'There's so many things wrong with them'

CLIFTON, N.J. - Dr. William Focazio, a New Jersey gastroenterologist, wasn't aware of the hardships and suffering that many former NFL players endure until he watched a TV story that highlighted the issue. He decided he could help.

Focazio founded an organization called Pain Alternatives, Solutions and Treatments, also known as PAST, a New Jersey-based network of doctors who provide comprehensive medical care -- often pro bono -- to retired professional athletes.

Mike Mosley is typical of the clients. The former Buffalo Bills wide receiver suffers from spinal stenosis -- a narrowing of the spinal canal -- and a crushed vertebrae in his lower back. He also needs wrist fusion surgery, shoulder surgery, ankle reconstruction and two knee replacements. The constant pain prevents him from sleeping more than two hours at a time at night.

But thanks to PAST, he's hopeful for the first time in years. "I'm on the right road for sure," Mosley, 54, said.

Focazio owns several surgical centers and had resources and connections to doctors in various fields. He enlisted a team of specialists with a mission to improve lives by providing a holistic approach to care.

Clients receive a comprehensive treatment plan under one umbrella, as opposed to a fragmented approach by a web of specialists who may or may not communicate with each other. Focazio finds no real value in sending someone to rehab for painkiller addiction, for instance, if that person emerges still dealing with chronic pain, debilitating injuries and emotional issues.

"There's so many things wrong with them," Focazio said.

"My regular patients, you see one disc problem and you can help them," said Dr. Amrish Patel, who specializes in pain management. "These guys come in with three or four disc problems in their neck, three or four disc problems in their lower back. It's just unbelievable."

PAST has treated several hundred athletes and currently has a waiting list. The majority of clients played in the NFL, but the program is available to athletes from other sports. Most hear about the program through word of mouth.

So far, PAST has provided more than $4 million of pro bono care, according to Jennifer Smith, director of player programs.

"I don't like to think about it," Focazio said with a laugh.

So why do it?

Focazio said he tried to align his program with the NFL in the early stages, but a partnership never formed. An NFL spokesman wrote in an e-mail that "we have no affiliation with Dr. Focazio."

"Independence is important," Smith said. "Would it be great to have funding from them or grants? Yeah. But in order to maintain the success we have with these players, you have to be autonomous."

The cases are complicated because they usually involve extensive physical damage and chronic pain, often coupled with depression and substance abuse, typically painkillers. Smith said 40 percent of their clients require inpatient drug rehab at some point.

PAST sends clients struggling with addiction to Turning Point, a treatment facility in Paterson, N.J. Turning Point helped create a program that fully integrates PAST's medical team so players continue to receive a comprehensive plan that focuses on their physical pain, addiction and any concussion-related issues.

Turning Point executive director Dr. Manuel Guantez also works with former New York Jets quarterback Ray Lucas and other PAST clients who serve as peer mentors to teach them new skills and techniques so that they can help athletes who are entering the program.

"It's almost inhuman," he said.

Mosley used painkillers at different times in his three-year NFL career but depended on them regularly as he grew older and his body failed. He took as many as 24 pills a day to cope with his chronic pain. He needed four in the morning "just to get out of bed" but has since lowered his usage to five Vicodin a day. His medical needs are complex, but PAST doctors are formulating a plan to help him regain control of his life, which Mosley described as a "godsend."