Fighting Pain Made It Worse — Here's What Finally Worked

Tom Bowen: [00:00:00] The pain was taking over my life and it was bigger than my life and all. All I did was think about pain. I tracked the pain daily. I, 'cause my doctor suggested I do it. Because someone else suggested I do it. So I would track the pain, I would, I would say, okay, here's my pain level for the day. Here's my high pain level for the day.

Here's what I was doing for the pain today. Here's the pains that I noticed today, the different symptoms. Uh, all I become as over-focused on the pain and not focusing on life and, and living life. 

Mark Kargela: In this conversation, we're continuing our series of interviews we're doing for the pain practice at West Course and our students, where we share real stories to help their patients make more informed decisions about their pain journey.

I thought the story was too good not to share with You'all. I would love it if you could share this with people you know who are struggling with pain. It's one thing to hear it from a clinician and their explanation of why a new [00:01:00] approach to pain might be helpful. It's completely different when a person in pain hears it from someone who has walked in their shoes.

Tom Bowen's story is one. Many of your patients will resonate with a relentless search for answers, a healthcare system full of well-meaning providers, and ultimately a life consumed by the fight. But what happens when the goal shifts from pain relief to living wealth? This interview offers not just insight, but a lived example of what's possible when patients begin to take a new empowered approach.

Enjoy the episode. 

Announcer: This is the Modern Pain Podcast with Mark ula. 

Mark Kargela: Tom, I'm wondering if you can share what it looked like for you when you were fighting the pain, when you were kind of in the midst of that struggle. What kind of things were you doing with your pain and what kind of things were you trying and, and kind of what, what did that struggle look like?

Tom Bowen: Well, the struggle, number one was a real, so just emphasize that, uh. It's a, it's a very real struggle for people, a very real struggle for myself. [00:02:00] I wanted the pain to be gone, and I was doing everything I could possibly to make that pain go away. Uh, visiting all sorts of different doctors, having all sorts of different tests done.

Um, getting all sorts of different types, types of treatments, uh, all to no avail. Uh, even going as far as, uh, traveling six hours out of town to have surgery, to have nurse removed from my body and considering a second one of those surgeries across country. So there's. Just the fight itself was very frustrating, challenging, uh, raised my anxiety level, uh, increased my, uh, de uh, depressed was very depressing.

Um, it, um. Just fighting the pain in general was, [00:03:00] was overwhelming, but I still wanted to be fixed and, and, and believed I could be fixed. 

Mark Kargela: Do you think healthcare kind of fed into that a little bit for you with the, the, the thought to be fixed, do you think? Kind of how. Your interactions with them and how they interacted with you influenced that kind of desire for fix?

Um, 'cause I, there's a lot of, well-meaning healthcare people, I was probably one of them who would willfully engage with that, fight with somebody. 'cause I wanted your symptoms gone too. 'cause I thought that was, you know, a a, the, the only ticket to, to a, a, a happy life. Um, did you feel healthcare influenced that for you?

Oh, 

Tom Bowen: of course. But you know, I never met a healthcare professional. I didn't think it was trying to help me. They were all trying to help me. They were working in their silos, in their area of expertise with what they knew and they could practice at the time. And so they were all trying to help me. Did they make it worse?

Yes, they did. [00:04:00] 'cause I kept getting referred from. Specialty to specialty to specialty. And there was no, there was no end, um, game. So it was just, uh, if I, I'm sorry. I can't help you anymore. I need to send you somewhere else. So that, that, uh, that referral game just got to be, uh, long and withdrawn. Um, I was also told things by providers, like, if I ever had this pain, I need to go to the emergency room right away.

So I spent a lot of time in the emergency room. Um, I was, um, told that, um, you know, there's, could be something wrong. So, you know, that anxiety level went up when I had the pain and made just worsen the whole experience. 

Mark Kargela: Yeah. Um, common stories we hear with patients. I'm wondering in the midst of this, when you're going through this struggle and kind of this, you know.

Just calendar that seems to be full of [00:05:00] medical appointments and specialists after specialists, like you said, that you're getting referred to. How does that, what are your, what are your relationships, kinda your work and your just daily life activities looking like in the midst of this? Like, how does life look like for you when, when you're in the midst of that fight?

Tom Bowen: I tried to keep my life as normal as possible, but it's hard. It's hard. It's hard to function, hard to function at work. My work quality declined. My, my relationships declined. I was, I was, uh, angry. I was depressed. So all those things affect my, my relationships. I didn't go out as much, I didn't do as much socially as I could have or should have.

Um, so all that affected, you know, those kind of relationships, very, um, very, I impactfully. Um, I think for me just. I mean, I'm maybe getting a little off here, but [00:06:00] just the whole idea of the pain was taking over my life and it was bigger than my life and all. All I did was think about pain. I tracked the pain daily.

I, 'cause my doctor suggested I do it 'cause someone else suggested I do it. So I would track the pain, I would, I would say, okay, here's my pain level for the day. Here's my high pain level for the day. Here's what I was doing for the pain today. Here's the pains that I noticed today. The different symptoms, uh, all I become is over-focused on the pain and not focusing on life and, and living life.

Mark Kargela: I'm wondering, I, I, having spoken to you before, I think I know the answer to this, but for those who are just meeting you or learning about you for the first time, what was the moment where you felt like there, realizing fighting, pain wasn't working, was there a turning point or a [00:07:00] point where you realized the, the fight just wasn't, wasn't being won and it was in fact the fight was the problem?

I'm wondering what was the turning point for you? 

Tom Bowen: I actually had a unique experience where this happened to me twice, mark, and the first time is I wanted to have a, another surgery to try to fix the pain. This was early in my pain journey and I wanted to have surgery. My family doctor had recognized, uh, a pain rehabilitation program for me to go to a formal program.

And I had actually traveled, uh, to Washington, DC uh, from the middle of the United States to, to talk to a surgeon about doing the surgery. And at the same, about the same time, I had a surgery in, in, um, but from a local surgeon. It was an emergency surgery. And I was doing a follow up with that surgeon, so I asked that surgeon, I, I said, I asked him, I said, so here's my [00:08:00] situation.

I have this chronic pain. I want to go have a surgery done. My family doctor, my wife want me to go to this pain rehabilitation program where I learn about pain and all this, and what, what do you think? Should I have the surgery? And he very profoundly asked me, Tom, if it was surgery that caused a problem in the first pace place, why would you wanna have another surgery?

And that prompted me to take the route of pain rehabilitation rather than surgery. So that was the first time. The second time was after that training, actually that rehabilitation training, and I had a new incident. Where I had that, that compounded the chronic pain, uh, for me. And I went five years and still looking for a solution again.

Got back on that, uh, merry-go-round of looking for a cause and cure. [00:09:00] And, uh, uh, it, it just, I I, I, I, I realized at the time for me, 'cause I had had that prior training that this isn't gonna go away and I needed to take control so. It's just, uh, being willing to change. Uh, the second time for me and being, um, told to change the first time was, was, was were the big drivers for me 

Mark Kargela: with this change in that shift.

'cause that's a massive shift. I, I have to imagine there's some significant fear or doubts that. You face as somebody who's considering a different approach. I'm wondering if you could share a little bit of the fear and doubts that arose with you when you were trying to think of like, I've been approaching it this way for so long and I'm trying to make this big change.

What, what showed up for you in those situations? 

Tom Bowen: I, I think for me is again, I wanted the pain to be gone. [00:10:00] I, I think I had to said to accept the pain, and I think accepting the pain was a big part, and I didn't accept the pain until I got part of that program, became part of that program and learned how to accept the pain and, uh, what that means.

Uh, so accepting the pain I think was the big part in both, both times for me when, when I changed my way of thinking and just changing. Changing how I think about pain and feel about pain and behave in relation to pain, just, um, made a big difference. But, uh, again, fear of pain. I, I, I wanted the pain to be gone.

And quite honestly, uh, now I use no medications for pain. No, no. Other [00:11:00] passive interventions. I don't use a heating pad. I don't put it on an ice pack. I use nothing to manage the chronic pain. Not even an aspirin. I, I do it all by changing my, how I think about the pain and, and man and self manage it. It, I don't, I'm not scared of it.

Mark Kargela: I'm wondering if you can unpack acceptance. 'cause I think there's some, as you and I know, 'cause we've talked about this before, but there's some misnomers of what acceptance means. I think sometimes people say, what you're telling me, I just gotta live with this and suck it up and this is the way my life's gonna be.

Can you kind of unpack what acceptance means to you as far as with pain and, and how it might be misunderstood by the, the general public or somebody who might be considering a program where they're saying you need to accept your pain. That might be a hard. Kind of thought process for someone to wrap their head around.

Tom Bowen: Yeah. I, to me, acceptance doesn't mean giving up. It doesn't mean that [00:12:00] you're giving into the pain. It doesn't mean that you're liking the pain. I mean, all that pain sucks, right? So, uh, it, it's, it's there. It's, it sucks, but the acceptance part is what gives me freedom from the pain. The pain's not, not, uh, dominating my life and I'm in control.

So by accepting it, I'm, I'm actually taking control of the pain and taking control of my life. And it's, um, you know, I may never be pain free and that's okay. I can live well despite pain. But as I've noticed, uh, through the years, the pain for me. Sometimes hardly even noticeable. And when it is noticeable, like I said, mark, I don't fear it.

It's just pain. It it, I literally just say it, pain, it's just pain. It's just a [00:13:00] sensation. It doesn't mean anything. There's wrong in my body. It's just a pain. It's like, uh, being hot or cold, right? So it's just a sensation. So I, I don't worry about it. It just doesn't bother me. 

Mark Kargela: So you've definitely changed your, your response to pain?

Very, uh, you know, impressively, as far as, you know, commonly we, we, that is a big hurdle for folks to accept that that can be part of the journey and still have a big life. With that part of our journey still being there with pain to hanging around. I'm wondering, were there any particular skills or practices that you've incorporated into your.

Your day to day that you felt have made the biggest difference. I know some of the acceptance, just using those skills. Is there anything else that you found were like some big skills that were part of your improvement? 

Tom Bowen: You know, when I was, uh, doing the formal pain, pain rehabilitation programs, I was using like relaxation, deep breathing several times a day.

I was, I [00:14:00] was, uh, you know, challenging rechallenging thoughts, constantly restructuring thoughts. I was using those kind of things today. Now for me. I don't do any of that really on a regular basis, on a, on a conscious basis. For me, it's just unconscious. Um, I just, I, I, for, again, I think for me it was just the biggest thing, mark, is just changing how I think about the pain and not being afraid of it.

Um, because that fear of the pain is what drives all those avoidance activities that we do. And it drives the anxiety, it drives the depression. Um, uh, pain is inevitable, but suffering is optional. Um, you know, if, if, if you look at, um. Um, situation, uh, and I love this, uh, this story and I, I [00:15:00] learned it at the pain program.

Uh, imagine a bear's coming at you and a bear's going to a bear's coming around the corner, and that bear is a big bear with man eating claws. Whatever, whatever. You're just imagining this bear. This bear's coming at you, what are you gonna do? You're gonna get stressed, right? Your attention, your stress level is gonna go up.

You're become scared. You might, you might flee, you might fight, you might, uh, you know, just freeze. But what if that bear was actually a teddy bear and how you viewed it and not a grizzly bear? So it's just changing your view. Of that pain from being a grizzly bear to a teddy bear and there, I, I'm not worried about it anymore.

Mark Kargela: Yeah, that's, I mean, and those are the helpful kind of ways that you reframe kinda your view of pain that can make a, a, a massive difference, obviously did for you. [00:16:00] In the midst of this journey you had, was there anything that mattered most to you that kind of helped you pull yourself forward? Was it like particular values, roles you had or passions you had that pulled you forward or, or what was it for you?

Tom Bowen: Well, for me it was, um, I actually had to quit working because of the pain. And I, I don't, I try not to say my pain 'cause it doesn't belong to me. It's just pain. Uh, so I try to distance myself with that. So the pain. Um, I ended up not stopping work because of it, but I've engaged myself differently. I've become, instead of being a pain patient, I've become a pain advocate and pain educator.

And I think for me, that personal journey in my personal journey that's made a big difference in my recovery is, is, uh, developing a purpose and that purpose is helping others live with pain. [00:17:00]

Mark Kargela: So huge. I think having some, something to, to move towards, like to have values that might be different than the values you had prior of, of, like you said, you had to kinda redefine your life.

It wasn't your work anymore. Now you found new purpose in work. So I think such a key for us to help our guide our patients to find what is the thing that will bring them value, bring their passions up, bring their, it may look different than what it is now, but there is definite. Definite opportunities to change.

I, I'm wondering how you define success now compared to where, where you were, what you would've defined success when you were in that, I gotta get rid of pain mode, was, how has that changed for you? 

Tom Bowen: Well, success back then was getting rid of the pain, or reducing the pain and success now is, is living well despite it, uh, being functional, doing things, making my life bigger than the pain, just, um.

Not letting it control me and me [00:18:00] controlling it. So those are the things that I think are more important. That's my quality of life than the pain itself. Um, and 'cause the pain doesn't dictate the quality of my life. I do. 

Mark Kargela: Absolutely. Uh, how do you, um. Yeah. How do you balance caring for your body and still engaging in life?

Because I think there's a balance that needs to be struck there for some patients. Right. Where, um, did you have some skills you had to learn, or how do you, how was that balance for you, where you were doing your appropriate self-care, taking care of yourself, you know, physically, but also making sure it wasn't to the detriment of completely.

You know, removing yourself from life and the things that you wanted to do 

Tom Bowen: well, there's so many self-management skills that are helpful in that area with moderation or pacing and modification. Uh, just taking time. I, I wear a bracelet on my arm that says, breathe, and it reminds me to breathe and. [00:19:00] Now, that doesn't mean I'm gonna take five minutes to do deep breathing, but what it tells me is I need to take some deep breaths and I just need to focus on, on, on something other than the pain.

Um, so those, those skills, cognitive restructuring, changing, unhelpful thoughts and uh, changing unhelpful behaviors has been key for me. So learning those self-management skills and then just applying them. And like I said, now for me it's all subconsciously I apply those. I, I don't consciously practice self-management.

It just happens for me. 

Mark Kargela: I think that goes to skill development, right? A lot of times it's a very explicit practice of really having to sit down, break it down, and, and practice these skills to where they become implicit. They just become part of our existence, part of our normal mode of operation. But as we learn them initially, there's probably that.

Need to practice and be more scheduled and deliberate with that [00:20:00] practice. Is that how you found it for yourself? 

Tom Bowen: Most definitely. It's the, like the old joke, how do you get to Carnegie Hall? Practice, practice, practice, right. So it's, it's, it's, it's doing the things. 'cause if you don't do 'em, you're not gonna learn 'em.

It's just, uh, reprogramming your body and your mind to incorporate those activities. And, uh, kinda like breathing. We all know how to breathe right. We never, we never really think about it. So when you think about it and then come back and change how you breathe, it's, it's much easier. 

Mark Kargela: I wanted to end it on one question, um, that I think is probably the one that I think hopefully will be most impactful for, for folks that are listening and might be in this struggle that you were in, but I'm wondering if, if you could speak to somebody who is, who is where you once were fighting and you know, kind of feeling stuck with pain, what would you want them to hear?

Tom Bowen: There is hope. There is hope. Pain can change and you can change the [00:21:00] pain. It it, it's not relying on your medical team, it's not relying on your family. It's not relying on. Anyone else, it's relying on you and you need to make those changes to change the pain experience for yourself, but it's completely possible.

Pain can change and just changing how the, the goals that we talked about, the changing the goal from pain reduction and elimination to, to living better and functioning better, so important. 

Mark Kargela: Yeah, absolutely. And, and, and you're a good, uh, testament to that process working and, and really made some amazing strides and continue to make some impact with, with all the great things you're doing with your pain groups and things like that.

We'll, we'll make sure we link, um, Tom's Pain Group 'cause it's a, an amazing resource for folks that are. In this struggle and you need support. And I think what better support and to get it from a group of [00:22:00] people, um, and someone who's been there and, and fa faced those struggles that can help you through it yourself.

So Tom, I wanna thank you for your time today and thank you so much for the amazing work you're doing. Thank you so much, mark. Alright, we're gonna leave it there this week. For all of you listening, we'd love if you subscribe. If you know somebody who's in the struggle right now who's having. Difficulties that life is getting very small or you're, you're having a hard time seeing them have their life get so small.

We'd love share this episode. 'cause there is hope for them. There is the ability for them to to, to get their lives back and it may look different. It can still look pretty full of some things that get them out of bed. Excited to, to, to get up each day. So again, thank you for everybody who's listening.

Make sure you subscribe where you're listening and share this episode, and we will talk to you all next week. 

Announcer: This has been another episode of The Modern Pain Podcast with Dr. Mark Karula. Join us next time as we continue our journey to help change the story around pain. For more information on the show.

Visit modern pain care.com. This [00:23:00] podcast is for educational and informational purposes only. It is not a substitute for medical advice or treatment. Please consult a licensed professional for your specific medical needs, changing the story around pain. This is the Modern Pain Podcast.