Two Advanced MMC patients—JoAnn LaGuardia and Tricia Risman—agreed to share their stories of debilitating symptoms and, ultimately, relief

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Patricia Delzell, MD, (center), is the founder of Advanced Musculoskeletal Medicine Consultants pictured with her staff, Correna Fondale (left) and Sarah Stevens (right). (Photography: Francis Angelone)

By Mitch Allen

When JoAnn LaGuardia drove from the Youngstown area to Dr. Patricia Delzell’s office in Chagrin Falls, it meant the tenth doctor she would see in the past 18 months for chronic pain. She made the trip lying down in the back seat because she was unable to sit up. Nor could she walk. As an accountant, she did her work in the only comfortable position she could find—lying on her side in bed.

“For 18 months it was debilitating,” she says. “I was in bed for the whole year of 2022 and six months into 2023. I had terrible back pain, leg pain and hip pain, and nine other doctors couldn’t figure out the cause.”

JoAnn had gone through physical therapy, injections and epidurals with no success. “Most doctors thought it was my back, but two different neurologists said, ‘It’s not your back, but I don’t know what it is.’ Some docs recommended surgery, but I was not a willing participant of ‘let’s cut you open and see what happens.’”

Finally, the ninth doctor referred JoAnn to Patricia Delzell, MD, founder of Advanced Musculoskeletal Medicine Consultants, saying, “If anyone can figure it out, she can.”

And she did.

Dr. Delzell reviews a patient’s ultrasound with Chris Smolko, PT, CIDN, STMT-1, CWT.


Ultrasound Diagnostics
Dr. Delzell is one of the nation’s leading authorities on the use of diagnostic ultrasound, which—unlike MRIs and CT scans—allow her to see tissues in motion, along with muscles, tendons, fascia, entrapped nerves, scar tissue, and much more. Using this technology, she discovered the source of JoAnn’s pain in a matter of minutes.

“It turned out I had scar tissue across my left cheek,” JoAnn reveals. “That’s why I couldn’t sit down.”

Dr. Delzell explored JoAnn’s diet and medicines, changed her vitamin routine, and gave her stretching exercises. But she also collaborated with JoAnn’s referring physician who did manual therapy to break up the scar tissue.

“It was such a relief to finally get a diagnosis,” JoAnn says. “Once I was able to get out of bed, I started walking again and building my endurance. I started going back to the office again. If it weren’t for Dr. D., I’d still be lying in the bed. She’s my savior.”

Dr. Delzell is renowned for her diagnostic abilities, which are rooted in spending time with patients and listening. “When I first meet a patient, I don’t spend 15 minutes with them, I spend an 2-3 hours,” she says. “Listening—really listening—that’s how you pick up on clues that may lead you the true source of the pain. And listening also helps us understand what each patient’s goals are so we can best work together to achieve those goals. Every patient is different.”

Indeed, just read on…

Dr. Delzell (left) with physical therapist Chris Smolko (right) offers treatments to Advanced MMC patients, including dry needling, cupping, manipulation, mobilization, percussion, and more.


Meet Tricia
For 18 years, Moreland Hills’ Tricia Risman suffered with chronic coughing and difficulty swallowing, often accompanied by nausea. “The symptoms started 18 years ago with my first pregnancy, but they never stopped,” Tricia reveals. “I coughed every few seconds to every few minutes for all those years. Doctors thought it had to be related to one of three things—acid reflux, allergies, or asthma—so that’s where they kept looking. I saw 30 to 40 specialists from allergists to pulmonologists. I had surgeries, endoscopies, and all kinds of tests.”

Tricia also had other symptoms, but since they did not seem related to the coughing, no doctor made the connection. “I was nauseated, I had difficulty swallowing, my digestion was off, and I had blood pressure and temperature regulation issues,” she explains. “But no one suspected a nerve problem so no one would refer me to a neurologist. Everyone was so focused on the coughing, they didn’t know what to do.”

Advanced MMC’s Sarah Stevens performs Class IV infrared laser therapy, which can dramatically reduce symptoms of peripheral neuropathy and other types of chronic pain


Finally, Tricia saw an osteopath for a new symptom—neck and shoulder pain. “When he learned about my coughing in addition to the pain, he began to suspect a nerve issue,” she says. “That’s when he referred me to Dr. Delzell. She spent a lot of time talking with me—much more than the normal 20 minutes you get with other doctors. She was the only one who put together all of the symptoms.”

Dr. Delzell suspected a dysfunction of the autonomic nervous system and referred Tricia to a neurologist for an official diagnosis. In the meantime, Tricia underwent ultrasound diagnostics which revealed a vagus nerve irritation and myofascial scarring of neck muscles due to stress from intense chronic coughing. Infrared laser treatments were started of her neck and vagus nerve at Advanced MMC.

They worked.

“After the first treatment, my coughing stopped for three whole days,” Tricia beams. “I’ve been suffering for 18 years and she fixed it in one hour. I now have treatments once a week, and my coughing is down by 90%. I can go hours at a time without coughing. It was a long journey and I am so thankful to Dr. Delzell. She is my rock star.”

Getting Started
Advanced Musculoskeletal Medicine Consultants treats pain related to the musculoskeletal system, including the shoulder, elbow, hand, wrist, chest wall, neck, back, hip, foot, knee, ankle, nerve pain, and more. The process begins when you schedule a chronic pain consultation to help Dr. Delzell understand your unique chronic pain story.

Advanced Musculoskeletal Medicine Consultants’ offices are at 8401 Chagrin Rd., Suite 20A, in Chagrin Falls. To schedule a chronic pain consultation, call 440-557-5011. Visit AdvancedMMC.com for more information, including blogs and videos.


Corridor of Care
Table Talks

Chagrin Valley’s Corridor of Care is a group of five healthcare professionals working together to bring quality information to the region through “Table Talks,” which occur on the third Thursday of every month, April through October. The panel is:

• Patricia Delzell, MD, Advanced MMC

• Jennifer Cabic, ReSet Lounge

• Rob Truax, D.O., Chagrin Osteopathic

• Polly Manke, The Heart Center

• Jennifer Emch, M.Ed., LPCC-S, Ubuntu Wellness

This year’s topics are:

April 18: The Many Faces of Pain

May 16: Considering Joint Replacement

July 18: The Power of Touch

August 15: The Pharmacy of Exercise

September 19: The Residue of Trauma

October 17: Experiential Session (to include EFT, Yoga, Acupressure)

All talks are free and open to the public and are presented at the ReSet Lounge, 530 East Washington Street, in Chagrin Falls. Talks begin at 6:30 p.m. (but please arrive 10-15 minutes early).