1st OA and Chronic Low Back Pain Edition

Paula Perry

Despite trauma and abuse, she remains a fighter—for herself and others

Paula Perry was 17 when it happened: a fall that sent her to the E.R. with extreme back pain. They gave her a shot for the pain and sent her home with muscle relaxants, but she felt no relief. Paula’s doctor sent her for an MRI (the first of many) and they discovered she had several slipped discs.

Physical therapy didn’t help, and Paula was frustrated. “I was constantly going to the E.R. for pain relief,” says Paula. “This was before the current opioid epidemic. I’m not proud of it, but I would go to the hospital where I knew they had all my test results and records, and they would give me something, like morphine, and send me home.” It was the only way she could get some relief from the pain.

Eventually, Paula found her way to a pain specialist, who prescribed injections—including one that burned the nerves that deliver pain signals to the brain. The procedure provided a couple years of relief, but Paula developed neck pain and had another MRI, which revealed multiple slipped discs in her neck.

Connecting the dots

“You’re so young to have this—were you in a car accident?”

asked Paula’s pain specialist. No, she hadn’t. Another round of physical therapy helped a little, and kinetic tape, gabapentin, and cognitive behavioral therapy all helped a little more. Paula thought she finally had her pain under control.

But in 2016, once again, Paula began experiencing severe back pain. Another MRI showed multiple slipped discs in places not previously diagnosed, with the discs bulging severely. Why would she have such injuries?

It was around this time that Paula’s mind opened up, and she connected the dots. As a child, she was raised in a family with an abusive parent. She began to recall a long history of abuse, including being pushed down the stairs multiple times and falling on concrete basement steps. Perhaps this was the source of her injuries and pain. She found another pain specialist to work with, one with more experience with patients with post-traumatic stress disorder (PTSD).

“I have herniated and bulging discs in the thoracic spine, and my physical therapist says that’s incredibly rare,” Paula says. “It’s uncommon to find people under 65 with thoracic slips. With my pain team, I’ve determined that my injuries and resulting pain are 100% the result of childhood trauma.” She sees a therapist to continue her work on reconciling her past and her present.

Finding the right treatment

Today, Paula says she’s happy with her pain specialist and the course of treatment. “My doctor determined that even though I’m 29 now and live with severe pain, there IS hope,” she says. “The tricky thing is that for me, opioid medicines are the only thing that keep me functioning, and many of us on these medications are being vilified.”

She’s tried physical therapy, cognitive behavioral therapy, kinetic tape, anti-depressants, non-narcotic pain medicines, sleep medicines, ice packs, muscle relaxants, TENS units, meditation, lidocaine patches, injections, creams—everything her pain care team has suggested. But the thing that brings her the most relief is opioid medication. And she’s afraid for her future.

“I’m very happy with my pain specialist because it’s so difficult right now to find a doctor who will consistently prescribe opioid pain medications,” says Paula. “The Centers for Disease Control have stopped recommending opioids as a first-line treatment. And many people are dying from overdoses, so it makes sense that doctors are being careful. But I’m one of the people for whom this is the only thing that keeps me functioning, working, and living.”

Because she can access the medication her doctor prescribes, Paula’s able to work a full-time job as a receptionist for a tax firm and is in the process of finishing her college degree. It’s taking her longer than she wanted, but she’s determined. She’s fluent in three languages besides English: Arabic, French, and Danish.

Paula says she gets frustrated when she sees people attacking pain patients who take opioids. “Just because I need pain medication doesn’t mean I’m a drug addict,” she says. “I’ve been taking these medications for 12 years, and I’m not an addict. When my pain is worse, I contact my doctor so she can modulate my dose—I don’t make that decision alone. I’m responsible, and my doctor trusts me.”

Fighting for her rights

“Right now, you can walk into an E.R. or a doctor’s office and see signs posted that say, ‘We don’t prescribe narcotic pain medicines,’ and that’s appalling,” says Paula. “Why are we punishing all pain patients for the actions of a fraction of those who use these meds? Why aren’t doctors better trained in how to prescribe them? Why aren’t we researching addiction to figure out why some patients have issues, and some don’t? There are so many unanswered questions.”

Paula says she’s excited to begin doing advocacy work, and recently attended a U.S. Pain Foundation Pain Connection support group training so she can begin to teach others how to live well with pain—and how to advocate for their rights.

“I was so happy to be able to introduce myself at the chronic pain support group training and explain that I have PTSD, which makes treating and living with pain more difficult,” says Paula. “Whatever I can do to help people, I want to do, including telling my story. There are so many ways people’s backgrounds impact their pain stories, so I hope I can run a support group that helps people with a wide variety of experiences.” Paula lives in Detroit, and plans for her group to meet at the Detroit Public Library.

An unusual twist

Paula’s background has an unexpected twist, one with a lifetime of ramifications she’s currently working to understand. She recently was finishing one of her college French courses when the professor held her after class to reveal something powerful: the professor was Paula’s birth mother.

Paula had never known she was adopted, let alone who her birth parents were, and was skeptical at first, but the professor, Samar, produced Paula’s birth certificate. Samar had become pregnant while living in her home country of Lebanon, and because Paula’s father is black, Samar had moved to the U.S. to give birth because she feared Paula would experience racism in Lebanon.

When Paula was born, her skin was a light color… but in time, her skin tone became significantly darker. (Paula has a skin pigmentation issue and is working with a dermatologist to determine the genetic source of her dramatic skin tone change.) Still fearing Paula would experience discrimination in Samar’s Middle Eastern community in Michigan, she gave up custody of Paula. Then, in a bizarre coincidence, she became Paula’s professor decades later.

Today, Paula is slowly developing a relationship with her birth mother. She has not converted to Judaism but honors her birth family’s practices by sometimes wearing a kippah, a small yarmulke, that Samar crocheted for her. (Paula’s birth grandparents were Holocaust survivors.) She is slowly coming to understand more about her background.

Putting the pieces together

Paula knows she still has a lot of work to do to reconcile all of her experiences. She lives with pain caused by physical and emotional abuse. She endured years of trauma and still she is a multilingual professional with a passion for helping others. She has an entire family to get to know, and she’s being thoughtful and measured in that effort. She cares deeply for her community in Detroit, and is working to help others.

“People in pain should not be ashamed to seek help,” she says. “Chronic pain is a lifelong problem, and we must teach each other how to live as well as possible despite being in pain.” Resilient, feisty, and strong, Paula is determined to do her part.