May 31, 2021
When Pain Slows You Down
David Capes is an attorney and avid photographer. He is also a golfer, but has suffered chronic back pain for years from the sport’s twisting and bending. A few years ago, while traveling and capturing fascinating photos, David’s back pain had increased enough to warrant a visit to his primary care physician. An MRI showed that he had issues in his back, including arthritis and disc degeneration at the L3 and L4 vertebrae that pinched the nerves that go to his legs. His doctor recommended physical therapy to improve the alignment and control of his spine, and to take pressure off the discs and the nerves. He says the exercises helped but the pain became debilitating. Compounding the back pain, David also suffers with neuropathy due to his type 2 diabetes.
David standing next to his photograph that is displayed in the Living Well Center.
“I was getting up every morning and icing my back. I was just in a horrible fix. I had previously always been upbeat about life, but the pain was seriously affecting my attitude and wellbeing.”
Around the same time, David’s brother-in-law was being treated by Devyani Hunt, MD, a Washington University physical medicine and rehabilitation specialist, for similar issues. He recommended that David make an appointment with Dr. Hunt.
Finding the Fix
When he met with Dr. Hunt, David says he knew right away he was at the right place. “The questions she asked. The movements she had me do. I think I am able to assess people fairly quickly as a result of being an attorney and immediately I felt she knew how to fix my situation.”
Dr. Hunt says, “When David first came to me, he was experiencing significant pain. Because of the pain, David was limited in what he could do physically. His goal was to travel and continue his photography. I could tell he was ready to commit to an overhaul of his health. We talked about how his back was driving the problem, but the inflammation, diabetes, high blood pressure and inability to move were significant contributors and really his barriers to success.”
Health Care, Not Sick Care
David says that with his many health problems, he was the ideal candidate for the Washington University Living Well Center®. “They have a nutritionist, psychologist, an acupuncture specialist…their whole-team approach caused everything to really turn around.”
Dr. Hunt explains, “The Living Well Center is a unique place where we provide “health care” and not “sick care.” It is a new model of healthcare delivery that is patient centered and includes multiple disciplines coming together to address the whole person. One of the key components is a partnership with a patient who is engaged and ready to make changes in their lifestyle.”
Dr. Hunt customized a treatment plan for David to maximize his result. “David’s treatment planned started with acupuncture sessions that greatly reduced his pain and allowed him to participate more in physical therapy. Mr. Capes also received specialized medical massage called myofascial release — a safe and very effective hands-on technique that involves applying gentle, sustained pressure into the myofascial connective tissue to eliminate pain and restore motion. He previously required periodic epidural injections to treat pain, but as he improved, this was replaced with periodic massage and acupuncture treatments. At the same time, David met with Dr. Hong, our clinical psychologist, to understand pain processing and learn about pain-diminishing techniques. David also had a few sessions with the dietitian, which was one of the key components of his care. Once he was able to transition to clean eating with a focus on decreasing inflammation, he started to see significant results.”
Food as Medicine
David shares, “I just can’t say enough good things about Nartana, the dietitian. She helped me incorporate more plant-based foods into my diet, which is now 40-50% plant-based. I had been to a few different nutritionists over the years and I never really got anything from those visits. Nartana’s approach is just so different. Her encouragement and telling me to just do the best I could and to just try — it made a huge improvement. She was totally right.”
Nartana Mehta, RD, registered dietitian with Washington University Orthopedics says, “From our first appointment, David was engaged and committed to making changes to reach his wellness goals. As he began to make these lifestyle changes, I was so impressed with his ability to identify his barriers and his willingness to find solutions. I provided him with information and support, but he did the hard work and put it into practice and transformed his health.”
A True Team Approach
David recalls his experience with the Living Well Center team approach, “Between the injections and the acupuncture, it brought my pain level from a ten to a four rather quickly. I also saw the Living Well Center psychologist, Dr. Hong and learned some breathing techniques that I still use to this day.”
Barry Hong, PhD — a Washington University professor of psychiatry and medicine — is part of the Living Well Center team and says, “We use psychological procedures such breathing and self-directed imagery relaxation for stress and pain management. For patients like David, they are very happy to employ these self-help interventions which makes them less dependent on medications.”
Showcasing Success
At his Living Well Center appointments, David would talk about and share his photography work with his providers. After seeing his photos, Dr. Hunt knew right away she wanted to showcase his work in the Center. Six of David’s pieces now currently hang in the new Living Well Center space at Barnes-Jewish West County Hospital. “Dr. Hunt really took a lot of time and put a lot of thought into picking each picture and placement.”
Dr. Hunt says, “I am continually amazed at the breadth and depth of David’s photography. He captures moments and people in a way that draws you in and takes you to a special place of possibilities. It’s perfect for the Living Well Center.”
Recently, David has been able to resume walking for exercise and now walks up to 20 miles a week. “I never thought I would be able to do that. I give the credit to the whole team at the Living Well Center. I can’t say enough about them and my outcome.”
Read more of our inspiring patient stories here.