Friday, April 29, 2011

Chronic Pelvic Pain Syndrome and Me

Not long ago, I got a phone call from someone who read one of my blog entries.  He's a young man suffering from chronic pelvic pain syndrome, or CPPS.  Listening to his story, his frustration and grief, took me back to the point in my own life five years ago when I started experiencing CPPS symptoms, to when I received my diagnosis and was told there's no effective cure or treatment.  The isolation, the anger and shame and depression and hopelessness--it all came back to me.  I truly did experience helplessness at that time.

I muddled through the pain and the emotions, and somehow, I felt my way into a set of practices that slowly but steadily gave my life back to me.  Feeling very fortunate, I put up a couple of web pages about my experience, in hopes that it might help someone else.  So I'm very grateful to this young man, and to the handful of people who've emailed me about CPPS.  I very much appreciate your feedback.  As a result, I've revised, updated and expanded my CPPS web site--it's here.  Thank you, all of you, for your helpful comments and questions.

CPPS is isolating.  At the worst point, my CPPS kept me from traveling more than a half an hour by car.  I had trouble sitting through movies.  I didn't feel like going out.  The isolation fed into the sadness and hopelessness.  So, when I hear from anyone who has CPPS, I respond as quickly as I can.

If you're suffering from CPPS, please take a look at my CPPS web site.  I hope you find something there that helps.  At any rate, it's free, and it's the best information I have available to me at the moment, based on what works for me.  And if you have a question or just want to communicate with someone who's been there, please write me.  You should be able to find my email address on my blog.

Friday, July 2, 2010

What is the Alexander Technique?

In India, sadhus (ascetic students of yoga) sometimes practice austerities, committing themselves to difficult, long-term observances.  One example is hand raising.  A devoted sadhu may decide to raise his hand and never lower it.  We in the West look at a practice like hand raising and wonder how a person could do that.  We would never choose to deliberately contort our bodies for years at a time.

But in fact, like the hand-raising sadhus, we do practice bodily austerities.  The difference between us and the sadhus is that they consciously choose to practice mindfully.  But we develop our bodily contortions unconsciously, mindlessly, seldom realizing what we are doing to ourselves.

As young children, we are taught to sit still for long periods of time, often in chairs or desks that don't quite fit our growing bodies.  We learn to focus our minds and ignore bodily sensations.  At home, we learn how to slump on the sofa and watch TV or play video games, remaining out of touch with our bodies as we lose ourselves in the sounds and images.  We learn how to deal with tension and unwanted emotions by holding them in our bodies.  We graduate and take jobs that demand continual repetition of bodily movements, maybe on an assembly line, maybe at a desk.  If we have a career devoted to abstract mental tasks, we sit for hours at a time in poorly designed office furniture, working with our minds and ignoring our bodies. 

In our 20s and into our 30s, our youthful bodies can adapt remarkably well.  Somewhere in our late 30s, however, our bodies most likely begin to try to get our attention--a little twinge here, a small ache there.  By the time we're in our 40s, after a couple decades practicing the Western equivalent of hand-raising, our bodies raise the volume of their protests.  The aches and pains are more intense and last longer.  We might have a sleepless night once in awhile or miss a day of work now and then.  Pain relievers and sleep aids begin appearing in our medicine cabinets.  A chiropracter or massage therapist might find a place in our address books.

And then one day, our bodies finally demand our undivided and complete attention.  The pain reaches a level of intensity that cannot be appeased, and it does not go away.  We discover that the medical community has no good answer for our suffering.  We wonder how this happened, and we begin searching for a way out.

If you are as lucky as I am, you may find an Alexander Technique instructor.  The Alexander Technique has been a very important part of my way out of chronic pain.  An instructor can see unnatural patterns of muscular tension and knows how to help the student perceive them, too.  She gradually, patiently guides the student to release muscles that have been held dysfunctionally for years.  Instead of trying to teach an idea of correct or good posture, which really is just another form of bodily holding and rigidity, she instills the idea of ease of use, of the body as a dynamic, ever-moving system.

Much about the Technique seems counterintuitive or just plain wrong at first.  The Technique is a form of undoing, of unlearning, of breaking habits, of changing the way the body is felt and perceived.  When the instructor first helps the body release into an easier state, it often feels odd, or even wrong.  Many times, my instructor has had to show me in the mirror that, no, despite the sensation that I'm leaning to the left, that I'm tipping forward, that my legs are bent, in reality, I am standing more nearly upright than I have in a long time.

The Technique can be an emotional as well as a physical exploration.  The body can hold anger, fear, embarrassment, shame, guilt.  Releasing the body can be like opening a shaken bottle of emotional soda.  The emotions can bubble up, memories can gush into consciousness.  The enhanced bodily awareness I've received from the Technique also is an enhanced emotional awareness.  When I feel my left abdomen tensing, I know I'm becoming upset.  When I feel my lower back become rigid, I'm aware that I'm feeling embarrassed.

The Technique is an ongoing education.  The lessons continue out in daily life.  I learn something new about my body and emotions nearly every day.  The Alexander work has given me a sense of curiosity about my body and its relationship to my mind and the world around me.  I'm feeling a pain in my jaw?  That's interesting!  I wonder what would happen if I invite my shoulder to relax?  I'm feeling tension in my hip.  Fascinating!  Could it be related to this deadline I'm working under?  What would happen if I took a short break and breathed deeply for a few seconds?

After a couple of years of working with my Alexander instructor, I am free of the chronic pain that led me to her.  But I continue the work.  As each layer of tension, each pattern of holding, peels away, I find a new layer underneath.  Lifting away the pain reveals new possibilities of a visceral joy and ease.  I can't wait to see what I'll find tomorrow.

Monday, May 3, 2010

Mortification in 12 Items or Less

I enjoy grocery shopping.  I usually run into someone I know and have a chance to catch up with them.  The grocery store is a great place to practice mindfulness and patience.  I'm rarely in a hurry when I'm at the store.  It's a good opportunity to tune into the fact that everyone shopping is trying to feed a household, trying to make sense of the huge selection of foods, trying to balance quality and taste and budget.

Yesterday afternoon, I went down to the store to pick up a couple of items we needed for dinner.  As I made my way through the busy parking lot and entered the store, I patted myself on the back for remembering the tote bag.  I grabbed a basket and walked the aisles, patiently waiting for people, picking out the few things I was searching for--milk, bread, jelly--adding a couple things I knew we might need that weren't on the list--some granola bars, a pound of hamburger.  I rechecked the list and headed for the check-out lines.

The store was busy, and all the lines were full.  I counted the items in my basket--eight--and headed for the express line.  The express line is served by two check-out stations, each with a sign hanging overhead that reads "Express line--12 items or less."  I stopped behind a woman waiting her turn.  To my left was a girl of about 12, pushing a cart that was sort of in the nearby line, but kind of angled into the express line.  I looked at her.  She smiled and said, "I'm with my mom," and nodded at the woman ahead of me.

That is when I heard someone's voice blurting out, "That's 12 items or less?"  My voice.  The woman ahead of me turned and looked at the cart, looked at her daughter, and looked at me and said, "No, you're right, we're in the wrong line."  It seemed to me she spoke those words less than enthusiastically, with a smile that seemed a bit on the icy side as she maneuvered her daughter and the cart to the back of the nearby line.

As the cashier rang up my items, I had time to feel into what had just happened.  All kinds of thoughts flew through my head.  Despite all my midwestern nice-guy upbringing, I had corrected this mother in public, in front of her child.  Sure, I was right.  But I was in no hurry.  I could have waited a couple minutes while her groceries were checked out.  But I was right, damn it!  I hadn't been nasty about it.  But how would I have felt if someone had scolded me, even nicely, in front of my children?  I let go of the train of thought as best I could and felt into the emotions running underneath, a rich stew of embarrassment and defensiveness, and even some compassion.  Ah, mindfulness practice!  So easy to do when things are simple and going well, so hard when I manage to insert my foot deeply into my mouth.

At that moment, in this busy store, somehow, the express line emptied.  I was the only person at the express counter.  The efficient young cashier at the next express register called out to the person at the end of the next line, "Ma'am, I can help you over here."  The person at the end of the next line happened to be the woman with more than 12 items.

"Oh!" she replied loudly--very loudly--"but I have 16 items!"

"That's okay," said the cashier.  "I'll check you out."

The daughter was grinning at her mom as she wheeled the cart up to the next register.  I quickly picked up my tote bag and gallon of milk, sidled by, and headed out the door.  The bag seemed a little bit heavier, what with the extra helping of mortification the universe had tossed in at the last minute.

Sunday, May 2, 2010

Joy, Ambivalence, and the Quest for Rational Household Wiring

It all started when our HD TV began misbehaving.  A couple of years ago, Di and I bought a 32-inch Westinghouse LTV32w6HD LCD HD TV.  It's a fine TV, doing exactly what we'd hope a TV would do:  reliably display TV-signal content.  Or at least it did, for quite awhile.  But last year, it began having trouble displaying a stable picture.  The problem went away on its own, but returned again this year.  At first I thought the jitters might be related to a poor cable TV signal.  But I noticed that the problem appeared immediately, while the set was warming up, and also when trying to watch DVDs from our DVD player.

So last weekend, Di and I looked at HD TVs on the web site of a big-box electronics store, found a couple we thought we might like, and drove to the local outlet.  We chose a Sony Bravia KDL40EX400.  We brought the new set home, moved the Westinghouse downstairs pending disposal, and installed the Sony in its place in the family room.  I fired up the Sony, did an autoscan, and life was good.

Or so I thought.  But on closer examination, the Sony had missed several HD cable channels that the Westinghouse had found.  And occasionally, the few HD channels it did find were as jittery as the picture on the Westinghouse.

I began to suspect our home's TV cabling.  We'd had trouble with our cabling before, when we'd had the cable company install broadband service.  Much of the cable in our home was actually outside our home, run along the foundation and up the siding, from splitters near the point where utilities entered the house.  I knew splitters were evil, so I disconnected all the exterior splitters to give the best possible signal on the cable we would use for broadband service.  The cables off the exterior splitters all went to the bedrooms on the topmost level.  Since we never watched TV in bed, this was not a sacrifice.  We still had a cable signal to the two outlets we used, one in the basement and one in the family room.

But the cable installer told us the signal at the outlets was marginal for broadband, even after he cleaned up several issues with the cable plant leading up to the house.  He was sure that there were several splitters buried inside the drywall that were causing the poor signal.  He finally installed a splitter in the utility room, right after the point where the cable entered our home, and ran a new cable from the splitter to the cable modem.  That worked.  We had Internet service, we had a cable TV signal, all was well.

But now, I knew that our cable TV signal was marginal for HD service.  I had two choices:  Rewire the house, or try a cable amplifier.  Rewiring the house seemed like an expensive, laborious process, and would probably require punching several holes in the drywall throughout the house, and then drywall patching and painting.  An amplifier seemed like a much more reasonable solution--if it worked.

A little googling led me to the Radio Shack 15-2505 Bidirectional Cable TV Amplifier.  At $32.99, it would be much cheaper and easier than rewiring.  I went down to the local Radio Shack and bought one, and bought a couple of probably overpriced patch cables and a power strip.  I drove home, went down to the utility room, plugged in the power strip and the amp, ran the patch cables, and presto!  We had HD TV on the Sony.  I did another autoscan.  The Sony picked up all the HD channels and had a great picture.  Success!

On a hunch, I plugged in the Westinghouse in the basement and turned it on.  The jitters were gone!  My best guess is that the poor signal affects the Westinghouse right at power-on, even if the input source is set to something other than the cable input.  This makes the Westinghouse extremely sensitive to signal quality.  But with a good signal, no problem.

Time to sit back, pop a cold one, and bask in contentment from a job well down.  But...  My sysadmin ethos would not let me relax.  Not yet.  Not with a rat's nest of cable and an amp and power strip sitting loose on a shelf down in the utility room.  Long had the technophile half of me dreamed of some kind of elegant structured home wiring system--a beautiful home-run phone-cable TV-data plant centered around a panel in the utility room that would house some kind of phone distribution center, an Ethernet switch, and a cable TV amplified splitter.  I'd fantasized about how to pull cable into various hard-to-get-at locations around the house, without breaking out the drywall.  I'd spent lost hours googling for equipment, staring at the structured wiring center at a home improvement store, doodling cable runs on pieces of scrap paper.  Yes--I admit it.  I am a geek.

Here was an opportunity to do something along these lines, to clean up the mess in the utility room and create some tiny beginning, some small seed, of a sensible home wiring system.  I grabbed the step ladder and a tape measure, headed downstairs to cries of "What are you up to?" from Di, took a few measurements, and headed out.  First stop:  Nagle Lumber, where I found a scrap of plywood just the right size.  I bought some other items I needed--screws and some plastic cable clips--and headed home.  Down to the basement again, and an hour or so later, I had the power strip and amplifier mounted on screws from the plywood bolted to the wall.


The patch cables hung from plastic clips.



Beautiful!

At last!  Time to sit back and enjoy the fruits.  But a couple things about this adventure diminished my contentment.  For one thing, I like to spend money at locally owned businesses, but for various reasons, Di and I had bought our Sony at a big-box store--we hadn't even looked at a local appliance store.  Slager's is the only one that comes to mind.  I did go to Nagle's, a locally owned home improvement store.  But that was depressing--it sure looks like Nagle's is not getting much traffic.

I'd tried placing the cable amp near the TV, in hopes that if it worked, I could put the power brick for the amp on the power strip for our home entertainment center.  We like to turn the power strip off when no one is using any of the audio/video equipment, to eliminate phantom loads.  The amp doesn't need to draw current when no one is watching TV.  But putting the amp near the TV did not produce a usable signal.  For the best signal, the amp needs to be placed before the splitters.  This means the amp will be on all the time, even when the TVs are off.

Finally, all my effort produced a better TV signal.  But is that necessarily a good thing?  Now all the reality TV shows, the political mud fests, the stupid pet tricks--all that is now available to me in HD.  Great.  Okay, I do get a beautiful HD picture on our PBS channels, too.

I'm reminded of a passage from Shikasta, by Doris Lessing.  She describes a typical middle-class mother in a developed country going about her daily routine, shopping for groceries and making a meal--but unlike mothers in ages past, her satisfaction in providing for her family is tinged with doubt and anxiety.  She knows that maybe the food she's serving her family really isn't all that good for them, maybe it's laden with pesticides, maybe it's tainted, maybe it was produced in a manner that contributes to the destruction of the ecosystem.

Oh, but, hey!  Look at that!  Madonna is on The Marriage Ref!  Honey, could you get me another brewski?

Thursday, February 25, 2010

Transparency

The folks at the Sunlight Foundation aren't putting virtual logos of contributors on speakers at the health care summit, but they have the right idea.  As each person speaks, a list of their top contributors appears beside the window.  Great idea!

Sunday, February 21, 2010

Claire Davies Saves My Life--Again!

What one book would I want with me if I were stranded on a desert island? Right now, that book would have to be The Trigger Point Therapy Workbook, by Claire Davies.  I've been working with a chronic pain condition for the past four years.  Self-administered trigger point massage is one of my primary tools.  It's relieved my pain and given me back my mobility.  Without it, I'd probably still be standing when I ride the bus, unable to drive for more than a few miles at a time, and swallowing handfuls of ibuprofen throughout the day.

And I wouldn't have healed enough to get back out on my bike last summer.  My wife loves to bike, and she's missed me for the past couple of years.  But last summer, I finally felt whole enough to dust off my bike helmet, pump up the tires on my Trek, and pedal.  We had a great time riding around Iowa City on weekends.

On Labor Day, we were flying downhill on Dubuque Street toward Waterworks Prairie Park, when the lip of the pavement caught my front wheel.  I crashed down onto my left shoulder and skidded along several yards of concrete.  Di said I was going about 30 when it happened.  I left a lot of knee and elbow on the road and had a lovely bruise on my left hip for quite awhile, but I didn't break anything.  And my bike was fine!  I had a little stiffness and pain in my left shoulder, which I figured would improve with time.  But gradually, the pain has worsened, and my range of motion has become more limited.

My theory about my pain condition is that it's primarily a mental disease.  The problem stems from the idea that the mind is primary and is the master of the body, that will alone can whip the body into line.  When pain flares up, the mind goes to work, trying to solve this problem, trying to diagnose and cure, trying to fix things.  But this approach almost never works with my chronic pain condition, and in fact, it can lead to worse pain and more limited motion.

After I'd been using trigger point massage awhile and had reduced chronic pain to a manageable level, I began seeing an ease of movement therapist.  She's helped me unlearn some of the body patterns that contributed to my pain condition, which has improved my life considerably.  With her help, I came to see that I'd been stretching incorrectly, tensing instead of relaxing into the stretch.  I've had great success with stretching the way she has taught me; I'm probably more limber now than I was before the pain condition developed.

So as the pain in my shoulder grew and my range of motion decreased, I decided to try to stretch my way back to wholeness.  I made what I thought to be an educated guess as to which muscles might be causing the problem and began stretching.  I should have known better.  This was my old mental pattern sneaking up on me again, convincing me that I could diagnose and fix myself.  In fact, I was most likely making things worse.  The pain continued to worsen, and I was having trouble putting on my coat or reaching for dishes in the cupboards.

Yesterday, I was on the road for four hours.  As I got ready for bed last night, I knew I'd be up again in the dark, knocking back some ibuprofen and sitting down with the heating pad.  And I was right.  As I sat on the sofa and waited for the heat and the pills to kick in, I dug out my Claire Davies and flipped through the section on shoulders.  For some reason, I spent some time with the section on the subscapularis.  And there were all my symptoms--why hadn't I seen this before?

I looked at the treatment diagrams and worked my fingers into my armpit.  A flash of excruciating it-hurts-so-good-I-can't-stand-it pain, and I knew I was onto something.  After I'd worked on my subscapularis for a few minutes, the pain was gone.  Remarkable!

So, of course, I've diagnosed and fixed my problem, right?  Wrong!  The tricky thing about trigger points is that the referred pain can create trigger points in other muscles, creating a complicated web of tension and pain.  The pain and limited motion affect the way I hold and move my body, which can overwork other muscles and lead to more problems--which can feed back into the original painful area.  I've learned from hard experience that searching for a single cause and a single fix is pointless and can in fact worsen the situation.  What works much better is a sense of curiosity and exploration, a sense of acceptance of the body as it is in the present moment and a willingness to work with it just as it is.

Right now, I'm typing this blog relatively pain-free.  My shoulder feels great!  I'll continue working with the subscapularis.  But I know I also need to continue massaging my other shoulder muscles, continue exploratory and tension-free passive stretching, continue checking in with how I'm using my body, with how my thoughts and emotions are interacting with my muscles.  It's a way of life, not a quick fix, like a pill, but a very interesting and remarkable journey.

But Claire Davies, you have saved my life again!  Thank you, thank you, thank you!

Friday, February 5, 2010

Bye-bye, Brugh

Last December, Brugh Joy passed away.  Brugh originally had been a doctor.  He'd interned at Johns Hopkins and finished his training at the Mayo Clinic.  He was a practicing physician until a bout of pancreatitis steered him toward alternative medicine.  Brugh dove into energy healing, Jungian work, and dreams.  He left his medical career and began leading self-development workshops.  Michael Crichton wrote about his experience at one of Brugh's seminars in his book Travels.

My wife and I do dreamwork once a month with a couple of friends who are students of Brugh's.  In 2008, they got me into one of his weekend workshops, in Chicago.  It was an amazing experience!  At the first meeting, he led a heart-centered ritual that inducted everyone into the work for the weekend.  I was amazed at how this one 80-something man could work with all 25 of us, taking each of us deep into the work.

In the evening, after the last session of the day, Brugh was chatting with me, when he casually put his right hand on my chest and his left on my back.  I felt intense energy flow through my chest, blowing my heart open.  Every morning, we'd do dreamwork.  He'd call for dreams, and he'd go around the circle and got right into the meat of each dream immediately.  And the dreams I had while I was there were very big, very vivid, as if Brugh's presence had evoked powerful forces from my subconscious.

This turned out to be my only chance to work with Brugh in person.  Brugh had had pancreatic cancer sometime in the 1990s and had fully recovered.  He was in such good health that he went on a pilgrimage to Mount Kailash in Tibet a couple of years ago.  But in 2009, he was diagnosed with a recurrence of his pancreatic cancer, his third experience with pancreatic health issues.  This time, there was no recovery.

The way Brugh worked with treatment for his cancer, and the way he approached his death, was a lesson in itself.  He treated chemotherapy as if it were a holy sacrament.  He was totally open to whatever happened, and he met his own death with a sense of wonder and curiosity.

Most of the people in the Chicago group had known Brugh for several years, some for a couple of decades, so I was surprised and grateful when I received email inviting me to a celebration of Brugh's life with the rest of the group.  I went with my friends to Chicago last Sunday, and we all gathered again.  We sat in a circle, conducted a Brugh heart ritual, and shared stories.  Brugh was certainly there in spirit.

I'm grateful to have had the chance to work with Brugh.  He helped me come to terms with my chronic pain condition.  He showed me that working with the physical body is a valid spiritual path.  His advice to find some type of body movement practice, such as dance or martial arts, led me to tai chi, which has been very good for me on a number of levels.  So even though I knew Brugh for just a little while, I'm going to miss him.