Cruelty and consequence: For people in chronic pain, everything counts in large amounts

By: Loolwa Khazzoom, Founder, Dancing with Pain

March 24th, 2010 • Leave a Comment

Although walking and hiking have been incredibly challenging, if not impossible, over the years, biking has been one of the few activities I have been able to do over the past decade and a half, despite pain.  Of course, there have been periods that I have been unable to bike, as a result of debilitating pain in my hands, ankles, or thigh/groin area. But for the most part, my bike has been my one connection to the outside world and to my super-active life before the car crash. 

While living in Berkeley, I joked that I was half-bike, half-human, because I was always on my bike — for transportation as well as for pleasure.  I biked 9-18 miles at a shot on a regular basis, on the bike path that hugged the Bay.

Biking has been more of a challenge since moving to Southern California, mostly because the drivers here are jacked up on crack and cruising around in tanks.  But over time, I found safe routes that could take me to the beach.  And on strong days, I could bike up and down the path on the beach, in addition to biking to and from the beach.  The beach path is not as safe as the path in Berkeley, mind you, because sand and cement don’t mix particularly well. But I just bike slowly, to avoid skidding, and it works out.

The other challenge I initially encountered upon moving down here was that I live on the third floor of a building without an elevator, and the landlord did not want me parking my bike on the ground floor. I simply cannot lug a bike up and down three flights of stairs.  That activity in and of itself can throw me into a fit of pain, never mind the fact that it is completely impossible to do on days that I already am in pain.

So I scoped around the neighborhood and found a low gate, serving no functional purpose, off to the side of a walkway hugging a building directly across the street.  There was plenty of room for people to walk or wheel past my bike when it was locked to that gate.  And so, for about a year, I kept my bike locked there and didn’t receive any complaints.

The downside was that because my bike was parked outside, it was exposed to the weather, and I had to get parts replaced more quickly than when my bike was parked indoors in Berkeley – which adds up financially.  But that was a small matter compared to having access to my bike.  On good days, I biked about 15 miles.

Then the sabotage began.  At first, I assumed that my tires kept going flat because they were exposed to the hot sun or because of some other cause unrelated to cruelty.  I did, however, find it very odd that I had to replace my tires on an increasingly frequent basis.  At first, it was the front tire going flat, which simply required popping the tire off and take it to a bike shop.  But then the back tire started going flat, which created all kinds of additional complications. Lifting my bike into the trunk can throw out various body parts and leave me in pain for days, which in turn causes a chain reaction of chaos in my life.

Once, it seemed that the air had just gone down, so I pumped up my tire and successfully biked about 3 miles to a meeting.  But when I came out of the meeting, my tire was dead.  I had some ankle pain that day, so it was challenging for me to walk about five blocks in my biking shoes (ie, shoes not intended for walking), to get to a gas station, where I could pump up the tire.  Fortunately, I had the little metal converter you need to pump up a bike tire on the machine designed for a car tire.  And fortunately, my bike made it all the way back home that day.

But the next time my back tire was flat, I had no indication before leaving.  So I went on a joyride and kept feeling that something was wrong with my bike.  I stopped about three times over the course of a mile, examining various bike parts.  Everything seemed to check out, so I kept going.

By the time I reached a busy intersection marking the far edge of my neighborhood, I decided that despite my inability to find something wrong with my bike, I should trust my intuition and turn around.  As I made a U-turn, there was a loud squeaking sound, and my bike nearly fell over.  In the middle of the street.  Fortunately, I was quick and strong enough to stabilize myself.  Had I not been, that turn could have been disastrous.

My tire was dead.  And I was a mile away from home, with no gas stations nearby.  I decided to see the situation as an opportunity to test how far I could go.  I walked slowly and took a few breaks on the way.  I was very proud (and fortunate!) that I was able to make it all the way home.  I blogged about my accomplishment.

Yet again, I hauled in my bike for repair.  Doing so not only cost me financially, but also pulled my thigh/groin area, which has been a bitch to heal.  Meaning, I couldn’t bike for about a week after repairing my tire.  That of course has its own consequences.  The less I get out and get exercise, the less well I feel on both the physical and emotional levels.

About a month after this incident, I went to get my bike, only to find that the back tire was dead (again), the cable was cut, the odometer was missing, and the back flashing light was missing.  You can imagine the anger I felt when I realized that somebody was deliberately attacking my bike and that as a result of this person’s cruelty, my life was put in danger, my pain levels were jacked up, and I was thwarted on multiple occasions from getting the exercise I needed, not to mention from having access to my preferred mode of transportation. 

So I had a conversation with my landlord.  He was a total doll and installed two bike hooks in the wall on the ground floor, so that I could lock my bike on the property — which has security gates at both entrances.

Because I am weathering a financial crisis at the moment, the only thing I fixed on my bike was the back tire.  I had an extra flashing front light, which I hooked onto my back rack, for safety.  I figured I would take care of the rest when my financial situation got better.

For almost a month, I did not risk riding my bike, because my thigh/groin pain got triggered the last time I did, leaving it very challenging to make it back home.  I decided to dance a lot and build up my strength.  Last week, I was ready and super eager to give my bike a spin.  I was shocked to find that my back tire, once again, was dead.  Considering that my front tire still had tons of air in it, and considering that I had just replaced the back tire less than two months earlier, it seemed that my bike had been attacked again.

I was running late for a meeting but had to take the extra time to go upstairs, change into regular clothes, and drive to my destination.  The 40 minutes I spent commuting could have been 40 minutes I was simultaneously commuting and exercising — a multitasking endeavor I really need during this time that I am working up to 17 hours a day.

Vandalism is distressing enough in and of itself, especially when it appears to have been done by someone who lives on the same property.  But it is especially upsetting when it means shelling out money I cannot afford right now; risking jacked up pain levels, so as to get my bike in the trunk; and taking an hour out of time that I cannot spare, so that I can get my tire replaced yet again. What’s more, I kind of feel like there is no point in fixing my bike. Who knows how long it will be before it is attacked again?

Not only does this situation put me on edge and feel scary (I’m going to have to check every bike part for safety, before leaving each time), but it really throws a wrench in my ability to manage my time, my pain levels, and my active participation in the outside world.  Over the past week, I could not afford the time or potential pain involved in getting my bike fixed.  So I drove to a whole bunch of places instead – meaning that I didn’t get the outdoor activity or exercise I craved, which in turn fed the stress levels that have been through the roof recently.

And then, because the bike attack keeps happening, I have the added anxiety involved in talking about it. Will people assume that my bike keeps getting attacked because I have done something to piss someone off? Will they then blame the vandalism on me, the way that people blame patients who encounter repeated medical negligence or women who encounter repeated sexual harassment? It is so often easier to blame the victim than the aggressor or the entrenched system. Which in turn further complicates the experience of being on the receiving end of any kind of carelessness or cruelty.

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Pseudo-quackery in Chronic Pain Care: a field with a large gray zone between overt quackery and evidence-based care

By: Paul Ingraham, , blogger at Save Yourself

March 23rd, 2010 • Leave a Comment

If you want your quackery strong, like a stiff shot of whiskey, you can certainly get plenty of that: the care of aches, pains and injuries is rife with alternative treatments that are experimental at best, and probably too good to be true. Traumeel, a homeopathic ointment, is one of the most popular topical remedies in the world. 

Reiki masters wave their hands over injuries and diseases, wishing them away. A sizeable sect of chiropractors sell the idea that adjusting the upper cervical spine can cure all disease, not to mention low back pain.

These are some of the superstars of scientifically dubious treatments in alternative health care, and they are easy to spot and avoid. A lot of average people are doubtful about these treatments, and many chronic pain patients in particular know all too well how little they have been helped by this category of care. You don’t have to be a card- carrying skeptic to know that what sounds to good to be true probably is.

Less obvious quackery, what I call pseudo-quackery, is the more insidious threat to pain patients: treatments that exist in a disconcertingly large gray zone between overt quackery and proven, uncontroversial medicine. The gray zone is especially large because there is precious little good evidence about how to help people in pain. Pain science is still distressingly, exasperatingly primitive.

Even simple overuse injuries continue to present surprising scientific difficulties. Is a tendon really inflamed? Turns out that tendons are not just boring ol’ gristle after all, but impressively clever bio- rope‚ with physiologic complexity undreamed of 25 years ago.

For lack of truly good, tested treatment methods, physiotherapists, chiropractors and massage therapists sell many treatments that would be considered highly experimental in most other fields of medicine. 

But patients generally have no idea when they have entered this gray zone of therapeutic guesswork, because pseudo-quackery treatments aren’t ridiculous on their face, and some of them are even interesting and promising. So what makes them dubious?

  • debatable plausibility
  • absence of (good) evidence
  • overconfident prescription despite the lack of evidence

One person’s plausibility is another’s eye-roller. I know of a lot of allegedly plausible treatments that have some merit but do not really impress me. I call dubious, debatable therapy concepts shruggers; an idea worth testing, but pointless to discuss, except out of intellectual curiosity. Manual therapists have a million of ‘em, all untested, or barely tested, or badly tested.

If a pseudo-quackery intervention had been proven to be effective, then it would not be any kind of quackery (d’oh). And if it were proven to be bogus (evidence of absence) then it would be full quackery. But an unstudied shrugger – maybe it works, maybe it doesn’t – is harder to define, and it can get pimped out to patients for many years, decades even, with varying degrees of overconfidence. It may be pushed as a promising treatment with the slightest nod to the lack of evidence, or (more likely) it will be sold as medicine.

Absence of evidence alone does not pseudo-quackery make, of course. 

Some of these things probably are medicine, and will be proven in time. But the degree to which we just can’t say is a bit shocking. The stock introduction to scientific reviews of virtually all interventions is “there is insufficient evidence to draw conclusions.” 

This is not just the fringe of the reasonable we’re talking about here. We’re talking about the bread and butter treatments of mainstream physical therapy, interventions that consumers and insurers spend billions on every year, as well as stranger and new-fangled stuff.

It is said by some that health care would be paralyzed if we dispensed only proven treatments, as many alt-med evangelists enjoy pointing out (they think it proves that interventions don’t need to be proven). 

Unproven therapies were particularly unavoidable in my former profession: As a massage therapist, I literally could not move a muscle in my office without doing something unproven. What’s an ethical practitioner to do? Here are simple instructions for converting pseudo-quackery into ethical therapy in just moments:

  • Look patient in the eye.
  • Take a deep breath.
  • Recite the mystical incantation “I don’t know if this will help you.”

I could only protect my patients from my own ignorance by proactively and candidly emphasizing it. Anything less would have been unethical.

Unfortunately, saying “I don’t know” seems to be a dying art amongst self-employed therapy mongers. The almighty dollar is the main problem. Most manual therapists are freelancers, and their rent only gets paid when patients return for more. This is all it takes for many practitioners to recommend unproven treatments with just a bit too much enthusiasm. Even just a little bit of normal human ego can do it.

Pseudo-quackery can be quite mild-mannered. It is routinely perpetrated by average professionals suffering from a little confirmation bias and a lack of familiarity with the scientific literature. In no case are they what a skeptic thinks of as quacks; they’re just ordinary professionals who can’t read journals all day long and have bills to pay. Their confidence in unproven therapies spans from apathetic assumptions to premature enthusiasm to over-the- top marketing zeal. 

And yet if it isn’t the job of a therapist to be openly humble in the face of our awesome ignorance of what really works, then I don’t know what is.

Despite its ho-hum personality, pseudo-quackery is a clear and present danger, particularly to chronic pain patients. Even skeptical patients routinely spend thousands of dollars on false hopes in the gray zone, often spending years in the therapy grinder, hammering away expensively at a condition that there was never really much hope of treating in the first place.

Chronic pain patients really are desperate, and it’s not wrong to cautiously try an experimental treatment method.  But very few are anywhere near as promising as their marketing makes them seem.  Be cynical.  Be careful.  And beware of professionals who haven’t gotten the memo: humility in treating chronic pain is not just a nicety, but an ethical necessity. 

Paul Ingraham is a science journalist and retired Registered Massage Therapist in downtown Vancouver. He has authored several books and hundreds of articles about science-based care for common pain problems, most notably about myofascial pain syndrome, low back pain, and knee pain. Paul blogs regularly at Save Yourself (linked above), and you can follow him on Twitter or on Facebook.

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Tips for Joining, Starting, and Running a Healthy Chronic Pain Support Group

By: Loolwa Khazzoom, Founder, Dancing with Pain

March 22nd, 2010 • 1 Comment

I interviewed Sharon Weiner, founder and president of Living with RSDS/CRPS — a chronic pain support group in New Jersey – about her tips for joining, starting, and running a healthy chronic pain support group. For more information about and resources on joining, starting, and running a healthy chronic pain support group, see the Spring 2010 issue of Pain Pathways magazine — available at Barnes & Noble or through purchase from the Pain Pathways website.

What are your thoughts about the purpose and benefits of a chronic pain support group?

The purpose of a chronic pain support group is to offer information, education and emotional support to those with chronic pain and to family and friends affected by the syndrome. The sharing of information and ideas creates a huge pool of resources from which to draw.  More importantly, many who attend a support group for the first time are so happy and relieved to find others who have the same issues — whether they have the experience of patient or caregiver. They realize that they are not alone.  

What are some of the resources offered by RSDSA in terms of joining or supporting a chronic pain support group?

RSDSA (Reflex Sympathetic Dystrophy Syndrome Association)  has very good website to use as resource  for information. All affiliated support groups are asked to have their meetings listed. A free information starter package  is available for prospective support group leaders, once they have spoken with the director, Jim Broatch. And of course, Jim himself is a great resource and very supportive.

Jim will most often send an alert to me about someone starting a support group. I then will contact that person via email – to answer questions,  give support, and offer suggestions and advice on what has worked for our group.

How can joining or starting a support group change the life of someone with chronic pain?

The first time a member told me that the support group saved his life, I was overwhelmed. When suffering with an often-misunderstood and painful syndrome, it is very welcome to have others understand you and to offer emotional support, suggestions, and advice on what may help. This feedback may lead to treatments not considered before, a better way to handle a situation, or just knowing you are not alone in this. A lot of people who attend meetings for the first time have never met another RSDS/CRPS patient.

What  are your thoughts about the elements of a successful chronic pain support group  – ie, what works and why?

There are few elements that come to mind: Organization, continuity, compassion, resourcefulness, and remembering that just because you lead the meeting doesn’t mean you need to know all the answers. I started our group by first finding a place to meet, then creating a flyer and mailing it to doctors and medical professional offices.

The meetings work best  if they are at the same place, time, and day of the month. It is enough for many to just get to a meeting, so keep it simple and consistent. Be organized, get member information (for monthly meeting reminders or pertinent information only), sign in sheets, an answering machine to receive calls, a website  and a basic meeting format.

Create a new member package about RSDS/CRPS, for new members who may need it. Let everyone tell their story, but keep it short. Everyone is there for support and needs to be heard. We also have a premise, “You leave it at the door.” We are all suffering, and this meeting is not a contest. 

Speakers are great, but also keep time for members to talk among themselves and for new members to ask questions.  If there are guest speakers, make sure they understand the syndrome and that we often move around a lot, due to our pain. I once had a speaker in tears, because I forgot to mention this information.  She thought we were bored, because we were fidgeting and moving around. Send thank you notes. 

Ask the members what they would like to learn, about and try to find someone who can talk about it. Don’t be afraid to ask for things; all someone can do is say no, and you are no worse off. In our group, we have had hypnotists, lawyers, doctors, therapists, self defense instructors, motivational speakers – any topic that involves living with the syndrome..

We do not charge dues and will not. Another concern about leading a group is that there will be costs involved. You can ask for a donation or charge dues. Ask for what you may need. Stamps? Copy paper? Ink? We had a member who owned a sign company, and he made us a huge banner to use. Snacks and drinks are nice, but optional, and can become costly.

We have run fundraisers for many years. We purchased coffee machines and supplies, a hand truck to pull all the supplies to the meeting, printed group materials, and a laptop, and we had our website professionally created. We even became non-profit. Be resourceful.

Our group always joked about all of the stuff I brought to a meeting.  I learned to create a travel office box of materials, new member packages, a scrapbook of the articles etc. 

We also keep a look-out for awareness projects or create our own to draw attention to RSDS/CRPS. It is also a way to keep the group united for a positive effort. I read many, many magazines and newsletters and receive health alerts. This is often the basis for a meeting, when there will not be speaker.

Have a plan. Take classes or attend workshops about leading a group. We can always improve, and it will help the group.  You may never know what situation you may find yourself confronted with. I enjoy leading the meeting and find a great sense of accomplishment, but there are times that it is overwhelming — emotionally and physically. But the rewards keep me going.

What are your thoughts about pitfalls to avoid in a support group and why?

Once your group is up and running, try to find help — someone or a few people within the group who would willing to help run a meeting if you are unavailable, or take on administrative tasks. A few may have had to stop working and will enjoy helping. Don’t be afraid to ask and accept help! You have this syndrome too.

Taking on too much too soon or too fast can be a problem . It’s better to commit to a smaller task and do it well, than to think grand and fail. You cannot predict how you are going to feel.  Many members may come to depend on the meetings for support. Don’t let them down.

Trying to please everyone also can be pitfall. I let all new members know that not every meeting will apply to them. Certain topics may have not appeal to some but may be life altering to others. Members receive monthly meeting notices, with the topics of discussion, so they do know ahead of time.

As the leader, you run the meeting and try not lose control of the meetings. A certain amount of “free for all” and smaller group talking is great, but at every meeting, it would be unproductive as a whole. Remember you are the facilitator of the meeting.

Many conversations about doctors come up. No doctor bashing! We do not allow this. Doctor-patient relationships are private. 

You also need to remember to remain unbiased with information. As the leader, you are there to provide information, not to tell the members what they should do. Recommendations can be made if pushed, but do not tell members that they must do or try something. Other members may give strong opinions. They are entitled to do so but must do it civilly.

Not listening to the needs of the group is a problem.  The group may consist of people in different stages of life, length of time with the syndrome, caregivers, patients, and so on.  You need to find ways to keep it interesting . Ask the group. They may have great ideas!  

What do you see as the potential fear of resistance to joining or starting a support group? What are your tips for how to overcome that fear?

When I talk to potential newcomers, they are concerned that it will be a depressing night of horror stories. I explain our mission and concept and what previous meetings have been about. The first support group meeting I ever attended was so demeaning and depressing, I swore to never attend another one. Then I realized that would be counter productive, and that if I put my mind to it, I could do better. We keep it positive and honest, and no grandstanding is allowed. It’s about offering and sharing information on how to live with chronic pain.

Before joining a group, I made a habit of asking, “What the meetings are like? How many members? How long has the group been meeting? Who attends (patients, caregiver etc)?” Make sure the group fits what you need. If you need to, bring ice packs and blankets, to be as comfortable as you can.

When our center started charging for parking, and a few members had difficulty with the expense, we went to the medical center, explained the situation, and were granted a pass for those members. Knowing that you will offer assistance, even for something like parking, may help members understand that you do have their interests at heart.  

Sharing personal stories, some of which can be emotionally painful (depression, suicide concerns, marital problems, financial issues) can be difficult. But what you gain from sharing at a meeting can be life-altering. Meeting someone who understands and is willing to listen to you vent, or have a cup of coffee, or have movie with you, can help you cope.

Another big issue is travel. A lot of RSDS/ CRPS patients have trouble driving, so getting to a meeting is difficult. Online groups work, but I think the in-person meeting offers something a bit more. Carpooling between members can help solve this problem.

Starting a support group is a major task that should not be taken likely. Some people may be afraid or worried about the responsibility of the monthly event, or concerned that the group may fail, or already may be dealing with so much related to pain. If you take the time and plan it out, being organized makes the process much easier.

The public speaking part intimidates some. Anyone who attends is not here to embarrass you or grade your presentation. They are thankful a group is available. Do your best, and ask for suggestions and advice. Use comment cards or surveys as a tool.

Please talk about the catch-22 of needing a support group because of chronic pain, but being unable to get to a support group because of chronic pain.

This will always be an issue, and often there is little to do about it. We are working on streaming our meetings live, though our website, so that those homebound individuals can be part of the meeting. It will take a while for us to launch that feature, but it may help. 

People can use email and the phone, but of course, meeting with a group in person is different. The give-and-take and exchange of ideas is a wonderful therapeutic tool. The personal interaction is so important.

We are hoping that if we have a speaker, and someone cannot attend, the member will email questions or concerns, and we will have them answered. Patients can register on our website, and we will get back to them ASAP. We considered satellite meetings, to help those that may not be able to travel to our current meeting location.  It is quite an undertaking and needs to be planned out accordingly, if it is to succeed.

What are your tips for identifying personal support needs around chronic pain? What are your strategies for matching those needs to the available resources?

The personal support starts from the time members share their story – either on the phone, in a meeting, or by email. Finding out how they got RSDS/CRPS, what  treatments, medications, and questions they ask about, and so on, determines a course of action. I may ask another member who has similar story or treatment to get in contact with them or offer information from our resources – sharing websites that may help or developing a relationship outside the group setting.  

Offering support is more difficult if the patient is young. Most group members are adults, and the issues affecting a teen will be different than those affecting an adult. I normally ask parents to first attend a meeting without the teen — to get a feel for the meeting. In some cases, the meeting helps the caregiver more.

What are your thoughts about how to know when a support group is working and when it’s to move on?

How do we quantify the success of a support group? If only one member attends, but it is helping, then isn’t the group a success? Many times, throughout the years, our group attendance has ebbed and flowed, for many reasons. Some have moved away; some have passed away; others have learned all they needed or wanted to hear. We have some members we only see once or twice a year, but that works for them.

If you, as the leader, become burnt out or lose the joy in running the group, it might be time to move on or give another leader a chance. Before throwing in the towel, I suggest polling the group — asking what improvements are needed and seeing what can be done. Maybe it’s just making changes – working on running a meeting live on a website,  promoting the group more to reach more people, or revamping the meeting concept.

If you lose your meeting location and cannot find another, that is a serious issue. I would not recommend having the regular meetings your home.

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James Dillard, MD, on The Science of Healing

By: Loolwa Khazzoom, Founder, Dancing with Pain

March 21st, 2010 • Leave a Comment

Loolwa Khazzoom: It seems that there is pressure to use pharmaceuticals to treat chronic pain, because there is more of an ability to point to a drug and say, “This has been proven to work.” Is there not the same level of research into the degree to which complementary and alternative medicine therapies work?

James Dillard, MD: There are literally thousands and thousands of clinical trials in acupuncture, mind-body medicine, nutritional interventions, manual therapies, and so on. There are also rigorous systematic reviews and meta-analyses of these kinds of treatments, as well as Cochrane consensus statements on them, so if someone says there isn’t data, it just means that person has not seen it. 

In terms of the professional academy guidelines, there is generally not a consensus that these treatments work. Keep in mind that the professional associations are trade organizations, so they are focused on what they do. You can’t expect the association for orthopedic surgeons to put a lot of effort into exploring the mind-body connection, as they develop guidelines on how orthopedic surgeons should practice – for example, relative to neck and low back pain. 

LK: What is the science behind energy healing – acupuncture, acupressure, qi gong, reiki and so on?  

JD: We don’t know all the exact mechanisms of how these things work. Certainly, they are tremendously comforting. Any time you put your hands on somebody, and anytime you actually just help somebody, you’re comforting that person. Doing so probably has a very primitive effects on the mind. Some doctors would call that placebo, but I think it’s real therapy.

There is also a lot of overlap in treatments – whether massage, yoga, or Trager work. They all have aspects of mind-body connection, physical contact, spiritual healing, and energy healing. If you give someone a reiki treatment, you put your hands on him or her. You administer to that person. Is energy being transferred from the universe? I don’t know.

Remember, for thousands of years, really smart people, with IQs just as high as our IQs today, stood at the edge of the sea and looked out and said, “It’s flat. It’s definitely flat. There’s no question about it. We know it’s flat.” And guess what? It wasn’t flat. And they were just as smart as we are today. They might not have been as knowledgeable, but they were just as smart. So we have to always be a little cautious about how we think things work. 

James N. Dillard, M.D., D.C., C.Ac., is one of the leading pain specialists in America and the author of numerous books on chronic pain, including The Chronic Pain Solution. His many media appearances have included The Oprah Winfrey Show, Good Morning America, and the CBS Evening News. He served as an assistant clinical professor at Columbia University College of Physicians and Surgeons for 12 years and also was the Medical Director of Columbia’s Rosenthal Center for Complementary and Alternative Medicine. He resigned from employment at Columbia in 2006, to go exclusively into private practice. He now writes a column for the East Hampton Star, “To Your Health.”

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Identifying and Cutting Out Trigger Foods May Surprise You with Results!

By: Loolwa Khazzoom, Founder, Dancing with Pain

March 11th, 2010 • Leave a Comment

In Overeaters Anonymous, they talk about “trigger foods” – foods that bring on that bottomless pit, must-have-now, at-all-costs, inhale-kitchen insanity. I thought I didn’t have a trigger food. Food was my trigger food – salmon, brown rice, salad, ice cream, apples, you name it, I could go to town.

But then last week I decided to cut out all sugar, kick cheese out of my house, and all but totally stop eating fried food, because I was outta control. I figured I didn’t need to be ingesting those things for nutrition, so away with them! Then a few things happened that surprised me:

  1. Food lost its sex appeal. It was no longer a source of entertainment, but rather a function of sustenance. I mean, seriously, when you take out all those ingredients, what’s left to play with?
  2. I do not have the crazy reaction to the same foods that were making me crazy before. I do not desire to eat an entire watermelon or pound of beef. Which leads me to wonder: Did the cheese, fried oil, and sugar change my brain chemistry in such a way that food almost triggered an allergic reaction in me? By removing those ingredients, am I now experiencing food the way that people who are not compulsive eaters have experienced all foods their whole lives?
  3. My eating behavior got more and more healthy each day, without trying. I went from inhaling two quesadillas, four oranges, and a big bowl of salad in one sitting, to having, oh, a small bowl of oatmeal. (With soy milk. Blech. Dairy milk is back in the fridge now, thank you very much.)
  4. I suddenly found myself wanting a social and romantic life. I was the Happy Hermit for a long while there. But all of a sudden, you take away my cheese, sugar, and fried goods, and – hey, where’d the party go? I also suddenly have the urge to paint. Go figger.
  5. People are getting out of my way. OK this one is seriously hilarious. Who knew there was a relationship between cheese and body space??? For a while now, people constantly were entering my energy field and nearly plowing me over when they passed. Not today. Suddenly everyone – and I mean everyone – was making arcs around me when they passed. Has my energy field taken on that of a football player, sans sugar? I need more observation time to come to a conclusion on this one.

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