NO LAUGHING MATTER JERRY LEWIS IS SPREADING THE WORD ABOUT THE DEVICE THAT ENDED HIS CHRONIC PAIN.

Byline: Valerie Kuklenski Staff Writer

FALLING DOWN is funny. Charlie Chaplin, Donald O'Connor and Peter Sellers knew it, as do Dick Van Dyke and Chevy Chase. Jerry Lewis says he learned it as a little boy performing at a Catskills hotel with his father, comedian Danny Lewis.

``I'm 5 years old and I'm singing 'Brother, Can You Spare a Dime,' '' recalled Lewis, now 78, during a recent interview in Beverly Hills. ``At the end of the number, I took a bow and my foot slipped and I hit one of the footlights, which blew up - smoke and glass and the loudest noise I ever heard. And I didn't know what to do - I was so frightened at almost falling over - and I hear the audience laugh. And I think to myself, 'That's not bad.' So I look at my dad. He said, 'You all right?' I said, 'I'm fine.' And I took a fall.''

Lewis hit the floor time and again, performing on stage with his parents into his teens, then opposite Dean Martin on stage and on the big screen in popular comedies such as ``At War With the Army,'' ``The Caddy,'' ``Scared Stiff,'' ``3 Ring Circus'' and ``Artists and Models.''

Those comedic pratfalls eventually took a toll on his health, leaving Lewis with debilitating back pain for years until April 2001, when he began using an implanted ``pain pacemaker'' to deliver low-voltage stimulation to his spinal cord.

The device, about the size of a heart pacemaker, delivers a steady stream of electrical pulses that block the pain messages sent along the spine from reaching the brain, where pain is perceived.

Now he is singing the praises of Medtronic's device through its Tame the Pain informational campaign (www.tamethepain.com), a spokesman role he was willing to take on voluntarily. He has made it his mission to spread the word to the estimated 70 million people nationwide who suffer from chronic pain - pain that recurs or persists for more than six months.

Before he found relief, however, Lewis tried everything to quell his constant back pain, exacerbated by a tumble he took March 20, 1965, at the Sands Hotel in Las Vegas.

``I mean, I had pain all through the years up to that point in '65. But from that night, that began the 37 years of constant pain.''

An end to misery

He tried common analgesics, Novocaine, Xylocaine, Marcaine, steroids and cortisone and was addicted for 13 years to hard-core painkiller Percodan. His only relief, he said, came from the natural adrenalin release he got while performing; it helped him cope through years of movies, TV appearances, Vegas dates and Muscular Dystrophy Association telethons. For years he rejected his doctors' suggestions of surgery.

Lewis hit his lowest point in April 2001, when he says he pulled out his 9mm Baretta pistol in preparation for killing himself. His young daughter, Danielle, walked in on him and unknowingly brought him back to his senses.

That day he received a trial model of the Medtronic neurostimulation device with a handheld control that sends electronic pulses to the affected nerves, blocking the pain message to the brain. Within a matter of days he was scheduled for the minor surgery in Houston to implant electrode leads in his spine and a battery pack just under the skin near his left hip.

``My (hospital) room was at the end of a hundred-foot corridor. I couldn't walk from my room to the end of that 100-foot corridor, so I had to be in a wheelchair. I came out of the surgery; three hours later, I walked out of that elevator and skipped all the way down that hundred feet to my room.''

Lewis demonstrated the device, positioning a remote a little bigger than a garage-door opener near his hip. The device gave off a soft vibrating hum and caused him to bounce lightly and rhythmically in his chair as he increased the power.

``Not everyone is a candidate, but in most cases they are,'' he said. ``They have to come and find out. Instead of a doctor writing a prescription for pain, let the doctor write the address of a pain specialist. Now I'm taking on the doctors. I'm very popular with the AMA lately.''

Dr. Michael Ferrante, director of the Pain Medicine Center at UCLA, agrees with Lewis that for too long, medical schools overlooked the issue of pain management. ``Basically, pain was ignored. Obviously you suppose it's a symptom. Treat the disease and the symptom goes away. But sometimes the symptom doesn't go away.''

Most in his field today are anesthesiologists, as he is. Other pain practitioners come from psychiatry, psychology, neurology and, in smaller number, physiatry - the diagnosis and treatment of muscular disorders. He said the aging of the baby-boom generation will increase demand for specialists as patients seek relief from injuries and the effects of aging, such as spinal stenosis.

Implantation of neurostimulators comes with a small risk of infection, and patients with implants cannot have MRI screenings because the heat on the electrodes' metal tips could cause serious nerve damage.

Little-known option

Medtronic's pain pacemaker costs about $10,000 plus doctor and hospital fees and is covered by most HMOs and other insurance plans, making it an affordable option for many. But Ferrante said thousands of patients have not yet learned about this choice, in many cases because they have not been referred to a specialist who can determine whether it's appropriate.

``That needs to change. Many, many people could be helped by this treatment,'' he said. ``We need to consider this option much earlier in the treatment paradigm. It was supposed to be an end-of-the-line salvage procedure. I wouldn't put it at the front because there are more conservative options to consider first, but it probably should be somewhere in the middle.

``When you're in the business of pain medicine, you don't want to sell hope. I think it is kinder to be kind and honest - 'This is what can be done and this is what can't be done,' '' Ferrante said. ``In the right patient it changes lives. If you're lucky and God is with you, you can make a big difference in people's lives.''

Today Lewis has weaned himself off prednisone, the steroid treatment for pulmonary fibrosis that caused significant weight gain and water retention, and he uses oxygen only while he sleeps. He complains some about having to give up his beloved golf, but that seems a small inconvenience to someone who has survived heart surgery, prostate cancer, pulmonary fibrosis and back pain so severe he nearly killed himself.

When Lewis sees younger comics and actors doing especially taxing physical comedy, he says he is tempted to warn them of the harm they are doing, but he doesn't.

``If anyone came to warn me, I'd tell them to mind their business. Nobody could change what I was planning and what I was doing, because I really believed I was right.''

Valerie Kuklenski, [phone]

valerie.kuklenski(at)dailynews.com

Choose your weapons in the war on pain

Acute pain is known by an immediate intensity that announces an injury to the brain and comes with physical indicators such as a grimacing expression or an elevated heart rate. Chronic pain, on the other hand, is the prolonged sort that can alter the patient's lifestyle, limiting routine activities.

What is chronic pain? Experts agree it is pain that lasts more than six months and is not relieved by medical or surgical treatment of its apparent cause. It may stem from a specific injury long since healed or an ongoing condition.

How is pain registered in the brain? Pain is a reaction to signals transmitted from the site of an injury or other pain source, through the nerves in the spinal cord, then to your brain, which registers them as pain.

What are treatment options for chronic pain beyond oral medications?

--Physical therapy, either passive (massage or chiropractic care) or active (exercise).

--Corrective surgery, as in cases such as pinched or herniated nerves.

--Therapeutic nerve blocks, usually local anesthetic or steroid injections at the site of the pain.

--Pain medication pump, which administers medicine directly to the spinal cord, allowing for a much lower dose of morphine than the oral dosage - 1 milligram vs. 300 milligrams. Manufacturers include Medtronic and Arrow.

--Neurostimulation devices, such as the Medtronic pain pacemaker and similar systems by ANS and Advanced Bionics.

--Neuroablation, the destruction of the specific nerves transmitting pain signals, considered a last resort to other options.

CAPTION(S):

drawing, 2 photos, box

Drawing:

(cover -- color) Chronic pain

How Jerry Lewis and others are using new technology to ease the suffering

Illustration by Tom Gapen

Photo:

(1) A ``pain pacemaker'' helped Jerry Lewis, who is now a spokesman for Medtronic's Tame the Pain campaign.

John McCoy/Staff Photographer

(2) Jerry Lewis says a career of pratfalls and other physical clowning - of the sort seen in this 1956 photo with Dean Martin, left - led to years of unrelenting back pain.

Associated Press

Box:

Choose your weapons in the war on pain (see text)

Sources: www.tamethepain.com and Dr. Michael Ferrante