Living with Chronic Pain
To help someone learn about exercise and diet and see them begin to implement small changes, and then start to realize the possibility for positive change; it's really rewarding to see that happen.Andrea Z-Covey
Thelma Gerow can pinpoint the exact day when her pain began. “December 6, 2005,” she says. That was the day she fractured her back in a fall. Three days later, she sustained a ruptured spleen and a hole in her small intestine following a car accident. Gerow underwent abdominal surgery at Dartmouth-Hitchcock Medical Center (DHMC) that month, followed by back surgery two months later. “I’ve got hardware and screws holding my back together. I’m half bionic!” jokes the spunky 75-year-old from Perkinsville, Vermont.
But she doesn’t joke about the chronic pain, which kept her out of work for a year. “There were some days where I could barely get out of bed,” she says. Gerow’s primary care physician referred her to the DHMC workshop “Living a Healthy Life with Chronic Pain,” which is led by Primary Care Health and Wellness Coaches Andrea Z-Covey and Inger Imset at Dartmouth-Hitchcock (D-H) Heater Road.
The chronic pain workshop is one of two that are regularly offered by Z-Covey and Imset; the other is “Living a Healthy Life with Chronic Health Conditions” and a third, “Living a Healthy Life with Diabetes,” is being added in early 2017. The pair are master trainers for these patient self-management programs, which were designed by the Stanford Patient Education Research Center. Christine Dyke, coordinator for D-H’s Health Coaches/Peer Leadership program, says the Stanford method was chosen because “it is evidence-based. We were also able to embed Inger and Andrea in Primary Care, giving them direct access to clinicians and staff for referrals. We thought this would provide a great opportunity for success.”
Dyke notes that the workshops are part of D-H’s Population Health initiative, which focuses on giving patients and community members the tools they need to lead healthy lives, and to ideally stay out of the hospital. “Diabetes and obesity are at an all-time high, and we’re at a point where one in five people will die of a lifestyle-related disease,” Dyke says. “These workshops provide the nutritional and lifestyle guidance that people desperately need, and help them find a supportive path to healthier and happier lives.”
The six-week workshops meet weekly for 2-1/2 hours, and participants learn about exercise and diet (the Stanford method stresses portion size using the “My Plate” method), and lifestyle changes that will help them lead healthier and more active lives. Over the past two years, they have had nearly 150 workshop participants and led workshops not only at DHMC, but also at Dartmouth-Hitchcock’s (D-H) Lyme Clinic, the Lebanon Senior Center, the Upper Valley Haven in Hartford, Vermont, and the Veteran’s Administration Hospital in White River Junction, Vermont. “We’re trying to get closer to where the patients are, and make it possible for a wide range of people to participate,” Dyke says.
Gerow was skeptical when she started the workshop for chronic pain sufferers. “I thought their suggestions, such as exercising to manage pain, were totally useless and would only lead to more pain. But my diabetes was totally out of control, and I wanted to lose weight, so I decided to give it a try,” says Gerow, who concurrently participated in another DHMC workshop taught by Margaret A. Caudill-Slosberg, MD, PhD, which is based on her book “Managing Pain Before it Manages You.”
She kept pain and food journals, as Imset and Z-Covey suggested, tracking what she ate and noting the activities that made her pain worse or helped alleviate it. She made weekly action plans and started exercising by walking her dogs twice a week, eventually working up to walking every day for about a mile. “For a long time I didn’t do much walking or very much of anything, partly because I was in a back brace from my waist to my neck,” she says. “But I noticed that just moving helped and that exercise actually relieved the pain.”
Gerow also embraced the other workshop suggestions, which included physical therapy, deep breathing exercises and relaxation therapy. “We were amazed at how she threw herself into it because, quite frankly, she was the biggest disbeliever going into it,” says Imset. “It’s been wonderful to see what she’s accomplished.”
Gerow seems astonished by her transformation. She lost more than 120 pounds through exercise and diet changes, improved her insulin levels and is no longer taking prescription pain medications. “I surprised myself by believing that I could take responsibility for my circumstances and control my wellness,” she says. “I honestly never thought I would have a reduction in pain. But I found that I just really had to make a lot of changes and that has made a big difference in how I feel. Now I get out of bed at 4:30 every morning, get going with housework and taking care of my pets, and I still sometimes work 72 hours a week with the developmentally disabled.”
The workshops are open to anyone in the community. “They’re a great way for people to be in a room full of their peers, people who understand them and their health conditions, and to realize that they’re not alone,” says Imset. “We talk about people’s barriers to self-care and then throw it out to the group so they can problem-solve together. So they learn from us, but also from each other.”
“We’re often meeting people at that point when they think there are no other tricks to try. They’ve done everything they think they can possibly do and they’re just really discouraged,” says Z-Covey. “To help someone learn about exercise and diet and see them begin to implement small changes, and then start to realize the possibility for positive change; it’s really rewarding to see that happen.”
If you are interested in participating in a workshop, contact Andrea Z-Covey at (603) 653-1824 or Inger Imset at (603) 653 -1826.