I felt like I was dying at 35 years old, my body was completely betraying me, exhausted, constant pain, no life as absolutely no energy on days off and still exhausted starting the next week. Even years in the Army never left me feeling like that
I had no idea it was the misery of the IT job that was causing most of my pain and suffering, and it had nothing to do with the job itself, it was the endless insanity of everyone else around me doing exactly what they were informed would cause problems instead of having discussions with people that actually knew how shit worked. I was endlessly picking up everyone elses mess and treated worse than a pile of shit all because people were incapable of having a speck of respect for other people since all their hatred for computers fell on me
I GTFO of the career of misery and took half a decade to finally start feeling better
I have now spent years and countless hours working on software and I greatly enjoy doing this work again and find I get even more done than I used to simply by doing life the way I need to instead of how some backwards/abusive control freak "needs it done"
I ended up in a similar situation last year. Amazing job, but typical startup stresses combined with some situational stuff in my personal life (moving, new jobs for partner, kids, day-care changes, etc, etc, etc) left me completely broken. I ended up leaving my job to take care of my family (thought I was done with my career, but it ended up being a sabbatical - back at the old job and doing great now)
It took about 6 months for the brain zaps to start fading. Then another 6 months for me to start feeling capable of really doing my job well. I'm 18 months into "recovery" and I still think I have another 6 to 12 months before I feel like my old self again (so about 2 to 2.5 years in total).
Time is really the only solution. You can't just think your way through it. You have to left your body's rewards systems re-adapt and re-learn how to be a healthy, happy human.
My grandfather said he experiences stupidity as physically painful. I suppose pain is an indicator that some kind of damage is actually occurring.
That's my experience at least, that it's not healthy to be in environments like that for any length of time. In such a place, my regret is always not leaving sooner...
experienced something very similar. thought I would leave my field permanently out of frustration and despair. I like my work now, but faced with that burnout again do not think I could power through it a second time.
Apropos, I had chronic pain throughout this experience. I thought it was just aging, irreversible, and something that compounded my hopelessness. It's very surprising to be 10 years older now but feel 20 years younger. Books like "The Body Keeps the Score" or "Healing Back Pain" used to seem woo to me, but now I am convicted that health comes from within as much or more than it does from without.
I had sciatica for years and inflation in my hips so bad I could barely walk 500 meters while in college. Basically only kept going by iboprufen, naproxen and paracetamol. I tried everything. Acupuncture/LSD/ultra sound/kiro/physio/yoga had mri’s/xrays/you name it
I had dr. Sarno’s healing back pain for 2 years on my shelf before I took a holiday and read the whole thing in one go. Fell asleep for 4 hours and woke up pain free for the first time in 7 years. Started to come back a few times but I would just read the book again and go for a run. Been smooth sailing for 10 years now.
I have worked with computers for decades, I love it, and for me to not even want to look at a computer was impossible for me
I made it through the Army (decades ago), I ran my own company, handled employees, etc.
I have no problem with hard work and stress. My joy for computers was destroyed for a while, and it had nothing to do with the work itself, it was due to targeted intentionally malicious discrimination from the top
Why do all such articles never talk about the meat of the solution? Why do I always feel like I'm being sold something.
Why is it so hard to explain the solution briefly, or directly present it to me upfront. Why does it need so much of mystery around it?
In this article the OP does not even mention "Pain reprocessing theory" which is what they seems to be talking about (based on the study they have linked)
Just woke up and this post's traction has surpassed my wildest imagination.
Similar to what pedalpete has said, I'm looking to release this in parts to ensure:
1. I am not overwhelming people and losing their interest
2. Quality remains as high as possible (I invested only a few hours into this last week as an experiment). I want this blog to be the most easily accessible, engaging + factual source for chronic pain sufferers. That requires sufficient time to nail (and it seems like I've struck a chord so far).
3. Get signals from readers week by week and tailor to the audience which is forming.
This will help me helpfully reach the most pain sufferers.
RE feel like you're being sold something. This series will cover what is needed to recover from chronic pain and be offered for free. I am looking to build a product eventually (why wouldn't I want help as many people as posssible while building a career which does good - I don't believe they're exclusive), but the information in this blog will remain free.
RE not calling out Pain reprocessing theory/therapy - I'll go through the post today and see if it makes sense to add this into #1 (or if it's better for #4). It's not something I consciously omitted when writting this post last week.
1. You've lost my interest with no "meat", as the GP stated.
2. There is no "quality" in using a couple thousand words of text to say "I'll be writing about what helped with my chronic pain over time".
3. Here's the signal: I am not in for "weekly" sessions. I do have chronic pain, but what you want to be producing is utterly incompatible with what I need.
TBH I couldn't tell what the condition was or what general kind of treatment it was from the article without making big assumptions. Chronic pain is a symptom, viz. pain that doesn't go away after a short time. What was your disease? Or was it never given a name but the pain was treated?
Then I had to click a link "a landmark study" to get an idea of what the treatment is. Why not put the title of the treatment there?
Finally, that article is about back pain. But you had tendon pain. Obviously a psychological technique can be applied to multiple diseases, but you might say something about that.
Your reply seems disingenuous, like marketing-speak. You're telling people "I have a solution to your chronic pain" and then they read the article only to find out "tune in next week for the next bread crumb".
Chronic pain drives people to suicide. You're toying with people's emotions.
Hi algo_lover, I also noticed that about the post. The approach being discussed is "pain reprocessing therapy". It was described in a book called The Way Out, by Alan Gordon and Alon Ziv. Here's my short summary of the book:
- Chronic pain is often generated by the brain, not any actual injury. Not always, but often. Especially if it gets worse during stress or high alert, and especially if the feeling of pain becomes connected to your fear of that same pain.
- In periods when pain is high, you need to kinda nurse it. Lie down, put warm water on it, whatever it takes. Don't try to power through the pain. Avoid situations where you have to power through.
- In periods when pain is moderate or low, take short sessions to examine it. "Ok, this isn't a threatening injury, this is just a sensation. Where is it located? What shape? Hot or cold? More dull or more like tingling?" Etc, etc. Don't hyperfocus, just explore the feeling in a light and curious way.
As someone who has overcome chronic pain, and frequently foils acute pain from turning into chronic pain, I started daily joint-mobility exercises from Kelly Starrett's Supple Leopard book (and his MWOD videos on YouTube) to achieve this. Physical therapy needs daily, incremental progress, which you can do yourself.
I've been guilty of this myself for our neurotech sleeptech company, and I still owe HN a better blog post clarifying our positioning.
I think there are a few reasons you see this in health/medical community.
1) just helping people understand a different view of the problem is often enough for one blog post. Stuffing new way to look at solution and new solution together can sometimes be a bit much.
2) we have to be cautious from a regulatory perspective about what we say, and sometimes in being too cautious don't give the people who REALLY want to understaned the processes enough to go on. For our company, I used to say things like "we can increase the synchronous firing of neurons which results in reduced 15^% drop in early night cortisol, and 14.5% increase in hrv....".
But prior to regulatory approvals, we can't point directly to neurological or physiological processes, which means we kinda end up talking around the solution a bit.
3) in marketing, they want to connect and build an audience, so they are dripping more information over time. One post gets feedback and interest from one group, then you do another, and another. It's about building the community and connecting with people, not just a "here's a problem, do the thing, thanks". If you are trying to build a business, you probably need to get in front of people 7-8 times, particularly if you're taking a new approach to a problem, to build trust and brand recognition.
It's not the best, but it is the way the world works.
As someone who has been mitigating and managing chronic pain for 25 years, with respect IMO your expectation is unrealistic.
There isn't a "solution" - you're looking at a life-long mitigation and management strategy that will not be "brief".
The time commitment typically goes up as one ages. I could spend 40 hours a week on nutrition, exercise and relaxation if I was trying to optimize for chronic pain reduction.
> Why do all such articles never talk about the meat of the solution? Why do I always feel like I'm being sold something.
The topic itself is broad, but I agree that posts like this (please subscribe to my substack so you can get the info…) are almost always a prelude to some monetization play that comes later.
In this case, there are numerous existing resources on the topic (as linked by others already) from people with actual academic research experience in the topic that could have been linked in the post.
The claim about having quit a tech job and sold his house to “work on chronic pain” is also a giveaway that some monetization motives are at play.
I’m not opposed to people earning money from their work, but everyone reading this should know that monetization motives inevitably conflict with giving you the best access to information. The more you get from existing resources, the less interested you will be in following this specific author and paying for whatever products or services they are pushing.
I recently decided to go all in on addressing chronic pain - a condition which affects an estimated 1/5 adults in the US[1] and nearly the same proportion in my country of Australia.
This is the first of several blog posts exploring this invisible condition.
If you're passionate about this space feel free to reach out, thanks!
Hi Dan, I wanted to share a few links to articles on pain and circadian rhythms that I wrote during my PhD. Would love to connect if you have any questions.
Awesome!I had two tumours in my hip and I lost around 90% of a few muscles. Pain is my friend since I started this journey, and I need to say, that learn how to deal with that should be the first treatment!
I did a 10 day insight-meditation retreat and experienced how pain is triggered by the mind first hand.
This is impressive to me and id be curious what your perspective is
agumonkey I love this - maybe it's about time a wellness/health "HN" was started. We're living in a time of chronic health dysfunction and lack of clarity. DM (and/or anyone else) if you'd like to jam
For my recovery my reading/listening was focused on people like Dr Schubiner, Alan Gordon and some folks in Aus like Lorimer Moseley.
I'm engaging more in linking research studies in now as I experienced a lot of people (often not practitioners) making claims without links to evidence (likely to keep things simple), which made my logical brain skeptical orignally and slowed my entry to this field
“As pain becomes chronic, it is increasingly associated with activity in the affective and motivational systems tied to avoidance and less closely tied to systems encoding nociceptive input” [1]
I’ve been on the slippery slope of chronic pain. Minor post surgery issues caused me to change my routine and avoid certain activities which only exacerbated the issues, which led to more avoidance. Eventually I couldn’t walk.
The American medical system is very focused on avoiding health issues that show up on mri, rather than quality of life health. But quality of life issues quickly become serious.
I think the middle ground of activity: not all out intense as if you are healthy, but also not avoiding movement is so challenging to find for many people but also so crucial. A lot of chronic pain for myself and I suspect for many others could be avoided with short and quick combination of therapy and daily movement. So simple but so challenging to effectively identify and allocate resources.
Not suggesting this is the total solution but it’s the pathway that I took to return to activity and I’ve seen it help a number of my friends as well.
My wife has had two surgeries and each time she had a minor post surgery issue. One of them was an area that was tender to touch; another was chronic pain. Neither was mentioned as a possible side effect of the surgery by the surgeon. The main takeaway even if a bit extreme here is avoid all surgeries unless absolutely necessary.
Surgery is a bigger deal than doctors make it seem, but after surgery care can make a huge difference.
I had a surgery asked for more pain meds once on day 5 or 6. Instead the surgeon had me come in to look at the wound, made a tiny incision a blob of pus came out and things felt fine the next day. That’s the kind of thing that could have easily resulted in major problems, but just the right treatment at just the right time fixed it.
Depending on the underlying issue, delaying a surgery could easily lead to needing an even more invasive or extensive procedure, with worse complications or side effects. A blanket avoidance of all surgeries is a great way to be even more miserable.
Anecdotal case: My wife broke her arm some 10 years ago or so. She was really upset about potential recovery time, insurance copayments and such, especially since she was (at the time) a single mother. The doctor suggested setting it and letting it heal on its own, which was absolutely the wrong call. Had she gotten surgery straight away, she would have recovered by the time she actually ended up getting surgery.
I've often wondered if there wasn't a malpractice case that could have been made, but it was before we met so that's lost to time.
Any time you have surgery, especially anything to repair a bone, joint, muscle, or tendon, do the post-op physical therapy religously. Do not skip it. It will be uncomfortable at first, but stick with it. If you slack off or don't do it, you may end up with persistent pain and mobility issues.
Vasectomies are never “absolutely necessary”, but the risk of chronic pain (very small) vs the risk of unintended pregnancy, risk to the partner, or potential financial hardship, can make it a good decision. It’s never black and white in medicine.
> used me to change my routine and avoid certain activities which only exacerbated the issues, which led to more avoidance. Eventually I couldn’t walk.
Anecdotally, I had a phase where pretty much the same thing happened to me with the Achilles (+ calf/ankle) flare-ups I was having (during this part of my chronic journey). Eventually got through it by doing small walks around my home, then outside but keeping the frequency high each day (i.e. instead of 1 "long" walk, doing 3-4 short ones). I.e. Desensitisation / daily movement
Splitting up activity to bite sized chunks was critical for me as well. It prevents over straining but I think more importantly it also prevents you from being stagnant for an extended period of time.
Your method is how I treated pain and it served me well for many years (including broken ankle, countless elbow/wrist/finger injuries), as soon as I could I started movement again, and for tendon injuries even decent intensity seemed to help trigger healing.
That all changed when I tore my achilles, the pain/recovery/etc. process had me doubting everything I knew about recovery and now 14 months later I still question if it needs more rest or more activity or the whole thing is in my head. Ankle/foot injuries seem to have an entirely different approach because standing and walking are so fundamental that you might overdo it just by deciding to make eggs or something.
I learned this the hard way, got achilles/ankle tendon issues trying to rest from a joint problem instead of ramping up activity which would've made me more resilient.
Pain is a symptom. There's a strong psychological component to pain avoidance which can lead to behaviors that make it worse. Physical therapy isn't going to feel good, but it plays an important role in lots of recovery scenarios, and I think should be more often prescribed after surgeries.
I deal with fibromyalgia pain. When I first developed it, I pretty much avoided doing anything, and really that was the opposite of what I should have done. There's no "recovery" and really no avoiding it; all I ended up doing was letting my physical condition weaken to the point that even normal activities were painful, so I was hurting for two reasons.
Treating the underlying cause of the symptom, and training to avoid behaviors that exacerbate the symptom is the real key.
I have a pretty severe back injury - double pars fracture and significant spondylolisthesis from an accident (not a car accident). For many years i was in incredible pain, but it just kept going, sometimes getting a lot worse. When this happened I would go get some imaging done to make sure there weren't degenerative changes that needed to be addressed - you should never, ever get back surgery if you don't need it, so I am cautious about it. But I noticed something, all on my own, and that is that it seemed to correlate with periods of intense stress. I still have a ton of stress, but recognizing that actually kind of made a tremendous difference.
I hesitate to add a link to this on the thread, but there is an interesting story around chronic pain actually being psychological and there are now some high quality studies coming out.
I didn't know about any of this and had never been exposed to any of it when I drew my conclusions and started to feel less pain. Don't get me wrong, there are still things that will set my back off, but now I probably go actual years without even thinking about it.
> I hesitate to add a link to this on the thread, but there is an interesting story around chronic pain actually being psychological and there are now some high quality studies coming out.
This is a misinterpretation of these studies which is common throughout this thread.
The research isn’t showing that chronic pain is a psychological condition. It’s suggesting that some cases of nonspecific chronic pain that specifically do not match the symptoms of typical physically-rooted pain are psychological. The participants in this study were filtered for this criteria.
For some reason, people see this idea and lose the nuance, concluding that most or all chronic pain is actually psychological.
I think if someone matches the description used by the author of the substack for this HN entry (he describes his chronic pain as random and popping up all over his body) then pursuing the psychological explanation would be a very good idea.
However, it’s getting frustrating to see all of the reductionist claims that “chronic pain is psychological”.
> However, it’s getting frustrating to see all of the reductionist claims that “chronic pain is psychological”.
It's incredibly frustrating and disheartening... For obvious reasons, I'm not going to go into too much detail, but chronic (non-visible) pain is the worst of the worst. People will either think you're "faking"[0] or it's "just psychosomatic"[1]. I actually relish being able to work for a good long day because I'm lucky enough to actually enjoy making computers do stuff.
[0] Yes, I love to miss lots of family occasions, just because.
[1] I'll just will myself better. Nevermind the MRI scans and all that.
EDIT: I should add... the cognitive biases at work are understandable because they've probably been around since proto-humanity, but that doesn't change the outcomes.
I agree. I lived with chronic pain for over a decade due to a specific medical problem that, though I could never get a precise diagnosis, was not caused by stress or my mental state. It was incredibly frustrating to deal with family and others who had read articles like this one and insisted all chronic pain was psychological in origin and needed a mind-body approach. I am happy for the author and am sure this approach works for many, but I'm not sure why they think that all chronic pain is common in cause. There are a host of chronic pain conditions that are physiological in origin and not psychological.
"You should never, ever get back surgery" sounds like that easily could be wrong. It's annoying to have to always caveat but talking to a (good) doctor is important when making such decisions and not relying on tech forum advice necessarily. I know someone who said they went in for back surgery and walked out feeling permanently cured from the specific problem they had and the pain was completely gone. Details matter. Always consult experts when possible.
You left off the 'if you don't need it'. Even back specialists will tell you that surgery is typically the last resort because of the risks of not fixing the issue and/or making it worse. It's not like fixing an ACL.
> there is an interesting story around chronic pain actually being psychological
I think this is an incorrect oversimplification.
I had a pretty bad accident a year ago and am still dealing with physical therapy and recovery from it. I have spent a lot of last year traveling the land of pain.
It's not that pain (chronic or not) is psychological. It's more that our pyschological state modulates how we experience pain.
If you hit your thumb with a hammer, the pain you feel is absolutely not psychosomatic and entirely in your head. There are real nerves in your hand sending your brain real pain signals.
But if you happen to do that on a day that you're really stressed out, it will hurt worse. And if days after the accident you are still hurting and you find your inner monologue saying things like "See, you hit your thumb because you're such a stupid clutz." then you will experience that pain with greater intensity and for longer than if you had a more positive narrative around the injury.
I’ve been dealing with chronic reflux for about 8 mos now. On PPIs and they don’t seem to do much. But once I get away from my typical routine of work/dadding then all the symptoms vanish, even to the point of being able to eat foods that are not good for reflux: spicy things, tomatoes, a bit of coffee. In my case, this is absolutely a downstream symptom of something mind-body. Already been scoped and got a diagnosis of visceral hypersensitivity, which is medical speak for “nerves in esophagus are too sensitive.”
The question of why is out of scope.
In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse.
I’ve made some life changes (new job) to see what happens here. But I also have to be prepared for the possibility that it doesn’t fix it. Been working through The Body Keeps The Score as well.
Looking forward to seeing what the author discusses here.
This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :)
I have shared my experience with others and it helped them too
Edit - Changed the link, had posted something else by mistake
How did you implement this? I can't figure out what these instructions in the article mean: "Exercises of dry swallowing in the bridge posture lasted for 4 weeks and were performed ten times per day (Fig. 2). The exercise was performed with 10-s intervals between swallows."
Does this mean that total number of daily dry swallows in bridge position was 10 or 10 times 10 (100)?
Thanks for this - it looks interesting, I'm planning on giving it a try for my low level reflux that's been bothering me for over a decade (but always had other health issues that seemed higher priorities to try to address).
That looks interesting, and can't hurt. So you do 1 set of 10 reps (swallows) a day in the morning? I'm surprised that just swallowing 10 times can provoke any sort of physiological change...
> In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse.
Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it.
I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief
[1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.
Western medicine “can’t treat stress” but Eastern medicine definitely claims to be able to. But then so do various nebulous “alternative medicines”. Another comment mentioned deep meditation as being effective, and I believe there are a number of studies that have shown it to have actual effect. I’ll add another tried and true stress cure but with a twist. Exercise has consistently been shown to help reduce stress, but I find that you have to pick an activity that’s different than what you normally do, e.g. if you’re a runner, try swimming or tennis. The goal is to actually raise the stress level while exercising by doing something unfamiliar and therefore more challenging. In my experience, if the exercise is too relaxed or routine, it doesn’t allow your mind to disengage from the other stressors that are causing symptoms. Of course, all this is pure anecdata from an internet rando.
> it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly.
Thanks for the edit that added this. Very similar experience as this.
It's BS that IC ladders top out at quasi-management roles, but perhaps part of the issue is believing that professional growth is as tidy as a FAANG career ladder (since most companies just copy them wholesale), and that not reaching those rungs reflects on me in any way.
It feels a bit taboo to say, but I believe not everyone can flex into management easily, even part-time. I'm alright at it, but it clearly isn't long-term sustainable.
Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.
>But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine
This, but also in particularly litigious countries like the USA, they have to be extremely careful of opening up lawsuits.
A doctor saying "I don't know." followed by a bad patient outcome has a pretty high chance of being a lawsuit.
I'd be fine with that if the posturing didn't go along with unnecessary medication and the lack of suggestions to search for treatment somewhere better equipped.
Hey, I just wanted to let you know that I have the _exact_ same issue as you since 2 years. It was much worse than what you described 2 years ago. Now it's just very annoying.
The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body.
The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day).
I wish you all the best and thank you so much for sharing.
For me, the two big things that help are losing weight and reduced anxiety. When either are high the problem is noticeable when both are low it’s gone.
Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.
The link between the gut and brain (especially in the case of dietary intolerances) is an interesting one! Keen to see if others have come across good research in the space
I had terrible acid reflux at night when I was in my 20s. It was awful. I was getting a couple of hours of sleep per night, then waking up in terrible pain, stuffing down plain yogurt under a doctor's orders, and sitting up on a sofa for the rest of the night.
Putting my futon on a sheet of plywood with two concrete blocks under the head completely solved the problem within a few days. It takes a while to adapt to sleeping on an incline. I kept it up for about a year, then went back to a flat bed. I've never had acid reflux again.
I had the same diagnosis, and treatment was getting on serious antidepressants for their nerve dulling properties.
After getting that diagnosis. I eat everything within reason. I decided not to take medication, knowing whats up with my body is sufficient. I mainly try to do all eating 4 hrs before bed.
What i have read is that covid may be responsible for micro lesions in the esophagus...acidic foods are essentially rubbing salt in the wounds.
Just a note about VH - it is more so over sensitivity to regular digestive function. Which is why feeling super full after eating/dispepsia is common as well. Im sure you did a 24 hr acid monitoring test - i pressed the reflux button during all my trigger foods and was surprised to see ph levels as neutral.
I had this for years. Then I took vitamin K2 (about 50mcg per day I think), and after a few months it went away. No idea why, though. Anyway, happy that I can drink coffee again :)
I had this for about a year, and it really only went away when I quit my job. It wasn't even a particularly demanding job, but I guess the lifestyle + the fact that I felt I was wasting my life away might have played a role. Nothing else is really different.
Most people are familiar with the Peter Principle where it talks about people rising to their level of incompetence.
But I think there's still plenty more that makes it worth a read. For example, something along the lines of, sometimes a man will pop an antacid and lament that their illness is negatively affecting their work, when in fact the causality is exactly reversed
I have had near-debilitating non-GI physical symptoms when it was time to leave a job in the past. I might just be bad at responding to those before it gets to be a five alarm fire.
Worth mentioning is I got the same symptoms (tendinitis) a few months prior to this, but went to PT and got them resolved. Bodies/minds are fun!
All of my reflux went away last year when I started tirzepatide via my Zepbound prescription. I was having horrible heartburn daily and it’s just completely gone. I used to take tums and omeprazole literally daily, now it’s basically never.
For me intermittent fasting after 6pm and small diet changes fixed my acid reflux. PPI were not helping and making things worse. I actually took Betaine HCI supplements to fix digestive issues after PPIs.
I seem to have something very similar going on. I'm on the early end of trying to understand it. Coffee was the first indicator because it'd ruin my day to drink some. I hope the best for us.
Lots of anecdotal cures here, but I'll add Aloe Vera gel to the mix since it seems to help* both soothe/recover/prevent the return of my reflux symptoms for long periods of time.
I love smoothies with aloe Vera juice and freshly grated ginger. I’ve never felt such a powerfully calming sensation from ingesting something before. Can’t tell if it’s the ritual/association or the ingredients.
FYI, The Body Keeps The Score is full of misinformation, and is alternately ignored and criticized by other psychiatrists
> The most consequential problem with BKS is its promotion of a large number of treatments, outside of EMDR, that have limited to no evidence (e.g., massage, acupuncture, yoga, community theater, and neurofeedback), according to the latest treatment guidelines by the International Society for Traumatic Stress Studies (Frank et al., 2020), while simultaneously ignoring or criticizing PE and CPT, the two treatments with the highest quality evidence (Sakaluk et al., 2019).
Just a sidenote: GERD can lead to Barrett's Esophagus (precancerous changes in tissue), and erosive damage to the esophagus can accumulate over time and abruptly become life threatening. After decades of terrible GERD, my father nearly died from exactly such an undetected gastric bleed, losing 11/12 of his blood (which doctors replaced as it coursed out) before an emergency-medicine team finally found and sealed the rupture.
He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't.
I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet.
Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.
As someone who had years of undiagnosable pain and after many years (and more than one doctor trying to suggest it was all in my head) I just want to say to anyone reading who has it -
Don’t let yourself be gaslit that it’s all mental. It seems some do have that, but there are also many hard to diagnose and completely valid physical health conditions that cause terrible chronic pain. And don’t give up on trying to find out what they are. Once I did, I was able to largely manage mine, and more importantly, to stop constantly questioning my own sanity.
> Don’t let yourself be gaslit that it’s all mental.
I agree, though this is a very difficult subject. Often, the people who would benefit the most from psychosomatic interventions are often the most resistant to accepting those explanations. Meanwhile, many of the physical chronic pain sufferers I know have desperately tried various mind-body programs (without success) because they will try anything that might help.
If people match the description of the author of this post and blog, where the pains are widespread, vague, and popping up around different parts of the body without explanation then you really should explore psychosomatic explanations like this author did.
However, I’m growing weary of the trend of people who fit this description starting newsletters they want you to subscribe to (like this one), writing apps they want you to download/buy, and making comments implying that they know better than doctors about chronic pain (while putting an obligatory “not a doctor” disclaimer juxtaposed to their comments complaining that doctors don’t know what they know). I think it’s great when people share their experience, but it’s getting tiresome to see it productized and generalized as a more universal explanation.
EDIT: Another trend in this space is to productize by building an audience (please subscribe to my Substack) and then introduce the monetization plan later: A subscription app, an e-book, a partnership with some product. It’s possible this person organically decided to quit their job, sell their house, and focus on writing a no strings attached Substack blog series to share information. However, I’ve seen this play out across enough health influencers that I recommend everyone stay cautious about people who claim to hold some information that will change your life but they need you to subscribe first. Be careful.
> and making comments implying that they know better than doctors about chronic pain (while putting an obligatory “not a doctor” disclaimer juxtaposed to their comments complaining that doctors don’t know what they know).
I am not claiming to know better than doctors whom are proficient in pain science/medicine.
Rather, that most doctors are not adequately educated on this topic. If you ask the average doctor they will tell you how little it is taught in most medical education programs. Case in point, most pain sufferers will tell you how many doctors they had to bounce between before they finally got some answers/direction (if they were lucky).
FWIW I was preparing for two months this year after I left my job to sit the Australian med school entry exam. Ultimately, I decided I would be able to help more people today, with tools readily available (including a computer and substack) than spending the next decade of my life preparing for a medical career.
I would consider amending that part of my post to say something more narrow like "Not a pain doctor", but it seems more straightforward as it is now.
Technically it is an experience that is internal to the nervous system... but a doctor telling someone that it's imagined because they can't identify the root cause is criminal!! If we have to make something up about it we're literally better off calling it a demon.
Very much agree it's critical to get an accurate assessment, ideally from a doctor who understands pain science to rule out a structural cause. In saying this, I recognise many practitioners are not fully across this so I'm hoping this series will help increase awareness.
This first blog is meant as a quick intro to the series - blog post #2 will break down the different categories of chronic pain (i.e. broadly including tissue, nerve damage and pain due to brain plasticity - what the series is primarily focused on).
Combination of two autoimmune conditions, one Ehlers Danlos.
Actually EDS is interesting because it became a fad I guess on TikTok to claim you had it like Tourette’s, further exacerbating the above issue.
It’s got a wide spectrum. My dad had it so lightly he was just considered “double jointed”. I gained a further thing from mom’s side, which seemed to interplay poorly. Spent 19-26 basically having extreme nausea and vomiting episodes every month or two, often having to go to the hospital to stop it. Had other weird symptoms and pains before that and during too.
Did every scan, met tons of specialists. Kept getting referred down the GI side, had gallbladder removed for no reason.
At one point I was convinced it was psychological. This was after a second doctor suggested it. It sent me down a dark path for a few years of trying to figure out what was wrong with me - didn’t help my mental state was terrible from all the uncertainty, and I had developed anxiety about eating since basically any meal could end up in hours of extreme pain. I was a total wreck. Then it just cleared up finally at 26.
It wasn’t until years later I got the EDS diagnosis, and then a genetic test showed the other immune condition. When looking at the two lists of symptoms it was such an intense moment in my life, finally having closure.
Not OP but similar story with someone I know. Five years of many specialists that always ended in "all the tests are negative so it must either be fibromyalgia or psychological." Doctors never helped but eventually they empirically found that abilify and rexulti in very low doses (ie: half the minimum) made it just go away. Empirically based on the reaction to various medications it was probably some type of dopamine imbalance or issue. There's other case studies of similar reactions to abilify and chronic pain but not many.
Extra fun fact, a deep research AI nowadays will actually suggest this as one of the treatments given a few paragraphs of information on the symptoms/medications tried/etc.
> Don’t let yourself be gaslit that it’s all mental.
This is a big problem women have around menstrual cycle pain. "It's normal" is what many doctors say - particularly men. A woman I know was basically bed ridden for a couple days/month until she found a doctor who believed her and addressed the problem.
I make an app called Reflect [0] that’s designed to track things like chronic pain and help you get to the root cause with self guided experiments. I’ve used it for my own pain symptoms, especially joint pain. Happy to answer any questions. Wish you the best on your journey.
Readit News
I had no idea it was the misery of the IT job that was causing most of my pain and suffering, and it had nothing to do with the job itself, it was the endless insanity of everyone else around me doing exactly what they were informed would cause problems instead of having discussions with people that actually knew how shit worked. I was endlessly picking up everyone elses mess and treated worse than a pile of shit all because people were incapable of having a speck of respect for other people since all their hatred for computers fell on me
I GTFO of the career of misery and took half a decade to finally start feeling better
I have now spent years and countless hours working on software and I greatly enjoy doing this work again and find I get even more done than I used to simply by doing life the way I need to instead of how some backwards/abusive control freak "needs it done"
It took about 6 months for the brain zaps to start fading. Then another 6 months for me to start feeling capable of really doing my job well. I'm 18 months into "recovery" and I still think I have another 6 to 12 months before I feel like my old self again (so about 2 to 2.5 years in total).
Time is really the only solution. You can't just think your way through it. You have to left your body's rewards systems re-adapt and re-learn how to be a healthy, happy human.
- taking sport seriously
- regaining control over my life (which I did by creating a startup)
- moving to a city that cares about walking pedestrians and social life (moved from SF to New York!)
That's my experience at least, that it's not healthy to be in environments like that for any length of time. In such a place, my regret is always not leaving sooner...
I have always had a passion for computing so I eventually found my way back with a project of my own
Apropos, I had chronic pain throughout this experience. I thought it was just aging, irreversible, and something that compounded my hopelessness. It's very surprising to be 10 years older now but feel 20 years younger. Books like "The Body Keeps the Score" or "Healing Back Pain" used to seem woo to me, but now I am convicted that health comes from within as much or more than it does from without.
I am on the same fence, just on my notice period in the shit show called corporate IT where there is 90% time spent on toxic politics.
Now dreaming to burn some savings, detox and then play with Raspberry Pi projects.
I made it through the Army (decades ago), I ran my own company, handled employees, etc. I have no problem with hard work and stress. My joy for computers was destroyed for a while, and it had nothing to do with the work itself, it was due to targeted intentionally malicious discrimination from the top
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Why is it so hard to explain the solution briefly, or directly present it to me upfront. Why does it need so much of mystery around it?
In this article the OP does not even mention "Pain reprocessing theory" which is what they seems to be talking about (based on the study they have linked)
Just woke up and this post's traction has surpassed my wildest imagination.
Similar to what pedalpete has said, I'm looking to release this in parts to ensure:
1. I am not overwhelming people and losing their interest
2. Quality remains as high as possible (I invested only a few hours into this last week as an experiment). I want this blog to be the most easily accessible, engaging + factual source for chronic pain sufferers. That requires sufficient time to nail (and it seems like I've struck a chord so far).
3. Get signals from readers week by week and tailor to the audience which is forming.
This will help me helpfully reach the most pain sufferers.
RE feel like you're being sold something. This series will cover what is needed to recover from chronic pain and be offered for free. I am looking to build a product eventually (why wouldn't I want help as many people as posssible while building a career which does good - I don't believe they're exclusive), but the information in this blog will remain free.
RE not calling out Pain reprocessing theory/therapy - I'll go through the post today and see if it makes sense to add this into #1 (or if it's better for #4). It's not something I consciously omitted when writting this post last week.
Thanks for the comment!
1. You've lost my interest with no "meat", as the GP stated.
2. There is no "quality" in using a couple thousand words of text to say "I'll be writing about what helped with my chronic pain over time".
3. Here's the signal: I am not in for "weekly" sessions. I do have chronic pain, but what you want to be producing is utterly incompatible with what I need.
Then I had to click a link "a landmark study" to get an idea of what the treatment is. Why not put the title of the treatment there?
Finally, that article is about back pain. But you had tendon pain. Obviously a psychological technique can be applied to multiple diseases, but you might say something about that.
Chronic pain drives people to suicide. You're toying with people's emotions.
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- Chronic pain is often generated by the brain, not any actual injury. Not always, but often. Especially if it gets worse during stress or high alert, and especially if the feeling of pain becomes connected to your fear of that same pain.
- In periods when pain is high, you need to kinda nurse it. Lie down, put warm water on it, whatever it takes. Don't try to power through the pain. Avoid situations where you have to power through.
- In periods when pain is moderate or low, take short sessions to examine it. "Ok, this isn't a threatening injury, this is just a sensation. Where is it located? What shape? Hot or cold? More dull or more like tingling?" Etc, etc. Don't hyperfocus, just explore the feeling in a light and curious way.
Yes and: Kelly's freq collaborator Jill Miller (author of The Roll Model, TuneUp Fitness, etc.).
I think there are a few reasons you see this in health/medical community.
1) just helping people understand a different view of the problem is often enough for one blog post. Stuffing new way to look at solution and new solution together can sometimes be a bit much.
2) we have to be cautious from a regulatory perspective about what we say, and sometimes in being too cautious don't give the people who REALLY want to understaned the processes enough to go on. For our company, I used to say things like "we can increase the synchronous firing of neurons which results in reduced 15^% drop in early night cortisol, and 14.5% increase in hrv....".
But prior to regulatory approvals, we can't point directly to neurological or physiological processes, which means we kinda end up talking around the solution a bit.
3) in marketing, they want to connect and build an audience, so they are dripping more information over time. One post gets feedback and interest from one group, then you do another, and another. It's about building the community and connecting with people, not just a "here's a problem, do the thing, thanks". If you are trying to build a business, you probably need to get in front of people 7-8 times, particularly if you're taking a new approach to a problem, to build trust and brand recognition.
It's not the best, but it is the way the world works.
There isn't a "solution" - you're looking at a life-long mitigation and management strategy that will not be "brief".
The time commitment typically goes up as one ages. I could spend 40 hours a week on nutrition, exercise and relaxation if I was trying to optimize for chronic pain reduction.
But then nothing else would get done.
The topic itself is broad, but I agree that posts like this (please subscribe to my substack so you can get the info…) are almost always a prelude to some monetization play that comes later.
In this case, there are numerous existing resources on the topic (as linked by others already) from people with actual academic research experience in the topic that could have been linked in the post.
The claim about having quit a tech job and sold his house to “work on chronic pain” is also a giveaway that some monetization motives are at play.
I’m not opposed to people earning money from their work, but everyone reading this should know that monetization motives inevitably conflict with giving you the best access to information. The more you get from existing resources, the less interested you will be in following this specific author and paying for whatever products or services they are pushing.
This is the first of several blog posts exploring this invisible condition.
If you're passionate about this space feel free to reach out, thanks!
[1] https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm [data from 2021]
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[Edit] Thanks so much everyone! Excited to get the next article out soon!
[0] Circadian rhythms and pain: https://www.sciencedirect.com/science/article/abs/pii/S01497...
[1] The disruptive relationship among circadian rhythms, pain, and opioids: https://www.frontiersin.org/journals/neuroscience/articles/1...
[2] Circadian rhythm disruption exacerbates pain behavior in male mice: https://www.sciencedirect.com/science/article/abs/pii/S03064...
I'll read this blog with love!
Thanks
Sometimes I wish there was a medHN
For my recovery my reading/listening was focused on people like Dr Schubiner, Alan Gordon and some folks in Aus like Lorimer Moseley.
I'm engaging more in linking research studies in now as I experienced a lot of people (often not practitioners) making claims without links to evidence (likely to keep things simple), which made my logical brain skeptical orignally and slowed my entry to this field
I’ve been on the slippery slope of chronic pain. Minor post surgery issues caused me to change my routine and avoid certain activities which only exacerbated the issues, which led to more avoidance. Eventually I couldn’t walk.
The American medical system is very focused on avoiding health issues that show up on mri, rather than quality of life health. But quality of life issues quickly become serious.
I think the middle ground of activity: not all out intense as if you are healthy, but also not avoiding movement is so challenging to find for many people but also so crucial. A lot of chronic pain for myself and I suspect for many others could be avoided with short and quick combination of therapy and daily movement. So simple but so challenging to effectively identify and allocate resources.
Not suggesting this is the total solution but it’s the pathway that I took to return to activity and I’ve seen it help a number of my friends as well.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC8482298/
My wife has had two surgeries and each time she had a minor post surgery issue. One of them was an area that was tender to touch; another was chronic pain. Neither was mentioned as a possible side effect of the surgery by the surgeon. The main takeaway even if a bit extreme here is avoid all surgeries unless absolutely necessary.
I had a surgery asked for more pain meds once on day 5 or 6. Instead the surgeon had me come in to look at the wound, made a tiny incision a blob of pus came out and things felt fine the next day. That’s the kind of thing that could have easily resulted in major problems, but just the right treatment at just the right time fixed it.
Anecdotal case: My wife broke her arm some 10 years ago or so. She was really upset about potential recovery time, insurance copayments and such, especially since she was (at the time) a single mother. The doctor suggested setting it and letting it heal on its own, which was absolutely the wrong call. Had she gotten surgery straight away, she would have recovered by the time she actually ended up getting surgery.
I've often wondered if there wasn't a malpractice case that could have been made, but it was before we met so that's lost to time.
Anecdotally, I had a phase where pretty much the same thing happened to me with the Achilles (+ calf/ankle) flare-ups I was having (during this part of my chronic journey). Eventually got through it by doing small walks around my home, then outside but keeping the frequency high each day (i.e. instead of 1 "long" walk, doing 3-4 short ones). I.e. Desensitisation / daily movement
That all changed when I tore my achilles, the pain/recovery/etc. process had me doubting everything I knew about recovery and now 14 months later I still question if it needs more rest or more activity or the whole thing is in my head. Ankle/foot injuries seem to have an entirely different approach because standing and walking are so fundamental that you might overdo it just by deciding to make eggs or something.
I deal with fibromyalgia pain. When I first developed it, I pretty much avoided doing anything, and really that was the opposite of what I should have done. There's no "recovery" and really no avoiding it; all I ended up doing was letting my physical condition weaken to the point that even normal activities were painful, so I was hurting for two reasons.
Treating the underlying cause of the symptom, and training to avoid behaviors that exacerbate the symptom is the real key.
I hesitate to add a link to this on the thread, but there is an interesting story around chronic pain actually being psychological and there are now some high quality studies coming out.
https://journals.lww.com/painrpts/Fulltext/2021/09000/Psycho...
I especially hate to link to LessWrong but this is an actually decent thread on the topic:
https://www.lesswrong.com/posts/BgBJqPv5ogsX4fLka/the-mind-b...
I didn't know about any of this and had never been exposed to any of it when I drew my conclusions and started to feel less pain. Don't get me wrong, there are still things that will set my back off, but now I probably go actual years without even thinking about it.
This is a misinterpretation of these studies which is common throughout this thread.
The research isn’t showing that chronic pain is a psychological condition. It’s suggesting that some cases of nonspecific chronic pain that specifically do not match the symptoms of typical physically-rooted pain are psychological. The participants in this study were filtered for this criteria.
For some reason, people see this idea and lose the nuance, concluding that most or all chronic pain is actually psychological.
I think if someone matches the description used by the author of the substack for this HN entry (he describes his chronic pain as random and popping up all over his body) then pursuing the psychological explanation would be a very good idea.
However, it’s getting frustrating to see all of the reductionist claims that “chronic pain is psychological”.
It's incredibly frustrating and disheartening... For obvious reasons, I'm not going to go into too much detail, but chronic (non-visible) pain is the worst of the worst. People will either think you're "faking"[0] or it's "just psychosomatic"[1]. I actually relish being able to work for a good long day because I'm lucky enough to actually enjoy making computers do stuff.
[0] Yes, I love to miss lots of family occasions, just because.
[1] I'll just will myself better. Nevermind the MRI scans and all that.
EDIT: I should add... the cognitive biases at work are understandable because they've probably been around since proto-humanity, but that doesn't change the outcomes.
I think this is an incorrect oversimplification.
I had a pretty bad accident a year ago and am still dealing with physical therapy and recovery from it. I have spent a lot of last year traveling the land of pain.
It's not that pain (chronic or not) is psychological. It's more that our pyschological state modulates how we experience pain.
If you hit your thumb with a hammer, the pain you feel is absolutely not psychosomatic and entirely in your head. There are real nerves in your hand sending your brain real pain signals.
But if you happen to do that on a day that you're really stressed out, it will hurt worse. And if days after the accident you are still hurting and you find your inner monologue saying things like "See, you hit your thumb because you're such a stupid clutz." then you will experience that pain with greater intensity and for longer than if you had a more positive narrative around the injury.
The question of why is out of scope.
In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse.
I’ve made some life changes (new job) to see what happens here. But I also have to be prepared for the possibility that it doesn’t fix it. Been working through The Body Keeps The Score as well.
Looking forward to seeing what the author discusses here.
This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :) I have shared my experience with others and it helped them too
Edit - Changed the link, had posted something else by mistake
Since reading the above HN comments, I have lost ten pounds and (mostly) stopped drinking carbonated beverages. My GERD is vastly reduced.
¢¢
Does this mean that total number of daily dry swallows in bridge position was 10 or 10 times 10 (100)?
Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it.
I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief
[1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.
Thanks for the edit that added this. Very similar experience as this.
It's BS that IC ladders top out at quasi-management roles, but perhaps part of the issue is believing that professional growth is as tidy as a FAANG career ladder (since most companies just copy them wholesale), and that not reaching those rungs reflects on me in any way.
It feels a bit taboo to say, but I believe not everyone can flex into management easily, even part-time. I'm alright at it, but it clearly isn't long-term sustainable.
Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.
This, but also in particularly litigious countries like the USA, they have to be extremely careful of opening up lawsuits.
A doctor saying "I don't know." followed by a bad patient outcome has a pretty high chance of being a lawsuit.
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The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body.
The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day).
I wish you all the best and thank you so much for sharing.
Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.
-https://www.healthcentral.com/digestive-health/acid-reflux-e...
-https://www.refluxguard.com/the-acid-reflux-game-changer-sle...
Putting my futon on a sheet of plywood with two concrete blocks under the head completely solved the problem within a few days. It takes a while to adapt to sleeping on an incline. I kept it up for about a year, then went back to a flat bed. I've never had acid reflux again.
After getting that diagnosis. I eat everything within reason. I decided not to take medication, knowing whats up with my body is sufficient. I mainly try to do all eating 4 hrs before bed.
What i have read is that covid may be responsible for micro lesions in the esophagus...acidic foods are essentially rubbing salt in the wounds.
Just a note about VH - it is more so over sensitivity to regular digestive function. Which is why feeling super full after eating/dispepsia is common as well. Im sure you did a 24 hr acid monitoring test - i pressed the reflux button during all my trigger foods and was surprised to see ph levels as neutral.
And as you have said, avoid anything that increases stomach acid production (such as caffeine or even tea, along with spicy food).
You might also have success with Venter[1] (Sucralfate).
[1] https://www.medicinesfaq.com/brand/venter
I suspect I have a histamine intolerance behind it all, as it tends to be comorbid with ehlers-danlos.
But I think there's still plenty more that makes it worth a read. For example, something along the lines of, sometimes a man will pop an antacid and lament that their illness is negatively affecting their work, when in fact the causality is exactly reversed
Worth mentioning is I got the same symptoms (tendinitis) a few months prior to this, but went to PT and got them resolved. Bodies/minds are fun!
I love smoothies with aloe Vera juice and freshly grated ginger. I’ve never felt such a powerfully calming sensation from ingesting something before. Can’t tell if it’s the ritual/association or the ingredients.
> The most consequential problem with BKS is its promotion of a large number of treatments, outside of EMDR, that have limited to no evidence (e.g., massage, acupuncture, yoga, community theater, and neurofeedback), according to the latest treatment guidelines by the International Society for Traumatic Stress Studies (Frank et al., 2020), while simultaneously ignoring or criticizing PE and CPT, the two treatments with the highest quality evidence (Sakaluk et al., 2019).
https://web.archive.org/web/20250120164320/https://journals....
He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't.
I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet.
Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.
Don’t let yourself be gaslit that it’s all mental. It seems some do have that, but there are also many hard to diagnose and completely valid physical health conditions that cause terrible chronic pain. And don’t give up on trying to find out what they are. Once I did, I was able to largely manage mine, and more importantly, to stop constantly questioning my own sanity.
I agree, though this is a very difficult subject. Often, the people who would benefit the most from psychosomatic interventions are often the most resistant to accepting those explanations. Meanwhile, many of the physical chronic pain sufferers I know have desperately tried various mind-body programs (without success) because they will try anything that might help.
If people match the description of the author of this post and blog, where the pains are widespread, vague, and popping up around different parts of the body without explanation then you really should explore psychosomatic explanations like this author did.
However, I’m growing weary of the trend of people who fit this description starting newsletters they want you to subscribe to (like this one), writing apps they want you to download/buy, and making comments implying that they know better than doctors about chronic pain (while putting an obligatory “not a doctor” disclaimer juxtaposed to their comments complaining that doctors don’t know what they know). I think it’s great when people share their experience, but it’s getting tiresome to see it productized and generalized as a more universal explanation.
EDIT: Another trend in this space is to productize by building an audience (please subscribe to my Substack) and then introduce the monetization plan later: A subscription app, an e-book, a partnership with some product. It’s possible this person organically decided to quit their job, sell their house, and focus on writing a no strings attached Substack blog series to share information. However, I’ve seen this play out across enough health influencers that I recommend everyone stay cautious about people who claim to hold some information that will change your life but they need you to subscribe first. Be careful.
I am not claiming to know better than doctors whom are proficient in pain science/medicine.
Rather, that most doctors are not adequately educated on this topic. If you ask the average doctor they will tell you how little it is taught in most medical education programs. Case in point, most pain sufferers will tell you how many doctors they had to bounce between before they finally got some answers/direction (if they were lucky).
FWIW I was preparing for two months this year after I left my job to sit the Australian med school entry exam. Ultimately, I decided I would be able to help more people today, with tools readily available (including a computer and substack) than spending the next decade of my life preparing for a medical career.
I would consider amending that part of my post to say something more narrow like "Not a pain doctor", but it seems more straightforward as it is now.
Very much agree it's critical to get an accurate assessment, ideally from a doctor who understands pain science to rule out a structural cause. In saying this, I recognise many practitioners are not fully across this so I'm hoping this series will help increase awareness.
This first blog is meant as a quick intro to the series - blog post #2 will break down the different categories of chronic pain (i.e. broadly including tissue, nerve damage and pain due to brain plasticity - what the series is primarily focused on).
Sounds like an interesting medical mystery.
Actually EDS is interesting because it became a fad I guess on TikTok to claim you had it like Tourette’s, further exacerbating the above issue.
It’s got a wide spectrum. My dad had it so lightly he was just considered “double jointed”. I gained a further thing from mom’s side, which seemed to interplay poorly. Spent 19-26 basically having extreme nausea and vomiting episodes every month or two, often having to go to the hospital to stop it. Had other weird symptoms and pains before that and during too.
Did every scan, met tons of specialists. Kept getting referred down the GI side, had gallbladder removed for no reason.
At one point I was convinced it was psychological. This was after a second doctor suggested it. It sent me down a dark path for a few years of trying to figure out what was wrong with me - didn’t help my mental state was terrible from all the uncertainty, and I had developed anxiety about eating since basically any meal could end up in hours of extreme pain. I was a total wreck. Then it just cleared up finally at 26.
It wasn’t until years later I got the EDS diagnosis, and then a genetic test showed the other immune condition. When looking at the two lists of symptoms it was such an intense moment in my life, finally having closure.
Extra fun fact, a deep research AI nowadays will actually suggest this as one of the treatments given a few paragraphs of information on the symptoms/medications tried/etc.
This is a big problem women have around menstrual cycle pain. "It's normal" is what many doctors say - particularly men. A woman I know was basically bed ridden for a couple days/month until she found a doctor who believed her and addressed the problem.
[0] https://apps.apple.com/us/app/reflect-track-anything/id64638...
Thanks!
https://bearable.app/
Here’s an actual peer reviewed study evaluating a pile (over 1000!) symptom tracking apps, including Bearable.
https://www.sciencedirect.com/science/article/pii/S245210942...