u201d alternative treatment modalities began to be discussed. Initially, Robinson wasn\u2019t interested.<\/p>\n

\u201cI wasn\u2019t sure massage or acupuncture or dry needling would really do anything for me,\u201d he said. \u201cBut they actually did. It wasn\u2019t more drugs and there was no invasiveness to the treatment.\u201d<\/p>\n

Robinson responded positively to the treatments. In 2018, he made the decision to work to get off his pain medications, albeit with a little apprehension and nerves.<\/p>\n

\u201cCarey was at the point where he was coming in and saying, \u2018What can I do to help myself?\u201d said Goodwin. \u201cUsually the conversation is, \u2018What can you, medical provider, do for me?\u2019 This was a very empowering place for Carey to get to, as outcomes for that mindset are pretty darn hopeful.\u201d<\/p>\n

\u201cOnce I began to understand that I didn\u2019t need medicine to counter the pain, that was a big breakthrough,\u201d said Robinson. \u201cAnd these things worked.\u201d<\/p>\n

Trust in oneself<\/strong><\/h3>\n

Because Robinson was responding positively, the team began to taper his medication, particularly the opioids.<\/p>\n

\u201cMost people have good intentions with wanting to taper down their medications as they realize what they\u2019re doing isn\u2019t the best thing for them. Most say, \u2018Sure, that\u2019d be great,\u2019 but actually doing it can be difficult,\u201d said Siegel. \u201cCarey had to trust that he made the right decision to be opioid-free, and he found that trust in himself.\u201d<\/p>\n

\u201cThere were times where he struggled during the tapering process, but he had a team supporting and encouraging him,\u201d said Toye. \u201cRemarkably during this, he had surgery for an orthopedic injury, but navigated his perioperative, seven-day course of medication and continued to decrease his opioid use.\u201d<\/p>\n

\u201cI knew I needed the medication after the surgery because there was tissue pain, but after that, I knew I didn\u2019t want opioids anymore,\u201d Robinson said. \u201cIt felt phenomenal to come to that realization because it was me saying it. Me. I made the decision.\u201d<\/p>\n

Make the appointment<\/strong><\/h3>\n
\"Carey
Carey Robinson adjusts a price sign at the seafood counter in the grocery store where he works. Photo by UCHealth.<\/figcaption><\/figure>\n

Today, Robinson is back to work in Summit County, working as a seafood manager in a local grocery store. He takes ibuprofen and a muscle relaxer as needed and wears a supportive elastic band around his lower back for additional support. He is no longer taking opioids.<\/p>\n

\u201cI\u2019d been taking them for years, but they weren\u2019t working any more. What was the point to continue them? I knew there were other ways to work through my pain,\u201d said Robinson. \u201cDr. Siegel, Stace and Amy showed me there was another way to manage it. They\u2019re the \u2018House of Healing,\u2019 where if one allows, they will share their love through professionalism and kindness with you, the patient.\u201d<\/p>\n

\u201cPeople are diverse and because of that, pain affects everyone differently,\u201d said Siegel. \u201cIt\u2019s not a cookbook recipe when you\u2019re working with patients experiencing pain. It needs to be more individualized.\u201d<\/p>\n

Siegel said a more coordinated, interdisciplinary approach to pain management is an old concept, but more important than ever in present day treatment.<\/p>\n

\"This
An interdisciplinary approach is used with patients at UCHealth Pain Management Clinic in Steamboat Springs. Photo by UCHealth.<\/figcaption><\/figure>\n

\u201cWe have all the people and tools in place for a more comprehensive program \u2013 behavioral health, counseling, case management, physical therapy, massage, acupuncture,\u201d he said. \u201cEveryone in our office \u2013 from the person who answers the phone to the nurses and practitioners \u2013 works to make change possible for our patients. Carey was successful in making a change in how he manages his pain.\u201d<\/p>\n

Robinson encourages others to pick up the phone.<\/p>\n

\u201cJust make the appointment,\u201d he said. \u201cThere are other ways to alleviate pain than opioids.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Chronic, endless pain overwhelmed Carey Robinson. It gripped his mind and paralyzed his body. It prevented him from doing what he loves. It threatened to change his life. \u201cHad I not sought additional help and learned there were other ways to manage my pain besides opioids, I\u2019d still be on them and in a rut,\u201d […]<\/p>\n","protected":false},"author":2146,"featured_media":23900,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[3921,1163,65],"class_list":["post-23896","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-community-benefits-report","tag-opioids","tag-pain-care-and-management"],"acf":[],"yoast_head":"\nOvercoming pain with help from the 'house of healing' - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Chronic, endless pain overwhelmed Carey Robinson. 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