Got Back Pain? These Patients Got Care Without Leaving Home

Posted June 17, 2020

Raymond Mitchell's lower back just gave out.

Sitting on his porch, the Grand Isle Rescue volunteer EMT shakes his head as he describes responding to a call to help a person up from a chair – ironically due to back pain. As he lifted, he felt his own lower lumbar give out. Mitchell's injury was 30 years in the making, beginning when he first hurt his back while lifting boxes during a home move. This latest injury was much more serious and could not have come at a worse time, right in the middle of the COVID-19 pandemic.

“I was just sitting on the couch all day long, because it hurt too much to do anything else,” Mitchell says.

Staying Safe Doesn't Mean Staying Away

With limited in-person appointments available Mitchell's options were few, or so he thought. His local primary care clinic, Champlain Islands Health Center, was able to connect with him via video visit and tried treating him with oral steroids. That worked for a short time, but the pain came back. It got so bad that Mitchell had to use a cane just to shuffle around the house. Bending over and his usual activities were impossible.

The Health Center referred him to the UVM Medical Center Orthopedics and Rehabilitation Center on Tilley Drive in South Burlington. Mitchell connected via video visit with physician assistant Rob Hemond who was able to examine, diagnose and determine a treatment without ever meeting Mitchell face-to-face.

Hemond prescribed Gabapentin, a non-narcotic drug that can be effective treating chronic or recurring nerve pain. Within weeks, the treatment not only improved his pain, it all but erased it. Instead of lying on the couch or leaning on a cane to walk, Mitchell was outside doing yard work again, even shoveling. “It's really ideal,” Mitchell says of video visits, which also saved him the 45-minute trip from his home to the office. All told, one in-person visit takes up about three hours or more by the time it's all done, he said.

Chronic Back Pain Becomes Too Much to Bear

Joseph Van Horn, known as Jody to his friends, flew A4 fighters as a Navy pilot in the late 1970s.

Takeoffs and landing were anything but smooth. Van Horn describes takeoff as being shot off of an aircraft carrier with a massive steam-powered sling shot. The latter, what Air Force pilots referred to as a “controlled crash,” involved Van Horn landing on the carrier hard enough to engage a hook on the jet's tail that caught a wire on the deck that jerked the plane to a stop.

“The seat was just metal,” he chuckles, sitting on a cushion chair on the porch of his home in the foothills of the Green Mountains in Underhill, adding that any padding in the cockpit would have interfered with the ejection seat mechanics.

After one tour of duty, combined with a lifetime of contact sports and weight lifting, Van Horn's lower back had had enough.

His back pain hit a peak and, with retirement coming, he needed to do something soon. Then, COVID-19 struck. In-person visits to his care providers stopped and he worried that, if he had to wait too long, he would miss out.

“It was like science fiction”

Again, Hemond had a solution. After an MRI scan was conducted – a procedure that was allowed because patients and providers could easily distance themselves – he connected with Van Horn via a video visit. To Van Horn's amazement, Hemond was able to screen share the MRI scans during their video visit and show him exactly where the problem was – a narrowing of the channel in one of his disks that was squeezing his spinal cord to about 90 percent of the size it should be.

During the video visit, Hemond asked him to stand up, walk around. He asked Van Horn to bend and perform other movements, all the while asking what hurt and what didn't.

Van Horn was diagnosed and given several options, from steroid injections to drug treatments to surgery. Pandemic or not, both Mitchell and Van Horn said they prefer video visits when possible.

“You don't have to fight the traffic,” Van Horn says of his video visit experience.

In both cases, Mitchell and Van Horn didn't have to delay the care they needed.

Zoom video visits through the UVM Health Network are safe, with enhanced security to ensure privacy. A support team helps install the Zoom app, which bears special encryption security measures, and can guide patients through the simple set up on their smart phone or other device.

Interested in learning whether a video visit is right for you? Call your provider or connect with them directly with the MyChart app.