Re: Mayo Pain Rehabilitation Center

[Guest guest]

Hi

I am so glad your trip to Mayo was worthwhile. They teach things there

that I was taught way back when in western Canada. Keeping active,

being as physically fit as possible, cognitive behavioural therapy,

weight control, and on and on are the things that have kept me going

over the years. Being in work where I daily get to see people, who

don't do these things, has helped a lot too.

I purposely went without medication (except for migraine) for many

years. I have had to go back to using medication over the last few

years. Unfortunately, my pain refuses to cooperate with my blood

pressure. It's been a fine balancing act to get the right combination

of exercise, mind set, and medication to keep me going as I do.

I regularly urge my clients to get more active. Alas! Too often that

message falls on deaf ears.

I'm leaving your full post attached to my reply - just in case someone

missed your message. It's a very worthwhile read. I encourage everyone

to read and take away what you can use from 's post. It has good

info in it.

Lyndi aka Lynne

Moderator

wrote:

> I promised I'd write about my Mayo Clinic experience. I had hoped to send

emails as I went, but I was just too darn tired and busy with homework to even

read my email. Sorry about that. Anyway here is what the Mayo Pain

Rehabilitation Center is all about. Or at least what I got out of it.

>

> 1. Philosophy. There are some critical assumptions about what you will and

will not get from them.

>

> a. No Magic Answers. Almost everyone coming to the program has been to a ton

of doctors, specialists and alternative medical specialists. You've tried all

the drugs. You are probably more of an expert on your condition than most of

your doctors. You've already exhausted the treatment and diagnostic options.

The Mayo Pain Rehabilitation Center does not promise that you will find any

answers to any of your health issues. If you had found answers or something

that worked, you wouldn't be seeing them.

>

> b. Living with Chronic Pain. They assume that you will probably have episodes

of chronic pain for the rest of your life. They try to give you options that

will allow you to get back to your life, get the greatest fulfillment out of

life and minimize how much pain interferes with your life.

>

> c. What Works. The program is based on the latest research based findings

about what works for patients with chronic pain. The techniques are often

different from what your other doctors, including pain specialists, have tried

for you. What many doctors suggest will usually works for acute (short-term)

pain, or if it would have worked for your chronic pain then you would not be

seeking their services.

>

> 2. Activity. If nothing else, they get you up and going for three weeks.

7:45 a.m. to 5:00 p.m. Monday to Friday. They have you scheduled for something

new every hour. It can feel kind of chaotic for new participants. You do get a

schedule. People are coming in and leaving pretty much every day, so there is

always someone who can help you find your way around. There are also

assignments to do over the weekend. Prior to coming to the program, I was

primarily in bed for a large part of the day. Some people were holding down

full time jobs and parenting, others were in bed 20 plus hours a day. By the

end of the 3 weeks, everyone was awake and functioning.

>

> 3. Physical Conditioning. They have you doing a 30 minute stretch every

morning, an hour of physical therapy (stretching, resistance bands, free weights

and either a recumbent bike or a tread mill), and then another 30 minutes of

either yoga or tai chi every afternoon. So that is 2 hours of concentrated

exercise every day. To me this was the most important take away. I would never

have imagined that I could do that much exercise daily. They build you up

gradually but steadily.

>

> 4. Medication Changes. They recommend people get off several medications:

opiates, narcotics, analgesics, sleeping pills, anti-anxiety, etc. They also

help you decide whether drugs used for controlling chronic pain are helping in

your case. This includes neurological drugs like Lyrica, Cymbalta, or

Neurontin. I'm on Lyrica and the higher dose seems to be helping me. They did

suggest changing the timing of when I take it.

>

> Many other people came off the neurological drugs at the same time they came

off the pain killers. Please note: do NOT try coming off any of your drugs

without medical supervision. You can do more damage than good. The goal of

coming off the medications is to help the brain and nervous system function

better.

>

> Too many drugs and/or drug interactions can cause things like: pain

sensitization, concentration and memory problems, daytime sleepiness, insomnia,

nausea, diarrhea, constipation, etc.

>

> The newest concept for me was the increase in pain sensitization caused by the

use of opiates/narcotics. The nervous system (brain, spine and/or nerves)

basically becomes over-stimulated and overly sensitive to all stimulation. The

use of the opiates in acute (short-term) pain reduces the pain sensitization,

but in chronic (long-term) pain the opiates actually increase pain

sensitization.

>

> As a demonstration, they put a heat sensitizer on your hand when you begin the

program and again at the end of the program. It blows heat over the back of

your hand.

>

> The first time I did it, I had to have them stop since the back of my hand

felt really quite burned. Three weeks later, I had no problem. Nothing felt

very hot. Same stimulation but my nervous system quieted down in such a short

period of time. Amazing.

>

> That does not mean my nervous system has returned to pre-chronic pain levels.

Unfortunately, for some people Mayo states that it can take the nervous system

six months to two years to fully reset. So what that means is that your pain

might increase as you come down off the opiates and that it could take you six

months to two years for the nervous system to go back to normal.

>

> They do teach you coping techniques (see CBT cognitive behavior therapy below)

to help with the adjustment. Most of the participants did not have any problems

easing down off the pain medications and most of them felt significantly better

when they left after the three weeks. Unfortunately for me, my pain has

increased and routinely interferes with my sleep more.

>

> On the positive note, I am much clearer headed, am not napping during the day

and am so much more productive. Also my pain routinely interfered with my sleep

when I was on the opiates. So, for me, the trade offs are more than worth it.

>

> 5. Cognitive Behavior Therapy. Explores how thoughts impact feelings,

behaviors and physical symptoms. For example, thinking I cannot cope with this

pain is likely to continue to focus on feeling like you have no options,

depression or anger; while behaviors that might manifest are avoiding

activities, staying in bed, calling in sick or isolation; and the physical

symptoms might be: physical deconditioning (loss of muscle tone, strength and

endurance), increased pain (because now everything takes more effort to do).

lack of self-care activities (showering, healthy eating, laundry).

>

> Whereas changing your thought to I do have some things I can do to help with

my pain, for example deep breathing, distraction, relaxation or moderation

techniques will likely change your feelings to empowerment. An ability to cope

or elevated mood; behavior changes might include being more engaged, not staying

in bed all day, going to work or engaging in activities with family and friends.

>

> Physical symptoms that might manifest include physical reconditioning

(increase in muscle tone, strength and endurance), decrease in pain (since you

are in better condition) and more self-care activities.

>

> They also suggest strongly that you do not talk about your pain and physical

symptoms as much as most of us probably do. Rather get involved with some other

activity and focus on that: your kids/grandkids, other people's kids/grandkids,

gardening, reading, playing or watching basketball, concert, plays, museums,

> volunteering, work, pets, woodworking, whatever.

>

> Then when people ask how you are doing you can say I am doing better. Did you

catch that game last night? Then you are not focusing on the pain, they are not

focusing on the pain, and you are reestablishing those normal behaviors.

>

> 6. Safety Net. With doctors and nurses on staff & an ER in the next

building, they provide a safety net. I had fears that with all the activity and

changes in medications that my pain might sky rocket, the pancreatitis would

flare up again and I would lose any ground I gained. I was not alone in my

fears. However, I am happy to report that I did not lose ground nor did my

pancreatitis flare.

>

> I highly recommend the Pain Rehabilitation Center program at Mayo. If you

have any questions or want more information, please contact me at:

lnelsongreen@....

>

[Guest guest]

Thank you for great info. I am looking into it.

>

> --- Warning: long post ---

>

> I promised I'd write about my Mayo Clinic experience.