“Get it fixed” I am a busy spine surgeon and my approach to a structural problem historically has been to tell my patient to “get it fixed” or decide the pain is not severe enough to warrant the risk of surgery. I felt this approach would be the fastest way to get on with the rest of the DOCC project. I was wrong. Surgery cancelled?? A few years ago I had a couple of patients come in for their pre-operative appointments for surgery on clear-cut lesions. While waiting for surgery they had engaged in the DOCC project tools and had begun to calm down their nervous system. Their pain disappeared and I cancelled the surgery. Then I had a run of patients who were pretty uncomfortable but just wanted to wait a while before undergoing surgery. They were interested in the DOCC tools and wanted to give them a try. Even in the presence severe spinal stenosis their leg pain would disappear. Again no surgery. Everyone now engages Then our team noticed that even if surgery was performed that engaging in the process made a huge difference. Post-operative pain was less, rehab was easier and the overall results of surgery were more consistent. We began to ask all of our patients to engage in a structured program for at least a couple of months before we scheduled surgery. Our practice and patients are thriving. Better without surgery I saw a woman about four months ago who was with miserable with back and leg pain. She had severe spinal stenosis at three levels of her lower back. It had been recommended that she undergo surgery to relieve the compression on her nerves to her legs. Since she had mostly LBP and very little leg pain I did not think surgery would be helpful. Back surgery rarely diminishes back pain. She came last week after engaging in many of the tools on this website beaming in that she had essentially no pain in her back or legs, she was sleeping and her mood was markedly better. She could not contain her excitement. I was also pretty inspired. Not a surprise anymore I am frequently seeing patients with structural lesions and significant matching symptoms improve without surgery. As their nervous system calms down it seems to raise their pain threshold. It is not a matter of just “living with the pain.” It disappears. Ray’s letter Hello, Dr. Hanscom and Linda, My recovery has been miraculous! Last Thursday’s meeting capped several weeks of increasing pain and increasing oxycodone use. During the meeting, I looked at my “med calendar” to show the correlation between increasing pain and decreasing Cymbalta dosage, and BINGO! ENLIGHTENMENT! There was no correlation with Cymbalta, but there was a 100% correlation of increased pain with my wife leaving on a trip! I still have trouble believing/understanding the connection, but my psychologist friend said it is quite likely. He called it a “strong dependency object relationship”. I’ll be seeing him frequently in the future, and will learn what that means, I suppose… He also says I’m “clinically depressed” and “clinically anxious”… (when in pain, who isn’t?) But back to last Thursday…when I realized the correlation, the pain stopped…the ride home was pain free, as opposed to the ride into Seattle, which was quite painful. Yes, there was an instance of pain on Friday and Saturday mornings, but in both cases I simply waited for the pain to subside, which it did in 10-15 minutes. I haven’t taken an “oxy” since last Thursday before our meeting! I’m back doing the DOCC program daily and there have been no painful episodes for five days now…the sciatic pain is essentially gone! I’ve been to the gym several times, again with no pain. So other than these severe mental problems, things are looking very positive! lol Integrating Dr. Hanscom’s DOCC concepts with traditional psychology is going to be “educational” I think. Thank you for your help…I’m so grateful that you suggested we postpone the surgery! Best regards, Ray p.s. Do you think it would be a mistake for me to attempt jogging again? I’ve run/jogged for 40 years, and thought that it might have contributed to the sciatic pain…but that doesn’t seem to be a factor now. I really miss the activity…the machines at the gym can’t compete with the deserted, sandy beach here. p.p.s. On Dr. Hanscom’s website, there are several anecdotal stories of patient testimonies, and the relief that DOCC has brought them…I’d certainly be happy to write a brief description of my own “story” if you think it might help others…acknowledging that it’s only been a week of no pain! My Perspective on Ray’s recovery He was a patient who came to Seattle from a distance. He had called our clinic about six months ago. As he was experiencing severe pain down his leg he wondered if we could see him earlier. He was miserable and I was open to performing surgery relatively quickly. However, although his scans showed some bone spurs that were probably causing his pain I did not see anything new that would explain why his pain had become so uncomfortable that quickly. I gave him material to read about surgery as well as a copy of my book and website and told him to call me in a couple of days with his decision. I did not hear back from him until a few weeks ago. He had engaged in many of the concepts of the DOCC project and his pain disappeared. But now his pain had returned more intensely than ever. It was located in the same leg and location. I repeated his MRI, saw him back, and was awaiting a phone call about when he wanted to schedule surgery. Instead I received this letter. The “Sarno effect” This occurrence is relatively common. We call it the “Sarno effect”. Dr. John Sarno discovered the Mind Body Syndrome in the 1960’s and 70’s. His approach was to identify the “trigger” that lit up the pathway and the problem would be solved. He was correct and it can and does occur. Deal with any trigger I feel that his methodology is very helpful. But the DOCC project is more generic in that it does not matter what the trigger is. Ray will definitely relapse. It is the nature of pain pathways. They are permanent and deeply imbedded. It is just important to understand that you have been triggered and then use whatever tools work for you to pop back out of the pain pathways. It is a learned skill that eventually you will become quite adept at. Where is Nirvana?? I keep thinking that somehow I will hit a place that I will never have to descend back into these circuits. That is not reality as life does keep coming at you. One of my goals is to be easier on myself when I get tripped up. What I have also discovered is that learning these skills is not difficult. You simply have to be open to change. Unfortunately, for many, anger blocks that possibility.