It's a Great Time to Have Chronic Pain (Part III)

In the last couple posts I've shared the story of back pain beginning in my mid-20's and the turbulent experience of treating this pain with a mind-body approach. When I left off in Part II of this series, I was explaining my difficulty adjusting to parenthood and the corresponding increase in my pain symptoms. After struggling to find a good fit near my house and place of work, I decided to return to the therapist I had been seeing during the initial confrontation with back pain I described in Part I.

It was certainly good to be seeing a therapist who I felt understood me & my history well. Even so, I unfortunately did not find the relief from back pain I had hoped for based on our sessions years ago.  I was feeling lost & hopeless with regards to ever finding relief.  I eventually began questioning my self-diagnosis of TMS, but some attempts at other treatment methods proved fruitless as well. I kept coming back to TMS as the only plausible solution, if only for the fact that it had been the only approach that had worked in the past.

I really thought returning to that particular therapist from earlier in my life would be the answer, but obviously I couldn't give up. I longed for TMS to become more widely known in the general public, and for a mind-body approach to healing chronic pain to become accepted in the medical community. I figured that would mean more TMS practitioners would start popping up, and some might even become available in my city. Many in other areas do currently offer Skype sessions, which I did try but found to be a format that didn't really work well for me. I needed the TMS treatment approach to become more mainstream, both for myself and because I felt it could help so many others. But I had also hoped this would happen years ago when I was first exposed to the concept, and it seemed not much had changed.

In an effort to understand TMS & its treatment better, I once again began digging into The TMS Wiki and reading more books by people who had successfully recovered from or treated TMS. It was around this time that I started to get a sense that perhaps a shift was indeed happening with regards to TMS in the arts & media:

• A documentary which had been in the works for over a decade was released in the summer. It's called All the Rage and contains interviews with celebrities such as Larry David and Howard Stern, in addition to lengthy screen time with Dr. Sarno. The filmmaker weaves his own pain story into the documentary as well.

• A book called Crooked was published on May 9, 2017. Written by journalist Cathryn Jakobson Ramin, it details the findings of an in-depth investigation into the back pain industry, inspired by- you guessed it- her own struggles with chronic back pain. While second half of the book, which deals with treatment, still focuses on physical solutions (although Dr. Sarno is featured in one chapter), the first half of the book does an excellent job of exposing what an ineffective, money-sucking behemoth the current back pain industry has become.

• TMS Practicioner Alan Gordon appeared on the CBS show "The Doctors." Admittedly, I would be skeptical of this story, had I not seen crazy changes in my own symptoms that cannot be explained by physical interventions. Believable or not, the story ended up being the catalyst for a groundbreaking study currently happening on the treatment of chronic back pain, due to the fact that Casey's fMRI's (images of his brain) were in such stark contrast before & after treatment.

• A mobile app called Curable was released. As the Curable website states, it "provides you with the tools used by doctors to reduce chronic pain caused by TMS." The founders of the app all overcame chronic pain of some sort using a mind-body approach. It's great to see another medium for people to utilize these treatment methods- I'm especially impressed with Curable's clean and modern branding. Curable also gained exposure in a Tech Crunch article written by journalist Jon Evans about his wife's recovery from migraines using the app. The Curable team also produces a podcast (oh how I've been waiting for something like this!) called Like Mind, Like Body, featuring some big names in the world of mind-body pain treatment and related fields, as well as success stories.

As you can see, a lot has happened in the past year in the world of TMS. These developments, and a sense of the public's growing dissatisfaction with our current treatment methods, are what brought me to the title of this series of posts.

As for my own progress? I mentioned that the return to my old therapist was not the magic bullet it had been the first time around. Fortunately, about 5 or 6 months after Dean was born, my symptoms did at least lessen. I can't say with certainty, but I believe it had to do with stability. Our sleep improved, I started to adjust to a completely new way of life, and I came up with new ways to implement self-care. However, I am not where I'd like to be- my back still hurts many days, especially near the end of the work day or while traveling. I realize this is not the inspiring success story that many TMSers like to share, but the truth is my recovery is still a work in progress.

It's a Great Time To Have Chronic Pain (Part II)

Last August I shared a personal story of my struggle with back pain. I had gone through my own version of the hero's journey and come out stronger. But as I alluded to, there's more to the story. In spring of 2016 Jennie & I found out we were pregnant. It was exciting but I definitely had plenty of fears & hesitations as any first-time parent does. We went on a "baby-moon" to South Korea, got the baby room ready, took a birthing class, and braced for impact.

Our son Dean arrived in January 2017 and he is about all new parents could ask for. Smiley, curious, friendly with strangers, and handsome like his dad. But parenthood is obviously not without its challenges. The new demands of a newborn baby, perhaps in addition to my aversion to change in general, were a shock to my system- physically and emotionally. Free time to write, read, and exercise was suddenly extremely hard to come-by. These and other methods of self-care that I had in recent years come to realize were so important for my mental-health and well-being, needed to be set aside for the needs of this new life.

Obviously, our marriage relationship took on a new dynamic as well. No longer were we able to spend long chunks of time giving the other our undivided attention. Naturally, each person directs much of their energy and availability to the needs of the baby, and this shift requires a time of adjustment by the parents.

Back pain came on strong probably only a couple weeks after Dean was born. I knew this was my brain's way of coping with the new emotional turmoil I was experiencing as these new demands were placed on me. Physical pain was a more socially acceptable form of illness than emotional and served as a distraction from the unconscious rage. The problem lay in figuring out the best way to treat it.

I made what in hindsight was probably a mistake by trying to find a new therapist. I was looking for someone closer to home to make appointments easier to fit into my schedule. But finding a new therapist is an endeavor in itself, and the search seemed to add stress instead of the relief I was seeking. I struggled to find a good fit and eventually decided to return to the therapist I had seen during my initial bout with back pain.

Around this time I also worked up the courage to sit down with my boss and do my best to explain what was going on with me. This was partly because I wanted my employer to have an idea why I was out for so many appointments, and partially because of my recent shift in thinking. I was starting to appreciate the value of being more open about one's own experiences with mental illness. "Telling your story" can help others going through their own suffering to feel less alone. It can be a source of hope or inspiration. The process may be therapeutic for the person sharing the story. And finally, it helps to destigmatize these conditions. There is definitely still some discernment required. But seeing other people share stories and hearing mental illness discussed more openly has given me courage to do the same. I no longer feel ashamed that I deal with these things, and new this attitude about my situation is what inspired this blog series you are reading right now.

It may seem like I've made a jump from talking about back pain & TMS to mental illness. In my mind, they are all inter-related. Recently I have even seen some practitioners refer to depression & anxiety as other forms of TMS. But that is a discussion for another day. Regardless, when one of the main treatments recommended is therapy, as is the case with both TMS & mental illness, there is a stigma involved.

This seems like a good place to pause for now. In my 3rd and likely final post in this series, I'll share the events of this journey all the way up to the present day, and I promise it won't take me 8 months to get around to it!

It's a Great Time To Have Chronic Pain (Part I)

You'll have to forgive the title. Obviously there's no great time to have chronic pain. I suppose a more accurate title would be "I'm slightly more hopeful that effective treatments for chronic pain are being recognized" but that didn't have quite the same ring to it.

Why am I writing about chronic pain? I have no medical background. No, this is more about my experience as a chronic pain... victim? Too defeatist. Sufferer? More accurate, but we'll just say "as someone who experiences chronic pain".

It's something I've actually wanted to write about for months now. But it's also a hard subject to tackle. Eventually though, when something bubbles up enough, it eventually needs to be spilled. I'll do my best to keep things concise, but no guarantees. It's a difficult subject to tackle not only because it's personal but because it's complex.

My story with pain starts all the way back in 2011. I started having back pain while sitting at work. Nothing in particular provoked it. When it didn't go away, I went to the doctor who referred me to physical therapy. And so began the carousel of treatments which provided no relief. Much work was missed, much money was spent. Frustration and despair grew after each failed treatment.

Finally, about a year later and at my wit's end, I mentioned an approach to my girlfriend at the time (now wife). The testimonies had intrigued me before but the method also seemed to go against everything I thought I knew about how the body worked so I hadn't taken it too seriously. However, after explaining it to her, Jen's simple response was all I needed to hear: "That sounds like you. You've tried everything else. What do you have to lose?".

Thus began an almost religious leap of faith and turbulent journey into my own psyche as I began to treat the pain as psychosomatic (which refers to a physical illness or other condition caused or aggravated by a mental factor such as internal conflict or stress).

The book that introduced me to this approach was called Healing Back Pain by the late Dr. John Sarno. In the book he talked about his realization that many people's pain stemmed not from structural issues, but instead repressed emotions such as rage. He called the phenomenon TMS (Tension Myositis Syndrome). Once this diagnosis was accepted, many patients healed very quickly, often by simply reading one of his books.

Despite significant anecdotal evidence of success, this unconventional treatment did not lend itself well to rigorous clinical trials, and Dr. Sarno was ignored or even scoffed at by almost all of his peers. Nevertheless, for a desperate pain sufferer like myself who's tried just about everything else, I was willing to give it a shot.

I didn't get better after reading one of his books (how nice that would have been). But I still believed that I fit the profile of someone with TMS. The good news is that as Sarno had treated other doctors & medical professionals dealing with pain problems of their own, these professionals then began to find success treating patients in this way as well. The bad news is that the closest one of these "TMS Doctors" was about 4 hours away. And while I came very close to making the trip to see one, I decided instead to move on to the next step which I imagined would be the recommendation of the TMS Doctor anyway- find a psychoanalytic therapist to address the emotional turmoil happening in the unconscious.

I'd been to see therapists before for a number of things (OCD in high school, anxiety and depression both in and after college), but analytic work (think old school, Freud & Jung) was very new to me. New & effective. By cancelling any other sort of physical interventions and simply treating my back pain as rooted psychologically, I was able to find relief from my pain after just a couple months. It definitely wasn't easy (and for awhile the pain also moved to my wrist & I thought I had carpel tunnel- more on that another time), but it was oh so worth it.

Shortly after my symptoms cleared up, I changed jobs, moved, and got engaged. Life was good. And things went smoothly for the next few years as well. Even with the challenges of the new job & stress of wedding planning, I don't recall having to worry at all about pain. In the years that followed, bouts of pain would come up, but introspection into the stresses of my life or a few visits to the therapist would clear things up. I also felt like I since I now knew the source of my pain, I no longer had to fear it. I was managing quite well.

I'm sure my use of the past tense has tipped you off- it's not all sunshine and roses from that point on. When I return, I'll talk dive into the more recent chapters of the David vs. Pain saga.

Update

Well it's been about a month and a half since my last post. I would prefer a higher frequency but that's how life goes sometimes. Safe to say it's been an eventful summer.

I'll start off with the biggie. In June, my wife and I announced that we're expecting our first child! The baby is due in January and we will not be finding out the gender beforehand. Safe to say our lives are about to change like we can't imagine!

In September, my wife and I will also be traveling to South Korea! She was adopted from there at a very young age and has never been back. It's become a bucket list item of hers and as we talked it over, we figured we may end up waiting many years if we didn't do it before the baby arrives. I've since been encouraged by several people to not let having a small child prevent us from traveling, and while I do hope that we do continue to travel, I'm glad we are making this "babymoon" happen nonetheless! Around the time we first began discussing the trip, I had heard a discussion of "travel hacking" on a podcast, and that strategy made the possibility of affording flights to Korea much more feasible.

You may have also noticed a change in the appearance of the blog. I put a link to my blog up on the r/blogging subreddit (wouldn't be a David Bartels post without a reference to Reddit!) and the fine folks gave me a bit of feedback- mainly that it was lacking visually. I had some fun customizing the themes that Blogger offers so you may notice more changes as I continue to play around with the options.

Obviously as my previous two posts discussed, I'd been thinking a lot about financial independence in the early summer. While it's still a goal of mine and something I may come back to, it hasn't been as big of a focus for me during the second half of summer. And fortunately since right now this blog is just a hobby for me I can move on to "the next big thing". I have a pretty good idea about what that's going to be, but it's more fun to be cryptic so sorry, no hints. 

More Thoughts on Financial Independence

In my last post, I gave some introductory thoughts on the concept of financial independence. I touched on what I would consider to be traditional thinking about when someone should retire. To close out the post, I asked why more people aren't retiring early. I claimed the short answer is that it's not easy. Other short answers that come to mind are that we can't afford it or that it's not the way we do things- we should remain a "productive member of society".

Before I go any further, I want to give credit to the places that have been helpful as I've been learning about personal finance & financial independence. They've been instrumental & inspirational as I've developed some new ways of looking at the world:

• The Root of Good blog. I'm not sure how I stumbled upon this one but his post $150,000 Income, $150 Income Tax was especially eye-opening to me. His monthly financial updates have also given insight into how a family with kids can keep expenses low while still living a fulfilling life.
• The Radical Personal Finance podcast. Initially I found this podcast about a year ago simply by searching for a podcast on finance. But I came back to it recently when I saw that there was an interview with Justin from Root of Good. Joshua, the host of RPF, puts out a crazy amount of content.
• The Early Retirement Extreme blog by Jacob Lund Fisker and his book of the same name. I found out about Jacob's work via the Radical Personal Finance podcast. He is an incredibly smart guy. I am halfway through his book so far and really enjoying it. He has a lot of great points but my biggest takeaway from his work so far is a shifting in thinking from "get really good at one thing so I can afford to pay people for everything else I want" to "strive to learn to do a wide variety of things myself".
• Finally, I must acknowledge the work of someone close to home. David Carlson went to my high school and college and has been putting out great content for 4 years at Young Adult Money. Whenever I'm learning about a financial concept I'll often cross-check it on YAM to see if David has anything to say on the subject, and more often than not he's written about it. David is an extremely hard worker and has at several times since I've known him given me encouragement to keep writing.

Now back to the topic at hand. I think it's important to ask the question "why?" in response to the short answers I proposed. Why isn't it easy to retire early? Working 40+ hours a week for 40+ years of your life isn't particularly easy either, but plenty of people do that. I would venture to say what makes it especially "not easy" is that it's not "normal". More to come on this in a future post.

Why can't people afford to retire early? The typical responses might be as follows: "Because the cost of living is too high." or "Because the wealth is all concentrated in the hands of the 1%, and we are lucky if we can get by while putting a small portion away".

The first two answers are complaints about the economy. In the first case the complaint is about the cost of basic expenses in the local economy, while the second case focuses on economic inequality. The political and moral implications of these complaints are beyond the scope of this post. Instead, let's focus on the areas one can have a real impact. In my opinion, one is going to have far greater success in changing their own "economy" than in changing the local or national economy (or waiting for it to change, for that matter). There are certain ways one can go about this. One can relocate and effectively lower their cost of living. I acknowledge there are certain limits which may prevent one from picking up and moving on the spot, but I do think this is more of a short term barrier, especially in the internet age. Maybe you've decided to stay where you are despite the high cost of living because you enjoy the amenities too much to consider living somewhere cheaper. This is fine- just recognize that it is a choice. And yes, there is a large income disparity, but putting all that aside for a minute- is there anything you can do personally to increase your income or decrease your expenses? Voting for the politician that makes better promises regarding taxes doesn't count. I am going to bet that there is at least one thing. And no, that one thing is not going to mean suddenly you are on track to retire early, but it may start the momentum in that direction.

Finally we reach the last short answer- "it's not the way we do things." If you've made it this far you know I'm going to ask "why isn't it the way we do things?" Is it because the government has encouraged arbitrary ages to withdraw from the workforce based on tax code for retirement accounts? Do we trust the government to know when the best time for us to retire is?

Now to address the part about being a "productive member of society". This idea operates on the assumption that having a traditional job is the best way to contribute to the economy. (It also is indicative of our dismissive attitude toward the elderly). I would point out that many people who retire early are often still involved in the workforce in one way or another. It just happens to be on their own terms and may take a less traditional form than we are used to. But isn't it possible that a person working under these favorable circumstances is going to be even more productive? Or let's even say that the early retiree does no work whatsoever and instead lives off dividend income. But maybe doing so allows them to be around for the formative years of their children. Would we not say this is a benefit to society as well?

I'm sure there are plenty of other responses someone might give for why more people don't retire early. But I hope this post has at least got you thinking about the reasons it is so uncommon, and maybe even breaking down some of the assumptions we hold about work.

Getting Acquinted with Financial Independence

The idea of financial independence is something I've been thinking about a lot lately. I recall coming across the term several years ago, before I paid too much attention to personal finance. I figured it sounded nice but was something reserved for the very wealthy. Either you inherited a lot of money or easily made six figures. A person in that situation, I thought, would then be able to save so much money in a short period of time that they would not longer need a job, therefore becoming financially independent. Since I had not inherited a large sum of money and didn't see myself making over 100k anytime soon, I wrote it off as unattainable for someone like me.

Now, while an inheritance & large salary can certainly help in the path to financial independence, what I have come to learn is that they are not requirements, In fact, I don't even think either of those would be considered the number one contributor to achieving such a goal. At the end of the day I think it's more about spending less than you earn, and investing the difference wisely. Now, that's easier said than done. Especially in America. Land of the "upgrade" and the "bundle". So many sources willing to lend me money for the right fee. So many Jones's to keep up with. But I digress.

"Ok", you might be thinking, "but I do save money & invest it wisely. It's call my 401(k)/IRA/Roth IRA/etc. But those funds are reserved for when I'm 65 and retire for good. That could be considered financial independence, right?" Technically, yes. However, I should mention that another term often comes up when discussing financial independence, and that is early retirement. You may come across the acronym FIRE (Financial Independence and Retiring Early). And here is where the biggest shift from the traditional American career arc takes place. Most people can accept the idea of saving  money in a retirement account until 65. Not everyone may do it, but at least they know they should. But to retire before that age? The general response is most likely something along the lines of: "If I were a government worker, then maybe at 55 or 60. Otherwise, you'd have to be crazy to even consider it. We all know social security is heading the wrong direction and pensions are mostly a thing of the past. Medical bills are going to be huge and my kids aren't going to let me stay with them. If anything, I should consider working past age 65."

Are these valid arguments? They are not without merit. You'll often hear reports about the high percentage of people that are not prepared to retire. So I propose the question, "does it have to be this way?" If there's a chance it doesn't, and financial independence and early retirement would generally be considered good things, then why aren't more people doing it? The short answer is it's not easy, but the better answer is more complicated than that, and requires it's own blog post, which will be coming next.

What's Next for This Blog?

I've been thinking a bit lately about what direction to head with this blog. As I mentioned in my first post, I'm committing one of the bigger blogging "no-nos" here by not having a focused topic. But I'm still okay with that for now. For the most part this is mainly a place for me to experiment with writing and maintaining a blog. Other than a few Gmail contacts who get this emailed to them and a few twitter followers, the audience here is really just me.

By the way, I'm finding out that html, while not necessarily difficult, can be very time consuming. The layout here is pretty bare bones but a few things I've experimented with have been a pain. I can't imagine the time that goes into some of the better looking blogs out there and can see why it's so worth it to hire design people.

So, what keeps me coming back? I think part of me just wants to prove to myself that I can keep a blog going beyond 5-10 posts, that this won't end up just another failed venture where the first few posts are easy while excitement is high. I think that if I can get some momentum and stay consistent with this thing it could be very rewarding.

What will upcoming posts be about? I am still playing around with ideas in my head. For whatever reason, I have recently been very interested in learning about the concepts & tactics surrounding financial independence, tax planning, travel hacking, and credit card churning. There is a plethora of personal finance blogs out there, many of them doing it better than I ever could, so while that's not what I expect this to become, at the same time I am going to write about what excites me at the moment. And who knows, maybe writing as someone who's learning as he goes along will help others who are coming from a similar place.

Lastly, I am unsure about what to do with regards to a platform & hosting. I chose Blogger as a platform because I wanted something simple, familiar, & free. I realize Wordpress is probably the standard in that area and I've enjoyed using it in the past but I guess I wanted to change it up. The one thing I most wish these platforms had when creating a post is a "format painter" like you'd find in Word or Excel. But maybe there's a good technical reason they can't implement them.

 At times I contemplate buying my own domain & hosting. I did that once with Bluehost for a Wordpress blog and learned a lot but I remember it being a fair amount of work to setup. I'm sure Squarespace would be an easier but more expensive option if I was worried about having to put too much time into the behind-the-scenes stuff. At this point I'm still leaning toward keeping it hosted here on Blogger while I navigate what things to write about, but I'd be curious to hear from others about the pros & cons of different approaches.