Derek S. TMS and Meds

[Guest]

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Question

I read Dr. Sarnos book and feel I truly have TMS. I also went through the structured program. My pain has definitely decreased and I am back to the gym few times a week. However I still have enough pain twice a day that requires taking ultram 50mg. I cannot seem to make it thru the day without it at this point. The past 2 days my stomach has been having pain apparently from using meds for at least a year. I tried to avoid meds last night but became really uncomfortable. As much as I am much more able to live more normally lately I cannot seem to eliminate the pain twice daily. Any thoughts?

 

[Derek Sapico MFT]

Answer

Thanks for your question.

This issue with medication comes up frequently in my practice.

Sometimes with TMS, there can be breakthrough pain during certain times of the day that is not caused by anything structural. Because of this, and the brain's tendency to get used to routines, the medication's effectiveness on your symptoms could be more due to placebo rather than psychopharmacologic efficacy.

When the pain comes, remind yourself that it is your brain causing the symptom rather than your body needing the medication for something structural.

Regarding the stomach pain, it may not be the medication that is causing the symptom. Could this be another vessel for fear created by your clever TMS brain? I've had patients who have been on medication for decades and it doesn't always have this side effect. Consider that this could be just another ingredient in your TMS stew.

Don't terrorize yourself about having to get off of the medication immediately. When you feel ready, you can work with your doctor to titrate down under medical supervision. You may find the process to be a lot easier than you had feared.

I hope this provides you with some hope and/or food for thought.

I wish you all the best in your recovery!

-Derek

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[North Star]

Derek, what great counsel!

Guest, Be gentle with yourself. When I stepped down my use of ibuprofen, I would tell myself, "this pain is from TMS" to help retrain any conditioning. I had a huge victory not too long ago…muscle pain started up. Severe muscle pain. I nearly limped to get some ibu but stopped myself and gave myself a good talking to. Within 10 minutes, the pain was gone. That was greatly encouraging to me.

Other times, I will take some ibuprofen and remind myself there is no condemnation. (BTW, ibu seems to be the only pain reliever that would work for me. Lyrica and Tylenol 3 did nothing. Ditto for other Rx drugs.)

Warmest wishes for your healing.