Chinese Medicine and CSS

Natural Born Pain Killers

Are you sitting at home feeling bad, like someone sucked the life out of you? Are you looking out the window wishing you would just have enough energy to go get the mail? Does the daunting task of going to the grocery store make you pull the covers over your head and hide??

How many of you out there are thinking about your old life? A time when your energy level seemed limitless and pain was a foreign concept that only your grandparents complained about. Now most of us are at home, not working, feeling grief from what we have lost from our past. We are in constant pain, feeling incapacitated and frightened of what is to come. But I have a message for you. This does not have to be your continuing lot in life. I can tell you from personal experience that some of the best pain medicines that can help you get to a better place don’t come from the neighborhood pharmacy - they are right inside of you.

I will never forget when I was diagnosed with CSS. I had just spent a week on the oncology floor in a Miami hospital. I was wrapped in ice to help alleviate the burning pain. My body was wrought with pain. Nothing seemed to get rid of the intense burning sensation shooting down my legs. It felt like someone was pouring acid on my feet while holding a blow touch under them for good measure. Electric shocks were flying all over my body. Sleep evaded me. I remember telling my doctors that my pain was so bad that it made my 36 hours of labor giving birth to my daughter without medicine seem like a day at the beach. To combat the agony I was prescribed Fentanyl sub mucosal lollipops, which deliver extremely strong pain medicine similar to Morphine. It is generally prescribed for end stage cancer patients. I literally waited every 4 hours for my next fix. I had become a junkie.

Two weeks after being released from the hospital, during an appointment with my pulmonologist, the doctor who diagnosed my CSS, I literally freaked out in front of him. I was begging him to increase my dose of prednisone since nothing was working. Having been his patient for 5 years he was very familiar with my case. He knew how well I took care of myself prior to being diagnosed. For years, I had been working out. Over 15 years prior I went to National Jewish Hospital in Denver to learn more about managing my asthma and how to keep it under control. I learned to exercise within certain parameters that would help increase my breathing capacity, yet not wear me out or cause an asthma attack. I never thought that my routine workouts would be the key to getting me better.

I will never forget that appointment and what my pulmonologist said to me. He looked me in the eye and said “Elizabeth, you and I both know what the best pain medicine of all is - exercise. Go throw yourself in a pool every day and start working out again.” I went home that day thinking about our conversation. I was so fried. How could I even fathom working out when I sounded like a duck walking with a foot drop. The extent of my daily work-out at that point was brushing my teeth.
Waking up the next morning, it felt as though someone had dumped lead into my veins and poured sawdust in my mouth - the result of the mass quantities of drugs I was taking. I stared vacantly out into my garage where all my exercise equipment sat gathering dust. The magnitude of the task ahead of me was incomprehensible, yet I knew it was time to take control of this illness.

Still in my pajamas I lumbered onto my small Pilates machine and worked out for a total of 10 minutes at a turtle’s pace. (Before the onset of my illness my normal routine was an hour of Pilates at a steady clip.) I was so medicated I recall being fearful of falling off a machine that was merely 4 inches off the ground. To my amazement, after just one small session, I felt better. My mood was elevated. It was if someone pulled all of the cobwebs out of my head. My legs were noticeably less painful. I actually felt like I had regained some of my old energy, which was fantastic compared to the sloth I had been for the previous month. I had just taken the best drug of my life, endorphins; natural born pain killers. Best of all, this medicine is free.

I am sure you have read articles or watched programs about marathon runners and how they get this high from running. Or even more unbelievable, how they are addicted to running from the high they get. I have some good news for you. You do not need to run a 10K race to start feeling better. All you need to do is move and breathe.

In Traditional Chinese Medicine (TCM), the organ that is responsible for the flow of Qi (the body’s energy) is the liver. Depression can be one of the results of stagnated energy in the liver. The liver (in TCM) represents both the organ and the function of the smooth flow of Qi and blood (nutrients) of the body. To better understand this theory I am going to give you an analogy. Imagine being on a freeway and as you are driving you notice that the traffic begins to slow down. At some point your car isn’t even moving. To make matters worse it’s rush hour at the end of the day of a long week. You cannot get where you need to be and neither can anyone else on the highway. After a few minutes you start getting agitated and anxious. You begin to notice that people in the cars around you are getting angry as well. You feel trapped and yet you have nowhere to go. The noxious exhaust is making you feel even worse. You are running out of gas and are now worried that you won’t make it to the exit, let alone trying to get home. You are stuck.

In TCM the body’s energy, Qi, travels along meridians. Imagine that meridians are like highways all over your body. Each specific highway gets you to different places you need to go. In a sick body, the meridians are blocked - energy gets stuck. Now think about your own body. You haven’t been physically active in a while because you are in pain and you have no energy. Your body is filled with medicine that you pray are staving off this rare disease. You feel positively horrible. Throw some fear and anger into the mix and everything comes to a stand-still causing physical and emotional pain, crushing your spirit.

One of the best ways to elimate pain is to simply move. I don’t mean running down the block. You can literally exercise from bed. Physical movement gets stagnated energy unblocked. Stagnation of the body’s energy is one of TCM’s etiologies for pain. You can find many good tapes or DVDs on how to get your body moving for your appropriate condition. Just the act of breathing removes all the metabolites built up from medicines. Tai chi can be wonderful because it both moves and builds Qi as well. Even a mild exercise routine can act like the garbage truck hauling away all the junk piling up in your body. If you are well enough to try it and you get your physician’s approval, I highly recommend it.

If you are not ambulatory, you can try breathing exercises while lying in bed. Try and use the technique of visualization. Visualize your body getting better. In your mind’s eye think about how the medicine is doing its work to get you better. While you are doing this, pace your breathing and try to get into a meditative state. If you need guidance, there are many books on the subject. With practice you can actually influence brain waves to change and induce a healing regenerative state.

Heat and cold can also cause pain. Think about how you feel. Do you hate cold weather? Does the thought of something hot make you want to run and put your head in the freezer? Just the simple act of using either hot or cold can help relieve pain. How many times do we get in a hot bath to relax? People who have used chemotherapy to control their disease certainly know how night sweats feel or the thirst that comes along with treatment. Eating foods that are energetically cooling like berries and cucumbers help the body reduce heat. I used ice on my legs for neuropathic pain.

Let’s go back to the car on the freeway. After a few minutes stuck in traffic you are likely to feel pretty frustrated and angry. Anger can be a killer. None of us are certainly happy what has happened to us. Why me? I did everything right. I was a good person. Having a chronic disease can be so frustrating. Pent up anger inhibits energy from flowing smoothly within the body. If possible, find someone to talk with, whether it be a Psychiatrist, a close friend or spiritual leader. You can find solace by talking with a trained professional to help you deal with and accept the changes in your life.

You can also try writing. Keeping a journal is a wonderful way to rid oneself of free flowing anxiety. The act of writing allows you to express your frustration in a calm and positive manner. I ask many of my patients to use this exercise to help them release their negative energy. If you hate to write you might try to construct a picture journal. Cut out pictures from magazines or newspaper that represent how you feel and how you want to feel. Glue them to the pages of a journal. You can write a little blurb beneath each picture or nothing at all. Using your creativity is a wonderful way to move the energy out from inside of you.

One of the best ways to build energy is eating well and taking proper supplements, as I wrote in my last column. The lack of Qi, the decreased nutritive aspect of blood that results from the meds, and the accumulation of phlegm from processed foods and side effects from medicines like steroids, can cause pain because you literally have no energy in your system to move. Returning to the car on the freeway analogy, if you run out of gas (blood) you’ll never get the car to accelerate (Qi). We are told to use premium gas in order to get the best performance out of our car. If you are not eating a healthy diet or if you put sugar in your gas tank, you can create a blockage in the gas line (phlegm) preventing your car from functioning.

If you are eating well and giving your body healthy nutrients, you can move more efficiently and help stave off the effects from medicine and minimize the symptoms of your illness. Herbs like ginger and turmeric are natural anti-inflammatories. Black cherry juice and green tea have pain reducing effects as well.

It took eighteen months for me to reduce and elimate pain medicine. Once I began exercising and doing light Pilates routines, I was able to get off Fentanyl almost immediately, and began taking a less potent pain medicine, Ultram. I began getting acupuncture and incorporating foods that had both anti-inflammatory effects and helped decrease pain. I also started 9 months of physical therapy 3 times a week. Every month I was able to decrease my Neurontin by another 100mg. Each month I got stronger and stronger, doing 10-15 hours of exercise a week. My routine included yoga, cardiovascular exercise on an elliptical machine and Pilates. If I didn’t work out I felt terrible, like I was hung over. After a year I began cutting my Ultram in half, then quarters, until finally I was off it for good. I took time to journal and meditate. I would do breathing exercises in my car, in the doctor’s office and the shower; any time I thought about it, I did it. I want to stress that I reduced my medicine under the coordination of doctors’ care. I followed a schedule to slowly decrease my medicine in a manner that enabled my body the opportunity to recuperate, resting more during the weeks I decreased my dosage.

Natural born pain killers are either free or at least relatively inexpensive compared to all the expensive drugs you are taking. However you choose to get back on track, DO NOT stop taking your medicine. Try to incorporate some of these ideas into your daily routine. In time you might be surprised that you are actually feeling better and in less pain. Once you build up your body’s own ability to reduce the painful side-effects, then it might be time to consult your physician about reducing and possibly eliminating some of the drug therapy.

Here are some resources you may wish to consider in your journey to assist your body in reducing pain.

www.livingarts.com This website has books, DVDs and audiotapes for breathing techniques, tai chi and other health related items.

www.newchapter.info Makers of Zyflamend, a supplement that has ginger and turmeric to reduce inflammation. They also make ginger syrup.

www.drweil.com Dr Weil’s website and books have a huge amount of information on breathing techniques and nutrition. He has excellent audiotapes for breathing and relaxation techniques.

Creative Visualization by Shakti Gawain
Healing and the Mind by Bill Moyers

Wherever You Go There You Are, Mindfulness Medication In Everyday Life by Jon Kabat-Zinn

Elizabeth Trattner is a Florida and National Board Certified Doctor of Chinese Medicine and Acupuncture and an exercise junkie. Dr. Trattner has been featured in national publications such as Elle magazine and First for Women as well appearing on The Oprah Winfrey Show. She has contributed to medical publications for world renowned doctors, Andrew Weil M.D. and Leslie Baumann M.D. In December of 2001 she was diagnosed with CSS as a result of a long term side effect from Singulair. Elizabeth is thankfully in remission from using various modalities from both western medicine and alternative therapies. She can be reached at elizabeth@trattner.net.