Byrd Schas manages life with pain by staying positive and powerful.
of meeting with different specialists— a neurologist, a physiatrist and a neu- rosurgeon—I was told that there was really not much I (or they) could do, aside from continuing to use narcotic opiates. In his note to my doctors back in New York, the neurologist who’d been the lead on my case wrote: “[Ms.] Schas has a difficult chronic pain prob- lem that likely has multiple contribut- ing factors…We suggested that she strongly consider enrollment in Mayo’s Pain Rehabilitation Center program [PRC].” I didn’t know what the PRC was, but, feeling on the verge of com- plete hopelessness, I considered it to be my last chance at a normal life. Mayo’s PRC operates on the coun-
Finding My Way
After years of searching for a way to relieve my suffering, I learned to make peace with it—and myself. BY BYRD SCHAS
i have had pain in my lower back— or, I should say, the pain has had me— for more than 25 years. In 1985, I suf- fered a burst fracture of my fifth lumbar vertebra in a terrible car crash on the Cross Bronx Expressway in New York City. I was 10 years old. By 2005, the pain was so debilitating that I was not able to stand for more than 10 minutes at a time. I underwent a long 10-hour surgery to remove part of my L5 verte- bra plus the discs above and below; three vertebrae, from L4 to S1, were fused with clamps and screws. The pain was mostly manageable
until 2008, when I endured a difficult delivery with the birth of my daughter, Ida. Six weeks later, I fell down the stairs and fractured my coccyx. I was, again, in agony. The months that fol- lowed brought a barrage of treatments: physical therapy; acupuncture; injec- tions into my sacroiliac joints, epidu-
28 PAIN RESOURCE FALL 2012
ral space and tailbone; heat; ice; and a drug regimen that increased in po- tency until I was sporting a fentanyl patch and popping upwards of 10 Per- cocet (acetaminophen and oxycodone hydrochloride) a day. The medication was the only thing that seemed to help, but it caused me to vomit and fall asleep at work. I became deeply de- pressed. I became desperate.
A Last Resort Fruitless appointments with dozens of doctors, each of whom had no idea what the others were doing, inspired me to plan a trip to the Mayo Clinic in Rochester, Minnesota, for a week-long evaluation by specialists. My hope was that Mayo’s “team approach” would be more efficient, and that they’d help me determine whether to undergo anoth- er surgery or suggest a treatment I hadn’t heard about. But after a week
terintuitive theory that most medi- cines, especially those in the opioid family, aren’t appropriate for the treat- ment of chronic pain. They base their drug-free approach on research show- ing that long-term use of analgesics may actually do little to ease pain, can be habit-forming, lead to long-term health problems, and may sometimes even worsen pain sensations, what’s called hyperalgesia. So before arriving in August 2009 for my three-week stay, I tapered off the heavy stuff. To my sur- prise, my back actually started to feel a little better. On the first day I showed up anxious to begin the program, but also nervous: What if this didn’t work? My PRC nurse case manager had told me explicitly that the goal wasn’t to reduce my pain (though a majority of participants in the program reported having less pain six months after com- pleting it) but to teach me techniques for managing my life with the pain. Still, I expected to feel some relief, if not from the unrelenting aching itself, then from the emotional anguish and anxiety that nearly always went along with my pain.
A New Way of Living When I arrived, I found myself in a kind of rehab boot camp. Every day started at 8 a.m. with a group stretch. Beginning at 9 a.m. we had classes,