P.S. If you hate doctors and never want to go to one again in your entire life, I get that. Don’t leave me hateful messages about what a bad person I am. Thank you.

By the time patients attended my pain clinic, they had already seen dozens of doctors in search for pain relief. While their biggest interest was to get pain relief, mine was to determine their underlying cause(s) that explained not only their pain, but other issues about their body.

I never wanted to simply “covering up” pain; I wanted to “heal” it from the inside.

Initially, patients found it hard to trust me.

Like me, they were told it was “all in your head”, offered anxiety pills, or told they were just having panic attacks. A fair amount of Post Traumatic Stress Disorder (PTSD) exists, and we try to offer a fresh start. That’s why I chose the following quote from Frank Crane and placed it at the front of the book:

After recovering from a traumatic brain injury that left me bedridden for twelve years, I assumed the spinal cord injury clinic of Dr. Forest Tennant, MD, Dr. P.H. He reinforced the endocrinology of his workups, and showed me his incredibly comprehensive management style. As an anesthesiologist by training, it was second nature for me to grab hold of the polypharmaceutical approach he offered, one that included supplements and various interventions. It is to Dr. Tennant that I owe all my gratitude and knowledge.

I wrote this guidebook after one year of treating the clinic. I poured in everything I learned, in the hopes that it would help others who spend the majority of their professional careers looking at people’s backs and spines.

Dedication

Table of Contents

Introduction

We are seeing more and more patients with severe, debilitating pain after receiving anepidural ste roid injection (ESI) for pain management. Epidural steroids are not approved by the Federal Drug Administration (FDA), are required to have a warning label that says the ESI could lead to lifelong disability, severe, intractable pain, stroke, respiratory failure, and death.

Many patients with low-back pain follow a path to getting an epidural steroid injection, or a series of them. All come to our clinic, which is a national referral center for a brain and spinal cord injury called spinal adhesive arachnoiditis (SAA). They may suffer from what will be lifelong, intractable, and burning pain that also affects major body systems like urinating, passing stool, eating, digestion, standing up and sitting down, and having sex.

It is for these women and men that this book is written, in hopes that they can understand what happened to them, what they have, and how to help it get better. I feel this book is mandatory reading for pregnant women and their partners, as well as for patients with lifelong or severely debilitating spinal pain, especially if they are considering an epidural steroid injection for pain management.

My goal is to help people understand what epidurals are supposed to do, exactly where they are supposed to go, and how to diagnose and treat a major complication. I offer this information for the benefit of knowledge and empowerment.

I also feel this kind of knowledge will help patients to be validated. This subset of patients has been on a rollercoaster ride for years, in and out of doctors’ offices, trying to get a diagnosis. They need to know their pain is not “all in your head.” You are not drug-seeking and you are right: there is something wrong with you.

I am eternally grateful that retiring Dr. Forest Tennant, MD, MPH taught me his treatment plan. This book is dedicated to those who trusted me with their care. They didn’t have to trust me blindly.

They just had to trust me enough.

Trusting without Opioid Obsession

The first two chapters show that the patients who trust me and follow the protocol are the ones that quickly get better. It requires they dance through some hoops, like being patient, getting extensive labs done (phlebotomists always told my patients they had never seen a doctor order so many labs), trying different medications, and not giving up on a medication that gives side effects.

Instead, patients followed our “alternative advice” to cut the dose in half, and try it again. That is because our protocol worked.

The ongoings of the “opioid crisis”, which is really an “illicit fentanyl” crisis had already harmed chronic pain patients. They could not obtain a prescription of opioids, and many have been force-weaned without additional therapies offered in their stead. If a patient arrived with a relative obsession of getting opioids, we quickly dispelled it by going beyond opioids. In time, we show them that other things can help by healing from the inside, instead of just covering up their pain.

Most patients came in with just a few diagnoses or about 10 maximum; a few had over 20 diagnoses. By the time a patient was in my clinic for 6 months, they had well over 20 diagnoses. With that, we could all begin to understand the magnitude of their problems, and their underlying causes.

The Professional Patient

We discussed the importance of being not just a ‘good patient’, but a professional one - unfortunately, it’s how you play the game and get what you want, so you can get better.

Let me interject that I totally remember what it was like to suffer 24/7 without relief. As written in my first few books, my pain was like a red-headed stepchild clamoring for attention, screaming at me with each movement. It was sad that I could not talk about anything but my pain. Every conversation with my family wound back to… my pain. The weather affected my pain, food affected my pain. Heck, even water affected my pain.

I had two choices: either talk about my pain and continue to make people sick of me, or get a professional to talk about my pain. So I went to a psychiatrist who helped me not only handle my pain better, but to persevere beyond my beliefs.

For this, I thank Walter Jacobsen, MD, author of Forgive to Win. His book helped me, and it helped every relationship since then. I highly recommend this book as a new beginning for general qualities in life that help us to be whole. You can check out Dr. Jacobsen’s Facebook Page here and get this book here.

Dr. J’s book changed your life, because I could stop blaming others for my problems. In fact, I learned how to take others’ perceived “offenses” as “cries for love”. That is a life-changing revelation for all of us.

If a patient could learn to be a professional patient, they accelerated their healing. If they understood how doctors think, and answered with just a “yes or no” to questions I asked that were “yes” or a “no” questions, I could accelerate my knowledge of what was wrong.

Why? So the doctor can think about the differential diagnosis and go to the left if the answer is yes OR go to the right if the answer is no:

Answering a “Yes or No” Question with One Word, “Yes” or “No”

Allow me to say this once again, because for the really traumatized patients, they need to hear it. Here’s a better graph, so you better understand how I grasp to figure you out;)

If you can allow your doctor to do her job and utilize your time together so it maximizes your care, you may walk out with a new diagnosis. This could not only change your mindset. It can change everything about your life: your outlook, relationships, sleep, lifestyle and longevity.

Healing

I only know these things because I know pain. And what it felt like to hae a severely incapacitating disability. More than that, I know about being alone, helpless, and being given up for dead.

How many others did the doctors give up on? If I hadn’t been a doctor, I would have died. As it was, I almost died about 40 times.

In the beginning, even though I had a near death experience (NDE), I was afraid to die and leave my toddler behind without me. That’s when I wrote No More Tears: A Physician-Turned Patient Inspires Recovery. In case I died, I wanted someone to know what I went through, what it was like and what was happening to me. Now completely Revised, I painted the cover:

I don’t want to see you go downhill. I want to see you thrive, and every time I look at you and see you standing instead of laying down, I like it. At the end of our medical appointment, it literally makes me happy just to see you walk away from me.

Walking Away

If we can walk away from one another at the end of an appointment, I know two very good things: I am walking, and you are walking.

So keep walking away.

~ ~ ~ ~ ~

I Know Pain

Part 2 is a Section on Insomnia, the biggest problem people had upon admission to my clinic. If I could just get them to sleep, it would help make literally everything else better. Coming Soon!

My Guidebook to Low Back Pain: Diagnosis and Treatment has four parts. This covers Part 1. Thank you to Main Spring Books for accepting my guidebook for Exhibition at the American Library Association Conference and Exhibition, June 23 - 28, 2022. Over 25,000 librarians attended.

FREEBIE FRIDAY:) If you would like a FREE PDF of my Guidebook to Low Back Pain, which is also on Amazon, just message me and I will email it to you.

WHAT I REALLY THINK

The pain world is a difficult one to be in, because it’s so difficult to find good pain medication or interventions. But you know me - I am not big on Big Pharma. Today, I like optimizing vitamin D, collagen protein powder, light therapy, and I have a FireFly for office/home use. It’s a professional model, upward of $10,000. Not ideal for most people, although there may be a nearby practitioner who can give you office treatments a few times a week.

There’s more information on the device and how to the inventor, Bales Photonics, Inc., HERE. The site includes a teaching video, as seen below.

Let Us Pray

Dear God,

Thank you for all You have done for me. Thank you for all the times You were there when I thought You weren’t paying attention. And forgive me for doubting You, for having trouble keeping my faith in You, and for doubting myself.

Forgive me of my sins and bring me to Your everlasting presence, when my time approaches. I resolve to hold back my tongue when it’s tempting to react to outside forces, and I will be better at remembering You and Your spirit of lovingkindness and mercy.

You call me by name. You calm the seas, You walk with me through all my fires.

I pray for my pain, for my suffering — and I give it all to You. Let me bear it as Christ bore the Cross for me, Holy Lord of All Ages. I give it to you.

I seek You, My Healer, and not my healing. You are my everything, my Protector, My Lord, My Savior, My Everything.

I believe that You are all I need.

I Give Everything To You, In The Name of Jesus.

Amen.

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I want to first give God the glory for all my experiences, and in His ability to turn the negative into the positive.

Guidebook to Low Back Pain: Diagnosis and Treatment

On June 23-28, 2022, my guidebook was presented in Washington, DC, at the American Library Association Conference and Exhibition. There were an estimated 25,000 in attendance, including librarians, press, film producers, and celebrities.

This Guidebook to Low Back Pain: Diagnosis and Treatment was a significant endeavor. I so much appreciate and thank MainSpring Books for accepting it as your top 10 selected for exhibition. Here is an overall review of the book.

Audience

If you have chronic back or neck pain that never leaves, or know someone disabled from back or neck pain, this book is highly relevant for you.

The above is doubly true if you had a labor epidural for the delivery of your baby, OR an injection into the back for pain, AND your back has not been the same since. It’s also perfect for you if don’t trust doctors any more;).

The wonderful Dr. Forest Tennant, who gave me his pain clinic, endorsed my book. I had just learned how to walk and talk again, renewed my medical license, and God led me to call him.

How God Led Me To Dr. Forest Tennant

I talk about it in my No More Tears book, page 263:

Endorsement

Table of Contents

I describe the novel and step-wise pain protocol (that got me investigated by the California Medical Board because I wasn’t Board Certified Pain Management), modified from the wonderful work of retired Dr. Forest Tennant, Dr.P.H.

This book is unique because it provides pictures of backs that most doctors, chiropractors, physical therapists and massage therapists and other health professionals have never seen.

Reviews

Uniqueness

Or, more correctly, most therapists and back doctors have seen backs like these, but they did not recognize what they were looking at. That is because they were not trained to recognize diagnoses like spinal adhesive arachnoiditis or EDS.

Co-Morbidities

This guidebook describes co-morbidities found with severe, unrelenting low back pain in detail, the most common of which is Ehlers-Danlos Syndrome or EDS.

Many with EDS may also have dysautonomia or Postural Orthostatic Tachycardia Syndrome (POTS), Mast Cell Activation Syndrome (MCAS), a neurogenic bladder, osteopenia/osteoporosis, gastroparesis, pelvic pain, lower legs with Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS), and more.

Associated Symptoms

If you have a list of experiences and symptoms that match up to this book, then you are looking at having a completely plausible explanation for your low back pain. See page 212.

Pictures

A massage therapist, chiropractor, or orthopedic surgeon who looks at backs for a living may never recognize a back of a patient with Ehlers-Danlos Syndrome or adhesive arachnoditis, which is quite easily diagnosed.

Early Spinal Adhesive Arachnoiditis

The skin is smooth and velvety.

Moderate Spinal Adhesive Arachnoiditis

Creases develop.

Severe Spinal Adhesive Arachnoiditis

Patients are bedridden and in wheelchairs.

(If you have never looked at your back in the mirror, have someone do it for you.)

Mental Health

Many patients with chronic low back pain or failed back syndrome also have been met with an array of doctors who do not prescribe pain medications, and essentially do nothing for patients but offer over-the-counter medications, perhaps sedatives for anxiety, all of which are insufficient at treating these patients.

They arrive traumatized by past experiences and a battery of doctors who did not believe their symptoms.

Readiness

Patients with chronic low back pain deserve a good, hard, look at what happened and why they were so adversely affected. Was the injury proportional to the accident? If it was out of proportion, that is a red flag for EDS.

Fortunately, once the practitioner knows how to do it, it is not difficult to diagnose EDS. Much of the diagnosis relies on clinical and family history, as there is no genetic test that reliably diagnosis the most common type of EDS, the hypermobility type. But fortunately, most patients were cheerleaders, were hyperflexible, and make the diagnosis based on the Beighton Score. Many patients have family members that died of a cerebral or aortic aneurysm.

Getting a Diagnosis. Don't have a diagnosis for your back? Then you can't get the right treatment. Use this book to discover the root of your problem, so you can heal.

Additional Audiences

Because of the detail, it is also good for those who have a medical record of their history of injury after an epidural for labor pain, or an ER spinal tap that led to upper extremity paralysis or postdural puncture headache, respectfully.

The reason this book is filled with so much detail is because my practice was a national referral center for EDS and spinal adhesive arachnoiditis. Dr. Forest Tennant had seen more cases than most doctors see in one lifetime, making this book an essential for any health care provider who works with the back or spinal cord. I asked Dr. Tennant to be a co-author, but he declined because he didn’t write the book. In retrospect, I should have asked him to write at least one chapter!

Thank you for remembering how to help those with unrelenting back pain. They deserve a close look at not only the structural problem, but the etiology of why their injury is not healing but persists to the point where they have central pain.

FREEBIE: GUIDEBOOK TO LOW BACK PAIN

Leave a comment

Patients initially find it hard to trust. Like me, they were told it was “all in your head”, offered anxiety pills, or told they were just having panic attacks. A fair amount of Post Traumatic Stress Disorder (PTSD) exists, and we try to offer a fresh start. That’s why I chose the following quote from Frank Crane and placed it at the front of the book:

You may be deceived if you trust too much, but you will live in torment if you don’t trust enough.

After recovering from a traumatic brain injury that left me bedridden for twelve years, I assumed the spinal cord injury clinic of Dr. Forest Tennant, MD, Dr. P.H. He reinforced the endocrinology of his workups, and showed me his incredibly comprehensive management style. As an anesthesiologist by training, it was second nature for me to grab hold of the polypharmaceutical approach he offered, one that included supplements and various interventions. It is to Dr. Tennant that I owe all my gratitude and knowledge.

I wrote this guidebook after one year of treating the clinic. I poured in everything I learned, in the hopes that it would help others who spend the majority of their professional careers looking at people’s backs and spines.

Trusting without Opioid Obsession

The first two chapters show that the patients who trust me and follow the protocol are the ones that quickly get better. It requires they dance through some hoops, like being patient, getting extensive labs done, trying different medications, and not giving up on a medication that gives side effects. Instead, they follow our “alternative advice” to cut the dose in half, and try it again. That is because our protocol works.

The ongoings of the “opioid crisis”, which is really an “illicit fentanyl” crisis have harmed chronic pain patients. They cannot obtain a prescription of opioids, and many have been force-weaned without additional therapies offered in their stead. If a patient arrives with a relative obsession of getting opioids, we quickly dispel it by going beyond opioids. In time, we show them that other things can help by healing from the inside, instead of just covering up their pain.

The Professional Patient

I totally remember what it was like to suffer 24/7 without relief. As written in my first few books, my pain was like a red-headed stepchild clamoring for attention, screaming at me with each movement. It was sad that I could not talk about anything but my pain. Every conversation with my family wound back to… my pain. The weather affected my pain, food affected my pain. Heck, even water affected my pain.

In time, I learned that I was making people sick of my pain. It affected my relationships.

I had two choices: either talk about my pain and continue to make people sick of me, or get a professional to talk about my pain. So I went to a psychiatrist who helped me not only handle my pain better, but to persevere beyond my beliefs.

For this, I thank Walter Jacobsen, MD, author of Forgive to Win. His book helped me, and it helped every relationship since then. I highly recommend this book as a new beginning for general qualities in life that help us to be whole. You can check out Dr. Jacobsen’s Facebook Page here and get this book here. It will change your life.

If a patient can learn to be a professional patient, they may accelerate their healing. They understand how doctors think, and answer “yes or no” questions with a “yes” or a “no”. Why? So the doctor can think about the differential diagnosis and go to the left if the answer is yes OR go to the right if the answer is no.

If you can allow your doctor to do her job and utilize your time together so it maximizes your care, you may walk out with a new diagnosis. This could not only change your mindset. It can change everything about your life: your outlook, relationships, sleep, lifestyle and longevity.

Healing

I only know these things because I know pain. And severe disability. More than that, I know about being alone, helpless, and being given up for dead.

How many others did the doctors give up on? If I hadn’t been a doctor, I would have died. As it was, I almost died about 40 times.

In the beginning, even though I had a near death experience (NDE), I was afraid to die and leave my toddler behind without me. That’s when I wrote No More Tears: A Physician-Turned Patient Inspires Recovery. In case I died, I wanted someone to know what I went through, what it was like and what was happening to me. Now in its Revision, last week I painted what I thought could be a new book cover, but of course the publishing company, MainSpring Books, will decide on the final:

I don’t want to see you go downhill. I want to see you thrive, and every time I look at you and see you standing instead of laying down, I like it. At the end of our medical appointment, it literally makes me happy just to see you walk away from me.

Walking Away

If we can walk away from one another at the end of an appointment, I know two very good things: I am walking, and you are walking.

So keep walking away.

~ ~ ~ ~ ~

My Guidebook to Low Back Pain: Diagnosis and Treatment has four parts. This covers Part 1. Thank you to Main Spring Books for accepting my guidebook for Exhibition at the American Library Association Conference and Exhibition, June 23 - 28, 2022. Over 25,000 librarians attended.

See our website for all eight eBooks. And download your FREE Guidebook to Emergency COVID Care ~ with Your Personal Tracker!

I have 6 books In Press. The first three are at the publisher, and the last 3 are still being revised, as of 11/14/2022.

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What is my next step?

1. Join Physicians and Patients Reclaiming Medicine at https://ReclaimingMed.org Physicians, health care providers, advocates, and patients all welcome. See you there.

2. Send a letter to Governor Newsom. Demand we get back our fundamental rights to medical freedom: https:CaliforniaForUs.org

3. Send a letter to your State's Attorney General. Ask them to do their job and protect those they have sworn an oath to protect. Demand they convene a grand jury and bring criminal indictments against the perpetrators.

https://10letters.org/

1. Visit AlignAct.com to Sign a Petition to Your Congress and get a Medical Freedom Act in the works: https://alignact.com/go/medical-freedom-act

2. For Health Care Professionals: Take Steve Kirsch’s Survey If you work in Healthcare. https://airtable.com/shrQZWaacOu9j2rhh?utm_source=substack&utm_medium=email 

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• My Guidebook to Low Back Pain: Diagnosis and Treatment: A comprehensive book for chronic pain, especially 24/7 low back pain. Perfect for the general public, doctors, attorneys, and any professional who sees people’s backs: physical therapists. Selected to be on exhibit at the June 2022 American Library Association’s Annual Exhibition and Conference in Washington, DC. See my Amazon book here.

  

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#GuidebookToLowBackPain #LowBackPain #backpain #braininjury #TBI #recovery #truestory #RealLife #TheRebelPatient #DrMargaretAranda #diagnosis #treatment #newbooks #booklovers #MedEd #books #chiropractors #physicaltherapists #massage #chiro #PT #spine #back #SAA #arachnoiditis #EhlersDanlos #EDS #MCAS #authors #writers #amwriting #writingcommunity #authorcommunity

This Guidebook to Low Back Pain: Diagnosis and Treatment was a significant endeavor for me. I so much appreciate and thank MainSpring Books for accepting it as your top 10 selected for exhibition. Here is an overall review of the book.

Audience. If you have back or neck pain, this book is for you. I describe our novel and stepwise pain protocol, modified from the wonderful work of Dr. Forest Tennant, Dr.P.H. You are walked through every step of pain, from insomnia to relationships.

This book is unique because it provides pictures of backs that most doctors, chiropractors, physical therapists and massage therapists and other health professionals have never seen.

Uniqueness. Or, more correctly, most have seen backs like these, but they did not recognize what they were looking at. That is because they were not trained to recognize diagnoses like spinal adhesive arachnoiditis or EDS.

Co-Morbidities. This guidebook describes co-morbidities found with severe, unrelenting low back pain in detail, the most common of which is Ehlers-Danlos Syndrome or EDS. Many with EDS may also have dysautonomia or Postural Orthostatic Tachycardia Syndrome (POTS), Mast Cell Activation Syndrome (MCAS), a neurogenic bladder, osteopenia/osteoporosis, gastroparesis, pelvic pain, lower legs with Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS), and more.

Mental Health. Many patients with chronic low back pain or failed back syndrome also have been met with an array of doctors who do not prescribe pain medications, and essentially do nothing for patients but offer over-the-counter medications, perhaps sedatives for anxiety, all of which are insufficient at treating these patients.

They arrive traumatized by past experiences and a battery of doctors who did not believe their symptoms.

Readiness. Patients with chronic low back pain deserve a good, hard, look at what happened and why they were so adversely affected. Was the injury proportional to the accident? If it was out of proportion, that is a red flag for EDS.

Fortunately, once the practitioner knows how to do it, it is not difficult to diagnose EDS. Much of the diagnosis relies on clinical and family history, as there is no genetic test that reliably diagnosis the most common type of EDS, the hypermobility type. But fortunately, most patients were cheerleaders, were hyperflexible, and make the diagnosis based on the Beighton Score. Many patients have family members that died of a cerebral or aortic aneurysm.

Getting a Diagnosis. Don't have a diagnosis for your back? Then you can't get the right treatment. Use this book to discover the root of your problem, so you can heal.

Additional Audiences. Because of the detail, it is also good for those who have a medical record of their history of injury after an epidural for labor pain, or an ER spinal tap that led to upper extremity paralysis or postdural puncture headache, respectfully.

The reason this book is filled with so much detail is because we are a national referral center for EDS and spinal adhesive arachnoiditis. We have seen more cases than most doctors see in one lifetime, making this book an essential for any health care provider who works with the back or spinal cord.

Thank you for remembering how to help those with unrelenting back pain. They deserve a close look at not only the structural problem, but the etiology of why their injury is not healing but persists to the point where they have central pain.

#doctors #chiropractors #physicaltherapists #massagetherapists #ehlersdanlossyndrome #ehlersdanlos #ehlersdanlosawareness #EDS #edsawareness #lawyers #attorneys #workerscomp #injury #injuryattorney #injuryrecovery #qualityoflife #medicalmalpractice #medicalmalpracticeattorney #medicalmalpracticelawyer #Medicalmal #MedMal #MedicalMonday #workerscompinjury #epidural #spinalcordinjury #spinaltap #laborepidural #LP #lumbarpuncture #lumbarspinalstenosis #spondylolisthesis #spondylosis #spinalcordinjury #spinalcordinjurysurvivor #SpinalAdhesiveArachnoiditis #arachnoiditis #SAA