• September 2, 2014

Clinic helps veteran wounded in Iraq cope with chronic pain

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Posted: Friday, February 21, 2014 4:30 am

Lying unconscious at a military hospital, Bobby Krei woke up to an armed military police officer standing above him, ensuring that doctors did not amputate his leg. An MP himself, Krei knew his guard.

“I asked, ‘Denny, what are you doing?’ and he said, ‘Commander said to not let them take you until you woke up,’” Krei said.

Days before, in June 2006, Krei and his squad were clearing a building in Iraq when it blew up beneath them. Badly wounded, his entire right side — ankle, knee and hip — was full of shrapnel. Acting quickly to save his life, medics used plastic wrap to bind his bleeding leg and swiftly airlifted him to Germany.

“The Army’s solution to my injuries … was to cut it off just above the knee. They actually didn’t tell me, the Department of Defense told my wife and … my commander found out,” he said, explaining how the guard ended up being posted beside his bed.

Krei’s wife knew he would want to make the choice himself about whether or not to keep his leg.

He refused the amputation, saying he wanted to be able to move around with his new daughter, who was born earlier that year.

7 years of debilitating pain

As a result, for the next seven years, Krei suffered from extremely debilitating chronic pain. He retired from the military in 2008 and now works with the Boys & Girls Club in Copperas Cove.

“They wanted to put me at 100 percent disabled, but I knew I couldn’t just sit around the house, so I made them put me at 90,” he said. “Like most soldiers, for the next seven years, I just tried to suck it up and move on.”

By the time his daughter was 6, she knew when her father’s pain became too much to bear. She would run to get ice packs and make him sit down.

Krei’s ankle, knee and hip would swell from the strain of walking. He still has a large piece of shrapnel in his right calf that doctors refuse to operate on, claiming removing it would cause more harm, he said. Exposing the whites of his knuckles, fleck-sized bits of metal can be seen beneath the skin as his body slowly works out metal from the accident.

“(My primary doctor) started asking about my scars (a year ago),” he said. “That’s when he referred me to Dr. (Pankaj) Mehta.”

Mehta is one of four doctors who focus on treating complicated cases at the Pain Specialists of Austin — a group of nine clinics in the Central Texas area that are run by medical professionals who specialize in pain treatment. Krei was able to fully recover when doctors implanted a device known as a “spine stimulator.”

“He developed a traumatic injury, which resulted in chronic damage to the nerve and spinal receptors, that had redefined his neural plasticity,” said Dr. Vic Mahendru, founder of the Pain Specialists of Austin.

Recalling Krei’s case, Mahendru said, “He had done a lot of things — physical therapy, rehabs, medication, ice. He exhausted everything.”

Electrodes inserted

Ongoing, long-term pain actually changes the body’s makeup, Mahendru said. In Krei’s case, the nerve damage nearly became permanent.

“We (inserted) temporary electrodes into the spinal canal where the receptors are, and we (overrode) the negative impulses with positive impulses,” Mahendru said. “He was able to do more activities in daily living, felt better both physically and psychologically, and was able to reduce his use of pain medication.”

Operating almost like an implanted defibrillator that manages irregular heartbeats, the “spine stimulator” at the base of Krei’s spine is controlled by a small remote.

With the remote, he can regulate how much “positive impulse” — basically microelectrical currents — are sent to nerve receptors to counteract the pain signals sent to his brain. The device is completely removable, Mahendru said.

“They did the procedure on Nov. 11, and in December, I was able to take my daughter to the circus in Belton and walk around with her. She’s 8 now, and I’d never been able to do that, ever,” Krei said.

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