Getting Past the Pain

THOUSAND OAKS — Their pain left them physically, socially, psychologically and financially crippled.

By the time they hobbled into the Pain CareCenter of the Conejo Valley, the newest offering from Columbia Los Robles Hospital, they had already seen dozens of doctors.

But the doctors at the pain center did more than dispense medication.

They set their patients on a regimen of physical therapy, relaxation training, dietary restrictions--techniques emphasized for years outside traditional medicine but rarely offered by a hospital.

Los Robles’ pain center--set in a crisp, new building in Westlake that offers pillows with all its chairs--is the first affiliated with a hospital in Ventura County. The staff takes a multidisciplinary approach, combining traditional treatments with therapy and life-skills training.

“We’re not against anything that works,” said Dr. Kamyar Assil, the center’s medical director and an anesthesiologist with a sub-specialty in pain management.

A year ago, Los Robles polled local doctors to see what needs they saw for the region.

“This is one of the services the physicians wanted us to develop. The pain-care center was right up there at the top,” said Gary Maier, chief operating officer at Los Robles. The center has seen about 50 patients since opening in December.

Purveyors of pain relief offer a variety of treatments--from Chinese acupuncture and herbs to physical therapy to medical intervention, such as surgery and anesthesia. Their workplaces can be anything from a one-room office to a teaching university hospital.

“That is wonderful that they are finally looking at things they have shunned for ages,” said Jay Dhawan, who operates the Holistic Health Center in Westlake. His center treats chronic pain using a variety of “alternative” methods, such as acupressure and diet. “They have shunned these modalities for decades. These alternative modalities didn’t just pop up yesterday, you know,” he said.

Dhawan, who says he is a doctor of “naturopathy,” is suspect of Columbia’s intentions. He said a company that focuses on running hospitals is likely to spread itself too thin to provide quality alternative pain treatments.

“They will do everything to go with the trend, where the money is going, the bottom line,” Dhawan said.

The Pain CareCenter of the Conejo Valley is run by Pain CareCenters of America Inc. of Van Nuys, in partnership with Los Robles. While it continues to shun some alternative treatments, such as acupuncture and herbs, it embraces others, such as biofeedback.

That involves using instruments to measure a patient’s physical responses, such as muscle tension and relaxation.

Treatments are tailored to the patient’s individual lifestyle and occupational needs, said clinical director Howard Stanley Rubin, who has a PhD in medical and clinical psychology. For example, one patient, a traveling salesman, learned how to carry his trunks from the car without injuring himself further.

“Pain is a subjective experience,” Rubin said. “If I were to prick your finger, someone might be on the ceiling, and you might say, ‘Gee whiz.’ ”

Two types of patients come to the center, Rubin said. The first continues to experience pain after a doctor has treated the underlying cause. These patients can often be treated in a few visits and freed from their pain.

Richard Massaro of Santa Monica is hoping he’s one of those patients. Physically assaulted in July, he suffers back pain and migraines. He has had surgery, and recently visited Assil for his headaches.

Assil dipped several cotton swabs in a local anesthetic and placed them in Massaro’s nose. The treatment has been known to relieve headaches, especially sinus headaches.

A nurse then came into the darkened room and taught Massaro relaxation techniques. Later, Assil asked him to what degree his pain had lessened. Massaro said 50%.

“I’m getting a lot better,” he said. The former telephone technician said he wakes in the middle of the night in tears, “not because of emotions, but because of pain.”

The second kind of patient suffers from chronic pain, a condition that converts pain from a symptom to a malady in itself, Rubin said. The pain these people live with touches just about every aspect of their lives. They sign up for daily, seven-hour sessions at the center for 10 weeks.

That’s the case with Celia Cunningham of Camarillo, who recently completed 10 weeks of daily visits to the Westlake center. When she arrived in December, she couldn’t walk.

“If only you would have seen me come in in December--like a hunchback old lady. I’m 55-- I’m too young,” she said.

Now, after learning how to live with her condition, known as arachnoiditis or inflammation of the spinal cord’s lining, she may even resume her favorite pastime: shopping. But she won’t spend more than an hour at it, because Cunningham has learned how to pace herself. She knows her limitations and is able to live with the pain.

“It’s a wonderful feeling, to be able to walk,” she said. Among the more important pointers she picked up at the center were how to breathe, how to relax and how to move properly.

At the pain center, Cunningham is in a group of four patients who have become friends, offering each other support because of their common experience.

The four sat--well, sometimes Cunningham laid down--through a pep talk with Rubin, who warned them that if they didn’t practice their exercises at home, they could relapse. By relapse, he asked them to recall their pain before they first arrived at the center.

The group members shuddered. “I hope not,” said Bob Post of Simi Valley. His back injury gave him a serious case of cabin fever before he learned to manage his pain.

Teddy O’Connor of Ventura knows the feeling. “I was almost fearful going out in public, almost an invalid. I felt inadequate, depressed. I wanted to hang myself half the time,” she said.

Now, after undergoing surgery twice and visiting a dozen doctors for her lower back pain, O’Connor has signed up for a cake-decorating class. “I don’t want to be dead yet.”