James Moharter stands outside his home in Raleigh, NC.
For 17 years, James Moharter suffered with a painful back injury that required increasingly powerful doses of pain medicine just to get him out of bed. That changed in 2019 when Moharter received a spinal cord stimulation device at Duke. Today, his pain has been reduced by up to 80 percent, he’s off almost all pain medications, and he no longer needs a cane to walk.
“I have a desire to get up and go do things,” Moharter said. “It’s just a whole different world. I count my blessings every day.”
Serious Injuries with Limited Treatment Options
Moharter was a passenger in a five-car pile-up on I-95 in 2003 that left him with herniated discs, a compressed spinal cord, and spinal swelling. He didn’t receive the medical care he needed right away. To stabilize his spine, surgeons placed a metal plate in his neck and put spacers between his vertebrae.
“I didn't want to have any other surgeries, so my options in the 2000s were medications like opioids and fentanyl,” he said. Fentanyl is 50 to 100 times more potent than morphine.
Opioids become less effective over time and require increasing doses. Side effects include drowsiness, confusion, digestive issues, depression, and dependence, just to name a few. Eventually, Moharter, who lived in New York at the time, was in so much pain that he couldn’t work. He slept all the time, had trouble remembering things, and needed home health care.
“My mind just wasn't there. I see pictures of myself at family events during that time, and I don't remember being there,” he said.
Making a Change
Around 2015, Moharter told his doctors that he wanted to take less medication. He weaned off fentanyl and switched to morphine. By 2018, Moharter had gotten down to a low dose of oxycodone. In 2019, Moharter moved to Raleigh, NC and started seeing Jay Kumar, MD, a Duke interventional spine and pain management specialist. Dr. Kumar asked Moharter if he’d be interested in trying spinal cord stimulation.
Spinal Cord Stimulators
Spinal cord stimulators are surgically implanted devices that use electricity to relieve certain types of chronic pain. According to Dr. Kumar, spinal cord stimulation targets specific nerves to change how they behave, how often they fire, and how the brain perceives pain signals from those nerves. “This is a way to achieve the same, if not a better, amount of pain control as you do with medication, but without the side effects or immune suppression associated with these medications,” he said.
Before the device could be permanently implanted, Moharter needed to complete a six-day trial. “When I decided to go through with the trial, I prayed, and I had high hopes that I would have a lot less pain while sitting and lying down,” Moharter said. “Not only was that the case, but I also had a lot less pain standing and walking. It was such a difference.” Moharter’s spinal cord stimulator was implanted in the spring of 2021. Within weeks, his life drastically changed.
A New Way of Life
Moharter, now 62, is doing things he hasn’t done in over a decade -- gardening, walking his dogs, walking without a cane, and driving. “These are big things that would not have happened had it not been for Dr. Kumar offering this to me,” he said.
Moharter charges his stimulation device every few weeks for about 30 minutes. If he experiences consistent breakthrough pain, he goes to Duke for wireless, painless adjustments to his device programming. Dr. Kumar hopes more people can find the kind of relief that Moharter experienced.
“He was the prime example of a patient who just wanted to get better. We were able to work together, figure things out, and create a treatment plan,” Dr. Kumar said. “I am happy that he is so happy.”