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lidge
USA
184 Posts |
 Posted - 11/01/2007 : 09:55:38
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Question for those who have seen TMS doctors-
Do you think that a TMS doctor can reliably rule out structural causes of pain based upon MRI reports, rather than reading films?
Does Sarno actually read the films or just the reports? I know that he mentioned in his books that certain herniations etc could cause pain in specific instances. I know that the MRI reports can exagerate and overstate the damage and one really has to know how to read the films to see if something really is impinging on a nerve to the degree it would account for severe symptoms.
Just wondering what others experience has been in this regard. |
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kelvin
USA
103 Posts |
Posted - 11/01/2007 : 10:39:33
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quote:
Originally posted by lidge
Question for those who have seen TMS doctors-
Do you think that a TMS doctor can reliably rule out structural causes of pain based upon MRI reports, rather than reading films?
Does Sarno actually read the films or just the reports? I know that he mentioned in his books that certain herniations etc could cause pain in specific instances. I know that the MRI reports can exagerate and overstate the damage and one really has to know how to read the films to see if something really is impinging on a nerve to the degree it would account for severe symptoms.
Just wondering what others experience has been in this regard.
Just curious, where and in which book does Dr. Sarno mention “that certain herniations etc could cause pain in specific instances”? I don’t remember that in any of his books.
In my experience, most doctors (TMS or otherwise) don't actually look at the films, they interpret the report and determine what they think the diagnosis is. The report is not a diagnosis. I personally think TMS doctors just look at them to make sure you don’t have a tumor and to ease our fears.
As for the likelihood that something is impinging on a nerve – that would have to be something very rare like a tumor or an aneurism in a blood vessel and would probably take a CT scan rather than an MRI. I am not a doctor, but after my wife and I going to a host of them and each of us having a multitude of MRI’s – I would never waste money on having another one.
Kelvin
Additional TMS files and links http://kelvin.gunnells.net (may not work with FireFox browser) |
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lidge
USA
184 Posts |
Posted - 11/01/2007 : 11:03:31
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Kelvin- I can't recall off the top of my head, but doesn't Sarno say in one book that while pain from a pinched nerve is unlikely to cause pain, if the space was totally obliterated etc. it might?
The reason I thought it would be helpful for a TMS doc to see the film, is that lets say, as in my case, with the herniated L4-L5- it says "mild disc bulge with superimposed central disc herniation present impressing upon the ventral thecal sac"
and with the cervical spine there is "diffuse osteophyte formation stretching across the entire spinal canal, flattening the ventral surface of the thecal sac (this is at multiple levels)
Also says in the neck- "broad based left paracentral osteophyte and soft disc herniation causing stenosis of the left lateral recess and proximal left foramen and flattening of the left side of the cervical spinal cord"
The question is without seeing "how much" the spinal cord is being impacted (or nerves) how could anyone give you an informed opinion based upon the report itself- you really do have to see the films.
There is no tumor.
I'd have to look back in the books for Sarno's precise wording. I seem to recall that he will admit that osteophytes and herniations while normal abormalities, can cause pain if it narrows the space enough.
Am I mistaken? Sorry for dwelling on the physical but I'm really overwhelmed with the pain at the moment.
P.S. What puzzled me is that the pain in the neck is on the right, whereas it seems most of the "bad stuff' on the left! However neurosurgeon saw pinched nerves and didn't really think this was contradictory.
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lidge
USA
184 Posts |
Posted - 11/01/2007 : 18:21:54
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Kelvin-
The part I refer to is pg. 90 of MBP. Sarno is debunking the pinched nerve from an osteophyte as a common cause of pain - but he does say it can occur- though rarely (it would have to totally obliterate the space he says). I would love for someone that understands MRIs to actually look at the film and tell me whether the encroachment is large enough to account for the stinging grinding pain in my neck. I don't have arm pain (knock wood!). I can see myself on the films where it is impinging quite a bit at three levels, but I'm sure its not completely obliterated.
I would love nothing more than to be convinced that the neck is TMS- this has been a huge hurdle for me. Having a well respected neurosurgeon tell you its pinched nerves leaves its mark on your psyche. |
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mizlorinj
USA
490 Posts |
Posted - 11/01/2007 : 18:46:41
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Lidge, I thought you were going to see the TMS doc in NJ?
Dr. Sarno looked at my MRI and xray films. He said, "Yes, you have a LARGE herniated disc at L5S1." and that it was not likely the cause of my pain. I assimilated the TMS theory and trusted that he knew what he was talking about. I am pain-free after the worst pain of my life (worse and longer than drug-free childbirth) and have had no operation to "fix" the disc. I did not read the blah blah blah of the reports because I realized they'd probably scare me.
It seems to me you are still hung up on there being a physical cause of your pain even though those instance are rare--it is usually TMS. Why not try some non-Sarno mindbody books from the library to see how many ailments can be (and likely are) caused by the brain and are not physical.
-Lori |
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lidge
USA
184 Posts |
Posted - 11/01/2007 : 18:59:39
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Lori-
Yes I am going - next week. But I had hoped to reduce this pain in the interim. But yes, I still am not convinced that the neck pain is TMS. I do feel that the back pain is not from the herniated disc, but rather acted as a diversion from either the neck pain or underlying issues. The MRI of the neck was pretty dramatic. Even a chiropractor wouldn't touch it so you can imagine.
I do hope to get some comfort level from the doctor. I'm pretty tied in knots right now as I do feel caught between the physical and psychological. Yes, I have been reading other books like Alice Miller's which have been a real eye opener. I just think that the cervical spine might be a true pain generator and that is making me very nervous. My options are not good if it is.
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armchairlinguist
USA
1397 Posts |
Posted - 11/01/2007 : 22:37:47
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Alice Miller is brilliant. I think I read that book like five times and every time noticed more things that she says.
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It's not 100% belief that's required, but 100% commitment. |
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stanfr
USA
268 Posts |
Posted - 11/02/2007 : 04:52:19
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| CT/MRI reports are amusing. Prior to the septoplasty (correcting deviated septum) I had last winter, i pulled out a CT report i got a couple years ago. The examiner wrote "septum appears normal" I thought this was pretty funny at the time since it was obvious to my untrained eye that my right septum was crooked to the point of nearly closing off the passage. In retrospect, since i know understand that my congestion is TMS and not deviated septum-related, the examiner was just stating the fact that abnormalities are indeed normal! In the vast majority of cases, i suspect that unless one's problem is trauma-related, structural abnormalities are nothing to fear. |
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lidge
USA
184 Posts |
Posted - 11/02/2007 : 08:15:03
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Re the MRI- I understand the whole concept of normal degenerative changes etc. However
I have had dr. after dr., chiro, neuro, physiatrist etc. ask me if I was in an accident (re the cervical spine). The degenerative changes are not those one would expect to see in someone my age (late 40s).Until last year, never had neck pain though. Now, it has been one full year of neck pain. The pain led to the MRI being taken. Then I was told over and over that they were surprised I wasn't in more pain before. Talk about nocebo.
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armchairlinguist
USA
1397 Posts |
Posted - 11/02/2007 : 09:37:59
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quote:
Until last year, never had neck pain though. Now, it has been one full year of neck pain. The pain led to the MRI being taken. Then I was told over and over that they were surprised I wasn't in more pain before. Talk about nocebo.
Hmmm. Talk about the time-onset of pain not being related to abnormalities, too. I'd take that timing as a strong sign that they might not be physically related!
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It's not 100% belief that's required, but 100% commitment. |
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lidge
USA
184 Posts |
Posted - 11/02/2007 : 12:27:50
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Keep telling me that ACL! I want more than anything to believe it!
The timing of my symptoms is without a doubt in keeping with TMS. I feel in my heart that the back pain, is most likely TMS, not the "puny" herniated disc Sarno speaks of. But the neck degeneration is so widespread and severe, and the pain so long lasting(except for a month I just had after an epidural (placebo?) that my conscious mind still believes it is structural, rare though that may be.
I would love it ALL to be TMS, but until I feel at least consciously that the neck is TMS, I know there is no chance to rid myself of it. I'm hoping a TMS doctor can help me figure that part out- just a little leery as to whether someone w/o training in that area can really say.
Re Alice Miller- I'm reading two of her books and she really is a wonderful writer- and fits in well with TMS theory. Wish there were more therapists out there like her. |
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armchairlinguist
USA
1397 Posts |
Posted - 11/02/2007 : 21:17:36
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Like I mentioned earlier, lidge, the reports are designed to be read by other doctors, and if the TMS doctor sees something he feels is suspicious, he can refer you to a specialist. But it also seems you have already done the rounds in that area and weren't impressed with the specialists either, so maybe you should hang up that possibility for a while and trust whatever your TMS doc says.
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It's not 100% belief that's required, but 100% commitment. |
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lidge
USA
184 Posts |
Posted - 11/03/2007 : 09:18:05
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I do agree that the reports are written for other doctors but the fact is most doctors who are not specialists cannot read the films themselves. And believe me, I know first hand how deceptive and overwritten the reports can be. It takes someone who can read the films and compare it against the actual MRI "films" to give you an accurate assessment.
I went to a rheumatologist when the back pain became unbearable. He could not read MRIs - just X-rays and reports. He sent me for an xray of the spine along with the hip. The report on the hip said that I had grossly deformed femoral heads and "probable severe avascular necrosis". His secretary told me that. Needless to say I freaked. It wasn't even my hip hurting me!
The doctor, not being able to understand what he was seeing, ordered a bone scan. That was negative for AVN. So was a subsequent MRI. So I had to drag myself to another orthopedist to read all the films. He said that I had deformities in my femoral heads from a childhood leg disease. He thought I should have more good years with my hip. Never did find out anything helpful about the back pain which is why I even went to him!
So, the reports can be wrong. If you don't have a doctor who can read the films you really are not getting an informed opinion. If the report is inflated or overwritten, relying on it is sort of -garbage in, garbage out.
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armchairlinguist
USA
1397 Posts |
Posted - 11/03/2007 : 15:34:18
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quote:
It takes someone who can read the films and compare it against the actual MRI "films" to give you an accurate assessment.
I am wondering why it is that you are asking US if we think your doctor can read films, instead of your doctor, then.
My understanding has always been that the reports physically describe the films, but that it is the doctor who decides what the physical description means.
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It's not 100% belief that's required, but 100% commitment. |
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lidge
USA
184 Posts |
Posted - 11/03/2007 : 16:55:49
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I was not asking whether "my" TMS doctor read the films. I know the answer to that. He doesn't.
I was wondering whether most of the TMS doctors, including Sarno, just rely on the written reports. This could only be answered by someone who has seen a TMS doctor.
I would be especially interested in hearing from one of Sarno's patients.
Simple question- Sometimes a cigar is just a cigar.
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lidge
USA
184 Posts |
Posted - 11/03/2007 : 17:28:15
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| Actually just looking back at the responses I see Lori, who has seen Sarno himself, said he does indeed read the films. |
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Webdan65
USA
182 Posts |
Posted - 11/04/2007 : 18:26:29
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Not to hijack this thread, but lidge and ACL both mention Alice Miller. When I search Amazon for her, there are many many books. Is there one or two that you recommend I start with?
Thanks!
Dan |
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lidge
USA
184 Posts |
Posted - 11/04/2007 : 18:50:52
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Dan-
The two books I have are Drama of the Gifted Child and the Body Never Lies-
I ordered the second one because it seemed it might shed some light on childhood traumas
and pain. While it may not pertain exactly to you- it does challenge some widely held beliefs about "honoring thy father" (even if that person has abused you mentally or physically) and how such repression can manifest in physical illness. Very much in keeping with TMS.
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broken wings
4 Posts |
Posted - 11/04/2007 : 18:58:30
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quote:
Originally posted by lidge
Also says in the neck- "broad based left paracentral osteophyte and soft disc herniation causing stenosis of the left lateral recess and proximal left foramen and flattening of the left side of the cervical spinal cord"
The question is without seeing "how much" the spinal cord is being impacted (or nerves) how could anyone give you an informed opinion based upon the report itself- you really do have to see the films.
If it makes you feel any better i have suffered exclusively with low back and leg pain. When an Mri was done it showed the usual l5-s1 degeneration and herniation, but oddly enough the 'worst' spot was a disc involving the spinal cord at T10-11, where i have never had any symptoms at all. This plus the studies Sarno cites has totally convienced me that MRI's are useful only to rule out serious disease, not to diagnose causes of chronic pain. |
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lidge
USA
184 Posts |
Posted - 11/07/2007 : 15:33:59
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Broken Wings- I think at this point, despite the fact that my "worst spots" do (to some degree)match up with the MRIs, I fully accept Sarno's belief that herniations etc are, for the most part, not the pain generators.
I went for my first visit to a TMS doctor who certainly saw my symptoms as TMS. I had hoped that the diagnosis, together with the lecture would have "jump started" my recovery to some degree. Oddly, I had felt some lessening of the severity in the days leading up to the appointment, but then an increase in symptoms following the appointment. I know the TMS dr. said if the symptoms get worse that could be a good sign that the "fight" has begun so to speak.
When I brought up the odd Leg Perthes disease that had been assumed to be the cause of my deformed looking hip on MRI, he thought it was not causing symptoms. I agree insofar as I do not have hip pain, but severe back and leg pain. Then, just my luck, I had the TV on the next day and hear the words "legg perthes" so my ears prick up. Apparently one of the men on Dancing With the Stars was telling his story of having childhood Legg Perthes which left him on crutches for years as a child. The commentator then said that Legg Perthes is a painful degenerative condition which leads to crippling arthritis if not treated! UGH- just what I didn't need to hear.
I know that the commentator was wrong in his description of the disease, that nothing more than mild degenerative changes have showed up in my hip, yet still - hearing that must have seeped in somehow. All I could think was how strange- I never heard anything about it before- could the TMS gremlins be infiltrating from the outside too!!
Well, since my visit Monday I have found the pain worsening from the week before, yet this could be because I have had to get yet another scan- this time of my thyroid. There is still the "physical cause" boogie man out there, so I guess I can't expect miracles.
Oddly, the other day I tried to really focus on the psychological when I felt the pain was more than I could take and found the only thing to do was cry. For a brief moment, I thought the pain toned down. It came roaring back, and I'm still not sure if it really happened or I just want to believe it happened.
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Question about TMS Doctors
