Injured Reserves

Just read this on the climber's blog this morning and was struck by how closely it conforms to TMS and the operation of the Dr Sarno's "symptom imperative" phenomenon. I know this woman (who will remain anonymous of course), and I also know that she began suffering lower back problems 30 years ago at the time she was researching her Ph.D. dissertation in biochemistry. Ever since then she's constantly been going to chiropractors and massage therapists during the winter months to "tune her up" for climbing during the spring, summer and fall. I remember her last rotator cuff surgery too: the pain wouldn't go away for a year and then she elected for surgery. Only now it's back, only on the other side.

All I know is that if I even hint mildly that her symptoms are psychogenic and emotional in origin, she flies into a towering rage while touting all the numerous benefits of chiropractic medicine. And what about personality traits? Perfectionist and goodist, who really wants to be liked and popular within a group context. Likewise, you can see why her surgery will probably result in a positive outcome: she loves her surgeon and believes in the surgical procedure. But you notice too that she's having the operation to eliminate the pain, just like before. To my mind, having surgery just to eliminate the pain is not exactly ethical unless there is some underlying tissue injury that needs to be corrected.

In this same string on the climber's SuperTopo blog I also see where a Colorado climber went in to see the orthopedic surgeon because he had a minor pain underneath his shoulder blade. Voila! To correct what sounded like a minor ache, he would up having double spinal disk fusion after the MRI showed that was the underlying problem. Only during the surgery, something went wrong, he went into cardiac arrest and had to have a tracheotomy! From a little ache under the shoulder blade to cardiac arrest and tracheotomy - is that progress?

Don't get me talkin'! I swear that SuperTopo climbing blog is like a TMS rogues' gallery. Hard driven, narcissistic, perfectionist, over-achievers who want to gain acceptance and popularity within a peer group seem to constantly be having operations and procedures to correct aches and pains in their shoulders, backs, elbows, hands, knees and feet. In Boulder, Colorado it must constitute a mini-industry fired by word-of-mouth referrals by people who feed a rumor mill about which corrective surgery or procedure to have to clear up this ache or pain.

I could go through this string, of course, and pick out tons of examples suggestive of TMS, but there are just so many, I'll let my fellow TMSers indulge their curiosity by posting it here:

http://www.supertopo.com/climbers-forum/1851247/Injured-Reserve-List

 

I went to a chiropractor years ago after falling on some icy stairs and landing on my back on concrete steps.
I think I healed myself with hot baths and a portable jacuzzi, and the back adjustments may just have been a placebo.
But the chiro had me coming back like a homing pigeon for days, then weeks, then months, into years.
I decided I didn't like any medical care that would never end, so I stopped going. Funny thing was, I didn't have
to pay him much. After a while, it was just a dollar a visit. Who could resist that?

 

Its memes and beliefs in all they think they know BruceMC , sad to say and unaware.
I do see these ads and I just feel the same as you pal, some how- some way-
We will let them know the truth,
The lady might get a good placebo, hope so.
But I see your concern and wonder is they will understand that just cause you've never
been taught what we teach doesn't mean its not true.
on the contrary mon frair.

 

I've never climbed a mountain, but I did walk down from one, in Austria,
and it was one of the most wonderful, beautiful experiences of my life.

I was in the army in Germany and took a two-week leave to Austria
and Switzerland. I visited Landek, a village where my mother was born,
along the Inn River in the Arlberg Alps. From there I took a short bus ride
along the river to a village called Ladis, and then a ride up the mountain to
Prutz where my mother's mother had been born and lived for years.

An old uncle from Chicago was visiting Landek and went with me on the
bus ride up to Prutz. After he showed me around, dark clouds were building up and
we figured rain was coming. There was no way to get back down the mountain to
Ladis except to walk, so we walked. We were still high up on the mountain when
we saw an old woman cutting hay with a sickle. I asked her if that wasn't hard
work and was she tired? She stopped, smiled, spread out her arms, and said,
in German which I understood, "Would you be tired, working up here?"

I hope those who posted about TMS pain will be over it soon so they can climb
more mountains. It must be a great feeling.

I also remember the song from "The Sound of Music" ... "Climb Every Mountain."
So inspirational.

Good luck getting back to mountain climbing. Keep at TMS and you will be soon.

 

I love that, Walt!!

 

.."Back like a homing pigeon..." oh, that made me laugh, Walt. Years and years and years of chiropractic services for this girl. I questioned deep in my heart over the non-ending nature of my appointments but you really do get swept away in the script. It all makes so much sense. But no more. All this unlearning to do!

Bruce, there is a person in my life who is TMSing something awful. It is painful watching her struggles and resignation to the doc's non-fatal, but very gloomy verdict. She's open to mindbody but only on a very superficial level. A huge does of religious walls and denials takes it to a new level....

 

Yes, Walt it does sound like the chiro was selling you an addiction to a placebo. At least, it was only a dollar a visit. However, I've seen where chiros are quick to sign you up for a year of visits for a one-time $1500 credit card swipe. Gotcha! One trick they have is to take an X-ray of your back and then post it on the wall in front of the examination table where you're laying stretched out. Then, the chiro, dressed in a white medical uniform, explains to you, the patient, how with all the "subluxations" visible in the X-ray, you're going to be paralyzed like a hunchback in five years if you don't sign up for a year's worth of spinal "adjustments". You got off cheap.

MontanaMom, the situation you describe where the patient is drawn in by the doctor's pessimistic verdict is indeed very common. See Steve Ozanich's chapter on self-fulfilling nocebos. But the woman in my SuperTopo posting is certainly not stupid; instead, she was a high-ranking scientist at Genentech at least up until the time of her recent retirement. There's a big stressor right there, retirement with a capital R. But she's been going on with this chiro, deep tissue massage, surgery business now for close to 30 years even though she's aware of the placebo phenomenon. Even someone who should know better has been drawn into the web of physical treatments for essentially psychological conditions.

I've been back to climbing for a good long while, Walt. Only problem is that until quite recently I wasn't climbing pain-free. Now I am. That's a big step in the right direction me thinks. But it certainly isn't just climbers who are getting caught in the PT-surgery industry that resides in Boulder, Colorado. Boulder is the home base for every outdoor athlete in the US and is, as a result, filled with doctors and surgeons who specialize in sports medicine. Seems as though the whole town is full of people seeking the latest treatment for their latest sports injury. But it sure sounds like 90% of those injuries have a strong TMS component. But what do I know?

 

Bruce, you know a lot. I'm glad you can climb pain-free.

We have a number of sports injury doctors and clinics here in the Chicago suburb I'm in, Glenview.
Not a mountain Illinois, but lots of runners and gym-goers. I never saw the need to go to a gym to work out.
I get my exercise walking my dog and doing house and outdoor chores, like mowing the lawns front and back,
raking leaves (I should have known better than to buy a house beside a cottonwood tree!) and snow-blowing in winter.


I have friends in Boulder. Do you know Bob and Susan Morgan? He's retired but she paints beautiful portraits of dogs.

 

Gigi, that mountain visit in Austria was only one day, many years ago, but it is still in my
memory like yesterday. What a beautiful country. I was lucky to have visited my mother's
birth village, and also Vienna, Salzburg, and Innsbruck.

 

Last time I was in Boulder was in January 1997 while I was on contract with a telecommunications company. I spent most of my time in house staring at a PC screen banging out another manual . Didn't get to socialize very much as I spent all my free time on weekends either bouldering on Flagstaff Mountain or road biking over mountain passes in the Front Range behind town. Funny, though, I do seem to recall seeing some dog pics in a studio on Pearl Street. Could have been some of Susan's work. Boulder does have rich cultural life, but while I was working on multiplexers, I sure didn't get to enjoy much of it. I did get free movies in the executive suite!

 

Movies are one of my passions. I practically grew up in movie theaters as a teenager during World War II years.
I've been collecting my favorites on DVD. Oldies and some good new ones. I have some classics about mountain climbing.

 

During the 1930s, my late father survived in the movie theaters on Market Street in San Francisco because they always had a free lunch and raffle tickets for prizes at the door. So even during the 50s when I was a little kid, my father always took me into the grand movie palaces like the Fox Warfield. His generation had a passion for classic cinema. I was too young to appreciate it at the time, but at least I was exposed to that culture even as it was in decline. Now, the walls of my father's library are lined with books on movie stars of that era. And someone was saying that kids today are too preoccupied with the media? During the 1930s, that was the only form of escape people had when the unemployment lines were stretching around the block. Everyone back then knew all about Vivien Leigh, Clark Gable and Gretta Garbo. Hard times make people want to escape into entertainment.

 

I escaped into the movies in the 1930s and 40s but they were worth escaping into. Many movies were based on classic books. Nobody writes a good novel anymore, just about vampires. I learned as much or more from those old movies than I did in school, about people of different countries, history, etc. Today all kids learn from the movies is how to blow each other up. Back in the 1960s and 70s there was a scare that Communists had infiltrated Hollywood. I don't think that ever really happened, but I'm wondering about if terrorists and other enemies of the western world (read U.S.) wanted to destroy us (young minds, at least), the movies and television today would be a good way to do it. I now mainly watch British and foreign films. They're about people and relationships and social issues. They can be fun, too. Best thing I've seen in years is the BBC Masterpiece Theater series,
Downton Abbey.

 

Stick with Aeschylus, Sophocles, Marlow, Shakespeare, Moliere, and Chekhov. Only the big themes! Stay away from that guy Euripides, though; way too lurid, sensational and bloody! Aristotle did say that 'spectacle' was the lowest form of drama, but he learned that in the theater of his own times. The more things change, the more they remain the same.

 

In particular, I like this quote from the Injured Reserves string on SuperTopo:

Just so many quotes on this string that assume that if a MRI shows a herniated disk that's the real structural reason behind any symptoms they're experiencing. You have to wonder about what role emotions would have had after a year of not climbing. Self-imposed stress? That IR string is just choke full of TMS goodies like that. Many of the contributors to this string seem to be overjoyed when they have a herniated disk or bone spurs to blame for their pain condition. It's like they've all been sold a bill of job by the sport medicine "industry" that a structural abnormality in the spine automatically results in pain. It's like they're relieved to have a herniated disk turn up because they confirms everything they've heard and been told.