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Susan Muñoz: Out of the Shadow of Pain

Susan MunozBent over in her son’s room, Susan Muñoz felt a pop in her back when she stood up. It was 2007, and she and her family had just moved into a new home.

“I was in terrible pain and was trying to paint the house and do all kinds of things I shouldn’t have been doing,” Mrs. Muñoz says. “I saw a pain management specialist, who tried a series of facet injections in my spine, but they provided no real relief. With the pain I was averaging three to four hours of sleep a night and couldn’t focus on anything.”

After learning she had desiccated and collapsing disks, Mrs. Muñoz underwent two spine fusions with implanted interbody cages for fixation, one in 2009 and the other in 2012. The pain improved but never went away. “We could never quite get a handle on the sciatica,” she says.

“Between 2009 and 2014, I was taking three heavy-duty pain medications. After the last surgery I saw a physical therapist who was very good, but my sciatica would flare up and I couldn’t do the exercises he prescribed. I had pretty much given up when I found Dr. Dhanani. She gave me hope at a time when I really needed it.” Nadya Dhanani, M.D., is an interventional pain management specialist at Mischer Neuroscience Associates-Texas Medical Center and a clinical assistant professor in the Vivian L. Smith Department of Neurosurgery at UTHealth Medical School. After talking with Muñoz and evaluating her condition, Dr. Dhanani prescribed sacroiliac (SI) joint injections for SI joint dysfunction. Mrs. Muñoz received the injections over the course of a year; each injection provided relief for about three months.

“Finally my husband said, ‘You shouldn’t have to live like this. There must be something that can be done.’ And there was. Now I can do things I haven’t been able to do for years.”

— Susan Muñoz

In June 2015, after trying more conservative measures, Dr. Dhanani performed a radiofrequency ablation of the nerves supplying the sacroiliac joint. “Radiofrequency denervation procedures provide more prolonged pain relief compared to sacroiliac joint injections,” Dr. Dhanani says. “This is not a procedure we perform frequently, but in certain patients like Susan, who get only transient relief from SI injections, it is appropriate. She responded very well.”

The procedure will provide six to 12 months of pain relief before the nerve repairs itself. “Before Dr. Dhanani, we went on vacation to Hawaii, and I couldn’t enjoy myself because of the pain,” Mrs. Muñoz says. “Finally my husband said you shouldn’t have to live like this. There must be something that can be done. And there was. Now I can do things I haven’t been able to do for years. I still have pain, but it’s minor versus major.”“Susan is one of my success stories. When I first met her, she was in an extraordinary amount of pain,” Dr. Dhanani says. “She’d almost given up on having a normal life. Over the year that we’ve been working together, she has minimized her dependence on narcotic medication in addition to increasing her range of activities. Although she’s not pain free, her quality of life has improved dramatically.”

Mrs. Muñoz sees Dr. Dhanani every three months. “She treats me as if I’m her only patient, always taking time to listen,” she says. “There’s a feeling of family and friendship in her office. They’re all very caring. I know when I go there, I’ll get relief.”