James Moharter stands outside his home in Raleigh, NC.
For 17 years, James Moharter suffered from 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%, 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 coming to Duke, where he was asked 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 Melanie Ellers, a Duke nurse practitioner who specializes in pain management, 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. As a result, you can achieve the same, if not better, pain control as you do with medication, but without the side effects or immune suppression associated with these medications, according to Ellers.
Before the device could be permanently implanted, Moharter needed to complete a six-day trial.
“At the end of the trial, he was a completely different person,” Ellers said. “He walked in to his appointment, whereas he was in a wheelchair before. His results were phenomenal.”
Moharter’s spinal cord stimulator was implanted in the spring of 2021. Within weeks, his life drastically changed.
A New Way of Life
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.
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 Duke offering this to me,” he said.