“I was a pedestrian in a motor vehicle accident. I’ve been in pain for the last six years,” he said. “First I was prescribed hydrocodone with physical therapy, and then morphine for four years. But everything was temporary, like putting a Band-Aid on a shark bite. I couldn’t focus at work and I was afraid I’d get fired because it just wasn’t working for me.”
And neither was the Xanax he was soon prescribed. Mendola says one morning before work, his daughter found him passed out on a bedroom floor. “That was it. I quit cold turkey and went back to work…but everything came back. Because I have a degenerative disc disease, doctors told me I couldn’t have another surgery. It got so bad, I was praying for my life to be over.”
Mendola’s doctor referred him to Dr. Deborah Kukal, lead psychologist with Mercy’s multidisciplinary pain management program in Springfield. Nearly 20 years ago, Dr. Kukal was part of a team that saw a growing need for specialized physical therapy, and looked at pain management from a new perspective. “If someone gets an injection or surgery and it fixes their problem, great. Move right along. But so often that’s not the case,” she explained. “So often it turns to this, then that, and another thing, until you’re falling down a rabbit hole and don’t know your way out.”
Today, Dr. Kukal is one of three chronic pain psychologists who lead intense, six-week group sessions that include two six-hour days a week. “We do meditation, guided imagery, relaxation techniques, and breathing exercises – all to teach the brain how to calm down and reorganize perception,” she said. And it has paid off for more than 1,200 people who have traveled from across the Midwest to learn about chronic pain management at Mercy. “We are pretty rare. It’s very integrated and very intense. We are going to work with you and give you all our time and attention. Some people stay all night in the hospital because they come from two hours away.”
The most common patients have fibromyalgia, post-laminectomy syndrome (also known as failed back syndrome), chronic low back pain, complex regional pain syndrome or even headaches. “But it turns out the biggest hurdle is the fear to join us,” said Dr. Kukal. “People think they’re being sent to a psychologist, therefore everything must be in their head, but that’s not true at all. That’s why I always ask them what’s in their head. It’s their brain! It’s not mind over matter. It’s mind and brain interacting for the sake of your body.”
Pain doesn’t just hurt; it can even cause the brain to shrink and age. A study in the Journal of Pain showed that women with high levels of pain from fibromyalgia had reduced brain gray matter – which controls sensory perceptions like decision making, self-control and memory – and their brains appeared to age rapidly. However, the same study found that patients undergoing treatment similar to Mercy’s multidisciplinary pain management program recovered significantly and built back gray matter while experiencing more control over pain.
“They begin to think more clearly, and they can function better in their everyday life,” added Dr. Kukal. “With patients who have learned to experience more control over what’s going on with their body, and react with ways that are supportive, we have found that their all-cause emergency room visits drop 90 percent. They don’t need to go as much because they can manage and calm things down.”
After 15 years of living with neuropathy, Cathrine Rhodes of Climax Springs, Mo., knew something had to budge. Now she and Mendola are pain management graduates. “It’s truly been a blessing,” she said. “Everyone has been very pleasant and helpful. Just going into the chapel in the evening after class changed everything around me completely.”
“Of course, I was very reluctant,” recalled Mendola. “I knew there has to be something out there for me. And the information I began getting made total sense. The meditation turned out to be one of the best drugs in my life.” Today, Mendola doesn’t resemble his former self. “I played basketball with my son on Thanksgiving. This was the first time I had a ball in my hand for years. I had a blast. It was fun and didn’t hurt. And that was my main fear after telling him no for months. I know that I’m not cured, but now I know that I can do something about it.”
Mendola is looking forward to continuing his education with eye movement desensitization and reprocessing (EMDR), a process used for soldiers or anyone with post-traumatic stress disorder. He and Rhodes have also signed up for advanced classes.
“We encourage patients to continue the methods they learned in these sessions,” said Dr. Kukal. “Many patients continue on different medications, but they’re not on that spiral where they’re not in control of their body.” Mercy’s multidisciplinary pain management program is also developing a mobile app that allows patients to self-direct based on a series of questions about stress level, meditation frequency or other needs. “The key is to remember that if you always do what you always did, you will always get what you always got.”
To enroll in the chronic pain management sessions, patients must be referred by a physician. “We have many patients who have come at their own instigation,” explained Dr. Kukal. “So ask your doctor if you think we can help. Physicians are very glad to make the referral. It’s valuable support for managing complex patients.” Doctors can call Terri Valbracht, RN, at 820-2170 or 820-6609, for specific information on how to make the referral.
“More people need to go to this class. It changed my life, and it can change theirs as long as they know about it,” added Mendola. “I’m not afraid to go out there and live my life. I can be myself again.”