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In a crisis of pain/symptoms -- structural or TMS??

Discussion in 'General Discussion Subforum' started by Bonnard, Feb 18, 2023.

  1. Bonnard

    Bonnard Peer Supporter

    Hi all,

    I've been in intense pain in both ankles and feet for 2+weeks. It has taken over my life, and the pain is borderline unbearable at times. I am also struggling with fatigue and chills.

    I need to figure out if this if TMS or structural. I have a history (going back to 2010) of successfully addressing back pain (and later, other pains) using Sarno books/methods. I read this site regularly. A physical therapist first suggested Sarno's books to me.

    There's more details and history below, for those interested. I welcome any comments/suggestions! Thanks.

    I've been pursuing a structural diagnosis for this pain for 10 days. In that time, I've seen multiple specialists, had many tests, and spent a day in the ER.
    The doctors are stumped, but have ruled out a lot, and have two current theories:
    Gout or a serious Bacterial Infection.
    Both diagnoses don't exactly fit (diagnostic symptoms/causes not there), and that's causing the doctors to struggle. I'm currently on meds. for both gout and an infection. The docs. are eagerly awaiting test results that are due in 2 days (lab testing on extracted fluid from each ankle).
    I am also just wrapping up a diagnosed case of Shingles. I first thought that the pain in my side (and the rash) was TMS and it took me a week+ to get to my primary doctor. He quickly diagnosed Shingles. I was already into the first days of the foot/ankle pain, but didn't deal with that then.

    When the first problem came out as structural (Shingles), I just assumed all of my current problems are Structural.
    Now, I'm thinking the foot/ankle stuff might be TMS.

    It is so confusing!! And, ridiculously painful.

    Thank you.
  2. Cactusflower

    Cactusflower Beloved Grand Eagle

    I think you are on the right track. Just like Sarno says, get checked out medically, and if there is no evidence of structural issues or disease, then you know what you need to do.
    Think: not about the pain or your doctors, think about stress you’ve been under. Big stress or small mounting stress. Think about the fear you may have had around the shingles. Shingles are a disease, but they often manifest in times of stress.
    What can you do to calm yourself, to reduce your fears, to address personality types that may feed a cycle, to send messages of safety to yourself?
    Read or listen to Sarno, start the SEP on this website or Alan Gordon’s shorter Pain Reprocessing program also free here. Journal, meditate, somatic tracking … all tools you can use to regulate your nervous system and begin examining why you may be having a flare up.
    JanAtheCPA likes this.
  3. Bonnard

    Bonnard Peer Supporter

    Thank you so much for those suggestions, Cactusflower!
    I realized that I only posted above about the symptoms and getting checked out medically, etc. Nothing about stressors/solutions. I have a heavy recent emotional loss, and then a series of increased stressors this winter. Not a lot of relief from them yet...I've been kind of pushing through. Also, just some difficult life stuff that's weighing on my mind.
    I've got a lot.

    After the shingles diagnosis, I was reflecting on what tools I needed to use (stress relief/TMS-related). That all got dropped immediately b/c the combo. of the shingles pain and then ankle pain --and fatigue/chills--was devastating. Just focused on pain and dr. appts., getting thru each day.

    On the plus side, I have a great therapist. I need to re-frame those sessions with what's been going on. I have had excellent results from journaling in the past. I have still not done the SEP or Alan Gordon's program.
    JanAtheCPA likes this.
  4. JanAtheCPA

    JanAtheCPA Beloved Grand Eagle

    I agree with Cactusflower, @Bonnard. Shingles results from a compromised immune system, and stress should always be the first suspect unless you are in fact immune-compromised as a result of some serious health issue (eg receiving chemo or radiation).

    I was diagnosed with sudden-onset Rheumatoid Arthritis in June 2020, and I'm positive it was the result of stress - because of the timing, and because no other reason existed (no family history, and it was unusually late in life). It's not in remission, but I've got it under good control with a low dose of the most standard (and cheap)(and never advertised) drug, and I attribute this to my TMS training.

    I was under an extreme level of stress in the spring of 2020 (in addition to one or two outside stressors going on in the world at the time) and I had allowed myself to become overwhelmed by new demands (which were in fact directly related to the shutdowns), which I met, of course, with extreme perfectionism and goodism. I completely failed to be mindful of my mental health (which was somewhat understandable given what was going on at the time!) The result, as Dr Gabor Mate puts it, is that my body said No!

    Thus, in my opinion and my personal experience, one should never assume or expect that any symptom or set of symptoms is either all TMS or all physical. So-called "real" physical conditions (such as measurable blood test results specific to RA) can absolutely be brought on as a result of unrelenting psychological stress (I refer again to Gabor Mate MD, who explains the physiological process involved in When the Body Says No) , so you have to treat both at the same time, AND you have to treat both as connected. It's called the mindbody connection for a reason, after all.
  5. Bonnard

    Bonnard Peer Supporter

    Thank you for making that mind-body connection, @JanAtheCPA.
    Even though I know about (and have had--Epstein Barr as one past example--and currently, Shingles) conditions brought on by stress, I never thought of it the way you're describing it. I've always thought of something as TMS-related or structural-related.

    I always thought those ailments brought on by stress weren't TMS, and I just needed to reduce stress. And, in fact, I've had a couple m0re-than-excellent primary care doctors in a row who have helped me in that area. Both would respectfully listen to me talk about TMS/Sarno/mind-body, but they wouldn't go any further with it. BUT, they were all about helping me with stress-removal techniques. And, I had success in the past with that.
    JanAtheCPA likes this.
  6. Bonnard

    Bonnard Peer Supporter

    @Cactusflower: Thank your again for the suggestions. Over the years, I have quietly resisted completing the SEP or Alan Gordon's program. I've gotten close, but then get myself distracted or busy or whatever and don't do the work. It's kind of like the TMS working on me (my brain telling me I don't need that or am too busy to do that.)

    Here is my commitment that I am making here:
    I started the Alan Gordon program on Saturday, so I'm on day#3 today. I am going to complete that program.

    I am also starting to incorporate some of the techniques I enjoyed and worked for me in the past. I am reluctant to make a specific commitment here yet (i.e this practice xx/days per week). I just want to make sure I get through the Gordon program above. I'm sure that program will push me into the work.
    I have always enjoyed reading passages from Sarno's books and reflecting on them. I have always gotten results from writing out & really feeling my current stressors/fears/life pressures/emotions/situations I'm scared of--stuff that I'm forcing b/c if I don't do it, nobody else will do it the right way, etc... (perfectionism/save-the-world that def. doesn't-need-saving kind of stuff). I end that by talking to my brain that I can handle these and I don't need any distractions, thank you very much.
    I did some of this yesterday and it felt great.

    Cheers. Thanks!
    JanAtheCPA likes this.
  7. Bonnard

    Bonnard Peer Supporter

    Hi all,
    Here's an update to my situation:
    Last weekend when I first posted, I was finishing up with Shingles and had a second condition--was in serious ankle/foot pain & was waiting for test results to help determine if I had Gout or an Infection.
    Doctors have now ruled out an Infection and have mostly (but not 100%) ruled out Gout. There's a family history of Gout (father & brother had it) so they say there's a small possibility I have it. (They have also discussed Rheumatoid Arthritis as a possibility.)

    I am now on a medication (Prednisone) that has eliminated the majority of pain (5 full days pain free!). I see the doctor again in a couple days.
    It's likely they won't be able to put a name/diagnosis to what is going on with my feet/ankles. These types of doctors do not diagnosis TMS!
    Most importantly, I've been on this Forum daily, and am over a week into Alan Gordon's program. Completing a program is one thing I was never willing to do in the past. I always found a reason/excuse not to.
    I had something of a breakthrough in today's Gordon program session. I've also started to get back to some of the techniques that have worked for me in the past.

    Also, There were several doctor missteps/mistakes that I'm having a hard time letting go of. I think these could be distractions for me and not helpful in my recovery. They bring about negative feelings and questions, pressure, fear, etc....
    Here are just a couple of the missteps/mistakes (there are more!): The specialist who completed the 'aspiration' (removing fluid from both ankles) did not get enough fluid from my ankles to complete the test for Gout. (He said he only needed a drop and had plenty of fluid after the painful test (I almost passed out) was completed.)
    The doctor who then reviewed the test results with me first read them wrong (thought the test was negative when, in fact, it was not even completed) and he missed (forgot about?) earlier bloodwork results that we had reviewed together in his office. The result was that he took me off meds that were working, because of his rushing and not going over stuff in detail, and the symptoms came right back, almost worse than before! It was extremely frustrating and discouraging. The pharmacist and my primary doctor told me the symptoms would likely come right back if I went off that med. so I knew what was likely coming.....and then it came, a painful ridiculous day where I couldn't function hardly at all.
    Last edited: Feb 27, 2023
  8. Bonnard

    Bonnard Peer Supporter

    One critical piece to all of this is the suggestion from @JanAtheCPA that symptoms don't have to be all TMS or all physical. That has been extremely helpful!! Thanks.

    I had also read elsewhere on the Forum that symptoms are real and we have to deal with them no matter what the cause. I get Sarno's advice about returning to normal activity as soon as possible. I found that worked with my back pain.
    BUT, I found myself in this situation where I had such intense pain that I could barely walk at times. The pain was real and stopped all normal life activities. Finding some medication to reduce the swelling, irritation, and pain helped me to be able to get through each day (2 days then a return to symptoms, and now 5 days in a row with limited symptoms!) . Ultimately, that has given me the freedom to do the real work that is necessary--the TMS work to get at underlying emotional reasons and why my brain is distracting me with the pain / how to re-teach my brain that, no thanks, I don't need that distraction any more.

    I don't know what I would do without this Forum, the kind/knowledgeable folks here, and the resources that are shared here!!
    Last edited: Feb 27, 2023

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