Pain Disregarded: A Nurse Practitioner's Chronic Pain Story

My story begins with a tragic multi-rollover single vehicle accident twenty-four years ago when I was just 16 years old. Among a plethora of other injuries, I fractured my pelvis and spine. I suffered paraplegia for several days—thankfully I regained sensory and function of my bilateral lower extremities. Fortunately, I did not suffer lingering pain beyond a few months post-accident. I successfully completed many years of college, rode a motorcycle, and led a very active life.

Fast forward to the year 2011, I was a front passenger in a SUV traveling on a local freeway. An impaired, unlicensed, uninsured motorist struck my SUV. His speed was estimated to be about 90 mph when he hit us. I don't remember the accident. The impact was on my side of the SUV. I was rendered unconscious, and had severe back injuries. Among other injuries, I sustained a significant traumatic brain injury, neck injury, and several torn or herniated discs in my spine. A few of the lasting effects include memory loss, intractable migraines, and constant pain throughout my thoracic and lumbosacral spine. A few of the discs are compressing my spinal cord.

Having learned a new normal, my family took a trip to Myrtle Beach. At the time, I was being treated with oral glucocorticoids for sciatica related to the 2011 accident. Begrudgingly, I agreed to a Jet Ski tour. About an hour into the tour, the Jet Ski I was on struck a large wake at about 68 mph. I was thrown about 20 feet into the air and landed in the water about 50 feet away. I sustained spine fractures, a neck injury, and a displaced comminuted shoulder fracture. The rotator cuff was torn completely off the shattered bone. The hospital workers wanted to admit me and take me directly to surgery but I was 700 miles from home. I made the decision to go closer to home for the surgery. Despite multiple providers recommending surgery at the time of my injury, the hometown hospital refused. They told me if the fracture displaced another 1 mm, they would take me to surgery. I likely displaced it another 1 mm walking back to my car. This was one of several mistakes made along the way.

After the Jet Ski accident, I underwent multiple surgeries and procedures. Eventually, the decision was made to remove one-third of my clavicle and one-third of my acromion process. Tendons were rerouted and screwed into my humerus bone. My medical massage therapist tells me she has never seen a shoulder look like mine. I also had some procedures on my spine. Between my shoulder and my spine, I endured 11 steroid injections, went to physical therapy, tried nerve blocks, suffered through acupuncture treatments, medical massage, used various essential oils and paid for these at my own expense. I even tried prolotherapy, a costly treatment where a solution such as dextrose or your own plasma is injected into your injured tissue. This experimental treatment, often used by professional athletes, cost $500 out-of-pocket per weekly visit. When listed, all of the non-pharmacologic and non-opioid pharmacologic treatments I attempted consume two type-written pages. I was offered opiate painkillers intermittently, and I refused to take them. I wanted to tough it out. Pain or injury doesn't preclude one from their obligations in my culture.

My providers told me I was in "pain by choice." I was on multiple prescription NSAIDS throughout all of this, at usual prescribed doses. I took acetaminophen multiple times each day, but never exceeded 3,000 mg per day, the current recommendation.

As a nurse practitioner, I was unable to work due to lifting and mobility restrictions as well as pain. Prior to the Jet Ski accident, I had worked every day since age 15. In early spring 2015, I returned to work because my family was nearing the point of losing our home and other assets. In June 2015, I was assaulted by a patient and sustained a severe concussion. Since then, I have suffered constant tinnitus, worsening migraines...