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Calming their tremors — Pain Management Clinic helps patients find relief from spasms

Teresa Nichols and Dr. Brad Noble

Calming their tremors — Pain Management Clinic helps patients find relief from spasms

On 20 Feb 2013, in Boone Hospital Center, bacolfen pump, pain management clinic, spasm

By Jacob Luecke and Shannon Whitney

This story is featured in the Winter 2013 edition of myBoone Health magazine. Click here for a free subscription.

During the last few years, sleep has been precious — and fleeting — for Teresa Nichols.

Teresa suffers from leg spasms. The spasms can be so strong that she often can’t sleep because her legs uncontrollably jerk around.

“I was only getting 2-3 hours of sleep at night,” she said. “It just took a lot away from me.”

This lasted for years. Teresa nearly became exasperated.

Losing her sleep was the last straw in a series of debilitating losses for Teresa. In 2006, she fell in her bathroom, causing spinal damage. She lost the ability to walk. Over time, she could no longer stand or even move her legs.

She tried medications and treatments advised at other facilities across mid-Missouri. Nothing helped.

She became more and more dependent on her daughters.

“I was at the point where I just wanted to give up,” she said.

But she found help at Boone Hospital Center’s Pain Management Clinic.

In May of 2012, Teresa came to the clinic and met Brad Noble, DO, a pain management specialist. It would be a life-changing visit.

“He’s my knight in shining armor,” Teresa said.

Dr. Noble thought Teresa could benefit from a medication pump implanted under her skin.

Pumps deliver pre-programmed amounts of medication directly to where it needs to go. Compared to medications taken by mouth, pumped medicine can be much more effective at lower doses as it completely bypasses the liver and kidney, which work to degrade drugs.

“With the pump, we are able to put a tiny bit of medicine directly into the spinal fluid and get unbelievable results,” Dr. Noble said.

Well over 100 patients have received pumps at Boone Hospital’s Pain Management Clinic.

In June, Teresa came back to Boone Hospital for a test injection of baclofen, a drug used to treat spasticity. Dr. Noble wanted to see how her body would respond.

Teresa said it was like a miracle — the spasms calmed and she could move her legs under her own power. She hadn’t been able to do that for months.

“It was the best day of my life,” she said. “I was able to move my legs without all the spasms.”

In July, Dr. Noble performed the surgery to implant the baclofen pump. It’s a small, round device on the left side of her lower abdomen. During check up visits, Dr. Noble, uses a wireless device to communicate with the pump and adjust her dosage.

The baclofen medication allowed her spasms to relax enough that she could participate in   physical and occupational therapy at Boone Hospital.

With the help of the Baclofen pump and therapy, another miracle happened — Teresa stood up. She hadn’t stood in years.

“It was wonderful, words can’t even express it,” she said.

The success she’s seen through the Pain Management Clinic has helped Teresa begin to regain her mobility and independence. She was able to stand and get herself into the car for her daughter’s recent college graduation.

She’s now working with Dr. Noble to set more goals. She’d love to be able to go fishing again.

But the best change for Teresa has been getting her sleep back. Now, she has no problem getting a full eight hours each night.

“I never thought that I would ever get a good night’s sleep,” she said. “It’s wonderful just to have that back.”

Neck spasms fixed instantly

The caregivers at the Pain Management Clinic have a knack for approaching problems from a fresh angle.

When Stephen Bailey, 65, came in to consult with Dr. Noble about his back pain, he had one of his neck spasms. Stephen didn’t think twice, his neck twitched like it had been for about 45 years.

Dr. Noble saw it happen and asked, “May I put my hands on your neck and feel it as you spasm?”

Stephen Bailey and Dr. Brad Noble

Stephen shrugged, why not?

After feeling the movement, Dr. Noble said, “We can fix that with a Botox shot.”

Both Stephen and his wife, Starlyn, laughed. He had seen many doctors, but none could help. They tried medications, but to no avail.

But after a Botox shot, the twitching finally stopped. The Baileys still can hardly believe it.

“It’s the first time anybody’s ever said that they can fix it. Everyone else was trying to cover it up with drugs,” said Stephen.

His wife said sometimes, while she was driving, his neck would jerk and his head would hit the window so hard that the car would move back and forth.

Now, she says, “None at all.”

Stephen explained the problem started after getting thrown off his feet in many explosions while serving in the army in Vietnam.

Since returning from Vietnam, Stephen has treated injuries in his back, neck and knees, along with a very severe case of post-traumatic stress disorder. He is thankful Dr. Noble was able to diagnose and treat his Spasmodic Torticollis.

“I couldn’t go to church, or anyplace. I’d have to get up and leave,” said Stephen. “I’d have to leave in the middle of conversations and it would throw me for a loop.”

Thanks to a shot every three months, Stephen can fish more easily from his house on the Lake of the Ozarks.

Contact Boone Hospital’s Pain Management Clinic at 573.815.2700.

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