Sunday, December 29, 2013

Traditional - Western Medicine vs Complementary/Alternative Treatments For CRPS

There are a lot of opinions about how to treat Complex Regional Pain Syndrome (CRPS) aka RSD.

The majority or 99% of the physicians out there will want to start with Pain meds., anti-inflammatory meds, Physical Therapy/Occupational Therapy, local/regional blocks and then move on to Sympathetic Blocks.   If there is no improvement with these modalities the next conversation will most likely be about having a Spinal Cord Stimulator implanted.  Or a pain pump that delivers morphine directly to the nerves affected in the spine.



What happens to the patient when they are told by their physician there is nothing more they can do? Do you just continue on large quantities of pain medications and continue down the slippery slope?  Or do you fight to find something that will help, a treatment that can possibly put this awful condition into remission.



I have been on both sides of this.  I personally was diagnosed with a very aggressive, volatile case of CRPS.  Local & Regional Blocks did not work on me.  My Pain Management doctor was dumbfounded when this occurred.  Thus we moved onto Lumbar Sympathetic Blocks.  I had 13 LSB, until the last one caused my Adrenal Glands to completely shut down.  This landed me in the hospital for a week.  Following this my Pain Management doctor stated we could no longer do any LSB.  Thus, his next step was talking to me about having a Spinal Cord Stimulator implanted.  I was against the idea and had a really bad gut feeling about it, but I was told this was the last option I had to reduce my pain.  I went through with the trial and it went well.  Approximately 6 months later I had a Medtronic SCS implanted.  I had nothing but issues with it.  Every time I charged the battery it caused my affected foot to swell.  They could not figure out why this was happening.  The next step was to have the battery replaced with a non-rechargeable battery.  I underwent the surgery to change out the batteries in hopes this would correct any issues.  Keep in mind that with each of these surgeries I had to be admitted to the hospital to control my pain, even though they were supposed to be an out patient procedure.  Unfortunately, the second surgery to change the battery did not help.  I then started to have issues with the paddle that was implanted.  Long story short, they had to explant the Medtronic SCS and implanted a BostonScientific SCS. It was during this time that my CRPS moved into my back!  I had asked my Neurosurgeon if this could happen and was assured it wouldn't - it did happen after all...  I had this one for less than 6 months when I lost the ability to control the stimulation.  Upon further review of the situation and my symptoms it was determined that I had a build up of scar tissue on my Dura, that could cause paralysis if the SCS was not removed.  In Feb., 2011 the last SCS was ex planted from my spine.  At that point I was told by my Pain Management doctor, who is highly regarded, that there was nothing else he could do except to keep me on pain meds.  He was ultimately throwing his hands up in the air! This did not set well with me.  I'm not a quitter and this was no exception!



I had been inquiring into other types of treatment options that were available for CRPS.  I had received information on Calmare Therapy, and there had been a lot of promising write-ups on it.  My Pain Management doctor and I had even spoken with a doctor in Florida regarding Ketamine Infusion treatments.  I had been on oral Ketamine for years, so I had an idea of what Ketamine was capable of.  I also had some family members that gave me information on treatment options outside the US, in Frankfurt, Germany.  The treatments in Germany consisted of Alternative Medicine or what could be called complementary medicine.  My first trip to Frankfurt, Germany was when I was 6 weeks post-op from having my SCS removed.  I was on so many pain meds to just make that trip and I was still in pain!



Germany does more research on CRPS and is more advanced in the treatment options than in the US.  Plus, they do not have the same restrictions since they do not have to deal with the FDA.  My first visit there they worked on boosting my immune system, I did Stem a Cell therapy utilizing Stem Cells from my own blood, Neural Therapy with Ozone, PT, Lymphatic Massages, bodywork, vitamin IV's, blood ozone therapy, and more.  This dropped my pain levels, but I did not go into remission.

My Pain Management doctor did not know what to say when I returned with my pain levels
significantly lower.  He was dumbfounded.



Between 2011-2013, I was treated outside of the US 5-6 times.  I was the first CRPS patient in the world to be treated with 'Regional Hyperthermia'.  This significantly decreased my pain levels.  There were numerous treatments that were completed in Frankfurt, Germany that decreased my pain levels to a 5 but over the long run I was unable to stay in Germany long enough to get into remission.

Unfortunately, in October of 2013 my pain levels started to increase again.  I had been told of a Master Hypnotist, Retired Captain in the Navy, Advanced Practice RN, Nurse Anesthesiologist, NGH - Ron Eslinger.    He specializes in Pain Management, working with patients that have Chronic Pain, Phantom Limb Pain, Cancer Pain & PTSD.  His office is located in TN.  I contacted Mr. Eslinger and we spoke for quite a while.  I wanted to make sure I was comfortable with going through with a commitment of time and money to be treated by him.  He also wanted an outline of what I had been through, how I was diagnosed, what treatments I had completed, etc.  He is very thorough to say the least.  I will say that I had tried hypnosis previously and it did not help me, but I was told by several people that Mr. Eslinger was considered the Top, Master, Best of the Best when it came to Chronic Pain.  I had nothing to loose and everything to gain!  The second week in November, 2013 I flew to Knoxville, TN.  Then I drove to the city that Ron Eslinger's office is located.



I was told to expect an intense week of hypnosis, bio-feedback, imagery, working with EFT, learning self-hypnosis and doing homework every night.  We spent approximately 6-7 hours per day together, then I had reading and reviewing of the CD's of our sessions as homework.  It was a busy, intense week, but every day I saw progress that I had not seen else where.  By day 3 the CRPS pain in my back was down to a 3!  Unbelievable.  With continued work, on day 4, my back dropped to a ZERO!  Then on my last day with Mr. Eslinger we were able to get the pain in my left foot/ankle to a ZERO!  In addition to this I had a little to that was in continual spasm due to a knicked lateral plantar nerve, and we were able to get the spasms to stop for the first time since 2007.  No one thought that could happen.  When I left TN, I was given homework to follow up on at home.  This included self-hypnosis, listening to the CD 's of my sessions with Mr. Eslinger, etc.  This is key to my continued progress.



I followed up with my Pain Management doctor a week after I returned from TN.  I walked in without my cane for the first time in 6+ years, I actually had long pants on that could touch my ankle, and I had a pair of shoes on!  When my doctor came in he was shocked to say the least.  He made me take my shoe off, he wanted to see if my little toe was still spasming as it had been since 2007. When he saw it was not moving, my coloration was great in my foot, and we could both touch my foot/ankle - he pushed back on his stool, looked around the room for cameras and asked, "Am I getting punked?"  I had to laugh at him.  How could someone make this up?  He finally told me, if I would have called him with this news he would have laughed at me, but seeing me in person is believing.  I just saw him for another follow up, and he said he can not stop thinking about what I have done... It is blowing his mind.  He is considering going to get trained by Ron Eslinger on his technique.  No joke.



Whether you try Calmare Therapy which has had some great success stories with CRPS, hypnosis with someone that specializes in Chronic Pain, or other proven treatments - there are options available.  Or you may be an individual that just wants to stick with Traditional medicine - do what is right for you and your body.  What is right for one person is not necessarily right for all, but as you can see there are other treatment options out there.  Sometimes you have to search, find resources,
and do some homework but if it can help you in the long run it just may be worth it.

Tuesday, December 24, 2013

Can Hypnosis help CRPS/RSD Patients?


First of all let us start from the beginning – what is hypnosis?  There are so many misconceptions out there and different beliefs about what hypnosis is, what it’s about and does it really work.



Yes, there are the stage shows that we have all seen where you have they guy on stage that pulls several people up there with him and makes them look stupid, quack like a duck, take half their clothes off or even has a participant try to seduce someone.  Those are the types of things that have given hypnosis a bad name and people can’t get over the fact that there really is more to it.





Here are some facts and information on hypnosis: 

Clinical hypnosis is a procedure in which a trained clinician or therapist gives a patient a series of verbal instructions with the goal of helping the patient to enter a state of deep relaxation.  In the relaxed state, the patient is aware of everything that is going on, but at the same time, becomes increasingly absorbed in using his or her imagination as directed by the therapist.  Therapists use a variety of techniques to help their patients acquire the self-control and confidence to visualize, realize, and achieve goals such as reducing sensations of pain.  Therapists often teach their patients self-hypnosis methods that they can employ on their own to reinforce and continue to process at home.

Patients participated in a self-hypnosis relaxation session that involved deep-breathing and concentration techniques.  The researchers found that these patients required less than half the amount of painkilling drugs used by those receiving standard treatments.  Procedures also took less time for the hypnosis group, and they had lower levels of anxiety and pain at both one hour and four hours into a procedure.



In addition, a review of 13 studies of Chronic Pain published in the International Journal of Clinical and Experimental Hypnotherapy in 2007 found that hypnosis consistently reduced pain and was effective that physical therapy and educational efforts.  Clinical research shows that hypnosis can be effective in treating fibromyalgia, migraine headaches, chronic pain conditions and CRPS/RSD.



In 1958 the American Medical Association (AMA) endorsed hypnosis and hypnotherapy as a legitimate treatment tool for pain, stress and relaxation management, weight loss, smoking cessation, childbirth, preparing for surgery, as well as overcoming fears of medical, dental and other hospital procedures.



Hypnosis is older than medicine and has been with us since mankind had its beginnings.  Virtually every culture and race of people have used it.



In biblical times, people went to “sleep temples” to be cured of their illnesses by the Egyptian priests.  The ancient Chinese employed hypnotic techniques in the form of prayer and meditation.  There is evidence that the Romans used “magic sleep” for various purposes.  The Greeks unknowingly used hypnosis, thinking that cures came from the Gods.  Hippocrates wrote about impressing health on the ill by inducing trances and by making passes.

Throughout the centuries, many medical individuals have studied, researched, and experimented with hypnosis.  In doing so, they usually were labeled charlatans, quacks, or imposters.  It is impossible to mention all of those individuals who contributed to the development and progress of modern hypnosis, but in seems necessary to mention a few.

From 1932 – 1974, Milton Erickson, a psychologist and psychiatrist pioneered the art of indirect suggestion in hypnosis.  He is considered the father of modern hypnosis.  His methods bypassed the conscious mind through the use of both verbal and nonverbal pacing techniques including metaphor, confusion, and many others.  He was a colorful character and has immensely influenced the practice of contemporary hypnotherapy, and its official acceptance by the AMA.  His work, combined with the work of Satir and Perls, was the basis for Bandler and Grinder’s Neuro-Linguistic Programming (NLP).



Top Hypnotherapists that deal with Chronic Pain Patients and CRPS:

There are two gentlemen that are very involved with hypnosis and hypnotherapy that I would like to mention to you.  David Spiegel, MD is a Professor at the School of Medicine and Associate Chairman of Psychiatry and Behavioral Sciences, both at Stanford University School, where he has been a member of the academic faculty since 1975.  He is also director of the Psychosocial Research Laboratory.  He received his medical and psychiatric training at Harvard University before going to Stanford.  He is the author of more than 280 research papers, chapters in scientific journals, and books.



David Spiegel has long had an interest in the use of hypnosis as treatment for medical symptom and treatment side effects.  In 1978, he and his father, Herbert Spiegel, MD, co-authored what has become a standard text book on the clinical uses of hypnosis, Trance and Treatment.  The use of self-hypnosis to help children undergoing painful procedures is among his current research funded by the John D. and Catherine T. MacArthur Foundation.  He is the past President of the Society for Clinical and Experimental Hypnosis, and in 1986, he was the recipient of the Schneck Award for significant contributions to the development of medical hypnosis.  In 1998, David Spiegel opened the Center for Integrative Medicine at Stanford Medical Center and serves as its Medical Director.



Dr. Spiegel has done many studies showing how hypnosis does affect the pain receptors in the brain.  They have utilized PET Scans before and after to show exactly where the pain shows in the brain when a patient is in extreme pain.  Then they have taken the same PET scan following hypnosis for pain and the area is no longer lighting up as it did when the patient was experience extreme pain.  This was a consistent finding thus it shows that hypnosis for pain does work.

Another person that is well known for Pain Hypnosis is Ron Eslinger, Captain, USN, Retired, RN, CRNA, MA, APN, BCH, CMI FNCH (Certified Registered Nurse Anesthetist, Master of Arts, Advanced Practice Nurse, Board Certified Hypnotherapists, Certified Master Instructor of Hypnosis, Fellow National Counsel for Hypnotherapy (United Kingdom)).



Ron Eslinger has dealt with chronic pain patients for many years now with phenomenal outcomes.  As a Certified Master Instructor of Hypnosis, Mr. Eslinger not only sees patients, but he also teaches others on how to treat Chronic Pain patients too.



When working with Chronic Pain patients or CRPS patients Ron Eslinger has found that the hippocampus, which controls memory, is another player within the Limbic System.  There are three types of memory:  working memory, declarative memory, and procedural memory.  The hippocampus is critical in cementing declarative memory, which can be compared to the memory in the hard drive of a computer.   Of these three types of memory – only declarative memory impacts our perception of reality. 



During recall, we fit together a piece of the puzzle here and a piece of the puzzle there and put it back together as a complete memory.  Hypnotic processes help reconstruct the pieces of a puzzle.  Hypnosis helps one to remember how they are supposed to feel, replacing the memory of pain or stress with a new memory of comfort.  Hypnosis brings memories back together completing the picture.  However, memories can be as false as they can be true.  All memories are based on perception and perception becomes the reality.



Procedural memory is stored as conditioned responses for reflexes.  Reflexes are actions, habits or skills that are learned simply through repetition.  We all develop procedural memories.



Hypnosis Relieves Pain:

Hypnosis has been used to relieve pain and influence behavior for more than 150 years now.  Evidence based research on the use of hypnosis to relieve pain is limited, but a larger, well-designed study did boost its credibility as a useful and cost-saving pain relief method for hospital procedure rooms.



Published In:  The Lancet in 2000, the study evaluated the effectiveness of hypnosis-termed “non-pharmacologic analgesia” – in easing pain and anxiety in people who were having minimally invasive surgical therapies such as angiograms, angioplasty, simply kidney procedures, or liver biopsies, during which they remained conscious.

Hypnosis allows pain relief without drugs or surgery.  Here is a link to an article from Harvard regarding this:  http://www.health.harvard.edu/special_health_reports/pain-relief-withouth-drugs-and-surgery.




If you would like additional information on hypnosis and chronic pain management please contact
Advanced Pathways Hypnosis at: Info@Advancedpathways.com  |  www.AdvancedPathways.com   |   714.717.6633






Monday, December 2, 2013

CRPS/Chronic Pain Patients & How Clinical Hypnosis Can Benefit Them


CRPS / Chronic Pain Patients and How Clinical Hypnosis Can Benefit Them



Complex Regional Pain Syndrome aka CRPS has been around since the Civil War.  Yet most recently when it is coming to the attention of the media it is being called, “The Mystery Illness…” as well as many other things.  Early on it was called Regional Sympathetic Dystrophy aka RSD, and then recently the name was changed to CRPS. 

According to most physicians that you will speak with they will tell you that they are not sure what causes CRPS.  What they do know is that your “Fight or Flight” nerves are continuously sending signals to the brain that there is trauma in the affected area.  Thus, the brain in turn sends back a pain signal and the patient is caught in a continuous loop of pain.  Yes, it is more complicated than this, but this is the easiest way to explain it so that everyone reading this can understand what is happening.  Now, the BIG question is how do we stop that pain signal?

For those of you that have read my earlier blogs, you know that I am a CRPS patient myself.  I was diagnosed in 2007.  I was diagnosed by a highly regarded Pain Management Doctor with two Doctorates and he is also an Associate Professor at a teaching University.  He initially thought he could have me in remission within 6 months… Well, as of the end of 2011 he had thrown his hands up as nothing he did worked and he was out of options.  That is not too comforting as a patient!  What he soon found out was that I refused to give in to CRPS, it had taken over my life, it had taken everything from me except for my will power.  I was originally diagnosed with CRPS type 2 in my left foot/ankle and after going through several Spinal Cord Stimulator surgeries, it also moved into my back.  After the usual traditional medicine failed me here in the US, I started flying to Frankfurt, Germany to get out of the control of the FDA to get treatment, and I even went to Mexico several times too.  Germany was able to get my pain levels from what you would know as a (10++++++) on the pain scale down to a 5.  I thought that was great, but after several months of being home it would slowly start to go back up.  I was treated in Frankfurt at a private clinic that I would highly recommend 5-6 times.  The Medical Director had dealt with CRPS previously and was not afraid to step out and try new things!  I was eventually introduced to what is called, Clinical Hypnosis, November of 2013.

I was referred to a person that specifically works with Chronic Pain patients, patients with CRPS, Phantom Limb Pain, Fibromyalgia, Cancer Pain, etc… 

Many people hear “hypnosis” and they think of the old stage shows, black magic, etc…  That is not what I am talking about at all! 

What is hypnosis?            The American Medical Association defines hypnosis as a temporary condition of altered attention, within which a variety of phenomena may appear spontaneously, or manifest themselves in response to verbal or other stimuli.  To state it simply, when a person is hypnotized or relaxed, their susceptibility to suggestion is increased.  Thus hypnosis or relaxation can be considered a learning process.

What is Chronic Pain?     Chronic Pain is pain that lasts longer than 6 months.  In some cases untreated pain may worsen as the nerve fibers which transmit pain signals to the brain become more efficient and effective at sending these messages to the brain.  This means that the intensity with increase to more than is necessary to get your attention and thus your brain will become more sensitive to pain.  If this persists then the usefulness of the pain will diminish and could instead lead to preventing individuals from going about their everyday activities / life.

When being in pain, pain causes stress or being stressed worsens pain – therapies including hypnosis, meditation and relation – may break the cycle (if taught by a Certified Clinical Hypnotist with experience in Pain Management).

Benefits of Hypnosis?    Research has shown medical / clinical hypnosis to be helpful for acute and chronic pain. In 1996, a panel of the National Institutes of Health found hypnosis to be effective in easing cancer pain.  More recent studies have demonstrated its effectiveness in pain related to burns, cancer, R.A. , Chronic Pain and the reduction of anxiety associated with surgery.  An analysis of 18 studies by researcher at Mount Sinai School of Medicine in New York revealed moderate to large pain relieving effects from hypnosis, supporting the effectiveness of hypnosis for pain management.

Overview:           A big part of chronic pain and dealing with it via hypnosis is an area of the brain referred to as the, “Limbic System”.  This area includes the Hypothalamus, Amygdala and Hippocampus.  When functioning properly, the Limbic System sets the emotional tone of the mind and influences changes throughout the body by using chemical messages.  However, when functioning abnormally numerous health problems can occur.  Physical problems, such as lack of sleep, too much stress, or chronic pain, exacerbates the problems created by an out-of-balance Limbic System.  In some cases, depending on the external factors, these imbalances can result in post-traumatic stress disorder (PTSD).  This is the essence of stress turning into distress. 

The Hypothalamus also regulates the functioning of the parasympathetic and the sympathetic (fight or flight) nervous systems, which in turn means it regulates things like pulse, blood pressure, breathing, and arousal in response to emotional circumstances.  Therefore, changing thoughts also changes our health.  Ultimately hypnosis is used, along with other techniques, to retrain the brain’s response through the Limbic System.

A good clinical hypnotherapist will take the time to find out where your Chronic Pain or CRPS is most prominent.  The person I saw explained the brain, the Limbic System, how cells regenerate every 90 days (and cells have memories… thus every 90 days you have the opportunity to reprogram your cells…), how the nerves fire in the brain and the biggest thing – “There is no pain, until the signal gets to the brain…”  How true that statement was!

We spent 30+ hours utilizing clinical hypnosis, bio-feedback, imagery, light/sound therapy and being taught ‘self-hypnosis’.   When all was said and done I found out that I too was suffering from PTSD in addition to CRPS.  This did make sense to me.  We worked on my pain levels or as he called them my, “comfort levels”, my sleep (going in I was doing good to get 2 hours per night), gaining control over what was important to me, etc… When I came home I had a copy of every session on CD, books, other CDs to listen to, my own light/sound therapy machine and felt fully equipped to keep my “Comfort Levels” at a ZERO.

If you would like more information on Clinical Hypnosis and how it could help you or a loved one dealing with Chronic Pain or CRPS please feel free to contact me!  I can be reached at rsd.crpsforum@gmail.com.




This is just an overview of hypnosis for pain management.  It is not meant as medical advice.  If you are under the care of a physician please continue their orders.