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 Returning in a bad way. Failed cortisone shot.
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positivevibes

204 Posts

Posted - 10/13/2008 :  18:33:28  Show Profile  Reply with Quote
OK, I totally fell off the TMS wagon over the summer. And now I'm back with my tail between my legs.

I wanted to have a new MRI to see what was going on in my back. (First mistake). The last one I'd had was 3 years ago. I had fallen in early May and was very shaken up by the experience. I wanted to know if I'd fractured anything.

I saw a new orthopedist (second mistake). Actually, this guy is a physiatrist, but I don't see much of a difference between him an the former orthopedist I used to see.

The physiatrist recommended that I get an epidural cortisone shot. He swore up and down and sideways that one shot would cure my pain, I'd be able to do all sorts of core strenghtening exercises, and my torso would stabilize and be strong again.

I had been avoiding epidural cortisone shots for years because they scared me. This doctor has a stellar reputation; he's even a team doctor for a very famous major league football team and has written papers and chapters in books about giving epidural shots. Plus,a friend of mine got a shot from him and it turned out well.

So, I had a shot in early August, just on the right side of my back (because I was experiencing pain in my right gluteal upon leg extension, plus some pain in my right groin area). The shot didn't do very much. However, the left side of my lower back began hurting. The pain went away after a few days, and I commensed physical therapy core training.

The core training was difficult. It took a few days for my body to "recover" from it and be in a pain-free state again. (The exercises were very light, but my back muscles apparently are very weak).

After two weeks of core training, the back pain really got intense and I had to stop. I decided, along with my physical therapist, that maybe I needed a cortisone injection for the left side of my back.

So I went in for another series of cortisone injections (third mistake). The physiatrist did two injections on the right side and one on the left side.

That was 3 weeks ago.

My right side seems fine, although I still have the groin problem when I turn my leg a certain way. But my left side is awful.

Previously "just my lower back" hurt (near the SI joint area). I NEVER had ANY sciatic symptoms down my left leg or in my left glute previously, EVER. Now, not only does my left lower back hurt, but I have nerve discomfort in my left glute and all the way down my leg. It is a feeling of extreme sensitivity, numbness, and a dull achiness. It is worse when I try to sit for any length of time. Sitting is what brought on the pain to begin with, when I tried to sit at my computer 3 or 4 days after getting the shots. I was dumbfounded, because I thought the shot was supposed to "bathe the nerve in cortisone so I wouldn't feel any more pain."

It was difficult to get the doctor on the phone. He didn't want to hear from me until 3 weeks had passed, because "you can feel all sorts of sensations within that timeframe." But now it's more than 3 weeks and I'm still feeling these problems. The doctor said that maybe my herniated disc at L4/5 got worse. Bullsh**. I've been doing nothing but lie around for the past 3 weeks, so how could the disc just spontaneously have gotten worse? He wants me to do another MRI. If I do the MRI, I think it will show no changes since the last one, done in June.

So here I am, back to Dr. Sarno's theories. I'm not sure if this doctor did something to my nerve, or whether this is all just a "nocebo" effect, as someone who knows about TMS pointed out to me recently. Either way, it makes it difficult to think about anything else. I'm once more obsessing about my back and I'm very scared that this stupid doctor did some sort of permanent nerve damage. If it continues, I will proably be evaluated by a neurologist. I noticed, after the injection, that there was a small bruise on the left side, but no bruise on the right side. Not sure if that's significant or not.

Anyway, I am planning to go down to Los Angeles and see Dr. Schechter. I've never been evaulated for TMS hands-on, and I think it's time. I live near San Francisco. If you know of a better doctor than Schechter who will see out-of-towners (Sarno will not), please let me know. I'll travel wherever I have to.

I have been re-reading Healing Back Pain and re-listening to Dr. Schechter's audio lectures. Someone said to me recently that "you can't do Sarno halfway." This is definitely true. However, whereas previously I was concerned about a structural problem, now I'm worried about damage done by an outside invasive procedure. I keep flip-flopping between thinking that "the body will heal itself over time" and "Oh no, is this the way it will be from now on?"

I'm very confused, wondering if I should see my osteopath or my acupuncturist. Take stronger anti-inflammatories or Prednisone as the doctor suggests. What to do? Something, nothing, or only Sarno?

One thing is for sure: I will never get any sort of shot in my back ever again. My husband said to me: "Read Sarno and try to get on with your life." The poor guy is run ragged with my obesssing about my stupid back and leg pain.

I appreciate any and all comments. I feel like such an idiot for letting anyone do anything invasive with my back. If I'd have stuck to Sarno to begin with, I'm sure I wouldn't be having these problems now.

Edited by - positivevibes on 10/13/2008 22:43:42

positivevibes

204 Posts

Posted - 10/14/2008 :  11:29:08  Show Profile  Reply with Quote
66 views of my topic so far, and no replies?
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winnieboo

USA
269 Posts

Posted - 10/14/2008 :  12:12:01  Show Profile  Reply with Quote
quote:
My husband said to me: "Read Sarno and try to get on with your life."
I would say, listen to your husband.

So sorry you went through all of this, and sorry, too, about the pain you are feeling post-epidural. If the doctor who administered the shot is not worried and says you might feel all sorts of sensations, then try to trust that. Cortisone is a powerful drug, however, and if all you've done is rest, perhaps you now can purge any remaining drug residue from your system...drink plenty of of fluids, try to work up a sweat at the gym, and yes, try to move on with your life.

quote:
I wanted to have a new MRI to see what was going on in my back. (First mistake). The last one I'd had was 3 years ago. I had fallen in early May and was very shaken up by the experience. I wanted to know if I'd fractured anything.

Since you've conquered TMS before, you'll have to put your more recent medical/physical experiences aside for now. You did what you did, and you had your reasons to do so at the time; all you can do is leave it in the past. Try not to beat yourself up about it. Take comfort in what you know from studying Sarno before: almost everyone's MRI will show some abnormality. These abnormalities are not what is causing your pain.

If you're like me and presumably other TMSers, I think too much about everything, and I particularly obsess about side effects from medical procedures, tests, meds and shots. It's possible that as soon as your leg pain was relieved by the meds, your brain went right to the site of your shot to create new pain to distract you from your life...these are just suggestions of course. If you feel it would help to see a TMS doctor and get a new diagnosis, then by all means, go asap.
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martyinbklyn

USA
3 Posts

Posted - 10/14/2008 :  12:13:30  Show Profile  Reply with Quote
I'm very new to this forum. I read your post earlier, and thought, wow, that's a tough one. I didn't think I could offer you anything but commiseration for the pain you're in. Maybe I was wrong. Anyway, I'll gently toss in my thoughts.

Judging by your post, you've probably kicked yourself plenty for what you see as your mistakes. When you're in pain, anyone naturally seeks a way out of pain. So stop kicking yourself. Learn from the experience (as you've done) and find a way to move forward. The bottom line is that the body will tend to heal itself, and you can't obsess over all the "what ifs" that are bound to come up.

I believe it's true that doing Sarno halfway won't solve anything. If you start down the road of treating it physically, it's like a child that wants attention, and keeps doing the same bad behavior because it works, and any attention is better than none. (I'm in the middle of a recurrence after a year-and-a-half being pain free. I don't know what brought it on, and I started doing the journaling and reading and talking to myself, and wondered if I should take pain killers, or stay home, or do all the things I knew I shouldn't do. So far, so good. I'm still in pain, but not out of control, and I think I can re-assert myself over my subconscious, but it's never simple.)

So as hard as it is, stop thinking about the physical pain, and find the root of the anger or hurt or fear that your subconscious is trying to keep you "safe" from, and make peace with it.
'Nuff said.
Be well.
Marty
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HellNY

130 Posts

Posted - 10/14/2008 :  12:40:55  Show Profile  Reply with Quote
Ok, I was one of those readers who didnt reply. Mainly because it appeared you were reverting back to your same old approach. So see throughout.

quote:
Originally posted by positivevibes

OK, I totally fell off the TMS wagon over the summer. And now I'm back with my tail between my legs.

Here (above) is the beginning of the problem. You return to be convinced and reinforced, which shows you havent really accepted TMS yourself. Your locus of control, and belief, is still external. As long as this persists you will remain as you are.


I wanted to have a new MRI to see what was going on in my back. (First mistake). The last one I'd had was 3 years ago. I had fallen in early May and was very shaken up by the experience. I wanted to know if I'd fractured anything.

Thats classic hypochondriasis, self-focus TMSing. You fell but you want6ed to know if you had broken anything. You also say you were "shaken up" by the experience. This shows a strong emotional reaction to falling. Something that has happened to most people in their lives, and more than once. Yes, really falling hard. Getting "shaken up" by it is the doorway to your brain laying emotional significance to the pain... and then overlaying the cognition of "did I break anything." This is hypochondriachal.

I saw a new orthopedist (second mistake).

Yes, it probably was. Not a mistake for a typical person, but given your history, likely a repeat of the same old same old. And since there are in the business of finding whats wrong with you, no doubt they likely will find something. Fueling your fire.
Actually, this guy is a physiatrist, but I don't see much of a difference between him an the former orthopedist I used to see.

The physiatrist recommended that I get an epidural cortisone shot. He swore up and down and sideways that one shot would cure my pain, I'd be able to do all sorts of core strenghtening exercises, and my torso would stabilize and be strong again.

Never heard of anyone guaranteeing teh effectiveness of epideurals before like that. The literature does not support a 100% effectiveness. But again you're digging even deeper into the "physical" hole and mdeical drs all too willing to help you along. And as long as your locus of control is external, you will believe whoever has spoken to you most recently and with the most conviction.


I had been avoiding epidural cortisone shots for years because they scared me. This doctor has a stellar reputation; he's even a team doctor for a very famous major league football team and has written papers and chapters in books about giving epidural shots. Plus,a friend of mine got a shot from him and it turned out well.

So, I had a shot in early August, just on the right side of my back (because I was experiencing pain in my right gluteal upon leg extension, plus some pain in my right groin area). The shot didn't do very much. However, the left side of my lower back began hurting. The pain went away after a few days, and I commensed physical therapy core training.

The core training was difficult. It took a few days for my body to "recover" from it and be in a pain-free state again. (The exercises were very light, but my back muscles apparently are very weak).

After two weeks of core training, the back pain really got intense and I had to stop. I decided, along with my physical therapist, that maybe I needed a cortisone injection for the left side of my back.

So I went in for another series of cortisone injections (third mistake). The physiatrist did two injections on the right side and one on the left side.

That was 3 weeks ago.

My right side seems fine, although I still have the groin problem when I turn my leg a certain way. But my left side is awful.

Previously "just my lower back" hurt (near the SI joint area). I NEVER had ANY sciatic symptoms down my left leg or in my left glute previously, EVER. Now, not only does my left lower back hurt, but I have nerve discomfort in my left glute and all the way down my leg. It is a feeling of extreme sensitivity, numbness, and a dull achiness. It is worse when I try to sit for any length of time. Sitting is what brought on the pain to begin with, when I tried to sit at my computer 3 or 4 days after getting the shots. I was dumbfounded, because I thought the shot was supposed to "bathe the nerve in cortisone so I wouldn't feel any more pain."

Injections can do any number of things. What I see from this was that 1) your pain was not cured by the injection, thus 2) your pain was unlikely to be due to inflammation, and 3) you have temporarily ramped up your pain due likely to nocebo and an aggravated violation of hope and expectations.


It was difficult to get the doctor on the phone. He didn't want to hear from me until 3 weeks had passed, because "you can feel all sorts of sensations within that timeframe." But now it's more than 3 weeks and I'm still feeling these problems. The doctor said that maybe my herniated disc at L4/5 got worse. Bullsh**. I've been doing nothing but lie around for the past 3 weeks, so how could the disc just spontaneously have gotten worse? He wants me to do another MRI. If I do the MRI, I think it will show no changes since the last one, done in June.

So here I am, back to Dr. Sarno's theories. I'm not sure if this doctor did something to my nerve, or whether this is all just a "nocebo" effect, as someone who knows about TMS pointed out to me recently. Either way, it makes it difficult to think about anything else. I'm once more obsessing about my back and I'm very scared that this stupid doctor did some sort of permanent nerve damage. If it continues, I will proably be evaluated by a neurologist.

Indeed - and How many Drs. will this be now?



I noticed, after the injection, that there was a small bruise on the left side, but no bruise on the right side. Not sure if that's significant or not.

Here is the return of the obsessive compulsive TMS - an almosty narcissitic form of self diagnosis and belief. Now, addingto your history of catastrophizing, you have some new catastrophies you have just brewed up in your mind. "Maybe the injection did permanent nerve damage....and whats this bruise?!?!" Can't you see this? From the outside its obvious. I should know as I used to do the same. After an unsuccessful surgery it was "oh my back is worse and Im getting new burning sensations in new areas. Now even MORE damage has been done!!" blah blah...

..the runaway train of the unchecked hypochondriachal mind, slef analyzing and mentally wringing the hands so profusely all that is created is more suffering. All the while the emotional state you have worked your brain up into enhances the painful experience by giving the "pain stimuli" emotional "significance" thereby imprinting it in your brain.

In fact, I hypothesize that "fear of the pain" is one of teh CAUSES of the chronic pain itself. Of true, then you are actually causing your own chronic pain by doing the very thing you are doing. But dont take my workd for it. Look at the phenomenon of tinnitus, or look at panic disorder, to see an analagous process at work.



Anyway, I am planning to go down to Los Angeles and see Dr. Schechter. I've never been evaulated for TMS hands-on, and I think it's time. I live near San Francisco. If you know of a better doctor than Schechter who will see out-of-towners (Sarno will not), please let me know. I'll travel wherever I have to.

I have been re-reading Healing Back Pain and re-listening to Dr. Schechter's audio lectures. Someone said to me recently that "you can't do Sarno halfway." This is definitely true. However, whereas previously I was concerned about a structural problem, now I'm worried about damage done by an outside invasive procedure.


Its is that worry which may be causing your pain to continue and intensify.

I keep flip-flopping between thinking that "the body will heal itself over time" and "Oh no, is this the way it will be from now on?"

I'm very confused, wondering if I should see my osteopath or my acupuncturist. Take stronger anti-inflammatories or Prednisone as the doctor suggests. What to do? Something, nothing, or only Sarno?

One thing is for sure: I will never get any sort of shot in my back ever again. My husband said to me: "Read Sarno and try to get on with your life." The poor guy is run ragged with my obesssing about my stupid back and leg pain.

I appreciate any and all comments. I feel like such an idiot for letting anyone do anything invasive with my back. If I'd have stuck to Sarno to begin with, I'm sure I wouldn't be having these problems now.



Dont take my comments harshly. You are just like I was in so many many ways. Id like to see you get better.

Edited by - HellNY on 10/14/2008 12:47:58
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mizlorinj

USA
490 Posts

Posted - 10/14/2008 :  13:58:13  Show Profile  Reply with Quote
PV, you summarize your whole post with this: "I'm once more obsessing about my back and I'm very scared . . ."

Fear is crippling.

Have you done journaling? Therapy? Digging in there about what the real causes are? Where your fears come from?

All the p/t and other things you've had done have not worked for you. That is a clear sign, but one you need to see yourself.

As HellNY points out, we've responded to you before. Perhaps re-read those responses. Keep reading Dr. Sarno's books, perhaps other mind/body books to reinforce how many conditions are likely emotional-induced, and get those emotions out.

-Lori

Edited by - mizlorinj on 10/14/2008 14:03:54
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positivevibes

204 Posts

Posted - 10/14/2008 :  15:25:29  Show Profile  Reply with Quote
I think that what I need the most are:

1. To see a TMS doctor for an in-person consultation. I think that will help to solidify things for me.

2. To see a TMS-oriented psychotherapist. This is harder, as I haven't found any that are within a close driving range of my location. I've been seeing a "regular" therapist for almost a year, but she just doesn't "get" TMS and I'm getting nowhwere with her.

You are all correct that my fear of pain is probably more paralyzing than the pain itself. I didn't used to be this way. But when my last episode of back pain became "incurable" and chronic (lasting now almost 2 years), I got really tweaked about it. It brought out the worst in me. Before that, the worst I'd ever been in chronic pain was 2 or 3 months.

I'm actually feeling better today. I did a lot of thinking yesterday about my "inner child" and what emotions or past experiences I'm still guarding from myself -- what am I still holding on to; what won't I admit to myself? I listened to the podcast that was posted in another thread between Dr. Schechter and Arlen Ring. It was very insightful, and I was able to apply parts of one of Dr. Ring's case studies to my own life. Particularly the part where he talks about a 54-year-old patient and says, "He's still having a bad childhood."

I haven't totally given myself over to Sarno and the TMS theory, and that's a big part of my problem. Part of me is still holding back. I realize that it's time to let go now. If I can't find a specifically TMS therapist in my area, I want to work with someone who deals with this "inner child" stuff, because I think that would be the most significant to me. Scary and hard -- but I don't think I'm going to get better until I work through some of the issues that my psyche keeps trying to bury. Not to mention, to re-train myself not to catastrophize and be hypochrondriacal.

It's really interesing. Today my back and my leg feel pretty good, and I haven't taken any painkillers. My housekeeper came over this morning to clean the house and asked me how my back was doing. Just talking about it made it begin to ache. Internally I thought to myself, "STOP IT!" and the ache went away.

Edited by - positivevibes on 10/14/2008 15:36:55
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RageSootheRatio

Canada
430 Posts

Posted - 10/14/2008 :  16:22:35  Show Profile  Reply with Quote
PV, just wanted to send some encouragement.

I too, got a lot out of the podcast with Arlen Ring. The first time listening I wasn't completely focused on the interview, but I heard the part about "bracing for the pain" and that perpetuating the cycle, and thought, "oh, I don't do that."

Then a day or so later, as I was really getting into this most recent relapse, I realized, "HEY I'm doing that!!" So I listened to the podcast again, and realized I also don't catch the cycle very early at all ! It's weird but I can be kind of *aware* of going down the spiral, but then just keep going down it, rather than interrupting it, somehow! So ... I am still working on that, but today is going better (so far, anyway!)

Anyway, just wanted to say 'hi' and looking forward to hearing about your continued progress as you move forward. :o) (I think my own relapse has about ended, again.)
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positivevibes

204 Posts

Posted - 10/14/2008 :  19:21:36  Show Profile  Reply with Quote
Well I must admit that it's rather humbling to come back here after several months and realize that I have to start over. I'm sorry if I sound like I'm whining sometimes and I appreciate everyone's patience with me and my TMS situation. But I'm not starting totally from scratch. I first read the Sarno books in January of this year. I think it just takes time. Maybe I wasn't totally ready to accept everything he and Dr. Schechter say in their writings/lectures earlier this year. But I do think I'm ready now.

Today so far is the best low-pain day I've had in weeks. I'm still limiting my sitting (which seemed to bring on most of the pain 3 weeks ago), but soon I will get back to sitting as well, and for the first time in a month I'm actually thinking about going to the gym.

Most of the pain in my leg seems to be gone. I was shopping with my daughter for 2 hours today and didn't feel it at all. It's amazing how powerful the mind can be, and I'm very proud of myself that I've been able to dig deep and turn this situation around.
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carbar

USA
227 Posts

Posted - 10/14/2008 :  22:21:43  Show Profile  Reply with Quote
quote:
Originally posted by positivevibes
Most of the pain in my leg seems to be gone. I was shopping with my daughter for 2 hours today and didn't feel it at all. It's amazing how powerful the mind can be, and I'm very proud of myself that I've been able to dig deep and turn this situation around.



Yay. I'm reading your post with interest to see how your attitude has change. If you are not having pain during something pleasurable, and enjoyable this is another ding-ding-ding on the "It's TMS bell." Since you are *noticing* that it's a ringing the "accepting TMS buzzer" too.

:D Feeling goofy and sleepless...

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pandamonium

United Kingdom
202 Posts

Posted - 10/15/2008 :  02:55:28  Show Profile  Reply with Quote
PV,

when I read your post I saw 3 things of note:

1) anger you fell off the TMS wagon
2) guilt
3) fear the jabs have done some permenant damage

all of which would be enough to get the ball rolling on the pain front.

When I self-diagnosed myself I wrote a list of all the things which happened to me since I was a child which could be sources of anger or repressed emotions and I went through each one, journalling, trying to feel the emotions and doing some EFT, forgiving and accepting myself. I was astonished at the length of the list!
It seems you need to do some emotional digging now and find out what started all this.

Good luck

Panda
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Dave

USA
1864 Posts

Posted - 10/15/2008 :  08:57:10  Show Profile  Reply with Quote
quote:
Originally posted by positivevibes
My husband said to me: "Read Sarno and try to get on with your life."

Your husband is wise. I suggest you listen to him.
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Wavy Soul

USA
779 Posts

Posted - 10/16/2008 :  01:07:45  Show Profile  Reply with Quote
Would someone post the Arlen Ring podcast link again?

Love is the answer, whatever the question
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LuvtoSew

USA
327 Posts

Posted - 10/16/2008 :  05:31:41  Show Profile  Reply with Quote
positivevibes- don't be too hard on yourself. Its really hard when your having so much pain not to go to the doctor and worry about it. Its good you came back to this message board instead of going to a back pain one.

I'm one on this board that has a hard time not thinking physical when it gets real bad, so your not alone there.

This is a such a good thread , everyone has such good advice- thanks.

Edited by - LuvtoSew on 10/16/2008 05:49:37
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positivevibes

204 Posts

Posted - 10/16/2008 :  10:04:45  Show Profile  Reply with Quote
This was originally posted by debbette. It contains the links to the TMS podcasts with Arlen Ring:

I ran across this website with TMS podcasts and video clips. If you haven't heard them, the podcasts are great! They're very interesting and informative. I haven't had a chance to watch the videos yet.
http://www.smi-mindbodyresearch.org/podcasts.htm
Enjoy!
Debbie
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positivevibes

204 Posts

Posted - 10/16/2008 :  13:45:24  Show Profile  Reply with Quote
I went back to that wretched Physiatrist today for my 3-week followup appointment. I really didn't want to go, but I figure that in case I wound up taking legal action against him or whatever, I should go to the scheduled followup for "closure" on the records.

Before going, I took a relaxing hot bath and kept thinking positive thoughts. I'm not surprised that after seeing him, my leg feels sensitive and achy again (it hadn't been feeling quite so bad in the past few days). I had a feeling that something like that might happen, just being there talking to him -- a typical TMS reaction.

Anyway, he was very defensive, and he said that my spine is "really in bad shape" and that I "might need surgery and should consider seeing a neurosurgeon." Well thank God for Sarno & Co, because under other circumstances those comments would have really upset me. Regardless, I'm still very angry that he said that to me, because other orthopedists I've seen in the past have always said that surgery would not be indicated in my case, because I only have some mildly bulging discs and arthritis in my spine (to which I say, SO WHAT?!)

It's very clear to me that he irritated the nerve with his procedure, and then my mind probably magnified the pain as a TMS episode.

He did finally admit that the nerve could be "irritated" and that these feelings of sensitivity will probably go away over time. He suggested doing a neurological test where he stimulates the nerves and muscles to test them.

Well I'm not letting this guy touch me again. And it seems to me that if these symptoms are a result of him irritating the nerve root with the shot, then re-stimulating them certainly couldn't HELP. He said it wouldn't hurt at all. Well I just don't believe him. IF at any point in the future I decide to get a test like that (and I hope I don't ever need to), I will have an independent neurologist do it for an objective point of view.

Before I left his office, he performed the usual nerve/muscle strength tests (walk on your tiptoes, bend over, push against my hands, etc). The strength in my left leg is just fine (I had thought so, but it's good to get proof). I'm just going to keep repeating to myself that my left leg is fine, and my mind is stronger than this -- this is mainly TMS, and this will go away, and no permanent damage has been done.

I'm relieved that the appointment is behind me and I will only go forward from here.

I plan to see Dr. Schechter sometime soon (I have to fly from SF to LA, so it will take some planning around my husband's work schedule and the kids, etc).


Edited by - positivevibes on 10/16/2008 13:54:48
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armchairlinguist

USA
1397 Posts

Posted - 10/16/2008 :  15:57:32  Show Profile  Reply with Quote
Hey PV, as I recall you are fairly close to me. I haven't been posting regularly anymore, but if you are interested, email me for the contact details for my therapist. She is 'regular' and not informed about TMS but I have had great success in working with her. She is really caring but also pushes me a lot to make sure I really understand how my emotions and actions all add up.

--
What were you expecting?
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