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Relieving Pain and Restoring Hope
Facing a possible "life sentence of pain," this Neptune woman is
now looking forward to her future, thanks to the professionals at Jersey Shore’s
Pain Institute and their inventive treatment.
In February 2006, Shirley Nelmes,
50, of Neptune had a simple
bunionectomy, but the procedure
left her with a rare condition,
reflex sympathetic dystrophy (RSD).
Not familiar to the public and not
yet fully understood by the medical
profession, RSD is a disruption to
the central nervous system that can
lead to serious complications,
including persistent pain.
Mohsen Kalliny, M.D., anesthesiologist
and pain specialist at the Pain Institute
at Jersey Shore University Medical
Center, explains: "The central nervous
system controls many essential parts of
our functioning, including pain sensors
and response. With RSD, people feel constant pain because the nervous
system is disrupted and reacts as if
there were trauma to the body. RSD
usually occurs after an injury such as
a broken bone, but the causes are not
well known and can start from
something as simple as a splinter."
Seeing the Silver Lining
The neurologist treating Shirley’s RSD
at Jersey Shore, Alan Deutsch, D.O.,
referred her to the Pain Institute when
he recognized that her condition was
in a late stage, having moved to both
legs and beginning in the right hand
and arm.
Nevertheless, Shirley felt reassured
by the subspecialist team that would
manage her case. "Dr. Kalliny
and the team at the Institute
have truly been the changing
factor in my life sentence of
chronic pain. When I first
came to them, my days were
filled with high doses of
medication, two canes to
walk, and a wheelchair just
to function. I very much
missed my once-active life.
Dr. Kalliny truly understood
what I was going through.
To find that in another person
was a blessing to me."
When a regimen of lumbar
sympathetic blocks did not
effectively alleviate Shirley’s
leg and foot pain, Dr. Kalliny
moved on to his next
recommendation: a spinal
cord stimulator implant.
First Things First
To determine eligibility for implantation
of a spinal cord stimulation system,
patients first participate in a temporary
trial. During the outpatient procedure,
a small lead, or wire, is inserted and
electric impulses are sent to the
nerves to mask the pain. The patient’s
responses help the specialist determine
the best areas for pain relief and the
potential for further corrective action
through an implanted device.
"Shirley responded well to our trial,"
Dr. Kalliny is happy to report, "and
we agreed that a permanent implant
would be her best option. By surgically
implanting a lead and generator under
her skin, Shirley is now able to deliver
pain-masking electrical signals to
the spinal cord with a small device.
With RSD, there is no cure or totally
pain-free days, but this procedure can
make dramatic improvements in a
person’s life."
Just ask Shirley. "Dr. Kalliny should
be very proud of himself and his team.
He and his colleague Dr. Geoffrey
Ndeto have given me hope of having
my life back. And the staff there is
top-notch and totally adept at his side.
My nurses, Nancy and Annette, are
my advocates — they care about me
and have gone above and beyond their
duties on my behalf many times. As for
me," Shirley concludes, "I’m looking
forward to life these days. I’m doing
so well with my implant. I’ve been
given the ability to get through my
days with much less pain. I’m
most looking forward to walking
on the beach."
 – Ryan Younger
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