- By Jen Singer
When my pain returned, I didn’t have an answer. But I knew I wasn't going back to Dilaudid, the prescription painkiller that one friend calls “redneck heroin.” Not this time.
Taking Dilaudid had made sense during treatments for a softball-sized tumor in my chest; the drug eased the pain that sometimes dropped me to my knees. But when that agony returned, nearly two years into remission from non-Hodgkin’s lymphoma, I wondered if it would ever go away. And I didn't want to take that powerful drug for the rest of my life.
During my cancer treatments, my oncologist feared the pain I was experiencing might indicate blood clots near my heart. After months of tests, scans, blood thinners and assorted meds, all while undergoing chemotherapy and radiation, we finally traced the source to my quickly shrinking tumor. By the time I achieved remission, the pain had gone.
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But then it came back, when there was no tumor, no cancer and, it seemed, few solutions.
Running Out of Options
Maybe if I hadn’t been so active, I’d have stayed pain free. But there I was, barely back in shape, playing one-on-one soccer against a Colombian dad overly enamored with his quick moves at a program for aspiring youth soccer parent-coaches. I dropped back and played defense while he showed off, and as soon as he made a mistake, I stole the ball, blew past him and scored, to much cheering from our peers.
The next day, however, there was nothing to cheer about. The pain in my chest was crushing. I chalked it up to too much soccer, too soon. But after the routine aches in my legs, back and arms went away, the chest pain stayed. And I was scared.
Soon after, I crossed my fingers at my semi-annual, post-cancer PET scan. The good news: no evidence of disease. I was still cancer free, but nothing on the scan could explain the chest pain. My oncologist sent me for an electrocardiogram; the results were negative. He sent me to a gastroenterologist, who performed an endoscopy: nada. Finally, having given up on finding a medical reason for my discomfort, he recommended a pain management specialist.
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The specialist prescribed Fentanyl, a potent patch that I recognized from my old oncology floor roommates, the ones who were dying of cancer. He prescribed a pill for narcolepsy as well, so that the Fentanyl wouldn’t knock me out. I took half a pill — and was up until 4 in the morning, watching movie after movie. I never took it again.
I stuck with the pain patch, but after two weeks I started to feel out of sorts. It was as if the happiness was being sucked out of me. When I snapped at my kids, I had to give myself a timeout to pull it together. Later, friends would tell me that even in emails, I didn’t sound like me. The patch didn’t even totally eliminate the discomfort. But its side effects had become more disruptive and disconcerting than the pain alone.
As I stood in line with other chronic pain patients waiting for prescription renewals, I had my "A-ha" moment: This was no way to live — I needed to make a drastic change.
I weaned myself off the patch and returned to my oncologist, my faith in traditional medicine almost evaporated. Turns out, he had one more trick in his bag.
This time, he sent me to an integrative medicine doctor, who ultimately referred me to a clinic for myofascial release, a manual therapy that involves a gentle pulling of the fascia, a fibrous connective tissue that binds together muscles and organs. This would be the therapy that would finally restore my health — and my life.
The fascia can become torqued, twisted or shortened through injury and disease, causing radiating pain that doesn’t show up on most medical scans, explains Roger Swiderski, a physical therapist with Stillpoint Therapy in Watertown, Conn., who has performed myofascial release for nearly four decades.
“The fascia system can be stretched and elongated by a skilled practitioner and it takes time,” says Swiderski, who studied under John Barnes, considered the technique's father. “It’s like pulling salt water taffy.”
Unlike traditional massage, myofascial release involves applying gentle, hands-on pressure to the fascia or connective tissue and holding it for several minutes. The technique involves pulling, not kneading, and it's tailored to your body's needs. "It’s a slow movement and you have to hold those stretches for three to five minutes," Swiderski says.
In my case, some of the adhesions pulling at my chest originated in the scar tissue from my hysterectomy, so my therapist spent some time applying pressure to the scars on my abdomen to release the fascia. Other times, he gently pulled my arm with one hand, while pulling the fascia on my chest with the other.
When I began my weekly one-hour appointments at Myofascial Freedom in Morristown, N.J., the affected areas of my body were very sensitive to the pressure. But within a month, I began to feel much better, and after a few months, my pain was gone. The technique helped resolve my chronic pain when traditional medicine couldn’t — and without side effects, although the experts are quick to point out that not all patients experience the same results.
Myofascial release can address a range of concerns, including post-surgical pain, the discomfort of cancer treatments, whiplash, temporomandibular joint disorder, fibromyalgia and more, says Dr. Raed Rahman, director of pain management at the Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Ill. “Find someone with an integrative approach who can explain your options,” Rahman says. “The goal is to release those tissues to improve motion and quality of life."
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I've been in remission for five years and I still go for occasional myofascial maintenance when my pain acts up (which is rare) and to prevent it from returning. Along the way, I have learned how to do some self-treatments to help me between appointments. For the most desired results, though, it’s best to visit a trained therapist who can launch and maintain your treatment and train you in self-treatment.
“The goal is to get the pain low, mild and manageable," Rahman says. "Keep trying and don’t give up. Patients should never consider pain a normal part of their condition."