Wise Anderson Clinic July 2011

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gl0342
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Re: Wise Anderson Clinic July 2011

Post by gl0342 » Wed Jul 20, 2011 12:11 am

Day Five (last)

The last day.

Important session with Tim - rehearsal of all TPs, he did them again so that I can memorize the "feel", and had me do them.

Session about how to handle Catastrophic Thoughts - especially in times of flare ups.

More sessions about relaxation approach - how tension in one place is related to tension elsewhere (tension patterns) - basically the benefit is that when you relax an area you get other related areas relaxed as well (for me - jaw tension -> abdominal tension -> pelvic tension). Also direct link between stress/anxiety to tension buy unconscious guarding (for me it happens sometimes in real time - for example I sometime feels contraction in the urethra sphincter when I get stressed).

A few other topics such as the role of the partner in the process (basically to go on with their lives, no guilty feeling and help only when asked).

At this stage pretty much everyone had some kind of improvement or relief, part of the symptoms and/or part of the time. Dr Wise stressed the importance of looking into small improvements as a good sign, and look at this as a process. Keep a journal of good days for self-support in bad days - which will occur.

This approach is better to me, as my tendency is usually all or nothing. Urinary symptoms/irritation are still there at some level, but I do feel better with sitting (in fact I sat all day with very minor discomfort), improved also on bowel movements (they are regular again, and I do not feel this numbness inside as before). Mood and energy back as six months ago... Another bonus is that I have started to use the TP training for other things as well - such as for shoulders (Theracane is a great tool) etc.. Another person did work on legs and got rid of long lasting pains.

We all exchanged mails to stay in touch.

Another benefit is finally being convinced, without any doubt at this stage (not easy for a skeptic like me), of the muscular (Trigger Points) and stress related nature of the symptoms. This is important (a) to reduce catastrophic thinking (b) to avoid painful/dangerous paths as surgery as one urologist suggested to me, or even intrusive tests like cystoscopy (I was the only one who did not yet do it, the average was 2-3/person, and all reported no finding and major side effects). Having done 5-6 DREs plus 3 ultrasound sessions plus endless blood/urine/semen tests & cultures, plus having typical CPPS symptoms was more than enough to rule out cancer.

Starting to pack, tomorrow I will tour San Francisco with wife. Then we fly back home, ready to start the Protocol with full speed. Relaxation twice a day, stretching 2-3/day, external TPs daily, internal 3 times a week, walking/aerobics daily. In fact the right order is (for those times you do the full protocol - I will do this in evenings): Areobic exercise-> bath -> skin rolling -> external TPs -> Internal TPs -> stretches -> Relaxation.

Closing the story. If anyone has specific questions, will be happy to answer if I can.

Best
George
Age: 51 | Onset Age: Early 2011 Symptoms: Before the Clinic: Pain while sitting. Pain in tip of penis. Reduced urine flow. Intermittent rectum and testicles pain. Poor sleep. After Clinic: Mild discomfort after long sitting, mild penis irritation. Attended the Wise-Anderson Clinic July 2011. Helped By: Physical Therapy (external & internal using the WA Wand - mainly external - abdominals and glutes), Paradoxical Relaxation, 30-min daily walk, Uroxatral (reduced tip-of-penis pain, but with side effects). Hot bath. Not helped by: Antibiotics, NSAIDS, Acupuncture, Homeopathy, supplements. Worsened By: Stress, Catastrophic Thinking, specific Yoga exercises, weight lifting.

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Re: Wise Anderson Clinic July 2011

Post by webslave » Wed Jul 20, 2011 12:50 am

gl0342 wrote:Dr Wise stressed the importance of looking into small improvements as a good sign, and look at this as a process. ... This approach is better to me, as my tendency is usually all or nothing.
The "all or nothing" tendency is responsible for the men who:
  • refuse to give up on the (now debunked) infection theory, because it implies the possibility of a sudden 100% cure with pills;
  • seek out a surgical cure, which they believe will be decisive, dramatic and curative (no such surgical cure exists);
  • claim that the Wise-Anderson Protocol is worthless, because they just cannot achieve the sustained effort required, and won't accept small incremental improvements over time.
These patients seriously confuse the rest of the patient group in many subtle and harmful ways.

Anyway, thanks for the description of the Clinic, George, and I hope to hear more about your progress over time. :smile:

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neue01
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Re: Wise Anderson Clinic July 2011

Post by neue01 » Thu Jul 21, 2011 12:28 am

Hey George. Can you go into more detailed explanation of the methods and process used for internal massage? For example what distance are you going in and how are you treating the secondary internal sphincter vs the external sphincter? Are you simple pressing for a period of time and are you waiting for any sort of response form the muscle... like a full clenching and release of it's area of control? More detail into this process would be fantastic.
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress

gl0342
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Re: Wise Anderson Clinic July 2011

Post by gl0342 » Thu Jul 21, 2011 5:08 am

Hi neue01

I do it with the Wand which was developed by the W-A team. It is a J shaped wand. We insert the short part of the J, which works as an "extended finger". That part is about 40% longer than my finger. But your supposed to look in all directions except 12 o'clock which is the prostate, and at various distances. Full finger, or half.

Technique is:
- Look for a spot which is tender.
- Press until you reach a pain level of 3 out of 10 (10 is "unbearable" - after a month you can work at higher pain levels).
- Pressure should be at least 15 seconds but never more than 90 seconds, constant pressure. You can stop before if you feel the pain is going away while pressing (a sign that the TP has been released).
- Work should be done 3 times a week.

- The exception is the sphincter itself, which should be worked only with finger. Stretching at 12, 3, 6 and 9 o'clock (no more than 3 on pain level).

The wand we received has two safety features:
- Pressure meter - we are not supposed to exceed a certain level (37). An in the first month it is recommended to do even less (<20). I was too enthusiatic yesterday and reached 30 and I had a flare after that),
- Mechanical stop - a circular part which blocks the "extended finger", so that you cannot insert it too deep (again for me it was set at the length of my finger + 40%).

Who will do the TP? Yourself? What tool do you intend to use?

Hope this helps.

George
Age: 51 | Onset Age: Early 2011 Symptoms: Before the Clinic: Pain while sitting. Pain in tip of penis. Reduced urine flow. Intermittent rectum and testicles pain. Poor sleep. After Clinic: Mild discomfort after long sitting, mild penis irritation. Attended the Wise-Anderson Clinic July 2011. Helped By: Physical Therapy (external & internal using the WA Wand - mainly external - abdominals and glutes), Paradoxical Relaxation, 30-min daily walk, Uroxatral (reduced tip-of-penis pain, but with side effects). Hot bath. Not helped by: Antibiotics, NSAIDS, Acupuncture, Homeopathy, supplements. Worsened By: Stress, Catastrophic Thinking, specific Yoga exercises, weight lifting.

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neue01
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Re: Wise Anderson Clinic July 2011

Post by neue01 » Thu Jul 21, 2011 6:52 pm

Yeah I've been to a couple PTs here in SF and have had a lot of success. It's always great for muscles that are lower and easily accessible. The thing is I've had success going to about 7-8 inches in. There are muscles in these areas too. I've recently switched over to simply doing the simple press and release for a brief period of time. Prior I would hold longer with more vigor in hopes of forcing a release. This works sometimes but also has a tendency to flare another area as well. This has sort of perpetuated things a little more then it has helped in the long run. This is why I'm backing off nowadays and going for brief and less aggressive methods. I'm in debate right now as to how far in we should be working. Again, I've had success going in much further with a tool like a slender 7". I know for a fact I've found areas outside of my PTs reach that are up further above where they can reach. What are your thoughts? I'm interested in why Dr Wise recommends only working the lower muscles?
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress

gl0342
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Re: Wise Anderson Clinic July 2011

Post by gl0342 » Sat Jul 23, 2011 8:35 am

Neue01 hi

I am afraid I can't give you too much advice regarding points which are not accessible by a PTs (and therefore not by the Wise-Anderson Wand). The people you saw in SF (Jerome Weiss and his related PTs) and their methods are not the same as Wise's and Tim's, Wise & Tim have much more experience, so best if you give them a call, as it seems you have been suffering for a while, it might be the time for a fresh approach.

The first thing Tim would do is to make a complete map of all your relevant TPs, internal and external, including all referred areas of pain. He has seen several thousands of CPPS guys, he is currently working on the Pelvic Floor chapter of the 3rd edition of the Myofascial Pain Therapy (originally produced by Travell and Simons, the pioneers on TP, with whom Tim worked in the past), he has issued one research paper and is preparing another one, so it will be difficult to find someone more knowledgeable. You are privileged to live in the area where he works, and it seems you now need the best expertise available, as you seem to be kind of stuck with self-treatment but still in pain.

BTW - I have been using their Wand for a week (following a just couple of treatments/training sessions by Tim), and I already see a significant reductions in tenderness, and I need to increase pressure quite a bit more to achieve the same pain level as before. In some areas which were hypersensitive, I need to press very hard to get some pain response. This seems to be a great tool.

Best
George
Age: 51 | Onset Age: Early 2011 Symptoms: Before the Clinic: Pain while sitting. Pain in tip of penis. Reduced urine flow. Intermittent rectum and testicles pain. Poor sleep. After Clinic: Mild discomfort after long sitting, mild penis irritation. Attended the Wise-Anderson Clinic July 2011. Helped By: Physical Therapy (external & internal using the WA Wand - mainly external - abdominals and glutes), Paradoxical Relaxation, 30-min daily walk, Uroxatral (reduced tip-of-penis pain, but with side effects). Hot bath. Not helped by: Antibiotics, NSAIDS, Acupuncture, Homeopathy, supplements. Worsened By: Stress, Catastrophic Thinking, specific Yoga exercises, weight lifting.

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Re: Wise Anderson Clinic July 2011

Post by scotsman » Sun Jul 24, 2011 6:31 am

Hi George

Many thanks for the write-up - certainly mirrors the experience I had back in Dec 2009 (wow - 18 months ago already!).

Relaxation still tends to be my big sticking point. I'm now at a stage where I'm spending 95% of the day pain free (all my other symptoms are gone, pain post ejaculation, frequency, burning, etc) and between work and 2 young children then I'm finding it hard to commit to the time and currently only manage a couple sessions a week. I'm still doing stretchng and physio every day (plus internal 4-5 times a week but these are light sessions). I still take 50mg Tramadol in the morning. I have no doubt that by doing the relaxation work I'll be able to drop the tramadol plus finish up with the regular internal sessions but I'm not in enough pain to push me to make the time for it. Something I'll have to just do though :smile:

I hope you have continued success :-D

Best
Richard.
Not medical advice: Read my progress to date : Read about my W-A clinic visit

Age: 41 CPPS: 7 Yrs Recovery Status: 90% Symptoms: Pain around perineum Makes Worse: Tension, sitting Makes Better: Stretching, triggerpoint therapy, relaxation, Tramadol (50mg)

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Re: Wise Anderson Clinic July 2011

Post by davioj » Mon Jul 25, 2011 1:29 pm

Dear George,

Thanks for your account of the WA clinics. You mentioned several times that your sitting pains reduced during treatment. Maybe its difficult to say but do you attribute this to the treatment of internal or external trigger points and which were responsible in your case you would say?
34 yrs old. Now rectal pain, some suprabic discomfort an occasional urgency. Still trying to figure out what helps. Episode of frequency in 2008 but this dissapeared for a year.

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Re: Wise Anderson Clinic July 2011

Post by gl0342 » Mon Jul 25, 2011 2:27 pm

Richard hi

Thanks for your comments. Your story really helped me to know what to expect. So happy that you have made such a progress.

I have started to do the protocol religiously, I even enjoy relaxation, but my problem is really expectation management.

From your experience, when did you start to see a reduction/disappearance of urinary symptoms? post-ejaculation symptoms? How was the recovery process?

I feel better sitting (a long as I do not see too much continuously), but I am so eager to improve/get rid of the other stuff. Should this happen after one month? or 3m/6m/1y? :-)

Many thanks
George
Age: 51 | Onset Age: Early 2011 Symptoms: Before the Clinic: Pain while sitting. Pain in tip of penis. Reduced urine flow. Intermittent rectum and testicles pain. Poor sleep. After Clinic: Mild discomfort after long sitting, mild penis irritation. Attended the Wise-Anderson Clinic July 2011. Helped By: Physical Therapy (external & internal using the WA Wand - mainly external - abdominals and glutes), Paradoxical Relaxation, 30-min daily walk, Uroxatral (reduced tip-of-penis pain, but with side effects). Hot bath. Not helped by: Antibiotics, NSAIDS, Acupuncture, Homeopathy, supplements. Worsened By: Stress, Catastrophic Thinking, specific Yoga exercises, weight lifting.

gl0342
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Re: Wise Anderson Clinic July 2011

Post by gl0342 » Mon Jul 25, 2011 2:36 pm

Davioj hi

When I got there I could barely sit (I was lucky to have been upgraded to business on my flight over there). After a couple of days, I could sit almost normally, and the flight back (in economy) was OK. This week I still can sit OK, unless if I forget myself and don't stretch from time to time ....

Difficult to say what helps most, for the TP part probably more the external (although Tim showed me a few internal places affecting the tailbone which is now less sensitive as before), maybe also being being in a calmer mood. I was restless before the clinic, I could see it impacting all symptoms.

Best
George
Age: 51 | Onset Age: Early 2011 Symptoms: Before the Clinic: Pain while sitting. Pain in tip of penis. Reduced urine flow. Intermittent rectum and testicles pain. Poor sleep. After Clinic: Mild discomfort after long sitting, mild penis irritation. Attended the Wise-Anderson Clinic July 2011. Helped By: Physical Therapy (external & internal using the WA Wand - mainly external - abdominals and glutes), Paradoxical Relaxation, 30-min daily walk, Uroxatral (reduced tip-of-penis pain, but with side effects). Hot bath. Not helped by: Antibiotics, NSAIDS, Acupuncture, Homeopathy, supplements. Worsened By: Stress, Catastrophic Thinking, specific Yoga exercises, weight lifting.

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Re: Wise Anderson Clinic July 2011

Post by scotsman » Mon Jul 25, 2011 3:06 pm

gl0342 wrote: From your experience, when did you start to see a reduction/disappearance of urinary symptoms? post-ejaculation symptoms? How was the recovery process?

I feel better sitting (a long as I do not see too much continuously), but I am so eager to improve/get rid of the other stuff. Should this happen after one month? or 3m/6m/1y? :-)
They went away pretty quickly with internal triggerpoint work - especially up near and around the prostate (the urinary symptoms were all away prior to going to the clinic).

How long it takes to go away? Some of my pain areas disappeared with one treatment session and I'm still treating others years later. This is where the relaxation comes in though as I'm not giving the really bad and chronic areas the environment to heal, I treat them when they get chronic but don't change the state of play that would prevent them coming back.
Not medical advice: Read my progress to date : Read about my W-A clinic visit

Age: 41 CPPS: 7 Yrs Recovery Status: 90% Symptoms: Pain around perineum Makes Worse: Tension, sitting Makes Better: Stretching, triggerpoint therapy, relaxation, Tramadol (50mg)

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Re: Wise Anderson Clinic July 2011

Post by webslave » Mon Jul 25, 2011 4:30 pm

I think the ugly truth is that some of us are living lives that are toxic to our pelvic floors, in one way or another. In my case, a complete lifestyle change was necessary, but I would not try to force that on anyone else.

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Re: Wise Anderson Clinic July 2011

Post by gl0342 » Wed Jul 27, 2011 5:29 pm

Update after one week into the protocol

I spend 2-4 hours / day on the protocol.
- Walk 30 min/day.
- Stretches 2-3 times/days.
- External TP 1-2 times/day. Abdos, Adductors, Glutes. Pretty much all the suspects list. Some places only once a day since they are sensitive. My wife helps me on the abdominals. Just for curiosity I am also working on non-pelvis related stuff in the legs, for the first time in years I can touch the floor while bending :-).
- Internal TP every other day with the Wand they gave me.
- Relaxation - 1 full session/day, trying to do a second one but either I find no time, or I fall asleep after few minutes. I used the tapes they gave us.

I am improving on relaxation (except when I fall asleep).
External TP is not easy - not yet enough confidence I am pushing the right spot/right pressure, and often I feel sore for 1/2 day or a day. In addition to the Clair Davies book, I also use another book Trigger Point Therapy for Low Back Pain: A Self-treatment Workbook, which I find even better - it does not cover the adductors but covers the rest pretty well).
Stretches I do mostly using a leaflet Tim gave us (updates from what you can find in the AHIP book), adding some stuff I found in this forum, and from the TP books.
Walking - 100% compliance (I downloaded a series of 30 minutes MP3 lectures ....).

The good - after one week
- Sitting improved (although not solved, some spots are still sore) - but I can start again working at the office at least partially. Before this I only came to office for 1-2 hour/week, the rest at home.
- Contraction/Pain in the urethra sphincter is gone for already 3 days!. This was a nasty ongoing one. By massive abdo TP work by my wife (I was not putting too much pressure with Theracane), don't get any more.
- Bowel movement back to normal (full voiding, on time, better sensation of what is going on in the rectum, no discomfort, etc...).
- Reduced post-ejaculation symptoms (I used the WA exercise).

Still need to improve
- Urine flow still low. I keep working on all the "textbook" points which are referring to this, still never more than 50%-60% of what it used to be 6 months ago. Any suggestions?
- Penis irritation - Still there from time to time.

I keep both under control with Alpha-blocker (Xatral, tried Flomax - same effects) - both were worse before I took it, but I do not see yet any change after the clinic, seems this is really too soon. On the other hand I really want to get rid of Alpha-Blockers, I think they have bad side effects (I started to suffer from tinnitus and less balance when walking at about the same time I started Alpha-Blockers - anyone with a similar experience?).

Not yet a success story, but I am optimistic (forgot to mention my sleep & mood are also improved), and I decided to give up on all further testings (MRI, cystoscopy, etc...) since I have full confidence I know what this is about (muscular/stress related etc.., and not cancer/infection etc...).

George
Age: 51 | Onset Age: Early 2011 Symptoms: Before the Clinic: Pain while sitting. Pain in tip of penis. Reduced urine flow. Intermittent rectum and testicles pain. Poor sleep. After Clinic: Mild discomfort after long sitting, mild penis irritation. Attended the Wise-Anderson Clinic July 2011. Helped By: Physical Therapy (external & internal using the WA Wand - mainly external - abdominals and glutes), Paradoxical Relaxation, 30-min daily walk, Uroxatral (reduced tip-of-penis pain, but with side effects). Hot bath. Not helped by: Antibiotics, NSAIDS, Acupuncture, Homeopathy, supplements. Worsened By: Stress, Catastrophic Thinking, specific Yoga exercises, weight lifting.

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Re: Wise Anderson Clinic July 2011

Post by gl0342 » Fri Aug 05, 2011 9:42 pm

Update - 2 weeks after coming back from the WA clinic

Nothing dramatic, overall slowly improving.

- Urinating symptoms (flow & irritation) starting to improve, cut Xatral to half a pill.

- Back to work at the office, now 3-4 days week (vs 1 day / week before, the rest from home) - still avoiding sitting for >5-6 hours/day. But there are some glute TPs which I can get rid off.

- Already had an occurrence of high stress (related to work) for 2-3 days. Incredible to see that most of my TP in abdomen came back very quickly, my belly was really hard. Started to feel again contraction in bladder, dull pain in groin etc... After intensive TP work by my wife, came back to normal. It gives a lot of confidence to see you can handle this.

- Having difficulty keeping up with relaxation. Was great during the clinic, probably because it was in a group setting, away from home/work etc... But now I am either too busy or too tired. I am considering joining a meditation group. Other suggestions? Anyone has been able to do relaxation 1/day. ?

Thanks

George
Age: 51 | Onset Age: Early 2011 Symptoms: Before the Clinic: Pain while sitting. Pain in tip of penis. Reduced urine flow. Intermittent rectum and testicles pain. Poor sleep. After Clinic: Mild discomfort after long sitting, mild penis irritation. Attended the Wise-Anderson Clinic July 2011. Helped By: Physical Therapy (external & internal using the WA Wand - mainly external - abdominals and glutes), Paradoxical Relaxation, 30-min daily walk, Uroxatral (reduced tip-of-penis pain, but with side effects). Hot bath. Not helped by: Antibiotics, NSAIDS, Acupuncture, Homeopathy, supplements. Worsened By: Stress, Catastrophic Thinking, specific Yoga exercises, weight lifting.

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Re: Wise Anderson Clinic July 2011

Post by webslave » Fri Aug 05, 2011 11:05 pm

I think you are starting to identify why some people fail to continue to improve post-clinic. Back in the real world, stress comes roaring back, time for relaxing is hard to find, etc. It's a matter of priorities, in the end.

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