Implant Device Keeps Forest Hills Man Active at 92, Despite Pain

FOREST HILLS, QUEENS – As Sid Rubin settles into a plush recliner beside his living room fireplace, he make one thing clear – he's not happy about it. Sitting, that is.

Even at 92 years old, the Forest Hills senior would rather be outside lapping the blocks of his neighborhood or – at the very least – working. For nearly a decade, both tasks were all but impossible after a surgery to Rubin's right knee brought "unbearable" pain that years of doctor's visits, prescription drugs and injections couldn't help.

But after nine years of searching for a solution, Rubin believes he's found one. A small pain-management device implanted on his right knee that uses an electric current to ease chronic pain.

Rubin told Patch that since he had the device implanted in May, the once unbearable pain has become tolerable and activities like walking and working are doable - albeit in limited quantities.

"This is the only thing that's worked," Rubin said pointing to the pain management device. "I used to be in constant pain with my knee. This isn't perfect, but I'm not in pain anymore."

The device, called a Stimrouter, stimulates the nerves to treat chronic pain. Bioness, a company that specializes in rehab therapy technologies, came out with the device to help patients with an active lifestyle control their own pain management. The Stimrouter, which started out as a clinical trial, was FDA cleared earlier this year and has since been implanted in patients across the country and in Europe to help manage pain.

The device includes a lead strip implanted in the muscles around the knee and an adhesive electric pulse transmitter stuck to the skin outside. Patients use a handheld wireless programmer to shoot electric pulses down to the lead to target the nerve, stimulating the muscles around the knee and helping them contract and strengthen. The device is programmed for each patient's needs by a doctor, but is ultimately controlled by the patient to address their changing levels of pain.

The whole process feels somewhat like the tingling of a small electric shock, said Rubin, who keeps the transmitter constantly fastened to his knee with a large gauze bandage.

"It's like the feeling you get when you touch something with electricity, but it lasts for several hours," he said. "After awhile, you don't even know it's there."

Though Rubin's knee still keeps him in slight discomfort, he said it was nothing compared to the pain he felt before the device was implanted.

Rubin, who got a knee replacement nine years ago, said he had the surgery shortly after retiring to alleviate a longstanding pain in his right knee. But the pain persisted after surgery and made everyday tasks like walking the neighborhood or climbing the stairs to his bedroom nearly impossible.

"At first, when I got home from the surgery, I was going to rehab and physical therapy and I was feeling pretty good," he said. "I was walking 10 blocks, I was doing good. I don't know what happened, but it started going downhill."

Over the next few years, Rubin would visit one doctor after another, undergoing countless X-rays, in failed attempts to diagnose the pain. Each one said the same thing: Everything looked fine.

"I went back to physical therapy and tried and tried, but I never got back to that point," Rubin said.

Some doctors prescribed opioid medications like oxycodone and Tylenol with codeine to relieve the pain, but Rubin quickly realized such pills weren't an option. Rubin has vasovagal – a condition in which certain triggers cause him to faint – and side effects from the pain medications always seemed to set it off, he said.

"The prescription pain medicines never worked on me," Rubin said. "The second time it was so bad they rushed me to the ER, so I didn't use them anymore because of that."

After ruling pain medications out, Rubin again thought he'd found an answer to his chronic pain two years ago in the form of liquid nitrogen injections. He saw a news story about liquid nitrogen that was cooled to 22 degrees below zero and injected into the body to alleviate chronic pain, and decided to give it a try. It worked, at least at first.

"It was an immediate thing," Rubin said. "The pain went away."

For the next year and a half, Rubin arrived at the doctor's office for a liquid nitrogen injection every three months to keep his pain at bay. Slowly, the injection's effects started to fade.

"I kept coming back until eventually it just stopped working completely," he said.

It was shortly after that, around six months ago, that a frustrated Rubin agreed to try the Stimrouter. Bioness claims the device is the first minimally invasive neuromodulation technology cleared by the FDA to treat long-term chronic peripheral nerve pain.

The technology has granted Rubin the relief to his chronic pain that he's long searched for. He can now move around his home and up and down stairs, small tasks that until six months ago had been unbearable, he said.

"I haven't done walking for a long time because of my knee," he said. "Now it's not as difficult. This is tolerable."

Rubin said walking is still difficult, and long distances – like the three miles around his neighborhood he used to do – are still a task he's yet to conquer. But the new technology gives him hope that one day he'll get back to that.

"One day I hope to go back to physical therapy for my knee again and get back to a gym and start working out," he said. "You don't even realize what you have until it's gone."

In the meantime, the device has allowed Rubin to continue his consulting work. Despite being 92, Rubin said he's still on the computer nearly every day, combing the internet for small consulting jobs in government safety regulations, his former line of work. His only criteria for a job? A place with reasonably close parking and minimal stairs.

"I have to work," Rubin said. "I enjoy it."

That means immediately strapping the electric transmitter to his knee upon waking up each day to keep the chronic pain away, replacing it instead with the tingling feeling Rubin said is best described as a slight discomfort. He considers it a small price to pay for the chance to live the active life he so cherishes.

"There are people who can sit in senior centers and play bingo or cards – and if they enjoy themselves, more power to them – but that's not me," Rubin said. "I have to be kept busy."

Lead image of Sid Rubin by Danielle Woodward/Patch