Amber Fable’s debilitating cramps petrified her during her “time of the month.”

Starting in 2010, Fable struggled with menstrual pain that registered to the power of 10. After being diagnosed with irritable bowel syndrome, she sought a second opinion.

The doctor told Fable, then 24, that she had the worst case of endometriosis he had ever seen.

Fable is among the 6.5 million Americans with endometriosis. According to the Office on Women’s Health, this long-term condition occurs when tissue similar to the lining inside the womb grows outside the womb and other areas where it does not belong. It can cause inflammation, scar tissue and adhesions as well as cause problems in the bladder and intestines.

Over the next five years, Fable tried several treatments to combat pain. She underwent laparoscopic surgery, followed by one year of lupron injections, then yearly ablation surgery to burn off endometriosis.

“I went from being so active to a barely-get-out-of-bed person who needed narcotics,” Fable says.

Fable moved from California to Fargo, N.D., in 2016 to get a fresh start. When she turned 30, she decided she wanted to try to have a child. Against all odds, she and her partner, Kristoffer, welcomed their son, Theo, in November 2017. Fable became a stay-at-home mom and underwent two painful nerve blocks to try to manage her relentless pain.

In June 2019, Fable opted for excision surgery to cut the endometriosis out of her body. For the next six months, her pain dipped from a constant 10 to a seven. And Fable started a new job (with heavy weight restrictions) at Club Kids, a drop-in daycare in Fargo.

She remembered seeing the construction of the Center for Pain Medicine in South Fargo on her work commute in 2016. Betting the new facility would have the latest in pain medicine, Fable met with Dr. Majid Ghazi, a board-certified anesthesiologist and interventional pain physician.

Ghazi performed a thorough examination and offered Fable a new treatment option: neuromodulation therapy.

This therapy uses implanted medical device technology to interrupt or modify the pain signals originating from the spinal area before the brain is able to interpret the message. It provides greater pain control than narcotics and eliminates common opioid side effects such as constipation, drowsiness and mental cloudiness.

“Chronic abdominal and pelvic pain is a very complex condition, which at times can be extremely difficult to treat,” Ghazi says. “Conservative and surgical treatments are usually associated with mixed results. Recent studies have shown spinal cord stimulation is a highly effective option to treat this condition.”

The surgery is a two-part procedure. First, a trial run is performed in a sterile environment, where (wire) leads are placed through the skin and up the spinal column. Patients are under intravenous sedation, known as conscious sedation. Staff from Boston Scientific, the company that manufactures the device, programs the equipment.

Fable underwent the trial in March 2020 and experienced her first five pain-free days in a decade. She even got down on her hands and knees and cleaned tile with a toothbrush.

After Covid-19 restrictions were lifted, Fable underwent the implantation in May 2020.

“I am virtually pain-free, except for the normal pains of a 33-year-old,” Fable says.

“I went from having 10-out-of-10 pain for the last decade—a shadow of my former self—to having my life given back to me by a device the size of a silver dollar,” Fable says.

Read more patient stories.

Amber Fable’s debilitating cramps petrified her during her “time of the month.”

Starting in 2010, Fable struggled with menstrual pain that registered to the power of 10. After being diagnosed with irritable bowel syndrome, she sought a second opinion.

The doctor told Fable, then 24, that she had the worst case of endometriosis he had ever seen.

Fable is among the 6.5 million Americans with endometriosis. According to the Office on Women’s Health, this long-term condition occurs when tissue similar to the lining inside the womb grows outside the womb and other areas where it does not belong. It can cause inflammation, scar tissue and adhesions as well as cause problems in the bladder and intestines.

Over the next five years, Fable tried several treatments to combat pain. She underwent laparoscopic surgery, followed by one year of lupron injections, then yearly ablation surgery to burn off endometriosis.

“I went from being so active to a barely-get-out-of-bed person who needed narcotics,” Fable says.

Fable moved from California to Fargo, N.D., in 2016 to get a fresh start. When she turned 30, she decided she wanted to try to have a child. Against all odds, she and her partner, Kristoffer, welcomed their son, Theo, in November 2017. Fable became a stay-at-home mom and underwent two painful nerve blocks to try to manage her relentless pain.

In June 2019, Fable opted for excision surgery to cut the endometriosis out of her body. For the next six months, her pain dipped from a constant 10 to a seven. And Fable started a new job (with heavy weight restrictions) at Club Kids, a drop-in daycare in Fargo.

She remembered seeing the construction of the Center for Pain Medicine in South Fargo on her work commute in 2016. Betting the new facility would have the latest in pain medicine, Fable met with Dr. Majid Ghazi, a board-certified anesthesiologist and interventional pain physician.

Ghazi performed a thorough examination and offered Fable a new treatment option: neuromodulation therapy.

This therapy uses implanted medical device technology to interrupt or modify the pain signals originating from the spinal area before the brain is able to interpret the message. It provides greater pain control than narcotics and eliminates common opioid side effects such as constipation, drowsiness and mental cloudiness.

“Chronic abdominal and pelvic pain is a very complex condition, which at times can be extremely difficult to treat,” Ghazi says. “Conservative and surgical treatments are usually associated with mixed results. Recent studies have shown spinal cord stimulation is a highly effective option to treat this condition.”

The surgery is a two-part procedure. First, a trial run is performed in a sterile environment, where (wire) leads are placed through the skin and up the spinal column. Patients are under intravenous sedation, known as conscious sedation. Staff from Boston Scientific, the company that manufactures the device, programs the equipment.

Fable underwent the trial in March 2020 and experienced her first five pain-free days in a decade. She even got down on her hands and knees and cleaned tile with a toothbrush.

After Covid-19 restrictions were lifted, Fable underwent the implantation in May 2020.

“I am virtually pain-free, except for the normal pains of a 33-year-old,” Fable says.

“I went from having 10-out-of-10 pain for the last decade—a shadow of my former self—to having my life given back to me by a device the size of a silver dollar,” Fable says.

Read more about regenerative treatment therapies available at Center For Pain Fargo or call 701-551-6980 to schedule your consultation.

Finding hope in the midst of pain

Brent Gillund hurried down the stairs to meet with his doctoral advisor one August afternoon in 2000 at the University of North Dakota in Grand Forks. He slipped on the top step, falling six feet over four steps. And landed on his tailbone.

That one misstep would lead to seven years of narcotic pain medication use to deal with the relentless pain in his legs and back. Pain that hovered at a five on a scale of one to 10, flaring to an eight.

Gillund, then 31, experienced annular tears and disc herniation in five discs in his lumbar region. Simply put, the spinal disc is like a jelly donut. The fall caused the “jelly” to leak out of the disc’s rubbery exterior, or annulus. As a result, his discs decompressed, irritating nearby nerves.

The National Institutes of Health reports tens of million Americans suffer from chronic pain.

Unable to continue his part-time job as a hospital orderly, Gillund became an adjunct instructor at an area college. He saw six doctors, including a pain management specialist, in the next seven years. Each doctor prescribed narcotics and encouraged him to lose weight. (He weighed 310 pounds at the time of the accident.) Gillund progressed from hydrocodone, to percocet, to oxycodone, followed by a fentanyl patch, to methadone.

The opioids left him groggy and provided no pain relief. Life became more demanding as Gillund and his wife, Brenda Jo, welcomed twins in 2002. And he began a new position as a behavior management/education specialist at a psychiatric hospital in Grand Forks.

His weight crept up to 340 pounds. Pain disrupted his sleep, and Gillund resorted to sleeping in his recliner.

Gillund underwent intradiscal electrothermal therapy, IDET, on two discs in 2004. This procedure basically cauterizes the nerve endings within the disc wall to help block the pain signals. Gillund gained some relief. But he was still on narcotics for the other three discs.

By 2007, Gillund was fed up with the narcotics and carefully weaned himself off methadone. He met with his pain management specialist to “fire” him. That’s when the specialist encouraged Gillund to see Dr. Majid Ghazi, a board-certified anesthesiologist and interventional pain physician in Fargo.

Desperate for relief, Gillund scheduled an appointment. Ghazi performed a thorough examination. And then Ghazi said, “I think there is something we can try.”
That moment was “life-changing” for Gillund.

“Not having hope for so long, emotionally it was the possibility of having a huge weight being lifted off my shoulders,” Gillund says.

Neuromodulation therapy uses implanted medical device technology to interrupt or modify the pain signals originating from the spinal area before the brain is able to interpret the message.

Neuromodulation therapies provide greater pain control than narcotics. And they eliminate common opioid side effects such as constipation, drowsiness and mental cloudiness.

Spinal cord stimulator surgery is a two-part procedure. First, a trial run is performed in a sterile environment, where (wire) leads are placed through the skin and up the spinal column. Patients are under intravenous sedation, known as conscious sedation.

Gillund remembers waking from the trial procedure in full pain. Then he was handed the stimulator control. Gillund adjusted it until he felt no pain.
“I sobbed,” Gillund recalls “I was in control again. It was liberating.”

After the trial run, Ghazi determined Gillund was a candidate for permanent implantation of the device. Ghazi removed the temporary leads, and staff scheduled surgery after the trial area was completely healed.

Gillund underwent the implantation on August 22, 2007. Similar to a pacemaker, the spinal stimulator is battery operated device. Gillund’s first battery was a non-rechargeable unit and lasted three years. He received an upgrade with a rechargeable battery in 2010.

He describes 2007 as his “miracle year.” Bariatric surgery in December 2007 enabled Gillund to lose more than 100 pounds. The weight loss allowed him to back away from needing the stimulator every day.

Since 2016, Gillund has worked as the associate director of clinical operations at Axis Clinicals USA in Dilworth, Minn. He began his research career at PRACS Institute in East Grand Forks, Minn., in 2006. Gillund resides with his family in West Fargo, N.D.

And on the days when he feels pain, Gillund turns on the stimulator for an hour or two to get through the worst. “Before it was on 24/7,” he says. He describes the sensation as a “vibrating massager on the inside.”

“Never give up hope,” Gillund says. “Even when several doctors say there is nothing they can do, keep searching.”

“Dr. Ghazi saved my life,” Gillund adds. “He gave me hope when others didn’t. He gave me my life back. I will gladly shout it from the mountaintops. Thank you, Dr. Ghazi!”

In 2019 he underwent replacement of his spinal cord stimulator battery. “Never give up hope,” says. “Even when several doctors say there is nothing they can do, keep searching.”

Read more patient stories.

Finding hope in the midst of pain

Brent Gillund hurried down the stairs to meet with his doctoral advisor one August afternoon in 2000 at the University of North Dakota in Grand Forks. He slipped on the top step, falling six feet over four steps. And landed on his tailbone.

That one misstep would lead to seven years of narcotic pain medication use to deal with the relentless pain in his legs and back. Pain that hovered at a five on a scale of one to 10, flaring to an eight.

Gillund, then 31, experienced annular tears and disc herniation in five discs in his lumbar region. Simply put, the spinal disc is like a jelly donut. The fall caused the “jelly” to leak out of the disc’s rubbery exterior, or annulus. As a result, his discs decompressed, irritating nearby nerves.

The National Institutes of Health reports tens of million Americans suffer from chronic pain.

Unable to continue his part-time job as a hospital orderly, Gillund became an adjunct instructor at an area college. He saw six doctors, including a pain management specialist, in the next seven years. Each doctor prescribed narcotics and encouraged him to lose weight. (He weighed 310 pounds at the time of the accident.) Gillund progressed from hydrocodone, to percocet, to oxycodone, followed by a fentanyl patch, to methadone.

The opioids left him groggy and provided no pain relief. Life became more demanding as Gillund and his wife, Brenda Jo, welcomed twins in 2002. And he began a new position as a behavior management/education specialist at a psychiatric hospital in Grand Forks.

His weight crept up to 340 pounds. Pain disrupted his sleep, and Gillund resorted to sleeping in his recliner.

Gillund underwent intradiscal electrothermal therapy, IDET, on two discs in 2004. This procedure basically cauterizes the nerve endings within the disc wall to help block the pain signals. Gillund gained some relief. But he was still on narcotics for the other three discs.

By 2007, Gillund was fed up with the narcotics and carefully weaned himself off methadone. He met with his pain management specialist to “fire” him. That’s when the specialist encouraged Gillund to see Dr. Majid Ghazi, a board-certified anesthesiologist and interventional pain physician in Fargo.

Desperate for relief, Gillund scheduled an appointment. Ghazi performed a thorough examination. And then Ghazi said, “I think there is something we can try.”
That moment was “life-changing” for Gillund.

“Not having hope for so long, emotionally it was the possibility of having a huge weight being lifted off my shoulders,” Gillund says.

Neuromodulation therapy uses implanted medical device technology to interrupt or modify the pain signals originating from the spinal area before the brain is able to interpret the message.

Neuromodulation therapies provide greater pain control than narcotics. And they eliminate common opioid side effects such as constipation, drowsiness and mental cloudiness.

Spinal cord stimulator surgery is a two-part procedure. First, a trial run is performed in a sterile environment, where (wire) leads are placed through the skin and up the spinal column. Patients are under intravenous sedation, known as conscious sedation.

Gillund remembers waking from the trial procedure in full pain. Then he was handed the stimulator control. Gillund adjusted it until he felt no pain.
“I sobbed,” Gillund recalls “I was in control again. It was liberating.”

After the trial run, Ghazi determined Gillund was a candidate for permanent implantation of the device. Ghazi removed the temporary leads, and staff scheduled surgery after the trial area was completely healed.

Gillund underwent the implantation on August 22, 2007. Similar to a pacemaker, the spinal stimulator is battery operated device. Gillund’s first battery was a non-rechargeable unit and lasted three years. He received an upgrade with a rechargeable battery in 2010.

He describes 2007 as his “miracle year.” Bariatric surgery in December 2007 enabled Gillund to lose more than 100 pounds. The weight loss allowed him to back away from needing the stimulator every day.

Since 2016, Gillund has worked as the associate director of clinical operations at Axis Clinicals USA in Dilworth, Minn. He began his research career at PRACS Institute in East Grand Forks, Minn., in 2006. Gillund resides with his family in West Fargo, N.D.

And on the days when he feels pain, Gillund turns on the stimulator for an hour or two to get through the worst. “Before it was on 24/7,” he says. He describes the sensation as a “vibrating massager on the inside.”

“Never give up hope,” Gillund says. “Even when several doctors say there is nothing they can do, keep searching.”

“Dr. Ghazi saved my life,” Gillund adds. “He gave me hope when others didn’t. He gave me my life back. I will gladly shout it from the mountaintops. Thank you, Dr. Ghazi!”

In 2019 he underwent replacement of his spinal cord stimulator battery. “Never give up hope,” says. “Even when several doctors say there is nothing they can do, keep searching.”

Read more about regenerative treatment therapies available at Center For Pain Fargo or call 701-551-6980 to schedule your consultation.

Physical therapist Tanya Couture remembers catching a falling patient. And feeling something “snap’ in her back.

The career-ending injury in 2006 set Couture, then 27, on a quest to find pain relief. Couture tried months of physical therapy. An MRI performed at Mayo Clinic in 2009 revealed a complete rhomboid muscle tear in her upper right back. Unfortunately, the accumulation of scar tissue made it impossible to surgically repair the tear without damaging surrounding muscles.

Saddled with a 10-pound weight restriction, life was difficult for Couture who resided in Valley City, N.D., with her husband, Chad, and their two young children. On a scale of one to 10, her pain was an eight. She fell into a hard depression.

“Pain sucks the life out of you,” Couture says.

Couture earned a bachelor’s degree in social work from Bresnia University in 2012. When work-related driving proved too painful for Couture, her husband purchased a clothing store in 2013 for her to manage.

Throughout the years, Couture has consulted with 13 different doctors, receiving trigger point injections, cortisone injections and numerous nerve and spinal blocks. Since 2011, her monthly prescription drug bill has averaged $3,000. And for the past seven years, she’s received trigger point injections every 11 weeks, roughly $8,000 each visit. Thankfully, insurance covered most of it.

Opioids provided meager relief while wreaking havoc in her stomach, liver, eyes, kidneys and bowels. When Couture’s eyesight became threatened, she determined to find a drug-free solution. As a new grandmother, she wanted to see her granddaughter grow up.

Friends suggested the Center for Pain Medicine in Fargo and Couture researched it online. She was almost deterred by the painful 60-minute drive from Valley City. But Couture’s desire to get off the opioids was stronger than her dread of pain.

In October 2019, Couture met with Center’s Dr. Dustin Goetz, a board-certified anesthesiologist and interventional pain physician. The Center, founded by Dr. Majid Ghazi in 2014, promotes the development and practice of safe, high-quality, and cost-effective interventional pain management procedures for diagnosis and treatment of spine and joint-related pain disorders.

Goetz performed a thorough examination and recommended wireless periphery nerve stimulation. In this outpatient procedure, one or two wires with four to eight electrodes are implanted near the damaged nerve to interrupt pain signals. Goetz explained Couture would need to modify her lifestyle for the treatment and continue to follow the 10-pound weight restriction.

“Wireless peripheral nerve stimulation is a novel technique to relieve pain caused by a damaged peripheral nerve–such as intercostal, dorsal scapular, ilioinguinal, among others–resulting in chest wall pain, back pain or pelvic pain,” Ghazi says. “The procedure is very safe. The effect is almost immediate, and the success rate is high.”

A trial is performed to determine whether it will bring the desired results. Couture would need to be off oral pain medications for three months prior to the trial. After she was drug-free for four weeks, Goetz performed a nerve block to determine which nerves innervated her right rhomboid area.

“He was the first doctor who looked at and targeted the problem,” Couture says.

Couture underwent the trial in January 2020 in the Center’s in-house operating room in a sterile environment. Staff from Stimware, the company that manufactures the device, programmed the equipment.

In the procedure, wire-like electrode leads are placed through a needle into the skin next to the damaged peripheral nerves. The electrode, or stimulator receiver, works with a wearable antenna, which is clipped to clothing, next to the skin. The wearable antenna sends wireless electrical pulses through the skin and into the stimulator receiver. The receiver, in turn, sends rapid electrical pulses to the nerves that feel like mild tingles. These pulses intercept and block pain signals. The amount of stimulation can be adjusted through a controller attached to the wearable antenna.

Goetz encouraged Couture to try things that she had not been able to do before. Couture shopped for two hours, went bowling (within the weight restriction), and cut her own steak. All without pain.

On February 10, 2020, Couture underwent the implantation. Today, Couture possesses stamina to operate their family businesses, and cherishes watching her granddaughter’s growth.

“It’s unbelievable,” Couture says. “I literally thought living in pain was my destiny. It’s given me a whole new outlook.”

“Some days are hard; don’t get me wrong,” she adds.

Even so, Couture says, “This little piece of equipment could be life-changing for a lot of people.”

Read more patient stories.