Today is September 10, 2018.
I have spent the last two weeks re-constructing this blog in WordPress.com. When I created this blog in Blogger (a.k.a., Blogspot), I chose this platform to figure out how it works because one of my web clients was using it. She still uses Blogspot, which is very appropriate for her posts, which are always text narrative with no images at all except for her headshot in her picture profile. But, like my diabetes journey, this blog has become so long, with complicated layouts and images, that it's time to move it to WordPress.com.
If you have been following this blog, please go to
https://yearwithoutcarbs.wordpress.com/ and re-subscribe. All the posts (from 1/1/15 to 6/8/18) have been moved to WordPress, and subsequent posts continue my story to the present date. Oh, and my new blog is published under my real name!
Thank you for following my journey with me.
Monday, September 10, 2018
Friday, June 8, 2018
Pain Physical Therapy #4
I woke up at 7:00 a.m. with a bonafide migraine! Got up, took sumatriptan and two Aleve, and went back to bed with an ice pack on my head and my feet on the heating pad. Fortunately, I woke up just in time to get a shower and pour coffee for us to take with us to Union City. Still bummed, though, about why I would be getting a migraine now! I'm convinced it's because the Clarified (brand) 4:1 tincture I've been taking for the past three weeks is just not enough THC to provide the prophylactic effect of my 1:1 tinctures.
Francis was ready to start on time, and I followed him through the corridors to his office. He had to unlock two hallway doors and the door to his office. I appreciate the level of security that Kaiser provides for this building, which houses psychiatric and addiction facilities as well as pain management.
We talked first, about how am I doing and reiterating what my goals are. I felt free to tell him what pain medications I'm on but that my eventual goal is to get off all pain medications, like I was able to get off all diabetes medication, except insulin. He asked if I was still eating low-carb and my response was, "Oh, yes! It's an ongoing permanent lifestyle." I told him about my horrific headaches with gabapentin and that the pain pharmacist was working with me to switch to Lyrica. "We'll see," I said. He was looking at my records on his computer and confirmed that I had last talked with John Poon, pain pharmacist.
He asked me how I'm doing with acupuncture, and I told him, "Fine. Paul Simon told me I'm a good patient!" I told him I have every intention of continuing with acupuncture as long as possible. Francis then told me that patients have a limit of 10 individual sessions with an acupuncturist. After that, patients can go back to group acupuncture for an unlimited number of times. At $35 co-pay for each visit, the same cost as going to individual sessions with Paul Simon. I asked Francis if there is a limit like that for physical therapy visits. He said he didn't think so. That he continues with a patient either until they are totally pain-free and healthy or until physical therapy has done all that is possible to do for them. I told him I knew that degenerative disc disease is not going to be cured, but that I'm determined to find out how to live with DDD without the level of pain that I have experienced.
I told Francis that Paul Simon had asked me if I was using any topical medication for my neck pain, and that I told him what I had never told any other Kaiser practitioner (except for Francis) that I used medical cannabis salve. "CBD?" he asked. I shrugged. "I have no idea. The container just says 'Medical Cannabis Salve'."
Francis had me go to the exam table where he checked how I'm doing with the exercises. He seemed very pleased that I am mastering the initial exercises, so he added dimensions to make them harder. He added one more exercise, which is like the one I've been doing lying down and turning my head as far as possible to the right. Only this one is done standing up against a wall, keeping head against the wall while turning it to the right and back again. A new challenge!
Near the end of the session, when I was still sitting on the exam table, I spotted a trifold brochure in a display on the wall. It was from Harborside. Just one copy, with a business card stapled to the top, and writing all over the brochure. I mentioned it to Francis. "Harborside?" I grinned.
"Oh, yes," Francis said. "You've been there?"
I laughed. "Yes, that's where I got my medical cannabis salve."
He scheduled me for my next appointment after our planned road trip. "First Friday in August?" he asked.
While I was in my physical therapy appointment, Linda and Emily stayed in the van, and Linda took measurements of various parts of the van and wrote them down in a notebook. When I came out, we drove to Home Depot on our way back.
Linda knew exactly what kind and size of wood she wanted. A very nice employee with the last name of Hernandez helped Linda find what she was looking for and then put the wood on the cart I was pushing. Emily and I waited patiently while the cuts were made. Linda located the hardware and drill bits she needed. The young Latina cashier was also very sweet and helpful. I was even able to load the car and unload it when we got home.
But I'm still quite bummed about the migraine I had this morning.
Francis was ready to start on time, and I followed him through the corridors to his office. He had to unlock two hallway doors and the door to his office. I appreciate the level of security that Kaiser provides for this building, which houses psychiatric and addiction facilities as well as pain management.
We talked first, about how am I doing and reiterating what my goals are. I felt free to tell him what pain medications I'm on but that my eventual goal is to get off all pain medications, like I was able to get off all diabetes medication, except insulin. He asked if I was still eating low-carb and my response was, "Oh, yes! It's an ongoing permanent lifestyle." I told him about my horrific headaches with gabapentin and that the pain pharmacist was working with me to switch to Lyrica. "We'll see," I said. He was looking at my records on his computer and confirmed that I had last talked with John Poon, pain pharmacist.
He asked me how I'm doing with acupuncture, and I told him, "Fine. Paul Simon told me I'm a good patient!" I told him I have every intention of continuing with acupuncture as long as possible. Francis then told me that patients have a limit of 10 individual sessions with an acupuncturist. After that, patients can go back to group acupuncture for an unlimited number of times. At $35 co-pay for each visit, the same cost as going to individual sessions with Paul Simon. I asked Francis if there is a limit like that for physical therapy visits. He said he didn't think so. That he continues with a patient either until they are totally pain-free and healthy or until physical therapy has done all that is possible to do for them. I told him I knew that degenerative disc disease is not going to be cured, but that I'm determined to find out how to live with DDD without the level of pain that I have experienced.
I told Francis that Paul Simon had asked me if I was using any topical medication for my neck pain, and that I told him what I had never told any other Kaiser practitioner (except for Francis) that I used medical cannabis salve. "CBD?" he asked. I shrugged. "I have no idea. The container just says 'Medical Cannabis Salve'."
Francis had me go to the exam table where he checked how I'm doing with the exercises. He seemed very pleased that I am mastering the initial exercises, so he added dimensions to make them harder. He added one more exercise, which is like the one I've been doing lying down and turning my head as far as possible to the right. Only this one is done standing up against a wall, keeping head against the wall while turning it to the right and back again. A new challenge!
Near the end of the session, when I was still sitting on the exam table, I spotted a trifold brochure in a display on the wall. It was from Harborside. Just one copy, with a business card stapled to the top, and writing all over the brochure. I mentioned it to Francis. "Harborside?" I grinned.
"Oh, yes," Francis said. "You've been there?"
I laughed. "Yes, that's where I got my medical cannabis salve."
He scheduled me for my next appointment after our planned road trip. "First Friday in August?" he asked.
While I was in my physical therapy appointment, Linda and Emily stayed in the van, and Linda took measurements of various parts of the van and wrote them down in a notebook. When I came out, we drove to Home Depot on our way back.
Linda knew exactly what kind and size of wood she wanted. A very nice employee with the last name of Hernandez helped Linda find what she was looking for and then put the wood on the cart I was pushing. Emily and I waited patiently while the cuts were made. Linda located the hardware and drill bits she needed. The young Latina cashier was also very sweet and helpful. I was even able to load the car and unload it when we got home.
But I'm still quite bummed about the migraine I had this morning.
Wednesday, May 23, 2018
Level 3 Pain Group Follow up #2
May 23, 1883, was the birth date of my maternal grandfather who lived to be 81. Today is another Level 3 Pain Group follow-up session. There were only five of us: two from my January/February group and three others from a more recent group.
Dr. Whitehead began with a long, slow meditation. Very nice. Then she went into the "group therapy" portion. The focus was on what struggles we are having and what successes. The she asked as to write down two tips. I wrote "gratitude" and "forgiveness."
Francis came in for the "gentle movement" part. He decided to go through an adapted series of Yoga positions, some standing, some sitting in our chairs. This is also something I could do at home with Linda, if she wanted to.
Dr. Whitehead began with a long, slow meditation. Very nice. Then she went into the "group therapy" portion. The focus was on what struggles we are having and what successes. The she asked as to write down two tips. I wrote "gratitude" and "forgiveness."
Francis came in for the "gentle movement" part. He decided to go through an adapted series of Yoga positions, some standing, some sitting in our chairs. This is also something I could do at home with Linda, if she wanted to.
Thursday, May 17, 2018
Individual Acupuncture Therapy #2
Everything is very familiar now in Building B of the Union City Kaiser, where I first went for my appointment with Dr. Sumetanon to begin my Pain Management journey. I am ushered into Paul Simon's treatment room by an assistant. She asked if I used the table or the massage chair. She brought in the chair. Then she scheduled my next appointment for June 25.
The first thing Paul Simon asked me when he came into the room was, "How are the headaches?" I explained (I did try to be brief, I really did!) that I was working with my pain pharmacist to gradually decrease the gabapentin to where it did not cause the headaches but would still be effective for pain reduction. We talked a bit more about gabapentin and how evil I think it is.
"Do you use anything topically?" he asked me. I paused then said, "Well, to be honest--and you are one of the few people I admit this to--" He laughed. "I know what you're going to say!" And I knew that he knew! "Cannabis salve," I said and he said, "Yep! A lot of patients do that." He went on to express his opinion that he wished the medical community would/could accept things. Things that work.
He asked me again exactly where the neck pain is (so he would know exactly where to put the needles). Then I got positioned on the massage chair and he put needles in my head and neck like last time. He also put two needles in my right arm, in the exact places of the points he had shown me last time: one on the outside edge of my hand and the other one on the thumb side slightly below the wrist. I could look down at my hands for the next half hour and, hopefully, memorize the exact points. After today's session, he also showed me another point on the top of the hand between the 4th and 5th fingers, explaining that was more for headaches. I recognized that this was the same point on the hand that Toni Narins of Elemental Sound Healing (on Facebook) had demonstrated only on the foot. Interesting. I wish I could reach my feet easily.
During the session, I listened to the background music as I did mindful breathing and for meditation focused on relaxation of parts of the body. The music was not the non-western music that was played in the group acupuncture sessions but was very familiar, soothing orchestral Western music. The first one I was aware of was Debussy's "Claire de lune" followed by the Quaker song, "Simple Gifts," and the Sibelius' "Finlandia."
A few minutes into the session, I began to feel a warmth, mostly on my neck and upper back. I noticed how good it felt and wondered if the acupuncture was responsible for those feelings of warmth. It was only when Paul came back in at the halfway point to make sure I was okay that I found out he was using a heat source above my back and neck! It was a very nice thing.
At the end of the session, when he came back in and took out the needles, he told me I was "a good patient." He checked to see that my next appointment had been made, and he was almost apologetic that it was over 5 weeks away. He explained that part of the reason for that is because he'll be on vacation the first part of June. I said, "That will work out, because I'll be on vacation the first part of July!"
Before leaving, I told him that I had looked at that "S"-shaped tool for using on one's back and neck and that I had then found a tool in Daiso and I pulled it out of my bag and showed it to him. He held it in his hand, put the end on his back and neck in different positions. I could tell he approved! "Plus," I said, half in jest, "it's small enough to put into my bag so I can take it with me on my trip!"
The first thing Paul Simon asked me when he came into the room was, "How are the headaches?" I explained (I did try to be brief, I really did!) that I was working with my pain pharmacist to gradually decrease the gabapentin to where it did not cause the headaches but would still be effective for pain reduction. We talked a bit more about gabapentin and how evil I think it is.
"Do you use anything topically?" he asked me. I paused then said, "Well, to be honest--and you are one of the few people I admit this to--" He laughed. "I know what you're going to say!" And I knew that he knew! "Cannabis salve," I said and he said, "Yep! A lot of patients do that." He went on to express his opinion that he wished the medical community would/could accept things. Things that work.
He asked me again exactly where the neck pain is (so he would know exactly where to put the needles). Then I got positioned on the massage chair and he put needles in my head and neck like last time. He also put two needles in my right arm, in the exact places of the points he had shown me last time: one on the outside edge of my hand and the other one on the thumb side slightly below the wrist. I could look down at my hands for the next half hour and, hopefully, memorize the exact points. After today's session, he also showed me another point on the top of the hand between the 4th and 5th fingers, explaining that was more for headaches. I recognized that this was the same point on the hand that Toni Narins of Elemental Sound Healing (on Facebook) had demonstrated only on the foot. Interesting. I wish I could reach my feet easily.
During the session, I listened to the background music as I did mindful breathing and for meditation focused on relaxation of parts of the body. The music was not the non-western music that was played in the group acupuncture sessions but was very familiar, soothing orchestral Western music. The first one I was aware of was Debussy's "Claire de lune" followed by the Quaker song, "Simple Gifts," and the Sibelius' "Finlandia."
A few minutes into the session, I began to feel a warmth, mostly on my neck and upper back. I noticed how good it felt and wondered if the acupuncture was responsible for those feelings of warmth. It was only when Paul came back in at the halfway point to make sure I was okay that I found out he was using a heat source above my back and neck! It was a very nice thing.
At the end of the session, when he came back in and took out the needles, he told me I was "a good patient." He checked to see that my next appointment had been made, and he was almost apologetic that it was over 5 weeks away. He explained that part of the reason for that is because he'll be on vacation the first part of June. I said, "That will work out, because I'll be on vacation the first part of July!"
Before leaving, I told him that I had looked at that "S"-shaped tool for using on one's back and neck and that I had then found a tool in Daiso and I pulled it out of my bag and showed it to him. He held it in his hand, put the end on his back and neck in different positions. I could tell he approved! "Plus," I said, half in jest, "it's small enough to put into my bag so I can take it with me on my trip!"
Friday, April 27, 2018
Pain Physical Therapy #3
Today is my third individual session for physical therapy with Francis.
When I checked in, the girl did not ask for a co-pay, so I'm sure someone down the line will bill me. I hate doing it like this. I would rather just pay with my card at the time of the appointment, because I have to rack my brain later, trying to remember what date I had an appointment on that I was supposed to be billed for.
When Francis came into the waiting room, I had my back to him and was attempting to perform acupressure on my neck. This did not escape his notice! He mentioned it and applauded me for doing it.
I followed him back to his office, now a familiar place. We talked briefly, as usual. I verbalized my frustration with gabapentin causing headaches but followed rather quickly with, "But I have an appointment with the pain pharmacist next week." He nodded.
I sat on the patient table and he checked my range of motion in my neck and said he thought I was making progress! He asked me to do various movements, and then he manipulated my head and neck in different ways, asking if what he was doing made it feel better, feel worse, or no different.
He gave me a new neck exercise and then showed me a hard rubber massage ball with rounded nubs, which he placed under my neck on the right side and showed me how I could use a ball like this for acupressure. Great idea!
Finally, he scheduled me for another appointment on the second Friday of June.
When I checked in, the girl did not ask for a co-pay, so I'm sure someone down the line will bill me. I hate doing it like this. I would rather just pay with my card at the time of the appointment, because I have to rack my brain later, trying to remember what date I had an appointment on that I was supposed to be billed for.
When Francis came into the waiting room, I had my back to him and was attempting to perform acupressure on my neck. This did not escape his notice! He mentioned it and applauded me for doing it.
I followed him back to his office, now a familiar place. We talked briefly, as usual. I verbalized my frustration with gabapentin causing headaches but followed rather quickly with, "But I have an appointment with the pain pharmacist next week." He nodded.
I sat on the patient table and he checked my range of motion in my neck and said he thought I was making progress! He asked me to do various movements, and then he manipulated my head and neck in different ways, asking if what he was doing made it feel better, feel worse, or no different.
He gave me a new neck exercise and then showed me a hard rubber massage ball with rounded nubs, which he placed under my neck on the right side and showed me how I could use a ball like this for acupressure. Great idea!
Finally, he scheduled me for another appointment on the second Friday of June.
Monday, April 23, 2018
Individual Acupuncture Therapy #1
Today is the long-awaited appointment with an individual acupuncturist (not a group of a dozen or more patients!). The assistant took me into a regular doctor's office, small, with chairs and a patient table. Mr. Simon had already looked at my medical records so he already knew everything I told him. He even actually remembered me as being one of the group acupuncture patients from January 17!
I told him upfront that, in addition to acupuncture with him, I am very interested in pursuing acupressure. He showed me two places on my right hand where pressure points for neck pain are, and he placed a small sticky on each spot. He also showed me three places on my left ankle that were pressure points to relieve pain on the right side of my neck.
He did some explanations of meridians and energy, which I appreciated. For the today's acupuncture session, he asked me if I would be more comfortable on the patient table or a massage chair. I told him whatever would provide the best support for my head. He left for a moment and came back with a portable massage chair, had me sit on it, and made some adjustments.
He placed needles in various spots on my head and neck and two on my arms. I was thinking the right arm needle must be in a small blood vessel because it was pulsating with my heartbeat! The left arm needle didn't do that, but there was no pain in either needle nor with any of the other needles.
I have learned how to stay extremely still, not even twitching a nose!, during an acupuncture session by practicing mindful breathing and meditation. Mr. Simon left the room, and there was soft music playing so the ambience was perfect.
Fifteen minutes later, he came back into the room and asked me how I was doing. "Just fine," I answered, not moving a muscle. So he left for another 15 minutes when he came back in and removed the needles.
How do I feel? Very relaxed and refreshed, as I did after the last two group acupuncture sessions with Sophie.
Before I left, he scheduled my next appointment for May 17.
I told him upfront that, in addition to acupuncture with him, I am very interested in pursuing acupressure. He showed me two places on my right hand where pressure points for neck pain are, and he placed a small sticky on each spot. He also showed me three places on my left ankle that were pressure points to relieve pain on the right side of my neck.
He did some explanations of meridians and energy, which I appreciated. For the today's acupuncture session, he asked me if I would be more comfortable on the patient table or a massage chair. I told him whatever would provide the best support for my head. He left for a moment and came back with a portable massage chair, had me sit on it, and made some adjustments.
He placed needles in various spots on my head and neck and two on my arms. I was thinking the right arm needle must be in a small blood vessel because it was pulsating with my heartbeat! The left arm needle didn't do that, but there was no pain in either needle nor with any of the other needles.
I have learned how to stay extremely still, not even twitching a nose!, during an acupuncture session by practicing mindful breathing and meditation. Mr. Simon left the room, and there was soft music playing so the ambience was perfect.
Fifteen minutes later, he came back into the room and asked me how I was doing. "Just fine," I answered, not moving a muscle. So he left for another 15 minutes when he came back in and removed the needles.
How do I feel? Very relaxed and refreshed, as I did after the last two group acupuncture sessions with Sophie.
Before I left, he scheduled my next appointment for May 17.
Wednesday, April 11, 2018
Pain Management Group Follow-up
It felt like six weeks passed pretty quickly. The commute was easy and uncomplicated. Checking in and sitting in the waiting room felt very familiar although a bit strange since there was only one person I saw from our original group of ten. After we had assembled in our group meeting room, there were just six of us from our original group, plus one other person from another group.
Dr. Whitehead began the session with meditation, which I expected, and that was very nice. It was a familiar guided imagery of the beach! Then we went right into "group therapy" with each of us telling what we are still doing that is helpful (with pain management) and what things we are still struggling with. Several said their struggle is with "trying to do too much." Mine was a variation of that: sitting too long at the computer without a break. Some said it was hard for them to ask other people for help. Well, that would have been me six months ago! In the past six weeks, I've had to ask Linda for technical assistance with web clients. We both struggle with brain fog, but apparently mine is worse when it comes to technology! Finally, we were asked to write down (on cards she passed out) two helpful tips. Then she collected the cards and typed them into a document which she printed out (on bright pink card stock!) and distributed for a take-home.
Francis ended the session with Tai Chi taken from a new YouTube video called "Adapted Tai Chi Part 1," which I looked up at home.
After class, I spoke privately to Francis to confirm that the Tuesday drop-in group on the 4th Tuesday of April (the 24th) would be focused on acupressure, which I will try very hard to be able to attend. It will mean getting to Alameda for the Farmers' Market and Trader Joe's two hours earlier than our "usual" in order to be able to get home to unload groceries and then to Union City for the 3-5 p.m. group.
Dr. Whitehead began the session with meditation, which I expected, and that was very nice. It was a familiar guided imagery of the beach! Then we went right into "group therapy" with each of us telling what we are still doing that is helpful (with pain management) and what things we are still struggling with. Several said their struggle is with "trying to do too much." Mine was a variation of that: sitting too long at the computer without a break. Some said it was hard for them to ask other people for help. Well, that would have been me six months ago! In the past six weeks, I've had to ask Linda for technical assistance with web clients. We both struggle with brain fog, but apparently mine is worse when it comes to technology! Finally, we were asked to write down (on cards she passed out) two helpful tips. Then she collected the cards and typed them into a document which she printed out (on bright pink card stock!) and distributed for a take-home.
Francis ended the session with Tai Chi taken from a new YouTube video called "Adapted Tai Chi Part 1," which I looked up at home.
https://www.youtube.com/watch?v=ZbGvYXB08uk
After class, I spoke privately to Francis to confirm that the Tuesday drop-in group on the 4th Tuesday of April (the 24th) would be focused on acupressure, which I will try very hard to be able to attend. It will mean getting to Alameda for the Farmers' Market and Trader Joe's two hours earlier than our "usual" in order to be able to get home to unload groceries and then to Union City for the 3-5 p.m. group.
Friday, March 23, 2018
Follow up with Francis
Today was a follow-up appointment with Francis, the physical therapist from the Pain Clinic. Once again, he spent a full hour with me. The first thing he said was to confirm his approval of the inflatable neck traction device I had sent him a link to and which is available to buy on Amazon. So, good, okay, I will order one when I get home this afternoon.
He started the examination, of course, with checking the range of motion of my neck, particularly on the right side. Since I had been in pain most of the past 24 hrs., turning my head to the right was very difficult and painful at first. He did various manual manipulations with my head and neck, then he checked me on the three exercises that he had given me at my first appointment (and confirmed that I was performing them correctly). He modified the "windmill" exercise to make my arm go further behind my back. He then gave me a new exercise to do with towel around the back of my neck, then pulling my head, first up, and then to the right and to the left, synced with "mindful breathing," of course. I can do that.
We talked about a lot of things related to my neck pain, including acupressure. I asked him to show me the correct pressure points on the back of my head and on my shoulders that are specifically for neck pain. Which he did. He also told me that the pressure with thumbs or fingers did not have to be hard pressure. Even just touching the pressure points would be effective. So now I have been affirmed with that tool.
I did ask him point-blank about the validity of "tapping," and his response was positive. I told him the hardest thing for me to do was to admit that emotions and highly emotional experiences affect my pain level. He asked, "Why is that?" I told him I guess because, at my age, I can't accept change as easily as I did when I was younger." Then I said, "Maybe I need to see Julie [the Pain Psychologist] again." That made him chuckle.
I told him I have an appointment in April with one of the acupuncturists and he thought that was very good. I told him I wanted to have regular sessions with him (Francis), perhaps every six weeks? He did not hesitate to open his calendar and make an appointment for me on another Friday, five weeks from today.
Thursday, March 22, 2018
Office Visit with Dr. Kalra
I put way more angst into anticipating this visit than I should have! How many times had I rehearsed and re-rehearsed everything I was going to say to Dr. Kalra?!? I wrote down carefully in my notebook the three things I wanted to discuss with him.
His medical assistant took me to Dr. Kalra's exam room, asked questions, took notes, and then checked my blood pressure which was 111/69 and she said, "Good!"
He was a few minutes late for my appointment but I didn't mind. It just gave me that many more minutes to rehearse!
I knew he was probably Indian, but he was younger and shorter than I had imagined. He was cordial but I knew he was a down-to-business no-nonsense kind of person and so I behaved accordingly. I told him that I couldn't take more than 600mg/day of gabapentin or I get horrific headaches. He nodded and said that was common. I said I had heard of a painkiller called tramadol—and he stopped me with a half smile. "That is the next thing I was going to suggest for you," he said, and I internally heaved a great sigh of relief.
The next item on my list was to ask him about meloxicam. I told him I was concerned about destroying my liver and kidneys with Advil and Aleve. He said he would prescribe Mobic (brand name for meloxicam!). Which he did, but only half (7.5mg) of the 15mg dosage that Linda had (and which I took for a few weeks).
Finally, I asked him about the c-reactive protein (CRP) lab test which Google said is "a blood test marker for inflammation in the body." Is it valid, in your professional opinion, Dr. Kalra? He said yes and no. No, because your body's level of inflammation varies so much. A negative test wouldn't really tell you anything. A positive test wouldn't really tell you anything. But (and apparently Kaiser allows the test, covered or not) he was willing to order the test if I wanted. I said no, that's okay. But I just had to ask.
He said that I should have a follow up phone appointment in six weeks. He didn't say it would be with a pharmacist, but I wasn't surprised when his assistant told me that. She also told me I could pick up my prescriptions in San Leandro.
It was raining pretty hard when we got to Kaiser San Leandro but I didn't mind. I had just scored two new drugs! I also purchased, on impulse, a box of Salonpas pain patches, since someone on Facebook had mentioned that they worked for her husband. So…we'll see just how—or if—everything works for me!
His medical assistant took me to Dr. Kalra's exam room, asked questions, took notes, and then checked my blood pressure which was 111/69 and she said, "Good!"
He was a few minutes late for my appointment but I didn't mind. It just gave me that many more minutes to rehearse!
I knew he was probably Indian, but he was younger and shorter than I had imagined. He was cordial but I knew he was a down-to-business no-nonsense kind of person and so I behaved accordingly. I told him that I couldn't take more than 600mg/day of gabapentin or I get horrific headaches. He nodded and said that was common. I said I had heard of a painkiller called tramadol—and he stopped me with a half smile. "That is the next thing I was going to suggest for you," he said, and I internally heaved a great sigh of relief.
The next item on my list was to ask him about meloxicam. I told him I was concerned about destroying my liver and kidneys with Advil and Aleve. He said he would prescribe Mobic (brand name for meloxicam!). Which he did, but only half (7.5mg) of the 15mg dosage that Linda had (and which I took for a few weeks).
Finally, I asked him about the c-reactive protein (CRP) lab test which Google said is "a blood test marker for inflammation in the body." Is it valid, in your professional opinion, Dr. Kalra? He said yes and no. No, because your body's level of inflammation varies so much. A negative test wouldn't really tell you anything. A positive test wouldn't really tell you anything. But (and apparently Kaiser allows the test, covered or not) he was willing to order the test if I wanted. I said no, that's okay. But I just had to ask.
He said that I should have a follow up phone appointment in six weeks. He didn't say it would be with a pharmacist, but I wasn't surprised when his assistant told me that. She also told me I could pick up my prescriptions in San Leandro.
It was raining pretty hard when we got to Kaiser San Leandro but I didn't mind. I had just scored two new drugs! I also purchased, on impulse, a box of Salonpas pain patches, since someone on Facebook had mentioned that they worked for her husband. So…we'll see just how—or if—everything works for me!
Saturday, March 17, 2018
Pain Management: My Review
I have completed the 3-days-a-week 5-week outpatient Pain Management program at Kaiser. The facilitators all made it clear from Day 1 that this is not a pain relief program but a pain management! And they were right. We were not allowed to talk specifically about our pain nor about medications.
I posted in detail about every one of the 15 sessions, for anyone who is interested in that level of detail (from January 15 through February 23). Most readers, however, just want to know my opinion, in general, about the Pain Management program. So, here goes.
In my opinion, Pain Management is probably 80% psychology. Pain psychology, they call it. They have names for specific strategies. Radical acceptance. Tiny habits. Planning, prioritizing, and pacing, which is knowing how to alternate high-impact and low-impact activities. Positive thinking. Social support. And "how to say 'no' without feeling guilty." There was even a session on how to manage a flare: we could list everything except medication!
The rest of it, somehow based on the premise that reducing/eliminating stress would also reduce/eliminate pain, consisted of achieving relaxation through guided meditation combined with "mindful breathing." And there was always a session of "gentle movement" exercises, mostly Tai Chi, with some yoga positions, and core exercises, mostly targeting back pain.
But your question to me is still: Did the Pain Management program help you? Well, yes, it helped me understand that there is no such thing as pain relief! The need to limit time on high-impact activities has made it possible for me to have one or two guilt-free bed rest times during the day, during which I practice my own internally guided meditation combined with belly breathing. I have learned how to do various "gentle movement" exercises during times when I can't do anything else, like waiting in a long line or lying awake in bed during a night of insomnia. These are all essentially attempts at distractions from the ever-present pain.
I still have three more individual office appointments, two next week. One is with Dr. Kalra, the medical director of the Pain Clinic, as a follow-up to my initial telephone appointment with him at the beginning of the program when he prescribed gabapentin. I need to let him know that 600mg of gabapentin is all I can take or I get intense headaches (not migraines but drug-induced headaches). But without the gabapentin, my typical pain level would be 7 or 8 instead of 5 or 6. Dr. Kalra does not think that physical manipulation of my c-spine will do any good, even though the only thing that has come close to pain relief was two specific manual manipulations I experienced in Physical Therapy.
Another is with Francis, the physical therapist specializing in pain management. I feel "safe" with him because he is the only Kaiser practitioner that I've admitted to following a ketogenic diet. I still do the three exercises he gave me to do during the one individual session that I had with him during the program. While these exercises have not perceptibly lessened my chronic neck pain, I can tell that the range of motion in my neck has become easier.
And, next month, I have a one-on-one appointment with one of the acupuncturists in the Physical Medicine Department. Until then, I am continuing to research and explore acupressure and hope that I might get some help with it from both Francis and the acupuncturist.
Finally, apart from the program, I have looked at some introductory materials (both articles and videos) on "tapping." Although it's supposedly related to acupuncture and acupressure, I am not convinced of its legitimacy or effectiveness. Their claims still sound like "snake oil" to me. I'm just not ready for it yet.
I posted in detail about every one of the 15 sessions, for anyone who is interested in that level of detail (from January 15 through February 23). Most readers, however, just want to know my opinion, in general, about the Pain Management program. So, here goes.
In my opinion, Pain Management is probably 80% psychology. Pain psychology, they call it. They have names for specific strategies. Radical acceptance. Tiny habits. Planning, prioritizing, and pacing, which is knowing how to alternate high-impact and low-impact activities. Positive thinking. Social support. And "how to say 'no' without feeling guilty." There was even a session on how to manage a flare: we could list everything except medication!
The rest of it, somehow based on the premise that reducing/eliminating stress would also reduce/eliminate pain, consisted of achieving relaxation through guided meditation combined with "mindful breathing." And there was always a session of "gentle movement" exercises, mostly Tai Chi, with some yoga positions, and core exercises, mostly targeting back pain.
But your question to me is still: Did the Pain Management program help you? Well, yes, it helped me understand that there is no such thing as pain relief! The need to limit time on high-impact activities has made it possible for me to have one or two guilt-free bed rest times during the day, during which I practice my own internally guided meditation combined with belly breathing. I have learned how to do various "gentle movement" exercises during times when I can't do anything else, like waiting in a long line or lying awake in bed during a night of insomnia. These are all essentially attempts at distractions from the ever-present pain.
I still have three more individual office appointments, two next week. One is with Dr. Kalra, the medical director of the Pain Clinic, as a follow-up to my initial telephone appointment with him at the beginning of the program when he prescribed gabapentin. I need to let him know that 600mg of gabapentin is all I can take or I get intense headaches (not migraines but drug-induced headaches). But without the gabapentin, my typical pain level would be 7 or 8 instead of 5 or 6. Dr. Kalra does not think that physical manipulation of my c-spine will do any good, even though the only thing that has come close to pain relief was two specific manual manipulations I experienced in Physical Therapy.
Another is with Francis, the physical therapist specializing in pain management. I feel "safe" with him because he is the only Kaiser practitioner that I've admitted to following a ketogenic diet. I still do the three exercises he gave me to do during the one individual session that I had with him during the program. While these exercises have not perceptibly lessened my chronic neck pain, I can tell that the range of motion in my neck has become easier.
And, next month, I have a one-on-one appointment with one of the acupuncturists in the Physical Medicine Department. Until then, I am continuing to research and explore acupressure and hope that I might get some help with it from both Francis and the acupuncturist.
Finally, apart from the program, I have looked at some introductory materials (both articles and videos) on "tapping." Although it's supposedly related to acupuncture and acupressure, I am not convinced of its legitimacy or effectiveness. Their claims still sound like "snake oil" to me. I'm just not ready for it yet.
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