opioids

Anissa Morgan is 46 years old and was born and raised in San Antonio, Texas. In her own words, her relationship with her body has “always been a little messed up.” She didn’t like how she looked. Growing up, her mom frequently told her that she was slouching and "should pull her shoulders back," anecdotal posture advice many of us have heard.

In adulthood, Anissa spent some time in the Army Reserves as a petroleum specialist. The military approach to posture reinforced what she’d heard from her mom in childhood: that she “shouldn’t be slouching and that everything should look ‘a certain way.’” In her job, she would deliver fuel to military vehicles such as airplanes, cars, and trucks. She had to leave this position due to medical hardship after her first husband suffered a severe accident and broke his back, resulting in his paralysis from the waist down. She didn’t have anyone else to take care of both her husband and her young daughter, so she left the military. It was a short career, but she loved a lot about the military experience and the connections she formed with people during her service.

Anissa, 46, has seen her life dramatically changed by the Gokhale Method. Image supplied.

As the primary caregiver of her then-husband, the load on her body was extreme. She would have to carry her husband’s wheelchair, even while pregnant. Not long afterward, she and her husband divorced. Between pregnancy, childbirth, parenting, and the end of her relationship, she endured a lot of emotional and physical trauma.

“I was never an athlete or in super-great shape, but when I was in the military, I’d started having problems with my knees and my feet. My arches started to fall then,” says Anissa. She feels that may have been the first sign that things were going wrong.

Military posture guidelines encouraging tension and artificial positioning in the body predispose servicemembers to posture problems, which can lead to pain and injury. Image courtesy 272447 on Pixabay.

After her time in the Army Reserves, Anissa recovered from her divorce and eventually remarried. She found a job working at the Officer’s Club doing clerical and computer work. Computers were just coming into widespread use at the time. After that, with her valuable skills, she began working at the computer helpdesk at the USAA office in San Antonio. One element of her job with USAA involved travel: visiting field adjusters to set up laptops for them. One day, after a training, carrying a heavy load of equipment and baggage, she bent over and felt something give. After a couple of weeks where her back was “uncomfortable,” she visited her husband’s chiropractor, which was “like magic.” One morning, however, while making lunch for her three daughters, she bent over to pick up a box of Capri Suns and couldn’t stand back up again, and could hardly lift her leg. That’s where “the really major problems” began.

This continued until she was about 32 and her “back was done,” leaving her unable to work due to severe pain.

With her level of pain, sitting at a computer desk all day was excruciating. “Even with the great resources they have there, like standing desks and the people that would come in from Ergonomics who would tell you how you were ‘supposed to sit and stand’ — all of which I now know was wrong — it just wasn’t possible for me anymore, so I stopped working at about 32.”

Sufficiently severe pain makes even desk jobs impossible, as it did for Anissa. Image courtesy Claudio Scott on Pixabay.

“It just didn’t work”
It turned out that Anissa had a rupture in the spinal disc between her L4 and L5 vertebrae, which resulted in severe pain in her lower back and radiating down her legs, into her calves, and a loss of feeling in her toes. At the time, all she wanted was to have her back “fixed” so she could be sent back to work. By then, she had 3 small children and a job she loved. She needed to be able to show up in her life. With this in mind, she opted to have laminectomy surgery to hopefully resolve her symptoms.

Although the laminectomy gave her around 6 months of improved symptoms, the surgery soon revealed itself to have been unsuccessful in resolving her pain, which returned and began radiating down her legs again. A second surgery was proposed to fuse her L4 and L5 vertebrae. Her surgeon’s perspective had been tightly focused on the disc as the cause of Anissa’s problems, suggesting that once it was removed and that joint was fused, she would “feel grand.” There was again a little relief soon after the second surgery, but it quickly became apparent that even after this fusion, working at a desk all day wasn’t good for her body and something she could tolerate. The one way Anissa could tolerate it was with the use of opioid pain medication, although this further complicated her ability to do her mentally demanding job — troubleshooting computer problems — well. “You’re problem-solving — that’s your gig,” Anissa says. “And when your brain can’t fire, there’s no solving going on. Unfortunately, that was the end of that.”

Within a year of the first surgery, she was starting to feel pain in her legs in a different location. At the time, she had a wonderful pain management doctor, but Anissa was still concerned about the side effects and addictive potential of opiate painkillers. She began feeling terrible pain on the front of her thigh, which would command all her attention while driving an hour and a half to visit a friend. By the time she got home, she’d have a bruise on her leg where she’d been pressing the muscle, trying to get some relief. Her pain management doctor recommended another MRI, which revealed that the discs above and below her fusion site were herniated — just a year after the fusion surgery.

For Anissa, surgery was a “band-aid” treatment which did not eliminate her pain long-term. Image courtesy Sasin Tipchai on Pixabay.

“My decade of darkness”
The worst of Anissa’s severe, debilitating pain lasted a decade during which she didn’t know what else to try. She tried acupuncture, and completed five different courses of physical therapy within a couple of years. She’d given it “everything [she] knew how to do” and was still having to resort to taking enough opioid pain medication to keep herself comfortable while trying to balance the demands of her body with those of being a wife and a mother. “That,” she says, “was my decade of darkness. There was no moment that was comfortable. There was no joy left in my life, because all I could think about was the pain in my spine, which then started radiating up through my thoracic spine and neck. My whole body hurt all the time.”

Anissa was hitting rock bottom. She would wake up at night heaving and sobbing from pain. She didn’t know what else to do or what to try. All her doctors wanted to do was more surgery: fusing two or even three more levels of her spine. Her pain management doctor would give her steroid injections and trigger point therapy, all of which were wonderful, but they weren’t long-term fixes and only took the edge off the pain. She felt like a burden to everyone, and a failure, and didn’t see how she was going to go on living like that.

In a moment of deep desperation, Anissa hid in the closet, kneeled, and prayed for assistance. In her own words, she “saw the light” and was filled with a new determination. She decided to start over, trying every approach again, so that if she did have to resort to another surgery, she would know that she had done everything she possibly could to avoid putting herself in a worse situation. That was her nightmare: that she would do what the surgeons advised and the new surgery would only do what the second surgery had done.

Opioid painkillers were something Anissa was not happy about having to take in such large doses. Image courtesy newsong on Pixabay.

The next day she got online and went in search of acupuncture. She Googled and found an acupuncturist and someone’s testimonial called him a “gift from God,” and hoped that perhaps he could be such a gift for her as well. She walked into the acupuncturist’s office barely able to lift her feet to walk, with numbness in her feet so severe she would avoid the stairs at her house for days at a time for fear of falling. By going to the acupuncture appointment, she felt she was just doing her due diligence and crossing something off the list.

Her first acupuncture treatment was “excruciating.” The acupuncturist is “old-school,” from Taiwan, and she found him somewhat frightening and difficult to understand. After the treatment, he asked her, “How do you feel?” And she replied that she didn’t know, but that she might have been feeling a bit better. She was experiencing a pulsing sensation which was new to her, and which she found encouraging. When he prompted her to lift her legs to waist level by raising his hands as targets for her to reach toward, she was shocked to be able to do so, considering that she had barely been able to walk into the office for her appointment. She got back up from the treatment table “thanking God that maybe this was something” that would continue to help her. She now had hope that something better — perhaps even relief — might be possible.

Acupuncture was the first partially effective intervention Anissa found, but it didn’t fix her underlying posture issues. Image courtesy Hamilton Viana Viana on Pixabay.

Over the next three months, she frequented her acupuncturist, seeing him by her choice for treatment two to three times a week. She could feel the healing occurring in her body. The treatments reduced her pain to a tolerable level. Her next target was stopping the narcotic pain medication she’d resorted to for years. Someone in a chat room online told her about kratom, which she investigated and then used for a short time in order to transition away from the prescription painkillers. “I’ve been pharmaceutical-free for going on about four or five years now. But during that time, I still had pain.” At this point, she still had pain to contend with, but “not to the level where everything was darkness.”

“I’ve learned now that if I manage my life right, I can have joy again. I can do things again.”

The Gokhale Method is something Anissa first heard about from a friend.

A new approach to pain relief
Anissa first heard of the Gokhale Method from a friend with whom she had a reciprocal coaching arrangement: Anissa would life-coach her friend, and her friend health-coached Anissa. “She said, ‘You know, I heard about this, and it might help you.’” Anissa looked it up, watched a few videos, and bought herself a copy of 8 Steps to a Pain-Free Back as it was more within financial reach than enrolling in a course immediately. “Let me see what I can get from the $20 book first, before I further the investment. From the book, I was able to tell that it was something and that it made sense to me. With what I had been through and what they had tried to teach me and what was so different.”

Anissa “almost didn’t go to the Pop-up Course.” She was aware Esther was travel-teaching in Texas, but the courses weren’t near Anissa. However, they were close enough for her to try to get to. She felt it was a sign: a response to her prayers. “I was actually experiencing higher-than-normal pain, the most I’d had in a few years, and I really wanted to go, but I didn’t know if I could. I didn't know if I was physically capable.” Determined, Anissa ended up driving 5 hours to Dallas — a drive that would be impossible for her most of the time due to her pain levels, but the endpoint of which was so important to her she didn’t want to miss it. She was assisted on the drive by one of her daughters.

During the drive back to San Antonio back from the Pop-up Course in Dallas, Anissa asked her daughter to take this picture of her standing without pain at a rest area — a truly memorable moment. Image supplied.

Dramatic results in a single day
By the end of the Pop-up Course and the drive home to San Antonio, Anissa almost couldn’t believe the results. “My camel hump on my neck was gone! And I knew it was gone, but I questioned how that had happened.” Just that day, she had noticed her longstanding kyphosis, also known as a “buffalo hump” or “dowager’s hump,” during the halfway point of the course, when she was experiencing some of her usual pain and applied a topical pain relief cream to it. She regularly asked her husband to rub this kyphotic hump to provide her some fleeting relief. But after the Pop-up Course, the hump was gone. This was a big change; nothing she’d ever done before had ever had such dramatic results in such a short amount of time. “The book was great, but I really needed the hands-on [learning], and I need to do the Foundations Course next. My body is used to being a certain way, and it’s taking time to train my brain to do things differently.”

In her own words, Anissa is “thrifty, so [the course tuition] felt like a lot of money.” It was actually her and her husband’s anniversary weekend and she wanted to do something with him for the occasion, but she reconsidered. “I thought, what better gift could I give to my husband than feeling better?”

“Acupuncture has helped me manage my pain to where I can have a life now. It’s a more limited capacity than I would maybe prefer. But what the Gokhale Method did is open the door up wider.” A couple of weeks after the course, Anissa and her husband took a trip to Marble Falls and went hiking for the first time in maybe 15 years. “I remembered how much I loved it, and how good it feels to stand in nature — wow, Lord, really! This is in my backyard? And I never would have seen it, because I was afraid [of debilitating pain].” On her hiking trip, she realized the course was “worth all that money and then some, because we get to do things we used to not be able to do, that we hadn’t done in a really long time. So it was amazing.”

Anissa’s once-debilitating pain is now well-managed enough to let her live her life again, as in this photo during her hiking trip to Marble Falls. Image supplied.

“An answer to prayer”
When she does experience pain, the Gokhale Method has given Anissa the tools to realize that something is in need of adjustment. Anissa is humble and adamant that, in spite of her excellent and heartening results, her posture journey is only beginning. “I only know this much, and it’s made such a huge difference,” she says. “Even knowing that much has made a huge difference. And there’s so much more.” The private online follow-up session with Kathleen was a needed refresher on the techniques. Being able to bring the method home to her space, to her desk, and to her home context was incredibly helpful for Anissa. Aside from the pain relief, Anissa appreciates the comprehensive nature of the Gokhale Method. “It’s for your whole body, working with your whole body the way it was designed to work,” unlike exercises focused only on giving people superficial benefits, like “great abs.”

When asked what Anissa treasures being able to do with her body, it’s the simple things that are most important. She has a young grandson, and being able to pick him up and get on the floor and play with him are precious. The freedom of being able to get in the car and drive for 10 hours and end up in New Mexico, for example, is a blessing. “I want a body that doesn’t limit my capacity to do what I do and what’s important, not to be sitting there with family and friends and wondering when I can go home because my back hurts so much. I want to be able to actually enjoy conversation and interaction with people without the primary brain focus being the pain in my body.”

Anissa considers her whole journey to have been “an answer to prayer. It was too weird the way it all happened, and the results. I always know it’s special — a gift — when it goes this well. Not that the process has been easy, because I feel like I’m constantly having to work on it and I have so much more to learn. But to get such an immediate injection of hope, to feel that maybe I wouldn’t at some point be managing the symptoms of my pain with acupuncture and supplements. I have hope that this can build up to more as I go further in the process and learn to work with my body the way it was designed to be.”

And given her history, she’s no stranger to despair. “I know what it’s like to lose hope. I know how different your life can turn out if you can’t be pointed and guided in a direction that’s not pharmaceuticals, that’s not injections, that’s not surgeries. I’ve met so many people whose long-term results are a disaster. Maybe in the beginning they’re ok, the first few years out, but talk to them 5 years after surgery and they’re all miserable, too. I’d like to be able to help share this and help save people from the decade of disaster I experienced myself.” Thankfully, with the Gokhale Method on her side, Anissa has a brighter future to look forward to.

Future generations, and our ability to show up for them, can prove excellent motivation for reducing our pain and improving our functionality. Image courtesy Sasin Tipchai on Pixabay.

At the end of his rope after chiropractic, physical therapy, massage and surgery, a Transportation Planning Consultant finds relief with Gokhale Method Foundations Course.

Travis Dunn, PhD, remembers clearly the onset of his excruciating back pain. He was all of 24 years old.

“It first appeared while I was on vacation in June 2005,” he recalls. “There was no specific, major incident that precipitated the pain, but it grew sharper and more debilitating over the course of a week or so, including occasional sciatica.”

He would start each day with his back pain registering “one or two” on a scale of ten, he recalls. As soon as he sat, the pain would grow worse. “If I were to remain seated, I’d be at seven or eight within a half hour. When I stood up, I would be like a hunchback,” he says, bending over to show how contorted his body was. “Then I would have to stretch to reset my muscles before I could sit down.”

He survived his workday by taking walking breaks—some were part of his regular routine of walking to meetings or lunch. Others were add-ons to a fully loaded workday. All told, he’d spend an hour or so walking each day, just so he could sit and work. When the pain became unbearable, he would rearrange his desk and stand at his computer, which helped only slightly.

Dunn opted for a conservative approach to treatment, starting with chiropractic care. “The chiropractor took x-rays, then put them up on the wall and showed me where everything was wrong in my spine. He said I’d see him three or four times a week at first, and then we’d taper off after that as I got better.” That lasted two months. “I wanted to believe it would work, and he told me it would. But I saw no difference.”

Over the following two years Dunn tried therapeutic massage—“short-term relief measured in hours, not days.” Next came six months of physical therapy, which provided some help if he maintained a strict regimen. Dunn had cortisone injections twice, with no benefit. 

“Long road trips and air travel were nightmares,” he recalls. Over-the-counter pain killers had no effect, he says, and he studiously avoided prescription pain relievers or muscle relaxants. “I knew of people with back pain similar to mine, who had become prescription pain killer addicts; I didn’t want to go down that trail.”

Dunn finally went to an orthopedic surgeon who, unlike the chiropractor, saw nothing of concern on the x-rays. “He looked at the same x-rays as my chiropractor and said, “You can’t see anything from these.” The orthopedist ordered an MRI, which showed a herniated L4-L5 disc.

After exhausting what he thought were all of his alternatives, he had surgery in December 2006, an L4-L5 discectomy to remove the herniation. It relieved his occasional sciatic pain, but the low back pain continued. “I followed up with routine physical therapy for the next 6 months which helped me to manage the pain, but if I skipped even one day of stretches and exercises I was miserable,” he says. 

At this point Dunn estimates he was out of pocket about $7,000 and that his health insurance company had absorbed at least another $20,000. He also missed work for a month while recovering from the surgery.

For the next several years he managed his pain with a strict regimen of stretching and exercise, but still struggled at work where he spent long hours sitting at a desk. The pain was constant, he remembers, with its severity tempered only modestly by stretching and back exercises.

The ordeal was at least as taxing emotionally as it was physically and financially. “I was never clinically depressed, but over time it took a toll on me emotionally,” Dunn recalls. “I’m an engineer by training. I solve problems, and I couldn’t figure this one out. I was going to all the medical professionals you’re supposed to go to, and they couldn’t fix it."

“The despair part of it is this fear that you’re going to have to live with this for the rest of your life. The longer it went on, especially after the surgery didn’t resolve the underlying back pain, the more I was left wondering if this was going to be a chronic lifelong cross to bear. I never stopped looking for answers, but I had five years of very limited success. And when a problem lasts that long, you can lose hope.”

In April 2010, nearly five years after the pain began, he took the three-day intensive Gokhale Method Foundation course. 

“It was intuitive, in a way that was revealing, or eye opening,” he recalls. He had seen Gokhale Method creator Esther Gokhale’s book, and the class came naturally to him. “I remember sitting down for the opening session, and listening to her explanation of posture. It was very intuitive, and I felt very comfortable. I saw results almost immediately."

“I quickly realized that many of the stretches and sitting positions I had been using to find relief were, according to the Gokhale Method, counterproductive. For example, arching or swaying my back and using a lot of lumbar cushioning—that was a big one—were actually making things worse. I had no guidance or foundation for the geometry and physics of a healthy back, so I used countless positions and exercises, many of which were ill-advised. Esther’s method was a very logical philosophy, easy to follow.”

Dunn shared an email he wrote to Gokhale six months after taking her course. "My low-back pain is, for the most part, a memory. I have applied your methods principally to my sitting, which was always the most uncomfortable position for me. The results are striking. Whereas in the past it was a struggle to get through a day (complete with standing / stretching / walking breaks every 10 minutes or so), I can now sit uninterrupted and pain free for long stretches."

“As evidence of that, I have traveled from Boston in the past three months twice to Portugal (that's four flights of seven+ hours each), twice to Texas (four flights of three+ hours), and once to Mexico (two flights of four+ hours). Each time, I flew comfortably and pain free!"

Dunn—now a 32-year-old transportation planning consultant—travels regularly overseas and has driven twice across the country—all pain free. And his advice to others in back pain? 

“This method is something everyone should be doing, regardless of whether they’re in pain. I notice posture now. I notice how people are sitting. For those in pain, it’s easy, low cost, and a low-hanging fruit. I wish I had done it first.”