Debbie is a 45-year-old woman who I have worked with for about four years. She was diagnosed with a severe bipolar disorder at age twelve.
About 10 years ago she had a lifting injury at work and advanced persisting low back pain. Over a series of eight years she underwent multiple low back surgeries. It began with a laminectomy at L5-S1. About a year later a fusion was performed and it did not heal. She then required other surgery to repair the fusion. Her back pain did not improve and in fact worsened. Her fusion was extended up to L4-5, which still did not improve her symptoms. In an endeavor to improve the outcome her screws and rods that had been place to generate the fusion were removed and bone spurs were trimmed away from her nerve roots.
Book
Up to this point she was not my patient. I had assisted on her last operation that was done on a Wednesday morning. I was the on call surgeon for my orthopedic group the next weekend. I made rounds on her about noon on that next Saturday. She was in a lot of pain and was not intriguing her legs. I plan it was probably just from the pain and turned colse to and walked out of the room. About five minutes later I turned colse to and re-examined her. I still could not tell what was going on so I ordered an accident Mri. By some unfortunate opportunity she had a huge disc rupture at L3-4 just above where we had done the surgery at L4 to S1. We took her to surgery immediately and excised the disc. She ended up paraplegic.
Over the next 18 months she advanced repeated bladder infections requiring several urological interventions. She additionally had yet other major spine operation to enlarge her fusion up to L3-4. All the while her pain did not abate.
Life became progressively worse. She had to fight with the state for basic healing coverage. She had small house support. There was a neighbor who was extremely difficult to get along with. I don't think there a word in my vocabulary to present the depths of her anger and despair. I would see her on a monthly basis utter some sense of buildings and deal with need for pain medications.
She was open to the Docc protocol and to reading the book draft that I have been emailing to my patients. The book lays out a detailed plan addressing most of the variables that work on their perception of pain. The one tool she engaged in with a vengeance was writing down her negative thoughts and throwing them away. In the midst of all of her bladder and healing issues, I would see her back monthly and to refill a stable dose of pain and sleep meds. As I was able to improve her sleep she felt somewhat better. With the writing her pain also began to diminish. My role was to guide her distinct directions with the writing and other reading resources. I tried for a year to get her to a pain psychologist but the state would not cover psych services.
I was feeling pretty good about the enlarge she was making. Her pain was at a manageable level, her healing issues stabilized, and she began to get definitive medicine for her bladder issues. I was ready to plainly utter her program, then it fell apart.
She got sick from her bladder infections. The fighting within her apartment complex became more intense. Her pain level shot straight through the roof. She was so angry I did not know what to do. So we had it out. My point was that her life was not bad it was terrible. She had every right to be extremely angry. I would present her mood as rage. I confronted her with the idea that the energy she was burning being angry was the energy she needed to solve her problems. Our conversations were blunt and she became even angrier with me as I was "not supportive". I acknowledged her right to be angry but it was still destroying her.
The more legitimate your anger the harder it is to let it go and the more destructive it is to your sense of well- being. Additionally it was unquestionably firing up her pain pathways. She was also upset with me because I would not growth her pain medications.
Whenever your peace of mind is dependent on external circumstances you are at the mercy of those circumstances. For three months we went at it. Every conversation began with her ranting about all the things that were wrong with her life.
Meanwhile I ran over a book, Forgive for Good by Fred Luskin. His book is based on his contact doing several major study projects at Stanford University on the physiological effects of anger and forgiveness. One of his projects complex studying parents who had experienced the bad dream of having a child murdered. As much work as I had done on seeing at my devotee role of playing a victim this book unquestionably shook me up. He is very blunt on the effects of anger. You either have to truly forgive the man who wronged you or pay the price. Last summer I gave Debbie this book. She had continued to do her writing exercises and work with the "Feeling Good" book.
About four months ago she came in smiling. Her demeanor was dramatically different. She was pleasant and engaging. There was also a marked decrease in her pain. I don't know exactly what happened, as I am not a advisor and my role is more of a coach. I had just held out the idea that although she unquestionably was a true victim there was nothing that was going to change. She was constantly paralyzed. She had long-term persisting pain and she had no real ability to improve her financial situation. I had been discussing the role of anger in flaring up her pain, but her anger was so deep she could not hear me. To her strong reputation she could still hear me sufficient to read "Forgive For Good" and she got it. With the same commitment she had engaged in with the Docc scheme she embraced his concepts and did the exercises Dr. Luskin had recommended. Forgiveness is not an intellectual exercise. It also takes awareness and admission that anger is a problem. It is difficult to let go of "being right." Somehow she did it.
But what was striking is that her bipolar symptoms essentially disappeared. Her anxiety diminished and she came off all of her bipolar meds. She re-established a relationship with her house and several friends. Her house is planning on helping her buy a computer. It is leading to her to begin to reach out and help others who are in a wheelchair and in pain. She is beginning to generate a life for herself.
Initially I did not believe her and every month for the last six months I kept request her the same questions about her ability of life. She is very clear that she is happier in wheelchair than she was when she was bipolar and able to walk. Her pain continues to steadily diminish.
Her case is one of the most surprising and rewarding situations I have witnessed in my practice. I will give myself some reputation for sticking with her although I was unquestionably ready to extraction her from my care several times. It was her being open to new ideas and committing to herself to seeking real convert that made the difference. I offer the same tools to all of my patients but only a small percentage will engage with the concepts.
Sustained anger will destroy every part of your life that has value. It also intersects with pain pathways. Make a easy choice. Let it go!!
Defeating Bipolar Disorder - One Woman's Journey
ไม่มีความคิดเห็น:
แสดงความคิดเห็น