| Author |
 Topic  |
|
|
mcone
114 Posts |
 Posted - 11/25/2008 : 23:34:40
|
So I just drove accross the midwest - 1,200 miles - including driving through a blizzard last night in Pennsylvania.
I drove from MN to NYC for two primary reasons:
(1) Visit the TMS doc, initials IGR, colleague of Dr. Sarno at the Rusk institute at NYU (I had seen him before, about a year ago); and
(2) check out the NYC Metro area for potentially moving here and starting life over again.
---Report on visit to Dr. IGR---
In all candor, I feel dissapointed. I was not inspired, my confidence in the diagnoses was not strengthened, I learned nothing new, etc. What would truly help me, I believe, is insight, wisdom, charisma, observational power and intuition that could illustrate in a novel way how or why TMS affects me--- AND/OR a powerful expression of commitment to help...AND/OR a strong statement of hopefulness...AND/OR help with resolving doubt.
Dr. IGR did not demonstrate these gifts, and did not offer these messages - at least not in a way that was meaningful to me. (And to boot, his staff really gave me an unwelcome hassle about some bizarre billing snafoo).
In all fairness, Dr. IGR did re-iterate his opinion that I have TMS, and that his recommendation is psychotherapy...and there is only so much information that can be assimilated and exchanged in the course of a 30 or 40 minute appointment. And I'm sure his intentions are good.
And I shouldn't be confusing the messenger with the message. It's just that I was hoping the consult might advance or enhance my understanding and application of the TMS model. It didn't.
|
Edited by - mcone on 03/17/2010 18:00:27 |
|
|
mcone
114 Posts |
Posted - 11/28/2008 : 00:34:10
|
Ira G. Rashbaum is a colleague of Dr. Sarno at NYU's Rusk Rehabilitations Center in New York City. He authored one of the chapter's in Dr. Sarno's Divided Mind.
Reflecting on my visit with him yesterday (and my few prior consultations with him this past year), I really feel that it was counterproductive to visit with him; and I really would recommend against seeing him.
The single most important function of a TMS doctor, in my view, is to instill confidence in the diagnosis. This means that a doctor diagnosing TMS should have a solid frame of reference for understanding the conventional diagnoses (and for less-typical symptom patterns, like RSI TMS, a doctor should be willing to entertain possibilities presented by the patient). Arriving at a TMS diagnosis after an informed, educated and well-deliberated consideration of all diagnoses is MUCH more confidence inspiring than a superficial exam and a proclamation that someone has TMS. I'm exaggerating somewhat, but basically that was what Dr. Rashbaum did. His superficial "physical" exam seemed kind of ridiculous - and it was really hard for me to take him seriously after he stumbled through checking some reflexes and then posturing as if he had done a comprehensive physical evaluation. This was just plain sillly.
This may be the odd case of NEEDING to shoot the messenger, because the manner of delivery of the message is so important. And I don't want the integrity of message to be compromised by the quality of messenger.
Another important function of a TMS doc, in my view, is troubleshooting reasons why a patient may be not be making progress.
Can they add to what's written by Dr. Sarno? (I've not read the other doctor's books).
I truly believe that the TMS phenomenon, and the model that has worked for many people with very significant pain issues, including RSI, is quite real.
The intuition I'm left with after this consult, however, is that maybe the doctors themselves really don't know how it works, why it works, under what circumstances people improve, or how to move people past obstacles in treatment. These would be the types of things a TMS doctor would really be useful for. Perhaps some TMS docs do have answers, but I'm pretty sure that Dr. Rashbaum isn't one of them. |
Edited by - mcone on 11/28/2008 00:56:19 |
 |
|
|
mk6283
USA
272 Posts |
Posted - 11/28/2008 : 11:52:33
|
Have you ever seen a "conventional" doctor for your symptoms/complaints? What diagnosis were you given then? What course of action/treatment was recommended to you at that time? Did you try it and did it help? When/How did you come to learn about TMS? Have you ever seen any success since learning about TMS? What was your primary objective in visiting Dr. Rashbaum?
Going to see a TMS doctor isn't always the solution. It may or may not have been in your case. I would urge you to refrain from disparaging the reputation of ANY doctor who is willing to explore alternative modalities to help his/her patients with symptoms/disorders refractory to all other forms of treatment. Every doctor has patients who they are unable to help despite their best/sincere efforts.
Let's try and see the positive in things. Casting blame and dwelling upon an experience that did not meet the high expectations you set for it are not the way to get better. After all, that is what you are trying to achieve here (I hope). I await your response. I'd love to help if I can.
Best,
MK |
|
|
|
chester
49 Posts |
Posted - 11/30/2008 : 16:05:30
|
Sorry to hear that the visit didn't work out for you. As we all have seen, this can be a very quirky condition, and what works in one case might not in another.
I saw Rashbaum about a year ago, and was (and still am) very pleased with his work. Having read most of Sarno's books and seen the videos beforehand, I was as confident as a lay person could be that I had TMS. What I was looking for was a confirmation, and he gave it to me.
I came armed with my full track history - x-ray reports, physical therapy notes, and MRI CD. While his diagnosis following the physical exam that I likely had TMS was reassuring, it was his reiteration in a subsequent visit - after he reviewed my MRI - that started me on the road to recovery, at least psychologically. I needed to hear a professional tell me to my face that my herniated disc and spinal stenosis were, as he called them, gray hairs of the spine.
In the ensuing months, my physical progress was slow and I became frustrated. I consider myself someone of above-average intelligence, and seeing how so many people were cured just by reading one of Sarno's books was quite a blow to my ego. I thought psychotherapy might be needed, but Rashbaum saw progress where I didn't and suggested that I keep trying on my own for a few more weeks. It was during those weeks that I first became aware that I had the willpower to stop worrying about the pain and to get on with my life.
It's now a year since my first visit with Rashbaum, and I've been 90% pain-free for the past first six months, and 98% pain-free for the past three months. Maybe I would have found my way without him, but I suspect it would have taken me a lot longer.
I think mk6283 may have hit the nail on the head by asking what your primary objective was in visiting a TMS doctor. From what I gather, all they can do is diagnose and recommend a course of action; it's up to the patient to follow through on it.
Good luck. |
|
|
|
mcone
114 Posts |
Posted - 12/09/2008 : 13:03:28
|
quote:
Originally posted by chester
While his diagnosis following the physical exam that I likely had TMS was reassuring, it was his reiteration in a subsequent visit - after he reviewed my MRI - that started me on the road to recovery, at least psychologically. I needed to hear a professional tell me to my face that my herniated disc and spinal stenosis were, as he called them, gray hairs of the spine.
Thanks for the input... and glad to hear that your experience with Dr. Rashbaum was helpful.
I've also had the experience of being able to assimilate a "benign" explanation for a very distressing physical symptom - and then having that symptom resolve - as my chest pain recently did.
This seems to be the key (as others have stated repeatedly) that one has to really believe that the symptoms are not due to a physical problem --- For me, for my chest pain, this re-assurance came from the Claire Weekes book, where my rather severe chest pain symptoms were clearly described by her and characterized as a form of "bad nerves".
It may be that with back pain, Dr. R. has enough experience to confidently and authoritatively rebut the conventional physical explanations - but with RSI, he may not have enough experience with the physiological explanations to confidently navigate the subject matter and rebut the extraordinary amount of "fear conditioning" that is plaguing me - due to so much of the treatment I've been through and materials I've read (past tense). It seemed like he was avoiding "dealing" with the physical - not entirely - but certainly not to a level that I really would need for a proper "debunking".
Although it might also be true that my TMS may be more extreme.
I'm not really sure...it could be with follow up we will connect and make better progress. Or I might have more success with a TMS therapist.
|
|
|
|
mcone
114 Posts |
Posted - 12/09/2008 : 13:59:25
|
quote:
Originally posted by mk6283
* * *
Going to see a TMS doctor isn't always the solution. It may or may not have been in your case. I would urge you to refrain from disparaging the reputation of ANY doctor who is willing to explore alternative modalities to help his/her patients with symptoms/disorders refractory to all other forms of treatment. Every doctor has patients who they are unable to help despite their best/sincere efforts.
Let's try and see the positive in things. Casting blame and dwelling upon an experience that did not meet the high expectations you set for it are not the way to get better.
* * *
I agree that a doctor's openness to alternative means of healing is *generally* a reflection of "courage" and commitment to really help patients. In fairness, I did see some evidence of these qualities in Dr. Rashbaum. But I'm not sure that these qualities alone should immunize a doctor from valid criticism.
It is true that I have very high expectations - higher than most people - from all professionals...including TMS doctors. In some ways it's a reflection of the expectations I have of myself and have generally lived by for much of my life (i.e., perfectionistic, 100% effort, etc.). And upon reflection, I might have been a bit harsh...
...but I still believe that IF the TMS model can potentially help me, a big part of recovery (perhaps the pre-requisite to recovery) will involve letting go of (or allaying) entrenched, deeply rooted beliefs and fears surrounding physical symptoms; and/or uncovering reasons (perhaps psychological ones) as to why such fears and beliefs have such a stranglehold, and figuring out how to break through, etc. I truly believe that these are the (perhaps universal) barriers to recovery for many people, and that one can reasonably expect that a TMS professional recognizes this and will commit to helping overcome these obstacles.
It may be that with more time, or continuity, etc. we could start communicating better. I'm not really sure. I agree that dwelling on this, isn't really constructive, although I would still need to decide whether I should continue seeing him or not.
|
|
|
|
mcone
114 Posts |
Posted - 12/09/2008 : 14:37:52
|
quote:
Originally posted by mk6283
Have you ever seen a "conventional" doctor for your symptoms/complaints? What diagnosis were you given then? What course of action/treatment was recommended to you at that time? Did you try it and did it help?
Seen at least a dozen conventional doctors - basically two categories:
1. The "hardcore" hand surgeons just read MRI's, perform routine tests, and see only trivial findings...basically no diagnosis.
2. The RSI / Myofascial Pain / Physiotherapists group find (or speculate) postural dysfunctions, muscle imbalances, thoracic outlet, etc. ...and treatment has been massage, braces, electrical therapies, heat, stretching, postural exercises, etc... Slight to Significant improvement with these things, but ALWAYS temporary.
3. My own (category 3) diagnosis - based on reading that I've done, is really, really, really morbid --- and ugly and hopeless (although it may not be entirely sound). Somehow I want to share it - as I need to "detoxify" myself of these ideas, but I'm always afraid to share it because it might freak people out. (Quite ironically, this diagnosis is suggested in one of Sarno's books...a major Nocebo for me).
quote:
When/How did you come to learn about TMS? Have you ever seen any success since learning about TMS? What was your primary objective in visiting Dr. Rashbaum?
In 2007 I went to Pennsylvania for treatment at a special intensive "RSI" program. My progress was still inconsistent after many months, and I think it was a co-patient that first mentioned Sarno. The TMS diagnosis made (and still makes) sense - I was suffering from rather serious anxiety at the time the wrist symptoms started.
I spoke with Dr. Sarno on the phone a few times in the middle of 2007; he insisted that I participate in the full program - which would have meant a month or two longer in NYC. But I was hell-bent on getting back to my job in Minnesota - so I asked Dr. Rashbaum if he would see me and he agreed (I was counting on the idea that getting the diagnosis would propel my recovery and enable me to recover while resuming my job) Turns out that without my knowledge, my employer had elminated my job during my leave.
I should note that toward the end of 2007 and early 2008 I might have had some improvement. I remember that computer use would aggravate symptoms, but I had more endurance in doing lots of day to day activities for a few months. (Importantly, I did have "imperatives" along the way, hip, knee, etc. that for just a brief time, overtook the wrist symptoms).
But I had a terrific flare-up in February after a workout class at the gym - symptoms went beyond what I could mentally and physically handle - for weeks and weeks and that put me back into the physcial therapy routines again for most of February through around August or September. And I actually started improving again - seemingly via the physical treatments - And then chest symptoms went through the roof in September (me and Jena - and some others). And then just as chest pain stopped (around mid November after reading Weekes) - the wrist symptoms (and thumb symptoms) are dominating again.
|
Edited by - mcone on 12/09/2008 14:54:03 |
|
|
|
johnnybill45
USA
9 Posts |
Posted - 03/18/2010 : 09:36:28
|
Psychotherapy? All they will do is ask questions to help you gain insight into yourself. So I certainly understand that your trip to the psycho doctor was less than you expected. I strongly believe we can do that ourselves. Try making a list of questions that your deepest self thinks you need to confront. Meditation, Tai Chi, yoga or whatever you can immerse your attention into also can help.
Like any skill, we have to practice. Going to a great guitar teacher won't make you play the guitar skillfully. You have to put in the practice time. In this day and age of speed, we have gotten lazy about putting in time and being patient with our progress.
Asking yourself questions, getting deeper into your understanding of yourself, takes a lot of time and practice. Be persistent, like Thomas Edison and his 1000 attempts to create a lightbulb. We also learn through our failures. |
|
|
|
Dave
USA
1864 Posts |
Posted - 03/18/2010 : 11:39:47
|
quote:
Originally posted by johnnybill45
Psychotherapy? All they will do is ask questions to help you gain insight into yourself.
This is quite an oversimplification.
Dr. Sarno's prescribes psychotherapy for his patients, using therapists specially trained to uncover potential sources of repressed rage. |
|
|
| |
Topic |
|
|
|
Extreme Measures, Part 1: TMS Doc
