Suzie! wil aN: lake eon ae 1ex! ite any ve OF ay“ace oud] oe sa ‘anho ton a oy te& wins iheRey al anAy oben ey sap wit Lal AceSA. u Tes, A val mt We jan— aay an | erty n pam aa at "Shy ‘oy aa er in .‘na Using N Neurostimulation To Treat Complex Regional Pain Syndrome (NAPSA)—On anicy ski hill in Colorado in 1994, sixth-grader Alexis Malkin began the long, difficult journey through years of severe pain when she fell and injured her knee. Two surgical procedures later, her leg pain was agonizing. “T had constant, burning pain,” recalls Malkin. Her doctor prescribed several different types of medication, but they were either ineffective or caused nausea, weight gain, insomnia, sleepiness, or allergic reactions. Months later, another doctor diagnosed her condition as complex regional pain syndrome—a disorder caused by trauma and marked by swelling and excruciating pain. Malkin’s doctor administered nerve blocks—injections near the nerves in her spinal cord designed to relieve pain. They didn’t help and were extremely painful for her. Physical therapy helped only marginally. Antidepressants and counseling helped intermittently through years of misery. “It’s not the kind of thing you wantto deal with when you’re just trying to be a normal high school kid,” says Malkin. She entered college at Emory University in the fall of 2000. Her doctor in Atlanta continued to try medications and nerve blocks. Her pain continued unabated. “I had a lot of problems in college such as trying to get tests rescheduled and missing classes,” she says. Years of medications resulted in inflammation of the stomach, and during an examination procedure for this, Malkin developed inflammation in the vein where an intravenous line was placed. The diagnosis was again complex regional pain syndrome. In 2001, she was scheduled to undergo a procedure to burn nerve tissue when fortune inter- Thanks to neurostimulation, Alexis Malkin is now able to participate in college life like any 19year-old. vened. Through a family friend, Malkin talked with Jeffrey Wasserman, MD, medical director at Dallas Pain Medicine Special- ists in Dallas, TX. “Alexis was in severe arm and leg pain,” says Dr. Wasserman. “She couldn’t walk for any significant length of time and she was extremely limited, given her age.” Malkin spent many hours on the phone with Dr. Wasserman. He suggested neurostimulation because all other treatments had been ineffective. “She wanted to be active again, and neurostimulation is a great modality for treating this type of pain,” says Dr. Wasserman.“I suggested Medtronic’s Synergy Versitrel™ neurostimulator because it has two leads and it is small— which is good because Alexis is petite.” Neurostimulation delivers electrical impulses to the spinal cord to block pain messages from reaching the brain. The impulses are administered through an insulated medical wire called a “lead.” Instead of pain, the patient feels a “tingling” sensation. The lead is connected to an implantable neu- rostimulator, which has a battery and electronics. “Dr. Wasserman knew that I had tried every recommended medication out there,” says Malkin. “I didn’t want to be on narcotics; I wanted to live mylife.” Malkin’s family flew to Dallas for the neurostimulation trial, when Dr. Wasserman placed separate leads for both her arm and herleg. “It worked great,” says Dr. Wasserman. “She had complete coverageofall areas of pain.” “We spent almost a full day at the mall,” says Malkin. “We walked for miles and I was compeltely fine.” On January 2, 2002, Malkin becamethe first patient in the world to receive a Synergey Versitrel neurostimulator (thousands of patients worldwide have received other types of Medtronic neurostimulators). Malkin now attendsclasses, vis- its friends, shops and dances like any 19-year-old. “About a month ago, one of my friends said, ‘You know, you just seem so much happier this semester. It’s like a huge load has been taken off your shoulders,” notes Malkin. “When other people actually notice you’re doing better, that really says something.” Although Malkin hasn’t experienced any side effects from neurostimulation, they are possible. Because the system is surgically placed, risks of infection do exist. Device complications, such as lead displacement causing an interruption in pain relief, also exist. “Alexis has dramatically reduced her oral medications and she’s doing wonderfully,” says Dr. Wasserman. For more information about severe pain and Medtronic’s neurostimulation systems, talk with your doctor and visit www. medtronicpain.com,or call Patient Services at 1-800-510-6735.
