An Insiders View Of Calmare
Posted by Christa Whightsel on Monday, April 22, 2013 Under: Calmare Articles
The Following Is A Q&A with Norman J. Black, the Clinic Manager of SPERO Pain Relief Therapy of Illinois & Gracie Gean, a RSD/CRPS Angel from Illinois.
This article is here to help those with Reflex Sympathetic Dystrophy, also known as Complex Regional Pain Syndrome, and many others to understand more fully what Calmare is truly like.
Christa:
Norman, what made you start administering Calmare and what kind of training did you receive?
Norman:
First Christa, thank You for reaching out to Gracie and Me. Those suffering from CRPS/RSD are fortunate to have advocates like you, who offer hope and guidance in dealing with this life altering ailment.
My interest in Calmare was a bit unconventional. My formal training is in accounting and finance where I’ve spent the last 30+ years running businesses in the commodity futures industry in downtown Chicago. My older brother Len approached me about 4 years ago to make introductions for him to my friends in Chicago who were physicians. He had become a sales contractor for Competitive Technologies (the company which owns the intellectual property and marketing rights to Calmare) and was trying to sell this new medical device that “non-invasively relieves chronic neuropathic pain”. After reading the literature about how the device worked and what types of pain it could relieve, I decided to do some of my own research to determine if Calmare could be commercially viable. That’s where my business background came in handy. One of my first priorities was to contact Dr. Robert Chalmers of SPERO Pain Relief Therapy in St. George, Utah. I flew to his clinic, met with him for a few hours and subsequently we worked out an arrangement where I could use the SPERO name and consult with him on our patients cases when needed. For Dr. Chalmers , having a SPERO clinic in Chicago was a way for the Utah clinic to gain more visibility.
To make a long story short, I finally opened Spero Pain Relief Therapy of Illinois, PC in August of 2012. We have a Medical Director, Mitchell Weisberg MD, MP who is an Internist with a certification in Psycho-pharmacology. Dr. Weisberg’s psychiatric background is an important benefit for our patients, especially those with CRPS. Almost all of our patients are taking some form of anti-depressant and it’s important to understand the effects these medications have on their emotional and physiological wellbeing.
Our clinic also employs three technicians who have been trained by Competitive Technologies in the use of the Calmare medical device. We should be receiving our Calmare Certification shortly. All of our technicians are licensed in the state of Illinois in their respective medical specialties. Although I also participated in the training, my purpose was to understand the treatment as best possible so I could thoroughly explain to prospective patients what they could expect during a Calmare treatment. I’m sure Gracie will tell you that she’d much rather have our technicians treat her than me!
Christa:
Gracie, How did you find out about Calmare? Why did you feel it was right for you? Also, How did you find Norman?
Gracie:
I am a 39 year old mother of two beautiful teenage girls. I took up kickboxing because it is a wonderful full-body sport and a great stress reliever!
I injured both of my wrists kickboxing at the gym. I had successful surgeries on both of my wrists, but a less than successful pre-surgical nerve block in my left brachial plexus. This triggered the RSD. I have been battling the beast for the last three years. I have tried aggressive OT, Stellate Ganglion Blocks, nerve stabilizing drugs, anti-depressant drugs (used for nerve pain), and a mountain of narcotics. Nothing cut the pain. I eventually just threw the drugs away and decided to go at it on my own. In desperation, I turned to the internet for help. I actually discovered Calmare Therapy on THIS site, RSD/CRPS Doesn’t Own Me! This site featured an interview with Dr. Rob Chalmers of SPERO Therapy, where he discussed his views on Calmare Therapy. I was intrigued to learn that there was a drug free treatment available! After doing my own research on this treatment, I just knew that I had to try it. There were no negative side effects that I could see. I discovered that there was a facility in Chicago, which is only a 3 hour drive from my home. I met Norman when I called the clinic to learn more, and we quickly became friends.
Christa:
What made you, Norman, want to help those with Chronic Pain diseases like RSD/CRPS?
Norman:
As I’ve mentioned in the first question, my interest in treating chronic pain was motivated by the business opportunities Calmare offered. Having no previous medical background (other than my mother and first wife being RN’s,) I now understand and have experienced the altruistic side of medicine. You cannot put a price on the type of hug I received from Gracie when we drastically reduced her pain from RSD during her initial treatment with Calmare. When you see mothers’ shed tears of joy instead of tears of sadness because their teenage daughter is finally getting some relief, especially since I have two children of my own, you appreciate the fact that you’re making a difference in someone’s quality of life. Yes, we have bills and the device is not inexpensive, but at some point I plan on treating patients that don’t have insurance and can’t afford the treatment.
Christa:
What did getting Calmare mean to you as a RSD/CRPS patient, Gracie?
Gracie:
Calmare Therapy has changed my life! Before the treatments, my pain was unmanageable. While I am actually connected to the machine, I have absolutely NO pain. After the treatment ends, I have experienced up to 24 hours pain free. Beyond that, I usually stay at a pain level of 3-4 for periods of about 4-5 weeks. .I make sure to get plenty of rest, soak my RSD arm in hot water with Epsom salts, and get Calmare boosters if needed. I do not take any medications for pain. This all allows me to have a relatively normal life, depending on the weather patterns and the amount of stress in my personal life of course.
Christa:
Is there a type of patient that responds best to Calmare and why did you believe Gracie was perfect to receive this treatment?
What is Calmare’s success rating?
Norman:
Patients who respond best to Calmare are those who have been diagnosed with chronic neuropathic pain. In addition, patients who have neuropathic pain that is localized, ie., limited to one or two areas of their body generally respond better than patients where the pain is widespread. The electrodes are placed on healthy nerve tissue that surrounds the area of pain. If the pain is widespread, then it’s often harder to find skin areas where we can place the electrodes. With Calmare we’re not trying to block or inhibit the pain, we’re trying to change the brain’s perception of what’s happening in the periphery by introducing non-pain stimuli. If the avenue by which we’re sending the stimuli is damaged or suppressed, then we can’t be assured that the message is getting through. That’s the primary reason we need healthy nerve tissue. Additionally, patients who are taking neuroleptic medications such as Lyrica or Neurontin may not have the best response to Calmare. As I noted above, if the nerve pathways are suppressed, then it’s more difficult for the non-pain message to get to the central nervous system and subsequently to the brain. Ideally patients should try to wean themselves off these medications (under the supervision of the prescribing physician) before undergoing Calmare treatments.
Gracie was an excellent candidate for several reasons. First, she was not taking any medications for her pain that would inhibit the device. And second, her pain was restricted to her wrist and hand so electrode placement was straight forward.
Answering any questions that address the “success rating” of Calmare is difficult. How do we measure success? If in some way we ease the pain from what was intolerable to something that’s tolerable, well that’s successful. If we increase the quality of life in some way, then that’s a success. If a patient is pain free for a day, a week, a month, then for them the treatment was a success. What I will say is that over 90% of our patients have had enough reduction in pain during their initial treatment for them to want to continue with the initial 10 treatment protocol. I would say that’s an impressive success rating.
Christa:
What were your fears if any about the procedure, Gracie? How did it, on the anxiety scale, compare to other treatments that you have done. Did you have any side effects mentally or physically?
Gracie:
My only fear about this procedure was that it may not benefit me. I already knew that it would not negatively affect me because I had done my research ahead of time. I had no anxiety about it at all. I had no negative physical side effects from the Calmare, other than a little redness where the electrodes were stuck onto my skin. I have extremely sensitive skin, so this was to be expected. There were no blisters or anything; just redness that went away within minutes. I must admit that it was a bit of a mental challenge during my first week of treatment. After being subjected to intense pain for such a long period of time, having a brief reprieve from that pain seemed like a cruel joke. The rebound pain almost felt more intense. It left me craving more and more Calmare Therapy sessions until the pain leveled out during my second week of treatment. One thing I cannot stress enough about Calmare Therapy is that you really need to give it time to work. The more treatments that you have, the better results you will experience!
I had PLENTY of anxiety prior to the Stellate Ganglion Block! How was I supposed to mentally prepare myself to have a huge needle stuck through the front of my neck, into my spine, while I am not sedated and being told not to breathe? That is not an easy task!
Christa:
As of right now Calmare isn't approved by many insurance companies.
How did you help in this aspect to make this treatment more available to the general population?
Norman:
We’ve actually received favorable responses from quite a few of the private insurers. So far we’ve received reimbursement from United Healthcare (including one of their regionally owned affiliates), Farmer’s Bureau Insurance of Michigan, and Blue Cross Blue Shield of Minnesota. I’m also aware of other clinics using Calmare that have received private insurance reimbursement. In cases where the coverage has been denied we will assist our patients in appealing the claim. It’s important for the patient to be diligent in their appeal. The more cases the insurance companies are presented with, the greater the likelihood that Calmare will receive insurance coverage. The success of clinical trials presently complete and in progress should also make a big difference in whether private insurance will pay for Calmare.
In Gracie’s case her insurance carrier not only covered the “out of network” expense of the treatment, but Gracie applied for a GAP exception (for procedures that are not available within a certain mileage range) which was approved and resulted in our receiving 100% of what was billed. This established a strong precedent for future patients with the same carrier.
I’ve also spoken with Carl O’Connell the new CEO of Competitive Technologies (CTTC)) and he mentioned that getting in front of the larger private insurance companies is a top priority. CTTC is working on aggregating all the positive insurance responses received by Calmare clinics to strengthen the case for reimbursement.
Christa:
How did your insurance cover Calmare, expand upon what Norman mentioned? What advice can you give to others trying to fight their insurance and/or workman's comp?
Gracie:
I have private insurance through my employer. I am fortunate that this is actually a covered procedure. SPERO Pain Relief Therapy was out of my network, so my insurance company only wanted to pay 80% of the charges. I filed a Gap Exception to prove that no one within my network could provide this service, and the Gap Exception was approved. My insurance company now pays 100% of the charges for all of my treatments. I am the first person in the US to have a private insurance company pay 100% for this treatment. Since that time, Renee Hanson, the Clinic Administrator at SPERO, has been able to reference my case and has gotten several other cases covered also. I have taken very detailed notes about my journey and successes through Calmare Therapy, and I have provided those notes to several friends that are fighting Workman’s Comp. Calmare Therapy is less invasive and much cheaper than many alternatives. Hopefully we can continue to share these success stories and maybe Workman’s Comp and the insurance companies will take notice!
Christa:
What are the long term results of Calmare? Does it need to be redone?
Norman:
The long term results of Calmare are varied. You have to evaluate each patient differently, especially those with CRPS. In cases where the pain has not started to spread our expectations are for longer periods of relief. We’ve had patients experience relief from several weeks to 3 to 6 months. Our goal is to zero out the pain for as long as possible. Short of that, we’ll treat a patient until their pain relief has plateaued. With CRPS we’re finding that it takes a greater number of treatments to achieve the same amount of relief as those patients with other neuropathies. What’s been promising is that most CRPS patients get enough relief to impact their quality of life. It often means being able to continue with physical therapy that had to be discontinued because of elevated pain levels. Increased range of motion has also been noticed.
If the pain starts to elevate after the initial treatment protocol, we encourage the patient to come in for “booster” treatments. This usually consists of 2 to 4 consecutive daily treatments or enough treatments to get the pain to plateau again.
Christa:
How many treatments have you done? How are you currently feeling physically? Mentally? Have these treatments affected your family life?
Gracie:
I completed three separate 10 day rounds of treatments. Now I just go in for boosters as needed. The boosters are 3 or 4 treatments. It is important to note that Calmare Therapy is not a cure. We all know that RSD is incurable. It is a treatment. It attempts to treat the symptoms of an incurable disease for unknown periods of time. Just as RSD manifests itself differently in everyone, it also reacts to the treatment differently in everyone. It is impossible to say how long it will last. Right now I feel really good, mentally and physically! These treatments have helped my girls also. Watching their mother in constant pain takes a toll on them too. They may not admit it, but I can see it in their beautiful faces. Seeing mom happier makes them happier.
