There are good reasons medical professionals don’t treat those closest to them. Ego, relational dynamics, and just deep caring can obscure the objectivity of both provider and loved one, especially the more that is at stake. As you have learned by now, I care very much for my patients. And for those closest to me, it hurts to watch them struggle with their pain. I too can lose objectivity in that I feel a heavy mantle of responsibility to get them back to their lives and to their loved ones. At times, it can be very hard for me not to fall into thinking that I have failed them. It takes a great deal of self-awareness and discipline to remain focused on the goals and objectives, and not let negative emotions overrun or influence me. And I have to add that along with the self-awareness and discipline, prayer is also pivotal behind the scenes in my treatments, for a loved one or not.

Most everyone tells my husband John, “Ohhh, you are soooo lucky to be married to your physical therapist!”, and he will immediately agree with them, “Oh yes! She has put me back together multiple times. Best decision ever!”

But let’s be honest: It is a challenge being married to your Physical Therapist. Equally challenging is the Physical Therapist being married to the patient. And when severe pain is involved, it is no cakewalk. It is typical human behavior for people to discard the perspectives of those closest to them, and John and I are no different. But, through the years, we have learned to work together and figure out ways to listen to each other, in spite of our stubborn tendencies. It helps a great deal if I give a heads up on “who” is communicating: wife or PT.  “K. My PT hat is on. Here is what I recommend.” And as soon as I am done, say, “PT hat is off now.”

Not quite my PT hat 😀    Many thanks to DeeDee

For the past couple of months, I’ve been wearing my PT hat around the house pretty regularly. Ending the 2021 year out, John began experiencing back pain the week prior to our travel to California for Christmas. It lingered well into mid-January when he saw his MD after our holiday traveling was completed.  Dr. H validated my diagnosis that it was not a kidney stone as John had been thinking but a mechanical back problem. He said strained muscle, and while that was part of the problem, it wasn’t the only player.

Moving forward into the design of my patient’s 3-step treatment program, my challenge was not exacerbating severe pain in an exhausted body. Nevertheless, it was time to remove the passive approaches like heat, medication, and soft tissue release as the primary focus. Research has provided ample evidence that these approaches will not improve the situation if you are dealing with chronic pain. What will? These 3 Steps which I implement with all of my patients.

 

The Karen Morgan 3 Step Approach (and then some)

Step 1: Education. John re-visited the booklet on “Why I Hurt” by Adriaan Louw, a booklet I give to all of my patients with a history of pain, and/or significant injury in their past. John has had both, having seriously injured his back on his high school wrestling team, crashing his road bike at 20 mph, and spinal surgery nearly 6 years ago. He was reminded again of the neuroscience of chronic pain episodes, and how they do not indicate injury has re-occurred, but rather point to an “overly concerned brain” trying to manage conflicting information. We know from research that the more patients understand this, the more their pain reduces, and the better they can control their pain. John has been highly active much of his life, and when he slows down in this, his back pain kicks back up. It is as if his brain is panicking about this slowdown and overreacts with concern.

Step 2: Re-introduce deep breathing through the pain. Rather than immediately reaching for medication or the heating pad, breathe in through the nose and out through pursed lips, like you are blowing out birthday candles. This immediately releases nitric oxide (NO) into the blood system and helps lower the blood pressure, relaxing the body, and more than anything distracts the focus from pain. Because this is something you are actively doing for yourself, I hypothesize that this tells the brain, “Hey, we got this!” The more active the approach, the more information you are giving the brain, and the brain will back off with its painful reminders to take care of the problem.

Step 3: Appropriately graded exercise. After a couple of false starts, John and I made it to where we agreed upon a re-design of his exercise program. I listened to what was working, what was kicking up his pain, and I determined where the weaknesses were, what motor programs were not correctly firing, and made adjustments. This is where having the expertise of a PT comes in handy, rather than “winging it on your own.” I started him on a series of squats, emphasizing weight shifting through the heels, which really activates the posterior chain of command (muscles on the backside of your body). He looked at me a little sideways, thinking this more aggressive approach would kick things up. The opposite happened. At the end of the sets, he looked at me surprised. “I feel much better.”

 

And then some

And, then this is critical: I had prayed for wisdom in how to speak the language his mind understands. “Keep me objective. Let me give him what he needs.” It’s a common prayer I pray daily for each of my patients.

I pray for healing over all my patients. Specifically, for him, I visualized the jagged edges of the lumbar facet joints inflamed with painful chemicals surrounding the joints. Deep in the night, I prayed over those joints and then the entire right area of his low back. I asked that the tissues and processes reverse what they were doing and bring healing, and to stop setting off the pain receptors. I prayed over those receptors and the central processing in his brain. Change his reaction to his sensations, Lord God.

I have prayed prayers like this for many patients in the dark of night, and yes, during the daytimes too. Sometimes with tears. I have seen some remarkable answers, but not always as I ask. Often, a significant change occurs. Western Medicine only recently has recognized the power of prayer, but naturally, can’t do much with it.

Within 3 days, his severe pain reduced and then disappeared completely by Day 5.  He went from not being able to lie flat, and requiring a heating pad through the night, to all positions became comfortable, even sleeping on his stomach. Modalities of heat and the theragun/massager were no longer needed. The ibuprofen and Tylenol disappeared from the bathroom counter. He returned to normal activities by the end of that week. At my recommendation, he now works once a week with a personal trainer friend of mine, who continues to challenge him with progressive resistance. On the other days, John performs those exercises at a nearby gym, as well as the program I’ve designed. He’s on his way to rebuilding bone mass in his hips and spine (his X-ray films showed significant bone loss).  Best of all, we’ve resumed our long hikes with jogs on Saturdays.

Munich 1/2 Marathon 2014

I am incredibly grateful for his remarkable recovery. And while I could lay claim to that, I know better. Yes, I am knowledgeable and skilled, and yet I’ve seen far too many folks remain in their pain. But when my patients do overcome their pain experience, I’ve seen that something shifts, deep within, beyond the cellular and organ level. When the healing of thought processes and expectations occurs, that is where I see the healing of body and mind. Does prayer bring that about? I absolutely believe so. Our bodies were designed with an innate ability to heal, and prayer can help unleash that process to its full potential. And, the change it works on our mindset is especially profound.

What about you? Have you prayed for someone’s health and healing, including your own? Has someone prayed for you? What happened?

I’d love to hear your story.

 

 

https://pubmed.ncbi.nlm.nih.gov/17592957

https://www.amazon.com/Why-Do-Hurt-Adriaan-Louw/dp/0985718625/ref=sr_1_1?hvadid=78134097066652&hvbmt=be&hvdev=c&hvqmt=e&keywords=why+do+i+hurt+adriaan+louw&qid=1645824837&sr=8-1

https://pubmed.ncbi.nlm.nih.gov/34378834/

The healing power of prayer and its implications:

https://pubmed.ncbi.nlm.nih.gov/18414311/

https://pubmed.ncbi.nlm.nih.gov/33897218/