March 17, 2018
I have completed the 3-day-a-week 5-week outpatient Pain Management program at Kaiser. The facilitators all made it clear from Day 1 that this is not a pain relief program but a pain management! And they were right. We were not allowed to talk specifically about our pain nor about medications.
I posted in detail about every one of the 15 sessions, for anyone who is interested in that level of detail (from January 15 through February 23). Most readers, however, just want to know my opinion, in general, about the Pain Management program. So, here goes.
In my opinion, Pain Management is probably 80% psychology. Pain psychology, they call it. They have names for specific strategies. Radical acceptance. Planning, prioritizing, and pacing, which is knowing how to alternate high impact and low impact activities. Positive thinking. Social support. And “how to say ‘no’ without feeling guilty.” There was even a session on how to manage a flare: we could list everything except medication!
The rest of it, somehow based on the premise that reducing/eliminating stress would also reduce/eliminate pain, consisted of achieving relaxation through guided meditation combined with “mindful breathing.” And there was always a session of “gentle movement” exercises, mostly Tai Chi, with some yoga positions, and core exercises, mostly targeting back pain.
But your question to me is still: Did the Pain Management program help you? Well, yes, it helped me understand that there is no such thing as pain relief! The need to limit time on high-impact activities has made it possible for me to have one or two guilt-free bed rest times during the day, during which I practice my own internally guided meditation combined with belly breathing. I have learned how to do various “gentle movement” exercises during times when I can’t do anything else, like waiting in a long line or lying awake in bed during a night of insomnia. These are all essentially attempts at distractions from the ever-present pain.
I still have three more individual office appointments, two next week. One is with Dr. Kalra, the medical director of the Pain Clinic, as a follow-up to my initial telephone appointment with him at the beginning of the program when he prescribed gabapentin. I need to let him know that 600mg of gabapentin is all I can take or I get intense headaches (not migraines but drug-induced headaches). But without the gabapentin, my typical pain level would be 7 or 8 instead of 5 or 6. Dr. Kalra does not think that physical manipulation of my c-spine will do any good, even though the only thing that has come close to pain relief was two specific manual manipulations I experienced in Physical Therapy.
Another is with Francis, the physical therapist specializing in pain management. I feel “safe” with him because he is the only Kaiser practitioner that I’ve admitted to following a ketogenic diet. I still do the three exercises he gave me to do during the one individual session that I had with him during the program. While these exercises have not perceptibly lessened my chronic neck pain, I can tell that the range of motion in my neck has become easier.
And, next month, I have a one-on-one appointment with one of the acupuncturists in the Physical Medicine Department. Until then, I am continuing to research and explore acupressure and hope that I might get some help with it from both Francis and the acupuncturist.
Finally, apart from the program, I have looked at some introductory materials (both articles and videos) on “tapping.” Although it’s supposedly related to acupuncture and acupressure, I am not convinced of its legitimacy or effectiveness. Their claims still sound like “snake oil” to me. I’m just not ready for it yet.
