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SALT LAKE CITY — If he thinks about it, Mike Roman can feel a tingling sensation where his toes used to be.
The constant stream of electronic pulses, however, is much better than the intense burning he used to feel — similar, he said, to pliers ripping out each toenail one by one — before a pain management specialist implanted a spinal cord stimulator to deal with Roman's phantom limb pain.
It's a seasoned medical device that has come a long way in the last decade or so, said Dr. Richard Glines, interventional pain medicine specialist at St. Mark's Hospital.
"Instead of pain, we are competing with the nerves to produce a different feeling," he said. The stimulator and a small battery, which are concealed completely under the skin at the small of the back, produce a small amount of electrical current that is delivered to the spinal cord, creating parasthesia so other sensations can interfere with the brain's attempt to interpret pain.
It doesn't work for everyone, but Glines said the device has a high success rate when it is used because it can be tested prior to the long-term commitment that implantation entails.
It's just one of the alternatives to addictive narcotic pain medications that is available to treat chronic pain, a significant public health problem that ends up costing society around $600 billion a year in health care and lost productivity, according to the American Academy of Pain Medicine.
And it isn't uncommon, as more Americans suffer from pain than from diabetes, heart disease and cancer combined.
Utah is one of the top states in the nation for deaths due to pain medication overdoses, which killed 236 people in 2010, according to the Utah Department of Health. Of those who died from either prescribed or illicit opioid use, approximately 90 percent suffered from chronic pain, which is difficult to treat because symptoms and experiences vary so greatly.
- 236 people died due to overdoses.
- 90 percent (approximate) suffered from chronic pain.
- 50,000+ Utahns reportedly use narcotic medications not prescribed to them.
- 20.8% of Utah adults had been prescribed an opioid pain medication in the preceding 12 months.
- 3.2% used medication more often or in higher doses than had been directed by their doctor.
- 72% had leftover medication.
- 71% kept the medication.
Information: Center for Disease Control and Utah Department of Health.
More than 50,000 Utahns reportedly use narcotic medications that are not prescribed to them and physicians have said that current economical conditions have spurred even higher use.
"The common visualization of a pain patient isn't very flattering and it isn't that way all of the time," said Roman. "There are people like me who are just trying to get their life back and trying to become a better husband and better father. We think maybe if we can get a handle on this, we can get a job and get back into society."
Roman became a candidate for the device after a minor knee injury and procedure in 1994 led to 43 surguries. He contracted an aggressive staph infection that required full amputation of his leg. He was taking up to 400 milligrams of morphine and 25 milligrams of Valium a day.
"My right leg is gone at the hip, but the pain from the scarring I feel in my toes of the foot that is missing, so there's nothing to rub, there's nothing I could do for it," he said.
To put it plainly, his life was consumed by phantom pain.
"My family watched me slowly disintegrate and what the pain left of me, the medication stole," he said. Roman spent more than 10 years taking high-dose narcotic pain medication and said he hardly remembers anything that went on during that time.
"Morphine never took my pain away, it just made me not care, but I also didn't care about bathing, or being a dad, or getting a job," he said. "There wasn't one aspect of my life that chronic pain didn't affect."
The suggestion to implant a spinal cord stimulator offered what Roman said was the first chance of hope in over a decade of pain.
"I wanted the hallucinations from the medications to stop, I was in crisis emotionally and spiritually and financially. I just needed that roller coaster ride to stop," he said, adding that he was desperate to try anything.
Glines, who did not perform Roman's life-changing procedure, has treated many patients who have had similar issues. He said steroid injections and cauterizing nerve endings provides only temporary relief, where the stimulator is more of a long-term solution for people suffering from neuropathic pain, or pain stemming from the nerves in the body.
My family watched me slowly disintegrate and what the pain left of me, the medication stole.
–- Mike Roman
Eligible candidates for the rechargeable device, like Roman, will have endured multiple other therapies or even surgery and still continue having pain. Glines said doctors often start with the simplest ideas and go from there.
"Pain is very complex," he said. "That's why it takes us a considerable amount of time and effort to make the decisions on what to do next."
What came next for Roman was what his wife calls his "great awakening."
"It is possible to reinvent yourself," he said. Roman now has a documentary film made about him, called "Racing Roman," and his passion for racing cars. He holds six world land speed records, including one set at Utah's Bonneville Salt Flats. He has tried paralympic bobsledding at Park City's Olympic Park and is forging new and repairing old relationships with members of his blended family. To his three grand-kids, he says, "I'm just 'Poppy.'"
"They've never known me to be sick. They've never known me to yell because of the meds. They've never known me to be angry," Roman said. "It's been incredible and for that gift, I'll remain internally grateful."
Roman and his wife are now on a crusade to help others who suffer with pain like he did and to change the mindset that, as a pill-popping culture, Americans embrace. They host a website, www.RaceAgainstPain.com, where people can go to find pain specialists in their area.
He isn't a living example of electrotherapy, but of what technology can do when it is in the right hands. General practitioners can help and offer many solutions, but Roman said he wouldn't be what he is today without the initial suggestion from a specialist in St. Louis, where he calls home.
"There's a place for medications, but for long-term pain management, they are disastrous," he said. "They change you in ways that nobody can anticipate."
Email:wleonard@ksl.com
