Spinal cord stimulation helps woman beat pain

Lora Williams is known to students and parents of Morningside Elementary as the crossing guard who wears colorful, fun clothing. But while Williams, who has been an aide at the school for more than 20 years, appeared on the outside to be silly or light-hearted, on the inside she was dealing with chronic pain.

Now, thanks to a device called a spinal cord stimulator, her pain has been greatly reduced.

“For me it’s been a lifesaver,” Williams said.

Spinal cord stimulation works by attaching electrical leads to an area of the spinal cord, then allowing electrical signals, controlled by the patient, to be fed to a spot on the spine. That stimulation prevents the pain signal from getting to the brain and registering and pain, explained Dr. John VanGilder, a neurological surgeon in Great Falls.

For people with arm, leg or trunk pain or people who have had failed back surgery, the technology may serve as a way to manage pain, VanGilder said.

Williams, 62, lived with ulcerative colitis for about 30 years before opting for an ileostomy in 2007. That procedure removed part of her intestinal tract, but another was needed a few months later to remove Williams’ rectal stump, a portion of the intestine left after surgery. That left her with nerve damage that triggered nearly constant pain.

Williams, a mother and wife, is upbeat. She has a deep faith in God that, along with her social network, she credits with helping her cope. But she does not deny the pain she experienced was debilitating.

“It was a throbbing, aching — it’s hard to explain,” Williams said. “I just put one foot in front of the other.”

Eventually, Williams asked her doctor about options to treat the pain. He sent her to a pain specialist who implanted temporary leads into her spine to see if she was a good candidate for spinal cord stimulation. Williams says the four-day trial provided her with “instant” relief.

The next step occurred in September 2013, more than six years after the rectal stump surgery, when Williams had the permanent apparatus implanted into her body.

The stimulator, called a paddle, was placed next to Williams’ spinal cord, then a generator is placed somewhere nearby that the patient can reach with her hand. The generator needs to be in a convenient location so an external “wand” can be placed next to it to change the level of stimulation.

The surgical procedure, which VanGilder calls “fairly straightforward,” required an overnight stay in the hospital.

Prospective patients are given a “pretty extensive workup,” VanGilder said. If the source of the pain cannot be treated in another way, with surgery for example, then a pain management doctor puts the patient through a neuropsychological evaluation that looks for opioid abuse or depression, which may hinder recovery. The next step is the trial, which some patients respond to and some do not.

If those hurdles are cleared, the permanent device can be implanted. Some patients may begin feeling relief that eventually fades away, VanGilder said. Sometimes the leads can migrate and need to be moved.

There’s no guarantee the stimulator will work. Back pain is complex and multi-factorial. Bones, joints discs, muscles, nerves and nerve and muscle coverings can contribute to the pain. People with leg pain seem to have better results with the stimulator than people with back pain, but the reasons why are unclear.

Williams was told her case would be considered a success if she experienced 50 percent less pain. She estimates her relief is more like 80 to 85 percent.

The generator contains a battery that must be recharged every five to seven weeks, a fairly simple process Williams can do while watching TV or reading a book. The battery within the generator itself must be replaced after 10 years. Williams communicates with a representative with St. Jude Medical, the manufacturer of the device, regularly about how the device is working.

Williams adjusts the level of stimulation based on the amount of pain she is feeling that day.

“It’s a tingling, massaging sensation that takes away the pain,” Williams said.

Too much stimulation leaves her with an unpleasant, funny feeling, she said.

Recently, Williams decided she wanted to help other people in situations similar to her own. She wrote a first-person account of her experience in a spring issue of The Phoenix magazine, a publication for people with a colostomy, ileostomy, urostomy or continent diversion. The project was a step outside her experience and comfort, but she’s happy she’s shared her story with others and hopes it can help someone.

For Williams, the stimulator is part of her life. She carries the tools with her every day. While it’s different from her life before, she’s thankful the pain isn’t controlling her life anymore.

“Most people carry their phones all day long. I carry this,” she said.