Pain Group Acupuncture #3

This is my last day of pain group acupuncture with Sophie. I have requested to be referred to the Acupuncture Clinic for an individual session. So, for that, I will just have to wait.

Today only 3 of us from the class went to group acupuncture! I don't know where everyone else was. Maybe they all think they will just do the make-up group next Friday, but I will be on a plane by then.

I positioned myself, as I did two weeks ago, with my chair back against the wall so I could rest my head on the wall, and I was ready when Sophie got to me with the needles. I don't think any needles came out this week. And, once again, I concentrated on "mindful breathing" and meditation. I may have dozed off and on, but it was a very relaxing, refreshing experience.

In Sophie's talking (as she was putting the needles in), I thought I heard her mention "tapping" in a list of other non-Western medicine strategies, including acupressure, for pain relief. She left the room, though, before I had a chance to ask her about it.

Day 15 Pain Management

Today is the last day of the Level 3 Chronic Pain Management program! The first thing they did was have us fill out questionnaires, which I knew was coming. Yeah, by this time, I really do know my Kaiser Medical # by memory!

After the meditation session, Francis led us in the 7 core exercises and then did a game in which each person was to cross the room doing anything--one of our exercises, Tai Chi, or any other movement that no one else had yet done. It was fun, in a campy sort of way. Francis did not, however, talk about acupressure as he had promised.

In Dr. Whitehead's session, she had us each, individually, tell how we deal with flare-up management, and then tell what our goals are now that we're leaving the class. She talked about the "aftercare" reunion class and went to a wall calendar. She announced that the date would be Wednesday, April 11. By my calculations, 6 weeks would be April 4; however, I will wait until the Pain Clinic contacts me.

In conclusion, Dr. Whitehead had us make a list, which she wrote on the white board, of things we had learned in this program. She talked about the "Healthy Living" classes available to Kaiser members, some free, some with a fee.

Finally, she gave out the graduation certificates, one at a time, while the rest of the class clapped (rather halfheartedly, I thought) and then gave the person a chance to say anything they wanted to the others in the group. Several of them talked about a new resolve to exercise. I talked about continuing my quest for actual pain relief, especially in non-pharmaceutical strategies. I asked about acupressure and biofeedback, and Dr. Whitehead indicated that patients could do either one or both by individual appointments with her or Francis. Hmm, I'll have to think about that one.

Many of the members were obviously emotional about leaving our little "community" we've had together for the past 5 1/2 weeks. I'm guessing they don't have a "community" outside their immediate families. They may not live on Facebook like I do! I have already started a new Facebook group called, "Jacquie's Chronic Pain Circle," with membership limited to those who are my Facebook Friends (including Acquaintances). We'll see how that goes!

Day 14 Pain Management

There was no Pain Management on Monday, which was Presidents Day.

Today Francis did the meditation session with affirmations. He then divided us up into two groups to go through the Tai Chi routine with no coaching. I asked about acupressure and he said he would talk about it on Friday. Also, there will be an "after care" class with this group on a Wednesday 6 weeks after this group ends.

After the break, Blanca (from the office) came in and requested us to all fill out a "life-care planning" questionnaire, primarily to identify a primary and alternative person whom we designate to speak for us if we cannot speak for ourselves.

Dr. Whitehead facilitated the discussion, starting with what did you do that was fun over the weekend/holiday? Topics of the day included flare-up planning and maintenance planning. Today was Rachel's last day so Dr. Whitehead gave her "graduation" certificate and we said goodbye to her.

Day 13 Pain Management

I have more pain today, I think after working so hard yesterday afternoon with no break. I opened a new can of "magic" espresso beans and took one.

Dr. Whitehead began with the meditation, this one focusing on body sensations of heaviness and warmth. Great distractions.

Francis came in for the exercises, starting with Tai Chi, only having us do the 10 exercises on our own without his coaching. Then he had us do very gentle head, neck, and body turning to increase range of motion.

After the break, Dr. Whitehead came back. The first exercise was in groups of two. We were to have an everyday, normal conversation without any mention or reference to our pain. The lady next to me asked me if I have any pets, so that opened an easy conversation as I told her about Emily and about Barley. Then she told me about her two cats.

Then Dr. Whitehead asked for "I Statements" to be shared with the group. Only a few had done the assignment, but I did one involving a difficult situation with a web client.

The next topic was how chronic pain affects relationships.

The final topic was to explore your social support system. We ran out of time, though, so I think we're supposed to finish this for homework, along with starting of a general maintenance plan and a flare management plan.

There was no pain group acupuncture today due to Sophie being gone for Chinese New Year.

Day 12 Pain Management

What a horrendous day! Started at 3:30 a.m. when I was awakened by an intense headache (not migraine) and was not able to get back to sleep, even after I took naproxen and used an ice pack. Pain Management class was fine, getting lunch at In-n-Out Burger was delicious, and spending the afternoon with grandson #3 was delightful! (Especially after taking a double dose of pain meds.) But then I log on to Facebook on the way home and find out about the 17 dead in a school shooting in Florida, a longtime FB friend who has had a heart attack, and a sweet trans woman FB friend who ended her life 2 days ago. I am stunned and saddened.

But back to Day 12 Pain Management group. Francis was the first presenter, starting with meditation on "loving-kindness" (being Valentine's Day and all). Then he took us through the 10 Tai Chi exercises and suggested we do it with the video at home. He passed out sheets with motivational quotes. He led in a discussion of more "Tiny Habits." And ended with the "Cupid Shuffle" as he had promised.

After the bathroom break, Dr. Whitehead came in for topic discussion. The first part was on good communication and self-esteem. She discussed the characteristics of passive, assertive, and aggressive. For homework, she assigned us to write out an "I Statement." Next will be discussion of social support systems.

Day 11 Pain Management

Linda has been sick all weekend so I had to drive myself today. Pain Level 4 (though I did have a magic dark chocolate espresso bean). Used neck pillow, turned off air and radio (they were distractions). In spite of several traffic lights being out (and we all had to have a four-way stop on about a half dozen lights), I arrived on time. Presenters seemed to be all-business-no-time-for-nonsense and they got right into the day's activities.

• Meditation (30 minutes) with Dr. Whitehead
• Exercises (45 minutes) with Francis. He started with the full set of Tai Chi (10 exercises) and told us to practice these at home with the video. He then taught us the "Cupid Shuffle" (an easy line-dancing move) and then we did it to music. He assigned 3 additional "Tiny Habits" for homework.
• Bathroom break (15 minutes)
• Discussion (1 hr) with Dr. Whitehead. She started with each group member sharing what "pleasant activities" we did over the weekend. I related the Church 1.0 Movie Day. Someone asked what movie so I told them about Jason & deMarco. 
• Topic of the day was resilience. Dr. Whitehead talked briefly about challenging any negative "core beliefs" we have. We read an article together and talked about "coping strategies." Homework assignment is to complete the Intentional Happiness Worksheet of writing 3 things that went right and our role in making them happen. Every day for 7 days.

Pain Group Acupuncture #2

Sophie was running a few minutes late today, but she did arrive and got us all settled. I moved my chair back against a wall so I could lean my head back against the wall. She started on the other side of the room and I was the last to get the needles, so that meant I would have 30 minutes of "needle time." She reminded us that she would not be here next Friday because of Chinese New Year. Then, as she inserted needles, she talked about Chinese New Year and China and how it was for her growing up in China.

I started my breathing before Sophie got to me and made sure I scratched all the places on my face and head and arms that usually itch. After I got my needles in, I continued the meditation with a beach scene. Whenever I felt an itch, I approached it with my own adaption of Dr. Arlene Taylor's famous phrase, "Your opinion is none of my business." I said to my itch, "You are none of my business," then I focused on somewhere else on my body that didn't itch. It must have worked; I think I even dozed off a couple of times. Even though it was only 30 minutes, I felt very refreshed and extremely relaxed.

Day 10 Pain Management

Meditation with Dr. Whitehead. Guided imagery of beach scene, my favorite.

Exercise with Francis. He started us off with three Tai Chi exercises and told us to go through all 10 with the video over this weekend. He added 3 new core exercises to the first 7: calf stretch, fold-over, and leaning forward from hips. We then did a circuit with all 10 and cardio in between each one. Homework: He passed out a handout and assigned us to do 3 of the "Tiny Habits" exercise using 3 of the core exercises.

Dr. Whitehead's discussion topic was a continuation of "Track Your Thoughts." She used real-life examples from group members. The focus of this exercise was that we may not be able to change a situation but we can change our reactions/behavior to it. Homework: Do two pleasurable activities over the weekend.

Day 9 Pain Management

Today is Alex's second birthday. I failed to get my phone before we left the house, so I am starting this blog with a pen and notebook while in the Kaiser waiting room. (Hence, no pictures or check-in.)

One discovery is that the "Chin Tuck," which can be done any time and in any position, is instant pain relief! For the 5-10 seconds I can hold the "Chin Tuck."

I'm in my second week of gabapentin, having added an a.m. capsule to the p.m. capsule. Still afraid to not take the full 600mg of Advil twice a day. I keep wondering if meloxicam would be any better than Advil or Aleve, which apparently I'm not supposed to take with gabapentin.

Francis started the 10 a.m. session promptly with meditation. I could definitely hear his instructions over the music! Then he discussed our homework to create a 20-minute routine with the 7 core exercises (repeating 3 of them twice) and interspersed with 1 minute of cardio. Then he spent the rest of the time on Tai Chi, using the 10 exercises in the video he introduced to us earlier. Homework is to read "Tiny Habits" handout. The idea is to add a "tiny habit" to some behavior that you are already doing.

http://www.success.com/article/tiny-habits#sthash.s3mkvDO7.dpuf

Dr. Whitehead's discussion topic was reactions to stressors. She started with the Cognitive-Behavioral Model of Pain. Then we did a class exercise with this, giving a specific situation then listing feelings/mood, symptoms/body response, behaviors, thoughts, and then a "new plan" of action that would better deal with the stressors. Our homework is to do one of these on our own at home.

Throughout these presentations, the Kaiser model of prevention comes through loud and clear!

Day 8 Pain Management

Meditation (half-hour) with Dr. Whitehead. Then exercise with Francis, to review the 7 core exercises. Emphasized benefits in strength, flexibility, coordination, and balance. He added in "Cardio" which he defined as any movement in place that will increase your heart rate. He taped 10 pictures of the core exercises on the walls around the room. He then instructed us in doing a "Circuit" with 1 minute of each of the exercises, interspersed in between with 1 minute of "Cardio" for a total of 20 minutes. Homework is to develop this routine at home for a 20-minute "Circuit" done multiple times during the day.

Dr. Whitehead facilitated the topics of the day, first a review of "mini-relaxation" exercises (primarily breathing and visualization). Then a reading and discussion, in class and small groups, of "Radical Acceptance." (Google it if you want more in-depth information.) In our small group discussion, we called it "emotional and intellectual honesty." Dr. Whitehead liked that.

Office Visit with Francis, Physical Therapist

Francis was prompt at 9:00 a.m. And I was ready. He spent a full hour with me, starting with a general overview of my current pain history. He was very thorough and professional and very holistic, asking me about other facets of my life, besides mobility, such as social and emotional factors. I asked him about Spinal Decompression Therapy and mentioned his interest in ketogenic diet (which he admitted was just something he was exploring). He was very careful with his answer.

Then he did a brief evaluation of my range of motion in not only my neck but arms, core, and legs. Then he could be very specific in what he recommended in the way of exercises that would target my neck pain. He went through each exercise with me, moving my head, neck, arms, and legs correctly. He then had me do a full set (10 reps) of each one. At the end, he asked me if I wanted to write them down. (If he had not said that, I would have asked him to review each one so I could write it down.) All 3 exercises can be done in bed (or, more correctly, on the bed), and he recommended that I do the full set first thing in the morning, before I get up for the day, and then twice more during the day (midday and evening). He stressed doing the exercises SLOWLY and only to the point of pain (not past it.)

He started with making sure I knew how to do the "Chin Tuck" and while I did that he placed his hands at the base of my skull and pulled upwards. I came to realize that the motion of the "Chin Tuck" simulates the decompression action he was doing at the base of my skull! The 3 exercises are:

1. Modification of one of the 7 core exercises: Lie on back, knees up, turn left including core and right arms, while keeping chin tucked. The "Chin Tuck" is instead of turning head to the right since that is painful for me. 10 reps.
2. Lie on left side, circle right arm clockwise (like a windmill), then reverse direction to counterclockwise. 10x each direction.
3. Lie on back, "Chin Tuck" while turning head to the right (only up to the point of pain, not past.)

At home, I did the exercise set before my midday bed rest. I am totally amazed at how much lower my pain level has been all day since my morning session with Francis! And whatever he did in the way of manual spinal decompression.

Pain Group Acupuncture #1

Finally met Sophie, the acupuncturist, who conducted the group acupuncture session. She was not there on the first Friday of the program (January 26) and will not be there on the 4th week (February 16) due to Chinese New Year. So we will get only 3 sessions instead of the "usual" 5.

There is no co-pay up front; attendees will be billed by Kaiser.

The room was set up with 2 chairs per person, 2 pillows, and all were facing the center of the room, with the back of the chair against the wall. We were each given a hospital blanket and instructed to "get comfortable. Sophie gave a long and complete explanation, that included:
Acupuncture is to:

1. Reduce inflammation
2. Enhance circulation
3. Detox (especially from medicines that are no longer as effective). The detox process is to remove any traces of the medication and allow you to "start over" with that medicine so it will be effective again.

Sophie pointed out that the acupuncture sessions held with the Level 3 Chronic Pain group are more intense than the regular acupuncture groups (the ones I previously attended).

1. To made medication more effective
2. To address emotional stress and increase relaxation.

Another significant difference is that Sophie used 14 needles instead of just the 10 in the ears. The 4 extra needles were for 2 in each arm. It's difficult to remain still for even the 25 minutes we had today, to ignore any itches on my face or head and to keep from moving my mouth (because, as Sophie said, any movement in the mouth also moves the ears!). Only 2 needles fell out. Next time I'll move my chair close enough to the wall to be able to lean my head back against the wall for support.

Day 7 Pain Management

With Francis:

• Meditation & Breathing
• Exercises (with breathing)
• Homework:
• Exercises 5-7 (in addition to 1-4)
  
  • "L" (backside stretch)
  • Wall plank
  • Lying down "bridge"

Most in the group have lower back issues
All 7 exercises are included in yoga and tai chi

Introduction to tai chi (10 exercises) - lots of arm movements
Find video on YouTube:
10 Simple Tai Chi Exercises in 10 Minutes - Daily Tai Chi for Beginners
https://www.youtube.com/watch?v=RYzBbo0462s

Second half of today's session presented by Dr. Whitehead. As she talked, it occurred to me that this is actually group therapy for chronic pain sufferers.
Topics for the Day:

• More on insomnia. Made 2 lists on whiteboard: things you cannot control and things you can control.
• Stress/Relaxation responses. Goal is to find a balance between the two.
• Homework:
  
  • Participate in 2 pleasurable activities
  • Do relaxation exercises