Dr.Patty's Chronic-Intractable Pain And You (Updates)

A Safe Place To Talk About All Aspects Of Chronic-Intractable Pain
Dr Patty's Pain Journey
Hello. My name is Dr Patty Hagler-Verdugo., PsyD. I am 49 years old. I am married to a wonderful man that I have known since 1995. We have been married for 10 years (2000). I was born in Freeport, NY and I lived on Long Island, NY for the first 11 years of my life (no, I don't have my accent still). I graduated high school in 1980 (Birmingham High School in Van Nuys, CA). Upon graduation, I went to college at UCSD. I went there for 1 year. Due to financial difficulties, and the divorce of my parents, I did not return to UCSD for a second year. I worked full-time and went to Jr College (LA Pierce College, Woodland Hills, CA). I saved money, applied for financial aid and then started another large university in LA in 1983.

I worked really hard to help my mom pay for school. I had worked part-time since the beginning of my college education, then full-time before going to another school. Once at school I got 3 jobs. I worked in a law office as a clerk, worked at a pre-school as an aftercare coordinator, and worked in my dorm food service.

On May 15, 1983 at 12:00pm (A date and time that are forever ingrained in my head), while I was working in food service, I was helping another student worker. We were working on dishes in the kitchen. He was taking care of the conveyor belt and I was just taking dishes off one by one. This young man was getting behind on the conveyor belt and dishes; forks, etc were almost at the end of the conveyor belt with more behind them. I gave him some help of moving a tray of silverware to another location. Unfortunately, at that time employers did not educate their staff on proper body mechanics, as they do now. While picking up the tray of silverware and carrying to another location, I felt a pull in my back. Apparently, what I did was not take the tray of dishes off of the conveyor belt correctly. I did not use my knees. Also, while walking the silverware to their location, I carried them in front of me (placing more weight on my spine). I held them too far in front of me. I didn’t think much of it so continued with my shift. After the brunch rush I went to my dorm room to lie down. My roommate and I had bunk beds and I was on the top.

When I awoke I had severe pain in my back and could barely move. I was told by my roommate (who also worked in food service) to go to the hospital. I felt uncomfortable about making a fuss. I thought that it was nothing. After a long discussion, I did what she said (she went to tell the supervisor). I thank the Lord she did. I went to the emergency room (at UCLA medical center). While I was there, x-rays were given. I was told that it was probably just a strain or sprain. It was suggested that I stay at bed rest for 2 weeks. I was given some pain medication that made me feel so ill. The first shot of narcotics in my life (Demerol). I told the nurse I was going to be sick. She didn't believe me (lol), so I vomited all over the place (talk about projectile vomiting…LOL). Anyway, I was sent home to rest and employee health got hold of me and sent me to an orthopedic surgeon 2 weeks after my injury. The surgeon just gave me some meds (Tylenol...4 and some NSAIDS and was sent to a chiropractor, physical therapy, and for multiple epidurals. Eventually, because the pain was so bad an oil based myelogram was done (oil based dyes are no longer used today because they were found to cause spinal arachnoiditis).

It turned out that what the doctor thought was sprain/strain was a mild disc herniation at the L5-S1 disc space. The pain never got better, just worse no matter what was tried conventionally. In 1983 a new surgery (experimental) was available called a chymopapain injection. (This is where a papaya enzyme is put into the disc space in the hopes that the herniation was to be dissolved. I remember going to the medical school library and looking everything up on this new procedure. All the studies that I read pointed to the fact that this was a better procedure than cutting into a person. Unfortunately, at that time, no longitudinal studies were done. I was referred by my orthopedic surgeon to a neurosurgeon so that he could do the procedure. I went through the surgery in August, 1983. In 1984, my original workman’s compensation case settled for Lifetime Medical and a few thousand dollars. I was released back to work and school.

I worked in the public library as a clerk, worked in a psychological testing firm that scored computerized MMPIs (Minnesota Multiphasic Personality Inventory I); I also worked in a Psychiatric Hospital doing groups.

I felt good for 2 years (except every month when I was menstruating). Then in 1985 I started hurting really horribly. I put off going to the doctor in the hopes that the pain would pass. Then I had no choice and went to see the neurosurgeon again. This doctor told me that my pain was caused by my parents’ divorce (what a crock). He said that I would have to live with it. Eventually, I went back to the orthopedic surgeon that saw me at the beginning of my injury. And then I started having horrible pain again. After more tests, he recommended that I go into a pain management clinic (inpatient). I stayed in the hospital for one month.

There were not many pain patients in there. We had group therapy (though we were not to discuss our pain out of the group), individual counseling, and physical therapy, occupational therapy, biofeedback, and yes, medication reduction.

I was not too thrilled by the approaches that this clinic used toward people in pain dealing with their lives. I had returned to the same pain unit every time I had to go in the hospital. I remember that the head psychologist there was trying to tell me how to live my life and deal with my pain. I was very sarcastic at that time. I asked her do you have chronic pain? She said no. My reply to her was, "so how can you tell me how to lead my life in pain if you have never experienced it?" That stuck in my head for a long time.

After my stay in pain management I decided to change schools and move to Orange, California. I began Chapman College (now university), to continue my studies in pre-med. I realized early on that I was not good in physics, Calculus, Chemistry, etc. So I decided to take more classes in psychology (strange because I failed my very first psychology class at UCSD). The difference between Chapman and the larger schools is how they teach and how you learn. For tests at Chapman, you had to think, not regurgitate information for a multiple choice test and then forget what you learned after the test. I found school fascinating at that time. I loved to write, do research, etc.

While at Chapman, in 1986, my pain was worsening once again. I am sure the sitting in class didn’t help. The pain management psychologist did not think that I was mature enough to have surgery. So I continued school. In February, 1986, I started losing reflexes and the surgery had to be done. I had this second surgery in February, 1986. This was to be a fusion from L5-S1. At that time, I was told that I had to be at bed rest for 6 months post-op. No car, no school, no nothing. I didn’t want to lose any time with school, so Chapman had videotaped classes at that time. I took one class at a time from my on-campus apartment. I watched the classes, had someone Procter my tests, did the homework, etc. After the first fusion, I stopped all medications except for an occasional Aspirin. I was so elated. No meds were needed 2 days after surgery. The doctor had told me that for some time, he did not know whether I was drug seeking or really in that kind of pain. Well, to his surprise, while I was under anesthesia on the operating table, (with my spine exposed), he touched the spine and I jumped. He said that he had never seen that happen in all the time that he had been a surgeon. That proved to him how sensitive my spine was. Well that showed him!!!

After going back to school in the fall 1986, my pain started to worsen again. That was 6 months after the last surgery. I had to start on pain medications again. I had been given Dilaudid early on (Vicodin had not been on the market yet), so I was given that once more. I was also on anti-inflammatories, muscle relaxants, you name it. The pain was horrible. I had to frequent nearby hospitals to get pain injections. In January 1987, I underwent another spinal fusion from L4-S1. I had facet problems, problems fusing, etc. After waking up from anesthesia, I remember how bad the pain was. This time, it never lowered, like after the first fusion. I had dreamed of that relief. While in the intensive care unit, those Ted hose that you wear after surgery did not fit me correctly. I had begun to gain so much weight since the injury. The nurse in the intensive care unit was giving my legs a break by lower them every now and then.

On January 12, 1987, my family and friends were in the hospital with me sharing my birthday. After the guests left, I felt as if I was having an asthma attack. Eventually I pushed the call button and the nurse came in. I was also beginning to have chest pain. The doctors were called, some nuclear scans run, and it turned out that I had a Pulmonary Embolism that went to my lungs. I was told that I was lucky that it was not fatal (as a lot are). I began a year round treatment of blood thinners. I had to be so careful with shaving, etc so that I did not cut myself. After my hospital stay, I returned to my campus apartment once again, where I was to stay at bed rest for 6 months. I was to no longer take more video courses because I was close to graduating. The pain never seemed to get better. During this time, I had had difficulties with my stomach. It turned out that I needed surgery for what the doctors thought was appendicitis. It turned out that it was not appendicitis, but a ruptured ovarian cyst. The surgeons took out my appendix anyway and then moved to the left side and did a partial oopherectomy (took out part of my ovary). Soon after that, the orthopedic surgeon placed me in a body cast! In the hopes that that would stop any extra movement, and help me fuse.

In May, 1987 I graduated from Chapman College with my Bachelor of Arts degree in psychology. While going through ceremonies, I remember being in this body cast under my cap and gown. I had to use a cane at the time also. I was continued on very strong medication also. After graduation, I stayed in the on campus apartments as long as I could. I decided to continue my schooling and go for my Master of Arts degree in psychology. I went through many classes and I loved school. In 1989 I applied for social security. It was granted with Medi-cal and Medicare. In 1989, I met a spinal specialist at UCI and he thought that he could fix my back. He said that I needed to lose at least 100 pounds. I had done everything at that time. I decided to have a vertical band gastroplasty with a gastric intestinal bypass. It was a new procedure at that time. It was a very invasive surgery. I had to be on baby food for 6 months after the surgery. After leaving the hospital, I went home to my school apartment and hoped to start a new life with this new procedure.

After starting solid foods I had a lot of problems. I vomited every day and had dumping syndrome. The benefits of the surgery at that time outweighed the bad stuff. Everyone was complimenting me on how I looked. This made me want to keep losing. In 1990, I had lost the 100 pounds and the spinal specialist operated. He did an anterior and posterior fusion, with isola rods and pedicle screws and titanium plates. I was in surgery for more than 8 hours. When I awoke, I was told I had to lie flat for 24 hours. I was still out of it from the anesthesia so it was hard for my mother to get me to understand that. I got up and started walking after the 24-hour period was up. I still had a lot of pain, but I thought that it would pass. After coming home, I did everything the doctors told me to do. It took a long time to feel any better. I was placed in a special Kydex Jacket (I called it the turtle shell) to limit movement. Well, needless to say, I went back to classes and continued my education. I was only taking Lortab after my surgery. Eventually, I was only taking classes part-time so I had to move off of campus. I found an apartment right across the street from the psychology department. I tried very hard not to miss classes because of my pain. I went through the majority of my Master of Arts degree in psychology, and it was time to advance to candidacy. At this point, if advanced, I would be able to work in the community clinic. Well, after trying to advance several times, I was never advanced from that school. I did not understand. Most of the professors knew me well. I even had a publication that was submitted without my knowing to the Chapman College Psychology Journal. I was surprised that a paper that I wrote on morphine was published in 1987. Still, that did not make a difference. I found out in later years, that most probably the reason why I was not advanced was because I was on pain medication to help my severe chronic pain. Of course, that hurt emotionally.

At that point, I stopped school to re-assess what I wanted to do with my life. I stayed in my apartment and just existed. I did not have a computer at the time, I had very little money (just my social security and work comp), and I just had the television and my phone. In 1993, a boyfriend that I had had since 1983 decided he didn’t wish to be with me anymore. Actually, it was a blessing in disguise. We broke up on Labor Day, 1993.

In 1994 I got really ill and a friend got me to a hospital in time. I developed a problem called metabolic acidosis. This happens to diabetics (I am not a diabetic). The emergency room doctor asked me to stay in the hospital so that they can find out how I got this. At that time, I was on heavier meds, such as Soma (yuck!), Dilaudid, etc. I thank the Lord that I stayed. The next day while going to the restroom in my hospital room, I apparently passed out in the bathroom, hit the floor and had a cardiac arrest. I have no memory of that except waking up in the bed and not knowing how I got there. It was recommended that I enter a detoxification unit at the hospital that I was in because at that time doctors believed that if someone had to take narcotics daily, they were addicted. I decided to try the program. I entered in February 1994. I stayed in the hospital 1 month and then continued with aftercare while at home. I was completely withdrawn from all of my medications. I was so sick. I didn’t sleep for over 30 days. The pain was horrible. They brainwashed me very well. I believed that I was an addict. I felt that if I took one more pain medication that I would die instantly!!! (Nice phobia don’t you think??). I went through Pills Anonymous, which is a group similar to AA.
After finishing the PA program, I came back to visit and ask some questions about a dental procedure that required anesthesia and pain medication. At that time one of the counselors asked me to volunteer at the unit. I was excited because I thought if I increased my sitting tolerance, then I could go back to school again. Soon after starting to volunteer, I was talking on the phone with the chairman of the department. He also had back pain. He was trying to teach me about the computer in the office and was extremely patient. About 2 weeks passed and this older gentleman walked in the office. I thought he looked like an old geezer. He thought I walked like a guy. Well, that gentleman was the chairman of the Department and his name was Dennis. He was 22 years older than I, had kids, was married (thinking about separation). We talked and talked and talked. We had so much! h in common it was uncanny.

One morning I woke up to go volunteer and I felt like I had a bad case of the flu. I decided to rest and go back to volunteer the next day. I was dizzy when I got up. Eventually, I went to the doctor and I had a severe gastrointestinal bleed. I was quickly brought to the hospital for a blood transfusion (6 pints) because my hemoglobin was 3.0. After the transfusion, the doctors did some tests to see where the bleed was coming from. They could not find it. So after the weekend, I went back to volunteering.

That morning I started feeling funny and decided to go back home. I started to bleed again and one of the nurses in the hospital got me to the emergency room quickly. I went into shock and started losing consciousness by the time I got there. During that time, I noticed that the clock had stopped in the emergency room. I heard a voice telling me that I was not going to die and that I was going to follow a path after I got through this. Soon after, the clock started. I had asked the ER doctor if the clocked stopped and if there was someone visiting me. He said no and that I was just in shock. What I realized soon after was that an angel was visiting me. Then my parents were called and I was put into Intensive Care. I was told that another endoscopy needed to be done to try and find where the bleed was. I had refused sedation a few days before because I thought I would explode and die. My mom held my hand and said that will not happen. So I eventually had the test with sedation and the bleed was found. I also did not blow up! Surgery was soon scheduled. Before surgery, I was told that I needed to reverse the weight loss surgery if it became necessary to take anti-inflammatories again. I said that I would not take any meds after surgery. So, they brought counselors over from the detox unit to tell me it was all right. They said to me, "this is under a doctor’s care." I said it was also under a doctor’s care before going into detox, so what is the difference? Well, I ended up having the surgery with pain meds. When I awoke from surgery, my mom and dad told me that the anesthesiologist lost a catheter tip when starting a central line. They were able to locate it, but said it would be better to just leave it there. I remember while recovering in the hospital that I wanted off IV meds quickly. They tried to give me Vicodin for pain, but I refused and only accepted Tylenol with Codeine.

I went to my sister’s home—where my mom was staying—to recuperate. During recuperation this gentleman, Dennis, called me every day to check on me. I only stayed at my sister’s home for 2 weeks and then went home to my apartment. Dennis and I got to know each other very well. We were like brother and sister. We found more things that we had in common.

On Labor Day, 1994, we went to Stateline Nevada for a break away. I remembered my pain getting worse again. I had to start using crutches. Soon after, I got accepted to another school and went to school again. I was also asked to do my internship there. After we came home, I went back to the spinal specialist and he said that it was most likely due to scar tissue. Dennis went with me and demanded that the doctor do another myelogram, x-rays, etc. They were done, and sad to say, I did not fuse from the previous surgery and had multiple defects that needed another surgery.

During this time before surgery, I was studying hard to get my Master of Arts degree in Psychology. Dennis helped me move to another apartment in Anaheim, CA, where I was on the second floor. The complex had a pool and much more room than what I had in Orange. He eventually moved in with me in 1995. About 6 months after moving, the surgery was scheduled. So I had to find another apartment on the first floor.

We found an apartment in Huntington Beach, California, and moved there right before the surgery that was scheduled for December 1995. I had the surgery in December and was sent for physical rehabilitation right afterwards for one month. I had to stop school and internship while recovering. It turned out that I needed another fusion from L1-S1. I had had some broken titanium screws and had problems fusing again.

I had the surgery and attempted to go back to my life: graduation, opiates, and working as a therapist. I graduated with my Master of Arts Degree in Clinical Psychology in 1996, and was scholar-shipped for my Doctorate, which I received one year after my master's because I had a lot of transfer credits. I became a Doctor of Psychology in 1997. While I was finishing school, I went to another pain management clinic. This doctor believed in treating pain with opiates. I learned a lot during this time about pain treatment with opiates. I had been diagnosed with multiple pain disorders early on, such as: Rheumatoid Arthritis, Chronic Fatigue Syndrome, Fibromyalgia, Osteoporosis (due to steroids), and the list goes on. In school I specialized in the assessment, diagnosis, and treatment of chemical dependency (thought I may need that knowledge while dealing with pain patients); as well as pain management. I also decided to advocate for people in pain.

While still in the early days when I was alone, I felt like I didn’t want to stay on this earth anymore. I was so depressed. I never wanted anyone to feel the way that I did. While I was working as a therapist, I learned that not everything is like what is in the books. In late 1997, I began having pain in my shoulder. I went through many tests, but the doctors couldn't figure it out. Finally, during that time, I developed a problem with my left pinkie. It was a bone infection called osteomyelitis. I was in the hospital for a short time, and was given a high dose of antibiotics.

About 6 months after, I woke up one morning and could not get out of bed. I screamed for Dennis, who was staying with me. I was taken to the hospital and was told that the infection from my shoulder and pinkie had spread to my spine. I went through several biopsies and tests just to try to get rid of this infection. My spinal specialist eventually told me that there was nothing that could be done. What usually happens is that an individual gets the infection, clears it up with antibiotics, and then they have surgery. For me, nothing else could be done. I was told that it was too dangerous to attempt to clean the infection out of my spine, and the chances of me surviving were not good. Also, the broken hardware eventually became encased in bone, and that meant that it would be too difficult, if not impossible, to get those out.
I was also told that I would fuse in a non-physiological angle. Unfortunately, it did. My chin/brow line (when I stand) is parallel to the floor. I am now fused at a 90-degree angle; I am unable to lie flat on my back or on my left side. I am also unable to sit for more than 10-15 minutes without causing my pain to go wild. When I was seeing the pain doctor in 1997, it was discovered that due to the previous stomach stapling and gastric intestinal bypass (even with the reversal), that I had a mal-absorption problem so that my meds (antibiotics, pain meds) have to be administered through other means; such as, intravenous, through patch, pop, sublingual, etc.

Dennis and I decided to get married July 2000. He is a wonderful man. I call him an angel without wings!! He loves me so much that he cares for me every day. Due to the osteomyelitis, at one point I was bedridden. I am no longer stuck in bed. Dennis brought me my meals, bathed me, etc. I figured out how to adapt to using a computer almost 10 years ago. Since I am unable to sit up straight when using the computer, I balance myself on my right elbow, have pillows between my knees, under my elbow, in back of me, and I have a keyboard on my lap to type. I had a laptop, but it finally died. I am attempting to use a desktop because it is not possible to get another laptop right now. I am adjusting toward using a regular mouse. I now have multiple pain diagnoses and problems that have come up due to my positioning problem.

I have neurogenic bladder, so I used a Foley catheter to urinate. Within the past several years, I trained myself enough to not have the Foley. I use a Hickman-Catheter to get my pain meds and antibiotics. I have had Atalectasis (where my right lung doesn't expand well), so I was on oxygen. I am vitamin deficient. I lost weight on my own (over 200 pounds) because, after the reversal of the stapling and bypass I gained the weight back and then some. I now work in my recliner as a pain patient advocate and help others suffering from severe pain. I am very happily married to a wonderful man who says he takes care of me because "it is a labor of love!" I was unable to cook, walk, etc. He brings me meals, cleans me up because it is too difficult to go in the shower, goes to the store, pharmacy, drives me to the docs when needed, and the list goes on.

In 2009, we moved to Nevada to be in a drier state than California. We have a lovely new home that was paid for through my settlement and have had a chance to somewhat start over. My health has gone through a number of changes. I am not bedbound anymore and can sit on the couch with a recliner with a pillow on my back and have me leaning to my right side. As long as I don’t sit straight up, the pain is somewhat manageable. Since the move, I tried and tried to have pain doctor’s take my case with the IV dilaudid. Nobody would take it. Last holiday season I allowed myself to go through withdrawals as I could not get the medication in that form. Since then, I had a pain doctor here in the area that saw me but was afraid of me having too many pills in the house. He gave me 8mg diluadid tablets and one time the pharmacy did not have them in stock and gave me 4mg but twice the amount. I found that I took the 4mg when the pain was not as bad and took two when the pain was high. When I asked him to do this all the time he mentioned feeling uncomfortable having me have that many pills at home!! I left him and am working with a doctor in Las Vegas who has over 20 years experience.
I have found out that I have a fracture that is chronic and also just found out that I have a screw that is broken and is encroaching on the spinal canal. Unfortunately, it is too dangerous to do surgery because of the fear of spreading the infection again. The only thing that can be done is to wait and pray that it doesn’t hit the cord more and paralyze me.
My mother passed away on Valentine’s Day of this year (2010) and on the way home from the airport, I had to drive. I had not driven in over 10 years. Due to being off the IV dilaudid, it has allowed me some changes in our new life. Since my port is not visible now it gives me a little more confidence and I started driving again. In this small town, the driver’s are very different. I did have to drive one time to Las Vegas and had to drive home in the dark which was scary but I managed the 45-60 minute trip up and down the mountains (that don’t have streetlights).
I also recently had a blood clot that was on my previous port and now am going to have to be on Warfarin for 6-12months.

Dennis also suffers from chronic pain and is disabled. His chronic back pain is getting worse as time goes on and is going to see a surgeon just to see if anything can be done. It has been difficult here in Nevada to get the right kind of treatment and medications for both of us.
A new problem made me face deep dark depression. This summer of 2011 I found out that there were 3 more screws hitting the canal and nothing can be done for it. It is too dangerous. Here I pray every day that paralysis does not occur.

So, this is my story...actually the short one. I hope this helps everyone to get an idea of who I am and why I do what I do. I will go out of my way to help another person in pain...because I never want anyone to have the feelings that I had.

God is now bringing us together. Things are done in God's timing not ours!!! Every morning I wake up and look at the things that I am blessed with--not the things that I don’t have!!!

In August 2008, I finally settled my worker's comp claim that was 26 years old. If any of you have insurance company that screws you around, “Don’t Give Up” your fight until it is settled! If you have any questions to ask, feel free to email me --


Remember, there are many of us in this world who are suffering. We need to come together and help each other!!


Hugs and Prayers to Those Sufferers, Of Chronic/Intractable Pain
Dr Patty Hagler-Verdugo, PsyD.

by Dr Patty