• Spine surgery is not an option if there is not a structural problem with matching symptoms.
• Back pain does not respond to surgery and it is often made much worse in the presence of untreated chronic pain.
• It is understandable why you might choose it as it seems definitive and you are desperate.
• Anger shifts your brain activity from the thinking to the survival regions. You cannot think clearly.
• Back pain is solvable with no risk and minimal resources. Don’t let your life be destroyed by a failed back surgery.

Imagine your life before the pain. Stop and visualize a day or period back then when you were just plain angry. What kind of a day was it? It wasn’t great. Now add the pain back into the picture and what you have – living hell.

One of the byproducts of anger is obsessing over negatives. With chronic pain, it is deadly. As the brain focuses on the pain, your nervous system becomes sensitized and the signal becomes stronger. (1) Then you’ll become even angrier. An endless cycle emerges, and you spiral downward. The other problem with anger is that your brain is producing inflammatory proteins called cytokines. This also creates a shift in the blood flow from the neocortex (thinking centers) to the lower levels of the brain (survival) and you simply cannot think clearly. It is critical to get your brain back “on-line” before making major surgical decisions.

I know you have pain, but what exactly are you looking for? When I ask that question in the clinic, the most common answer I hear is “ I just want to get rid of the pain.” I’m sure you want this too, but even if the pain disappears, will the rest of your life just come together and be great? Being pain free is just one of the things you need to live a stress fee, happy, and healthy life. It turns out that if you work on some of these other things, like learning to deal with stress, the intensity of your pain becomes reduced. (2)

Bonnie

Around 1990, I had a patient in her mid-thirties who had suffered a lifting injury at work. She was seeking another surgical opinion. She had a moderate curvature of her lower back that she had been born with. The term for the disorder is congenital scoliosis. Although there is a slightly higher chance of low back pain with lumbar scoliosis, I felt strongly that she should not have surgery. I reminded her that patients with straight spines have the same type of pain after a lifting injury. She was also under a lot of personal stress and extremely angry. She had not fully participated in a conditioning program. I talked to her for over an hour about why she should not have an operation. She wanted to have seven levels of her spine fused. This included her whole lower back and her thoracic spine. She was determined to go ahead with the surgery. I was unwilling to do it, so she proceeded to have another surgeon fuse her whole lower back.

Didn’t work

She returned to me two years later in a wheelchair because of ongoing severe low back pain. Although the fusion had not completely healed, it was stable. She had yet another recommendation to have the weak spot in her fusion surgically repaired. The success rate of making the fusion solid is high. We are able to remove the hardware, re-graft the area, replace the hardware, and obtain a solid fusion most of the time. However, the chances of relieving her pain were almost zero. Her pre-operative mental state had markedly deteriorated after two more years of pain. There was nothing that could be done to surgically relieve her suffering. The tragedy was that she could still have done well with a structured rehab approach.

This situation occurred before I knew much about comprehensive rehabilitation and the importance of calming down the nervous system. Her main reason for returning to see me was to undergo yet another operation. She could not let go of the idea that surgery was the definitive solution. The tragedy is that her pain was so solvable without surgery. I don’t know her final outcome, as she never returned. She was even less open to non-surgical options.

Surgery is a not definitive solution for chronic pain

This is a common scenario. A person has ongoing chronic mental and physical pain and is justifiably angry about the whole situation. A surgeon offers them an option, which seems like a way out a dark situation even though there is no data to support the procedure. (3) I don’t blame her since there doesn’t seem like a lot of other options and surgery seems to be a “definitive solution.” But an operation should have never been offered to her that has less than a 30% chance of success. With anger in full gear, no one thinks clearly and the downside of a failed surgery is not fully comprehended. Then when a given surgery fails they often pursue surgery again and again.

Her situation was one of the major reasons I quit my surgical practice. I could no longer watch people have their lives destroyed with surgeries that should not have been considered. The DOC Journey is a platform that presents proven medical treatments in a manner to optimize surgical outcomes or completely avoid surgery. My book, Do You Really Need Spine Surgery? Take Control with Surgeon’s Advice clarifies the issues around the surgical decision-making. It is a much bigger deal than you can imagine and people just can’t comprehend the downside of a failed spine surgery. It has the potential to destroy your life as you know it.

Don’t let anger alter your decisions about surgery – or about anything. I have a little mantra that I keep in the forefront of my mind, “No action in a reaction.”

1. Giesecke T, et al. “Evidence of augmented central pain processing in idiopathic chronic low back pain.” Arthritis and Rheumatism (2004); 50: 613-623.
2. Schiavon, CC et al. Optimism and hope in chronic disease: A systematic review. Frontiers in psychology (2017); 7: 1-10.
3. Carragee EJ, et al. “A Gold Standard Evaluation of the ‘Discogenic Pain’ Diag­nosis as Determined by Provocative Discography.” Spine (2006) 31:2115-2123.

The post Anger Altering a Surgical Decision first appeared on Back in Control.

The post Anger Altering a Surgical Decision appeared first on Back in Control.

She was a healthy physically active rancher. Her low back pain started in the summer of 2005 after a lifting injury. The pain had become constant and was located throughout most of her back. She was still functioning at a fairly high level, in spite of the pain.

Her prior care

Jean’s care so far had consisted of six visits to physical therapy, and two sets of cortisone injections in her back, none of which had been helpful. She had not been prescribed a ongoing organized treatment plan. On her second visit to a spine surgeon, it was recommended that she undergo a eight-level fusion of her lower back from her 10^ththoracic vertebra to the pelvis. It is a six to eight-hour operation that carries significant risks.

Jean’s x-rays showed that she had a mild curvature of her lower back. Other imaging tests did not reveal any identifiable, structural source of pain. From my perspective as a scoliosis surgeon, I felt her spine was essentially normal for her age.

Instead, I felt that her pain was probably from the muscles and ligaments around the spine. The medical term that we use is myofascial. When an operation geared towards the bones, such a fusion, is done in the presence of mostly soft tissue pain, it rarely works. In addition to the risks, the entire lower back becomes a solid piece of metal and bone. This surgery should only be done if there are no other options. The procedure comes with long-term lifestyle limitations and she was still so active.

At this point, I was perplexed as to why surgery had been recommended when she had done so little rehabilitation. I also didn’t understand why she was continuing to experience such severe ongoing back pain without any obvious cause.

What was missing?

I consulted her spine intake questionnaire to look for clues.

It revealed that she’d had some marital difficulties and had just reconciled with her husband six months earlier. That immediately caught my attention because marital troubles usually indicate significant stress. She then said her job had become much more difficult. Although she worked for the same employer, they had forced her to switch duties without adequate training. She was worried about not only her performance, but also her ability to keep her job – another major problem.

I turned the page. A month before her pain began, her twenty-six-year old son had drowned. I knew that outside stressors played a role in chronic pain, but this factor had never been so powerfully demonstrated. Her case really brought home for me how crucial it was to take a full view of the patient’s life and circumstances, instead of just looking at surgical solutions.

As I sat there stunned, I realized that I needed to do something different. In fact, the whole medical profession needed to do something different. How could a surgeon have recommended a fusion without taking the time to get to know Jean and to hear her circumstances? I have always wondered if she went through with the surgery, but I never heard from her again.

From that moment, some form of structured rehabilitation became my focus with every patient, without exception. I have not taken my eyes off of that vision since that day.

The post My Call to Action first appeared on Back in Control.

The post My Call to Action appeared first on Back in Control.

My scoliosis surgery at age 14

This brilliant book (Back in Control) is a must read for anyone who lives with chronic pain, and for anyone whose life is affected by loving someone who has chronic pain.

I have lived with severe, chronic back pain, since a failed back surgery eighteen years ago. When I was 14 years-old I underwent surgery to correct scoliosis. Hardware was place in my thoracic spine (T6 to T12). Within a few short weeks following the surgery, I began experiencing an unusual amount of pain. My spine surgeon, Dr. A told me that the pain that I was experiencing was normal and that it would get better. The pain didn’t get better, in fact it got worse.

You’re a “chronic pain patient”

During the next eight months following my surgery, the pain became so intense that I couldn’t attend high school. Every time I returned to Dr. A to tell him how much pain I was in, he told me that the pain was not a function of the surgery; rather, I was a “chronic pain patient”. Operating under this assumption, I engaged in months of painful physical therapy, chiropractic treatments, and eventually I was referred to a chronic pain specialist, who put me on methadone to control my pain.

The spine surgery was infected

I eventually developed flu-like symptoms (vomiting, headaches, listlessness and high fevers) that didn’t remit. After eight months of dealing with ever worsening back pain, and repeatedly being dismissed by my surgeon, I went to a different spine surgeon for a second opinion. This surgeon was Dr. David Hanscom, and the year was 1995. Within a short time, he determined that it was likely that I had a staph infection in my spine. I was taken in for emergency surgery the next day to clear the infection. Dr. Hanscom was right, and so was I.

Fast forward to 2013… “The pain isn’t going away”

Just one week before my thirty-third birthday, I found myself unable to stand in an upright position – the muscles in my jaw, neck and back were in spasm; and I had a headache so severe that I felt nauseated. No amount of Ibuprofen, analgesic rub, or time laying on an icepack made a difference. I felt trapped and hopeless. Over the years, since my surgeries as an adolescent, I tried every alternative therapy known to man, and yet I still experienced pain on a daily basis. It finally hit me; my pain was not going to go away — it was getting worse. At the age of thirty-three, I felt like an eighty year-old woman. I thought that maybe another surgery would be my ticket out of the chronic pain hell that I had been living in for almost two decades. I had sworn to myself that I would never undergo another spine surgery, but I was at the end of my rope, and desperate for relief.

Stress?

Just before this pain flare-up, I had been dealing with a very difficult client at work. I could not control the trajectory of this issue, or the behaviors of my client; and coincidentally, my back pain was out of control. I had the sense that my back pain and stress with work were loosely connected. I was stressed with work, so it stood to reason that my muscles felt tense. I had no idea just how interconnected my back pain and stress levels actually were.

I have long thought that I had back pain because there was fundamentally something wrong with my spine. I have scoliosis, and had a corrective surgery that failed, and a traumatic experience post-op, with a spinal infection that went ignored, and could have killed me. I also experienced a great deal of anxiety since early childhood, and this anxiety increased in severity, as I got older.

Pain and anxiety are connected

Essentially, I deduced that I had two major issues in my life: back pain from a failed surgery, and anxiety and depression. What I know now is that these two issues are not independent of one another; rather they are one in the same.

It was by divine intervention that I learned about the work Dr. Hanscom is up to now. After visiting Dr. Hanscom’s website, I immediately ordered his book, Back In Control, and read it in two days. Once I finished his book, I signed up for the Hoffman Process, which is something you will learn about in his book. I then made an appointment with Dr. Hanscom, and was able to get in quickly because I was a patient of his eighteen years ago.

Hope

Back in Control blew me away, and it gave me a spark of hope. When I saw Dr. Hanscom in March of 2013, he told me that there was nothing wrong with my spine. Of course, I still had scoliosis, but my spine was solid. I was shocked to learn this! All of these years, I believed full-heartedly that my scoliosis and failed surgery was causing my pain; and for all of these years I was wrong. My pain was a function of pain pathways created by my central nervous system, post-surgery. Essentially, my pain was, practiced pain. This was a concept that was hard for me to grasp! But my faith and trust in the man who saved my life when I was young, helped keep me open to these new concepts.

Pain free!!

As I write this review, I have no back pain. This seems miraculous! The information provided in Back in Control, and my experience participating in the Hoffman Process, has radically changed my life in more ways than I could have ever imagined. I am so grateful!

Instead of my pain being constant, it comes in waves, and once I identify the pattern in my thinking that is the root of my pain, the pain goes away – completely. I used to have back pain 95% of the time, now I have back pain 15% of the time, and the numbers keep improving the longer I stay engaged in this work. Many days, I am pain-free. I don’t wake up with headaches anymore, I don’t grind my teeth at night, and I no longer take anxiety medication to get through my day. I simply don’t need it. I feel more alive than I can ever remember feeling, even pre-surgery. Many of the things that I have struggled with for years seemed to have vanished.

Be open to possibilities

My hope for you is that you read Back In Control, and consider going to the Hoffman Process. No one deserves to live in chronic pain. It tramples your quality of life, and negatively impacts the lives of those around you. Be open to the fact that the source of your pain is probably not what you think it is. We all deserve to be liberated in both mind and body. Living in pain is devastating and dehumanizing.

You are so much more than your physical pain, your psychological challenges, and your patterns.

The post Trapped for 18 Years from Scoliosis Surgery first appeared on Back in Control.

The post Trapped for 18 Years from Scoliosis Surgery appeared first on Back in Control.

One of the byproducts of anger is obsessing over negatives. With chronic pain, it is deadly. As the brain focuses on the pain, your nervous system becomes sensitized and the signal becomes stronger. (1) Then you’ll become even angrier. An endless cycle emerges, and you spiral downward. The other problem with anger is that your brain is producing inflammatory proteins called cytokines. This also creates a shift in the blood flow from the neocortex (thinking centers) to the lower levels of the brain (survival) and you simply cannot think clearly. It is critical to get your brain back “on-line” before making major surgical decisions.

I know you have pain, but what exactly are you looking for? When I ask that question in the clinic, the most common answer I hear is “ I just want to get rid of the pain.” I’m sure you want this too, but even if the pain disappears, will the rest of your life just come together and be great? Being pain free is just one of the things you need to live a stress fee, happy, and healthy life. It turns out that if you work on some of these other things, like learning to deal with stress, the intensity of your pain becomes reduced. (2)

Bonnie

Around 1990, I had a patient in her mid-thirties who had suffered a lifting injury at work. She was seeking another surgical opinion. She had a moderate curvature of her lower back that she had been born with. The term for the disorder is congenital scoliosis. Although there is a slightly higher chance of low back pain with lumbar scoliosis, I felt strongly that she should not have surgery. I reminded her that patients with straight spines have the same type of pain after a lifting injury. She was also under a lot of personal stress and extremely angry. She had not fully participated in a conditioning program. I talked to her for over an hour about why she should not have an operation. She wanted to have seven levels of her spine fused. This included her whole lower back and her thoracic spine. She was determined to go ahead with the surgery. I was unwilling to do it, so she proceeded to have another surgeon fuse her whole lower back.

Didn’t work

She returned to me two years later in a wheelchair because of ongoing severe low back pain. Although the fusion had not completely healed, it was stable. She had yet another recommendation to have the weak spot in her fusion surgically repaired. The success rate of repairing the fusion is high. We are able to remove the hardware, re-graft the area, replace the hardware, and obtain a solid fusion most of the time. The chances of relieving her pain, however, were almost zero. Unless the weak area of the fusion is unstable, my feeling is that surgery is not necessary. Her pre-operative mental state had markedly deteriorated after two more years of pain. There was nothing that could be done to surgically relieve her suffering.

This situation occurred before I knew much about comprehensive rehabilitation and the importance of calming down the nervous system. Her main reason for returning to see me was to undergo yet another operation. She could not let go of the idea that surgery was the definitive solution. The tragedy is that her pain was so solvable without surgery. I don’t know her final outcome, as she never returned. She was even less open to non-surgical options.

This is a common scenario. A patient has ongoing chronic pain. They are justifiably angry about the whole situation. A surgeon offers them an option, which seems likes a way out a dark situation even though there is no data to support the procedure. (3) I don’t completely blame her since a surgery should have never been offered to her. But the option is hard not to pursue since surgery seems to be a “definitive solution.” With anger in full gear, no one thinks clearly. The downside of failed surgery is not fully comprehended. Then when a given surgery fails they pursue surgery again and again.

Her situation was one of the major reasons I quit my surgical practice. I could no longer watch people have their lives destroyed with surgeries that should not have been considered. The DOC Journey is a platform that presents proven medical treatments in a manner to optimize surgical outcomes or completely avoid surgery. My book, Do You Really Need Spine Surgery? Take Control with Surgeon’s Advice will clarify the issues around the surgical decision making. It is a much bigger deal than you can imagine and people just can’t comprehend the downside of a failed spine surgery. It has the potential to destroy your life as you know it.

Don’t let anger alter your decisions about surgery – or about anything. I have a little mantra that I keep in the forefront of my mind, “No action in a reaction.”

1. Giesecke T, et al. “Evidence of augmented central pain processing in idiopathic chronic low back pain.” Arthritis and Rheumatism (2004); 50: 613-623.
2. Schiavon, CC et al. Optimism and hope in chronic disease: A systematic review. Frontiers in psychology (2017); 7: 1-10.
3. Carragee EJ, et al. “A Gold Standard Evaluation of the ‘Discogenic Pain’ Diag­nosis as Determined by Provocative Discography.” Spine (2006) 31:2115-2123.

The post Anger Altering a Surgical Decision first appeared on Back in Control.

The post Anger Altering a Surgical Decision appeared first on Back in Control.