STORIES OF PATIENTS IN THEIR OWN WORDS PRACTICING THE WISE-ANDERSON PROTOCOL
Here are some stories from our early patients who were trained in the Wise-Anderson Protocol, most of them being treated before we had in hand and trained our patients in the use of our Internal Trigger Point Wand. Each patient below is writing after a certain amount of time of practicing our protocol. A larger picture of our results are found in the clinical studies that we published in the Journal of Urology, Gold Journal of Urology, Clinical Journal of Pain and other medical journals. You can request these studies at firstname.lastname@example.org.
These reports came from patients who often were given different diagnosis – they were all treated using the Wise-Anderson Protocol
As we have discussed in a recent podcast, pelvic floor related pain and dysfunction is given different names by different doctors. Everyone who wrote to us to report their success with their program, while having been given a variety of diagnoses including prostatitis, pelvic floor dysfunction, levator ani syndrome, interstitial cystitis, pudendal neuralgia, chronic pelvic pain syndrome, piriformis syndrome, coccydynia, anorecatl chronic proctalgia, among other names, we determined all suffered from the same psycho-neuromuscular disorder we described in A Headache in the Pelvis, and that we treat in our 6 day program.
I am a 52-year-old internist (family doctor for adults) with a busy practice in Los Angeles and the married father of 2 small children (ages 4 and 9). In addition to all the responsibilities of my practice, my colleagues and myself were in the early stages of organizing a move of our medical practice a few miles away (we actually started our planning in January, 2005). This process began to take up an extraordinary amount of my time. I should add that I also have been very involved caring for my children. I was, to say the least, quite busy. I always felt that I had previously handled stress quite effectively. I always had a plan of action and somehow got through the task at hand methodically. At no time prior to June of 2005 did I ever have any physical symptoms that I could recall related to stress other then the occasional sleepless night. As a result, I was completely caught off guard by the symptoms that I was to develop.
I was awakened one morning in June of 2005, at about 6:00 AM quite abruptly (I usually get up at about 6:30AM). A pain deep in my pelvis somewhere between my rectum and testicles had developed. I got up to void and was relieved that the pain had resolved promptly. Prior to this particular morning I had on occasion had an episode of what I presumed to be prostatitis. From time to time I would have some mild dysuria (pain on urination) and would take 7-10 days of an antibiotic- usually “Cipro” (also known by its generic name of ciprofloxacin). This episode was different in that I had no dysuria-just pelvic pain. I started the Cipro again for 10 days but noticed that I was getting these intermittent episodes of pelvic pain in spite of the antibiotics. The episodes were intermittent over the next month but no other symptoms had developed. I sometimes went a week or so without the pain and was just hoping whatever “inflammation” was there would go away by itself. I flew back East in July of 2005 to spend a few days with my brother and a friend from medical school at the New Jersey shore. The pain was becoming more frequent and starting to wake me up at night. I was becoming quite concerned that I had developed something a bit more serious than “prostatitis.” I didn’t want to tell my friend from medical school as he would have instructed me (rightly so) to get further (appropriate) evaluation and I feared I would find out I had cancer right in the middle of my life!
Back in Los Angeles after this vacation the pain became more frequent and it was beginning to wake me almost every night. I began taking anti-inflammatory medication (ibuprofen is the generic but is also sold as Advil, Motrin, as well as under other names) but this didn’t seem to do much for the pain. I then began to develop low and mid-back pain which raised my panic level. I tried to recall any patient with this constellation of symptoms and couldn’t think of one. Over the years I had seen multiple patients with what I thought was “prostatitis” and treated them with antibiotics-sometimes for months but didn’t appreciate that they might have had pain this severe. I would occasionally refer them to urologists who would continue the antibiotics and recommend that they take hot baths and have frequent sex. But when this back pain developed I felt that I indeed had something more ominous then prostatitis. I had back films taken which were entirely within normal limits but due to the severity of the pain I then had an MRI scan performed of my spine and pelvis.
I assumed at this point that I had metastatic cancer and the scan would basically be my death sentence. I reviewed the scan with several radiologists who all felt it was unremarkable. In spite of these normal studies I was still convinced that I probably had some, as of yet, undetected malignancy because of the severity of the symptoms. The pain was becoming continuous and now it was becoming very difficult to sit. I had to continually shift my weight back and forth or the pain would be triggered or exacerbated if I sat incorrectly. My mood was becoming somber as I knew I had an undetected fatal disease. I then began to develop low and mid-back pain which raised my panic level. I was trying to think of a patient with this constellation of symptoms and couldn’t quite think of anybody.
I began to take sleeping pills (Ambien, etc.) which seemed to allow me to sleep for some of the night free of pain but I would always wake up abruptly with pain. Unfortunately, after taking these pills for more then 2 or 3 consecutive nights they became ineffective and I couldn’t think straight during the day. I never took any time off from work but I stopped my in-line skating (usually skated about 30 miles per week) as I felt that this might have somehow been the trigger. One day I noticed my urine was dark and tested it for blood and it was positive. I now knew that I had a cancer of the urological tract (kidneys, bladder, prostate, etc.) and became completely depressed.
I had no choice but to seek out the opinion of one of my urological colleagues who would do the appropriate studies and tell me that I had a cancer. The only problem with all of these thoughts is that I couldn’t think of one of my patients in my career of now over a quarter of a century who had pelvic pain like I was having and found a cancer. In fact, prostate cancer almost never causes pain at it’s origin in the pelvis (although one of the urologists that I consulted told me he knew of one case!). It does cause back pain after it has spread but by that time your x-rays are very abnormal-which mine were not. With much trepidation I consulted one of my urological colleagues who was quite kind and caring. I finally had a belated digital prostate examination (using a gloved finger) by the urologist who assured my prostate felt normal (except that the actual examination was quite painful). In fact, my prostate was of normal size which is actually a bit unusual by the time you reach your fifties. Most men by then have some non-cancerous enlargement of the prostate gland known as benign prostatic hypertrophy (BPH). My PSA (prostatic specific antigen) and other laboratory studies were normal.
The PSA test is a test used to help diagnose prostate cancer. He was still concerned however by the blood I found in my urine (rightfully so) but also told me he has seen that in others taking large amounts of anti-inflammatory medication (ibuprofen). I was panicked but now underwent a CAT (computerized axial tomography) scan of my kidneys, bladder and the rest of the urogenital tract. Unfortunately, the CT scan showed some abnormality at the base of the bladder. The urologist assured me that this was probably a variant of normal but in light of the blood in my urine and my pain he recommended a cystoscopy. This is a procedure I have had performed on many of my patients and seldom heard that it was particularly uncomfortable. It is frequently used to evaluate blood in the urine. A very long thin tube with fiber optics in it is inserted through the tip of the penis and is passed until the bladder can be visualized. It is something I never want to go through again! It is extraordinarily painful and my symptoms for the next few days were even worse then before. I was now in complete agony.
I was getting increasingly depressed. I had near constant pelvic and low back pain and slept poorly. I began to fear going to sleep at all and was exhausted all day long. The urologist had reassured me that there was no evidence of cancer as evidenced by a normal physical examination, normal laboratory and x-ray studies, and a normal cystoscopy. He concluded that I had chronic prostatitis but was puzzled because “most of those guys were really uptight.” He said my prostate was congested and needed to be de-compressed. He suggested frequent hot baths, frequent ejaculations, and a trial of medications. The medications recommended were either “alpha blockers” such as Flomax, Hytrin, Cardura, or Uroxatral or drugs that shrink the prostate such as Proscar or Avodart. The alpha blockers are usually used to help alleviate the urinary frequency and decreased force of stream caused by BPH.
I have prescribed these drugs many times over the years to many of my patients. I tried 2 of these drugs, exactly one time each to see if they would help with my symptoms. I promptly developed a rapid heart beat and dizziness with each of these drugs and had to discontinue them. Of course, they had no effect whatsoever on the pain. I then began Proscar (also used for BPH symptoms), being warned that this drug may take many months to be effective for prostatitis. I was also concerned about the the potential side effects of this drug which includes erectile dysfunction as well as gynecomastia (breast enlargement in males)! While I was concerned about these side effects my symptoms were increasingly taking over my life and I felt I had to do something as I was starting to feel that I don’t want to live if this continued.
I thus began taking the Proscar. I had by now stopped taking the ibuprofen due to stomach upset and it seemed to have no impact on the pain anyway. I would take the sleeping pills every 3rd night or so. It was a kind of “treat” so I could sleep more then 2 hours and not be awakened with pain. Unfortunately, the pain continued and I was now crying intermittently.
This was making life difficult at home and at work. The summer was over and the kids were back to school and I was miserable. I then began to experience urinary frequency. It began gradually but over the next several months I developed the need to urinate almost every hour. At its worst I would be going every 15 minutes and it made it difficult to see patients. My staff knew something was wrong since I seemed to always be using the bathroom. To make matters worse, I couldn’t quite get all of the urine out and it would wet my underwear and trousers occasionally making this very embarrassing. I was beginning to see why some people might contemplate suicide with severe medical problems. I was also losing weight as my mood worsened and I didn’t want to eat.
I consulted several other urologists during this period. These were doctors in my community that I knew and respected. They felt that I had chronic prostatitis and warned me the symptoms could go on for some time. This I didn’t like to hear. One had suggested that he felt drinking a large volume of liquid was important and he thought beer was particularly well suited to this. I dutifully increased my fluid intake (not beer though-it made medical practice a bit difficult) which unfortunately just exacerbated my urinary frequency. Another urologist recommended a supplement called “Quercetin” which I dutifully began taking. The increased sex which was highly recommended by all (sounds like a great idea in general) did not seem to help and in fact, was becoming uncomfortable. I experienced no difficulty having an erection but it was painful and orgasm uncomfortable. I was feeling as despondent as could be. I now was developing constipation which required stool softeners, fiber supplements, and frequent suppositories.
It all came to a head in November. I had tickets for a rock band that I had seen several times since the seventies. They were performing in LA for only one night at the Kodak Theatre (where the Academy Awards have been held in recent years).
I was becoming nervous because my seat was not an aisle seat and I feared having to go to the bathroom frequently and bothering people. I also wasn’t sure that I could make the trip in Los Angeles traffic without having to stop to go to the bathroom! In any event, as soon as the first number was being played I had to urinate. The rows were so close together that everybody had to stand to let me out. By the time I reached the aisle I was crying uncontrollably. I stayed ultimately to half-time but only in the lobby. I couldn’t bear going back to my seat and went home very depressed. I was truly at my wit’s end.
My wife started to check out Internet web sites to see if there was something else new to treat “chronic prostatitis.” I must admit I didn’t encourage my wife in this regard. I assumed (wrongfully in retrospect) that it was unlikely to yield any help for me. As a physician with twenty-five years experience and after having consulted several urologists I thought it unlikely that I would find any help there. I also remember how many patients brought me useless Internet information with regards to their health problems. My wife printed out a few pages from Dr. Wise’s web site (www.pelvicpainhelp.com) and put them on my desk at home. She pointed out that my constellation of symptoms were almost exactly what Dr. Wise discussed. She read about the Stanford Protocol and correctly concluded that my symptoms were stress-related and he might be able to help me.
I still was not quite ready to accept having a stress-related disorder. I reluctantly purchased the book (I have never bought a self-help book in my life). When the book finally arrived I started to read it but had to put it down when I noticed that some people had these symptoms for decades. I didn’t know this and this made me feel more discouraged and didn’t feel I could even keep reading! Meanwhile, there was no let up at all in my symptoms. My life revolved around pain, urinary frequency, constipation, and increasing depression. I found no joy in anything, including my children.
It was now November of 2005 and I didn’t know where to turn. My wife finally coaxed me into calling Dr. Wise to see if he could offer any help. I was pretty skeptical. I assumed that if he had the answer— everybody would know it. Effective treatments for diseases are not secret and if they are successful everybody realizes it sooner or later. The urologists I had consulted would have the same information-right? When I spoke with Dr. Wise in November he seemed to know about my symptoms in some detail and also that my only relief (however temporary) was from the sleeping pills. This relief from sleeping pills comes, in part, from their effect as muscle relaxants. Other drugs in this general category include benzodiazepams such as Valium (diazepam), Ativan (lorazepam), and Xanax (aprazolam). I never did take any of these medications as they are generally used in anxiety type disorders.
I still didn’t think my symptoms were related to something like that. In any event, Dr. Wise felt that he would be able to help and urged me to come up to Sebastopol for the Stanford Protocol clinic. I signed up for the December, 2005 session. I felt some brief alleviation in my symptoms after this conversation-likely related to some relaxation due to feeling there maybe some help for me after all and I was going to do something about it. I picked up A Headache in the Pelvis again and read on before my trip North. My brief and slight improvement in symptoms was extremely short-lived as the time got nearer to going for the Stanford Protocol. It just seemed to me that this was going to be a waste of my time and money and I was utterly despondent, although I had some faint hope that maybe this treatment would help.
The time had come. I flew to the Bay Area and rented a car to see a urologist who confirmed the diagnosis of the “chronic pelvic pain” syndrome. While waiting to see him I remember going out to eat (although I no longer had any appetite) to get some strength and feeling that I should just turn around and go home because I really felt that nothing could be done. I drove up to Bodega Bay and spent the night absolutely despondent in a very beautiful and serene location. I could not even enjoy these beautiful surroundings and felt that if I can’t get help here there is no solution at all. When I arrived in Sebastopol, I was taking Proscar, Quercetin, Cipro (in case there really was an infection!), mineral oil, psyllium (fiber supplements), suppositories (in case the oil and psyllium didn’t work), and of course, sleeping medication.
I drove out the first morning to Dr. Wise’s compound expecting nothing and feeling ridiculous having come all this way. I met the other dozen or so patients who also made the journey with symptoms more or less similar to what I was experiencing—many of them had had symptoms for years! The surrounding was peaceful and the environment created by Dr. Wise and his staff quite nurturing. We spent long days together doing group relaxation, learning stretches, and having Trigger Point Release by Tim Sawyer. By the end of the first day I noticed that somehow the need to urinate had improved slightly and that I didn’t have to always get up during these sessions. I also noted that the pain itself would diminish (although at first just temporarily) after the Trigger Point Release sessions.
I was still symptomatic that first evening but had a glimmer of hope that there may be something to these interventions. I certainly wasn’t ready to abandon any of my pills yet! There were four additional days of relaxation sessions, stretching, Trigger Point Release (this entails direct pressure with a gloved lubricated finger on tender areas in the rectum which in effect transmits pressure to the underlying muscles which are in spasm) and discussion. I woke up on the third morning (after 2 days of therapy) and had my first normal bowel movement in months. This is not normally reason for celebration but I was feeling increasingly hopeful. I experienced progressive improvement over the ensuing days of the program with diminution of all of the symptoms I had been experiencing. The symptoms did wax and wane and I was hopeful when they improved but still depressed when they returned. I completely stopped the Proscar, Quercetin, and Cipro on the last night. I concluded that these drugs play absolutely no role in this disorder. (The other possible explanation which I consider highly unlikely is that suddenly all of these drugs “cured me”—I finally had taken them long enough!).
My pain, constipation, urinary frequency, and most importantly, mood, had dramatically improved. I distinctly remember sitting in the airplane terminal in Oakland going back to Los Angeles and feeling completely euphoric! I was totally asymptomatic! I have never enjoyed being in an airport so much in my entire life. I did not have to use the bathroom even one time from my arrival at the airport until I touched down in Los Angeles (probably a total of 3 hours overall). That was the longest voiding interval I had in probably 3-4 months.
Alas, much as Dr. Wise predicted, my euphoria and lack of symptoms were not to last. When I arrived back in Los Angeles and went back to the stress of my career and life the symptoms came back over about a weeks time, although not to the extent they were before the Stanford Protocol clinic. I continued to listen to his tapes as much as possible and do the stretches I was taught 3-4 times per day. It was time consuming and I was trying to do everything I was taught including reducing work and personal stress which is probably the hardest thing to control. The symptoms again improved over the next several months using the tapes and stretching and I was feeling hopeful although there were continued exacerbations and remission of my symptoms. I did not initially have the Trigger Point Release done when I came back to Los Angeles as I was trying to see if I could get by without it. I had improved significantly but now hoped for complete resolution of my symptoms. I asked my physical therapist (who I had known and used for years for a variety of minor musculoskeletal conditions) if he would be willing to learn the technique. I gave him a copy of A Headache in the Pelvis which he read. After several sessions he was able to perform the Trigger Point Release effectively. Luckily for me he previously used Trigger Point Release techniques extensively in a variety of musculoskeletal conditions and he was quite sensitive to the obvious delicate nature of this particular type of intervention. I began the Trigger Point Release therapy weekly in Los Angeles in March of 2006 (approximately three months after leaving Sebastopol). With the addition of this to my daily stretching and 2-3 times weekly relaxation tapes I have had minimal symptoms since about the beginning of May, 2006. I attribute all of the success to the method that Dr. Wise and his colleagues have worked out. I take no medication whatsoever right now and have no constipation, urinary frequency, and virtually no pain. I also can sit in any chair I want without a cushion (which I failed to mention that I had to take to restaurants when my symptoms were at their worst).
It might be nice if there were a “simpler approach” that was successful. Who wouldn’t want resolution of something like this with a couple pills for a week or two. Unfortunately, I do not believe that exists. I actually find it remarkable that the therapy (at first blush somewhat complex) could be figured out at all. It requires a multiple modality approach over time. It is not a simple therapy which a 15 minute office visit is going to solve. As I discovered when trying to eliminate the Trigger Point Release, it is clear that all of the recommendations by Dr. Wise appear necessary (at least they were for me). I also strongly feel that the intensive initial approach to this disorder (such as the Stanford Protocol) is necessary. I think that had I tried all of the components piecemeal I might have still improved but I think it would have taken much longer… maybe never.
As a physician I am almost shocked about the lack of knowledge and ridiculous suggestions about this disorder by the urologists I had consulted. I mentioned earlier the recommendation to drink beer. Some of the other sexual recommendations are almost comical such as “not holding back” during sex and having sex exactly 3 times per week. To their credit, they didn’t seem offended when I offered to give them a copy of Dr. Wise’s book. As Dr. Wise pointed out in his book there are a multitude of reasons that urologists are not enlightened about this disorder which is indeed unfortunate as it is one of the most common disorders for which urologists are consulted. It certainly has changed the way I treat patients with this disorder. As a primary care physician I see many patients with this disorder first. After appropriate evaluation and a clear diagnosis I recommend Dr. Wise’s book. I would only have them see a urologist if there is something unusual which requires intervention that only a urologist can offer. Hopefully there will be further research on this disorder but there is no doubt in my mind that the approach of Dr. Wise is the correct one for those afflicted with this disorder.
A day has not gone by since I returned from Sebastopol when I have not thought of my experience there and how grateful I am to Dr. Wise that I have been able to return to my life.
I was 20 years old when my symptoms started with a vengeance. I was in constant pain, with a deep ache in my pelvis, and the feeling like I had to urinate all day and night. For months I don’t think I slept longer than an hour at a time (usually intervals of 20-40 minutes) even with sleeping aids. However, since reading this book, being fortunate enough to attend the clinic, and actively applying the methods I learned, I have made tremendous improvement. My symptoms have decreased, in a conservative estimate, by 75%, and sometimes, I am pain free. Things I could have only dreamed of when this torture started. So for those who despair, as I once did, there is hope, and for many I believe that hope lies within actively practicing the methods that are taught within this book.
I struggled with pain during intercourse since I lost my virginity at age 17. It was extremely painful that first time and continued to be so for nearly 20 years. For many years, I had no idea that it wasn’t supposed to hurt. I was in major denial not wanting to face this very personal and sensitive subject. While I always heard others (personally and in the media) talk about the joys of sex, I absolutely could not relate. Sex for me was filled with anxiety, fear and literal physical pain. I suffered from embarassment and shame when hearing others talk about sex (as well as during my own sexual encounters since I could never be honest with my partners).
After meeting my husband at the age of 34, I finally faced this situation. I considered surgery but then got pregnant shortly thereafter (through painful intercourse). Since the doctors thought a vaginal birth might help with my pain, they advised to wait until I gave birth. Unfortunately, I had a c-section. A few months later, my husband and I visited Dr. Wise’s clinic in Sebastopol. After learning and doing the physical therapy and breathing exercises for just a few weeks, we had nearly pain free sex and I got pregnant again! I continued with the breathing exercises and physical therapy daily for the following 9 months. I credit the relaxation I achieved from these exercises with helping me have a vaginal birth with no drugs whatsoever (this was only 12 months after a drug-filled c-section!). The vaginal birth has made a tremendous difference for me. I oftentimes now have no pain or discomfort during intercourse. I hope that continuing with Dr. Wise’s protocol will make me 100% pain-free in the near future.
Dr. Wise’s protocol is not an easy fix. It takes time, patience and perseverance. But I do believe it helps shift the anxiety response that my body has been conditioned into after nearly 20 years of dealing with painful intercourse. It has helped me be more comfortable with my own body and in relating sexually to my husband with more comfort, pleasure and therefore, intimacy.
My pelvic pain started at the left tip of my penis. I went to over twenty doctors, checked myself into the hospital emergency room, did a CT scan, ultrasounds, and many other schemes to find the cause of this pain. Gradually my pain spread and sitting, sleeping, walking and every part of living was painful. Through my research on the Internet I believed I may have pudendal nerve entrapment. I had a pudendal nerve latency test. It came back positive, showing irregular reactions from my pudendal nerve. PNE was a term that horrified me. The information on the Internet indicated that given my test results I would never be able to have pain-free sex, sitting would always be painful, and as time went on I would get worse. I read online that some people were trying new physical therapy techniques to improve their condition. I found a local therapist and started to work with her. I started to feel slightly better with internal Trigger Point Releases. However, despite the temporary relief, I always found the pain returning. She gave me a bunch of books to read. One of them being A Headache in the Pelvis. I was overwhelmed that there was a book out there that described my condition in full detail. The approach to healing also made sense to me. I attended the clinic and learned the complete guide to self-healing.
I was finally empowered to take control of my condition. I completely dedicated my life to healing. I would spend anywhere from four to eight hours per day doing Paradoxical Relaxation, stretches, skin rolling, jogging and hot tub. I actually invested in a hot tub and a treadmill. That’s how dedicated I was. Within four months I was completely pain free. Through my process, I had many realizations. The most important was, in order to fully recover in the minimum amount of time, the protocol had to be followed religiously. If I did three out of the four steps, I would have relief, but not full recovery. I evaluated my therapy, and tried to improve it. I realized that I couldn’t do skin rolling on my back side as effectively on myself as a therapist could. So, I went to a PT just for skin rolling. Sure enough, that was the missing piece in my puzzle. Once I complied with the protocol 100%, I felt 100% better. I just want to thank Dr. Wise again, you have saved my life, without the protocol, I probably would have been in physical and mental pain forever, THANK YOU!
It all started at a Halloween party in 2009 where my boyfriend’s band was playing. My abdominal pains were so intense that I left the party before the band even started. And so began what I later came to call my 2010 Bladder Odyssey. I was supposed to leave the next day for a public speaking engagement that had my nerves on edge, but my pain prevented me doing so. Instead, I visited my general practitioner who ordered a battery of tests. In the end, I was diagnosed with H. pylori, a stomach infection that is the leading cause of ulcers. I was prescribed a ten-day course of intense antibiotics that made me feel drunk, like there was a fog in my head. Despite this and the fact that I hadn’t taken antibiotics in over 20 years, my doctor encouraged me to finish the prescription. Not wanting to have to start over with this awful medication, I stuck with the program and the H. pylori infection was resolved.
After I finished the medication I felt weak and my energy was depleted. I would come home from work and drop down on the couch with my coat and sunglasses still on and fall asleep sitting up. Up until this point in my life, I had always been very healthy and active and this loss of energy inspired me to seek care at an integrated medical clinic to work on balancing my body chemistry.
A month after I finished the antibiotics, on a Saturday night, I started having symptoms of a UTI. The next day, Sunday, was perhaps the most painful day of my life. I was doubled over in pain the whole day, but I waited until Monday to see my doctor at the integrated medical clinic. The urinalysis revealed that, indeed, I had an infection in my bladder and I was prescribed another round of antibiotics. This was the last thing I wanted to take after what the last round of antibiotics had done to me, but I also wanted the UTI to go away. I waited a few days to start the antibiotics in hope that the UTI would clear up on its own. When it didn’t and I couldn’t take the pain any longer, I broke down and took them. The symptoms diminished, but they didn’t clear up completely. Another urinalysis revealed I still had a mild infection for which I was prescribed more antibiotics. When I finished this final course of antibiotics, the infection was gone, but I still had urinary urgency and frequency.
My practitioners at the integrated clinic said it was likely that I had interstitial cystitis, but that the procedure for diagnosis, cystoscopy, often causes confounding bladder problems. Also, my acupuncturist at the clinic was diagnosed with IC eight years earlier and was able to heal herself with herbs. In retrospect, consider this one of my lucky breaks. Although it turned out that I didn’t have IC, at least my practitioners didn’t exacerbate my situation as is the case for so many other CPPS patients. I clung to this bit of information, that my acupuncturist healed herself, as I began my search for a cure. If she could do it, then so could I.
If not for this knowledge about my acupuncturist, I might have sunk into deep depression. Certainly, I had my fair share of catastrophic thoughts. I worried about maintaining my career since I was missing so much work. I worried about my relationship because I was such a drag. And, of course, at times I worried that I might not get better. Ever. Nonetheless, compared to many, I maintained a relatively sound mental state while I searched for the answer and had my acupuncturist not told me about her experience with bladder pain, this would have been far more difficult. Instead, I immersed myself in solving the puzzle of my condition. I knew I didn’t want to live this way for another minute, let alone the rest of my life, but I also didn’t want to die. So, there was no choice but to become healthy again.
In the proceeding months, I visited a number of alternative health practitioners around the U.S. searching for cures to my dreadful bladder pain. I read everything I could get my hands on about IC and I contacted many patients whom I met over the Internet. I focused on success stories and I shied away from the plethora of tragedies that plague the Internet. I never once saw a urologist. My father’s experience with prostate cancer left me with a healthy distrust of urologists. I restricted my diet to the IC and candida diets. Basically, I was down to fish, chicken, and non-acidic vegetables; I lost 20 pounds in three months. My diet and my pain put an impossible kink in my social life and I withdrew from the scene. At first, this frustrated me, but I eventually came to accept it as a much needed time for self reflection. It helped that I believed my condition was temporary.
Interestingly, even though my practitioners didn’t have my diagnosis correct, they all told me I needed to relax. I had a high-stress job that didn’t fit my personality and I was miserable at it. They all suggested that I find a new job, something that was impossible to do in the economic climate of the time, but I did take these suggestions to heart and made some adjustments to my work habits that led to improvements in my symptoms. However, even though I was out of gut-wrenching pain, I still had nagging pressure and urgency that waxed and waned.
Then one day about six months after the Halloween party, I saw an advertisement in a local natural foods magazine for a physical therapist who specialized in women’s health and pelvic pain. I’ll never forget walking into my physical therapist’s office for the first time after a particularly stressful day at work. My symptoms were elevated and I didn’t know what to expect from the visit. When she explained her internal trigger point and myofascial release techniques I was stunned, but I was desperate and willing to try anything that didn’t involve a urethral probe. One hour later I walked out of her office with drastically reduced pain and the next day I had my first pain-free day since the onset of all of this. I was onto something.
I continued seeing my physical therapist and she educated me about pelvic floor dysfunction. She lent me her copy of A Headache in the Pelvis and I read it in a single sitting. These guys, Drs. Wise and Anderson, got it. The moment I finished the book, I called Dr. Wise’s office and was surprised when he answered the phone. His calm voice was soothing and I immediately had hope that this practitioner could help me. I’ll never forget when he told me that he thought I’d be a good candidate for his clinic and I asked, “You mean, there’s a possibility that my problems are outside of my bladder, not in it?” and he said simply, “Yes.” My heart turned a cartwheel. This is what I had hoped for all along and I decided this avenue was worth exploring. I was so happy to learn that the mandatory urologic exam with Dr. Smith at the start of Dr. Wise’s clinic did not include any sort of urethral probing because that would have been a deal breaker for me. Dr. Wise and I were on the same page.
I went to the clinic in August 2010 and my life will never be the same. I went knowing that physical therapy already worked for me and, while I was looking forward to learning the self-treatment trigger point techniques, I was most interested in learning Paradoxical Relaxation techniques because I’ve struggled with anxiety my entire life; learning to control my anxiety was appealing. So was a non-invasive self- treatment that focused on stretching and relaxation.
My urologic exam with Dr. Smith was amazing, something that not many people say about urologic exams. At the end of the exam, he declared that to the best of his knowledge, I didn’t have IC and that my problems were related to chronic muscle tension in my pelvis. These was the best news I’d received in my entire life! The rest of clinic was a dream. It was such a relief to be in a room full of people who understood the frustration of living with chronic pelvic pain and it was empowering to learn the recovery techniques from Dr. Wise and Tim.
After clinic, my symptoms diminished abruptly. Within two months, I felt normal on a fairly regular basis. I started testing foods I hadn’t eaten in months and to my delight, I tolerated them. I still have occasional flares, but they’re much milder than they were prior to clinic and they occur once every three to four weeks. The rest of the time,
I’m normal. I expect one day to be completely normal. The best part is that I don’t panic when I start to feel the onset of a flare. Instead, I do the protocol and tell myself to rest with the tension that’s causing my pain. My flares end within a day’s time. The home program is timeconsuming and I was worried about how I’d fit it into my very busy schedule, but somehow I just do and I look forward to doing it when I get home from work every day. I haven’t returned to my regular physical activities like backpacking, biking, or pilates, but I am certain I will one day. Knowing that makes this time of rest tolerable. For now, I walk and do yoga.
What I’ve learned from all of this is that I have not handled stress very well throughout my life and my body and mind are not built to take on long-term stress. I’m continuing to reduce my stress at work and I’m taking steps to repurpose my career so I can find another job. I’m well enough now that I can look at my CPPS as a gift. Had I not been forced to examine my lifestyle, I may never have made these very necessary changes for my health. I am eternally grateful to the crew at the National Center for Pelvic Pain Research for giving me the skills to recover from CPPS.
It’s been almost six years since I first met Dr. Wise and we are still in touch. Once or twice a year I email Dr. Wise to inquire about his continuous great work for people with pelvic pain. In these emails I ask Dr. Wise for new relaxing tapes. It is through these tapes that our connection is greatest. What a true pleasure it still is to put everything aside and to relax with one of David’s tapes. I still listen to them regularly although the days that I was in pain lie far behind. Every time I finish a session I promise myself to have the next one sooner than later. David’s relaxing tapes have cured me from my pelvic pain and have given me a tool to get rid of any tension and anxiety. I can’t thank him enough for that!
I have been meaning to write you a note for some time. I have benefited greatly from your program and my symptoms have decreased to the level of being insignificant. I continue with the protocol and have taken up yoga on a regular basis to improve my stretching. I have used your relaxation techniques repeatedly to help deal with the stress I have experienced with my work. While this has probably been the single worst year of my career and I have lost significant amounts of money in my business (I manage a hedge fund), my pelvic pain has disappeared using your protocol. I used to experience discomfort while market crash, but I am so thankful that I have my health and wellbeing and am amazed that I have been able to get better while experiencing the severe stress caused by the lousy stock market. Once again, Thank You and Happy New Year!
After the clinic, my symptoms diminished abruptly. Within two months, I picked up the second edition of this book and couldn’t put it down. For once someone understood, it got straight to the heart of the matter. After 30 years of mild pain followed by 7 years of chronic and severely debilitating pain I knew I was on the right path. It had felt for years that I was in emotional solitary confinement, unable to share the extent of the pain with anyone who could really know what I was talking about. I had read articles that depicted pelvic pain sufferers as the lepers of the medical world. Consultants had made me feel psychotic, untreatable, and an “interesting and perplexing” case. Complementary and physical therapists had been supportive and really helped. However many years on and £30,000 later I had some of the jig saw pieces and had started to make some progress towards full health but it wasn’t until I read this book that the full picture emerged.
It was time to bear the cost and take my pelvic pain thousands of miles away to Dr Wises” seminar. A decision I didn’t regret. I arrived in California and met fourteen men and women with the one common denominator of pelvic pain and its debilitating effects on life. However we didn’t wallow in mutual pity as each one of us had the positive intent to return to full health. Some had feared that a mixed group of pelvic pain sufferers would be embarrassing but we quickly got to know each other and respect each other’s privacy. We would talk candidly and even have moments of humour about our pain.
Our discretion was assured through the protocol being called a “seminar” rather than clinic. If anyone had peered into the room of neatly laid out mats with pillows and blankets they may have wondered what was going on. This was our paradoxical relaxation room where Dr. Wise in his unflappable manner talked us through his immense knowledge of the subject. It was also where he taught us the art of paradoxical relaxation. We shuffled, scratched, snored and fidgeted but eventually, one by one, found moments of peace where we could truly sink into the feeling of letting go, accepting how our bodies felt and giving up the fight to control the pain. Throughout our lives many of us realized we had strived; for perfection, to excel, to achieve and … to get better. We had worked hard at getting better, very hard, and now we were learning that the secret was exactly the opposite; NOT to work hard at it! Here in Santa Rosa was the dawning realization that to get better we needed to let go of doing anything, accept our pain and learn how to relax; profoundly.
Every day of the protocol we each had a session with Tim Sawyer, the protocol’s chief Physical Therapist. I wondered if Tim had ever dreamed as a child of becoming a therapist. One who excelled at teaching patients to self massage pelvic muscles which lay deep inside their “private parts.” Possibly not. And yet what a gift he gave all of us. He taught us to find trigger points, those knotty sore areas of muscle that triggered pain elsewhere. There was no embarrassment thanks to his professionalism and I now feel quite adept at this strange but wonderfully relieving skill.
Five days later I left Santa Rosa feeling renewed in spirit and knowing that I was on a journey that would lead to a full recovery. Eleven months after my visit I am 90% better. I have learnt to recognise tension and to relax, not just when I’m listening to the tapes, but as I climb stairs, walk the streets, work, lie in bed, watch TV and do every day chores. My levels of awareness are heightened and I am able to recognize what may cause a “flare up” and how to avoid it. Together with Claire, my physical therapist in the UK, I am learning to exercise again, breathe properly and to build up the other muscles that remained weak as my overly-strong pelvic muscles took the strain. I am learning new habits to replace those that have exasperated the pelvic pain and to sink into Dr Wises” protocol and work with it rather than “try hard” at it.
You can’t beat this pain by trying, striving or driving for a cure. You have to be with it, allow it, almost befriend it and then slowly it subsides; that’s the amazing paradox.
In 2001, when I was twenty-three years-old, I was walking to class and started to feel a pain at the tip of my penis. It was a mixture of stinging and burning, and it would hurt terribly as it rubbed against my clothes.
I figured I had a urinary tract infection, and went to the school infirmary to see a general practitioner. The doctor found no infection, and referred me to a urologist. The urologist also found no infection, and said that there was nothing wrong with me. In a way, I believed him wholeheartedly, and even wanted to. Of course, the pain was still there. For over a year, I simply put up with the pain, not wearing blue jeans or other rough clothing. Sometimes the pain wasn’t that bad, sometimes it was terribly annoying. I developed other symptoms: pain in the urethra during ejaculation and afterwards, frequency and urgency related to urination. Although not relating it to my pain then, another symptom that I had dealt with since a teenager was nervous stomach, that is, always seeming to have a bowel movement before any significant event of pressure. However, the severity of my symptoms always stayed manageable, and I carried on without telling a soul about my symptoms.
I had always been a popular and successful young man. I did very well in school and always had a plethora of friends and girlfriends. I never had any social anxiety, and was extremely gregarious and outgoing. Looking back, however, it is clear that I dealt with extreme anxiety. I am an intense, type A personality, always having to do more and more and more, and no amount of work or pressure or activity ever seemed enough. I lived almost manically in my professional and personal life, and I could never seem to get enough of any aspect of life. I was searching for something, but had no idea what it was. Again, looking back, I can see that my pain and symptoms, combined with my manic and unpeaceful personality, was causing deep emotional and psychological problems in my life. I lost relationships with people that I loved very much. I began to withdraw from social circles, and spent more and more time alone.
As I graduated from professional school and started my working life, my pain started to get worse. I was in a high-stress job, and my pain began to spread into my legs, perineum, hips and back. From 2001 until 2004 (when I discovered the Stanford Protocol), I went to several different urologists, and basically I got the same treatment as most other men diagnosed with prostatitis: antibiotics, anti-inflammatories, worse because they masked my natural intuition about what was going on with me. Finally, my pain exploded, and I could no longer carry on my routine I was in so much distress. I hurt 24/7, and I fell into severe depression. I truly believed my life was over. I had a dark night of the soul.
Then, I found A Headache in the Pelvis on the Internet. I read it and it described perfectly what I was experiencing. In fact, I never had a doubt from the beginning regarding the muscular basis of the Stanford Protocol, as I had been abusing myself through the old, high-school athletic modes of weightlifting and contraction. My entire body, and especially my pelvis, was riddled with trigger points. Immediately I went to California and attended one of the clinics. I learned Paradoxical Relaxation from Dr. Wise and the basics of trigger point therapy from Tim Sawyer, both internally and externally. I immediately felt better, but knew that I had a very long way to go before I could consistently reduce my symptoms.
During these past two years that I have been practicing the Stanford Protocol, there have been many ups and downs. However, I never doubted the efficacy of the program and knew that such steps forward and back were what had to occur for true healing to happen. Drugs are easy and mask the problem; true healing takes faith, commitment, and compassion for oneself. I have always continued to improve. In fact, the setbacks for me were not that I physically felt any worse, but rather I had to work through my anger about no one ever teaching these wonderful truths about my muscles to me, and how it related to the central nervous system arousal in my life. I was mad that I had not been raised on the teachings in a Headache in the Pelvis
Of course, the Paradoxical Relaxation helps tremendously when these suppressed emotional responses begin to surface. My pelvic musculature is, I would say, about 97% healed, and I know over the course of the next year it will slowly dissolve.
You may very well forgotten me since we have not communicated by phone since the spring of 2004. It is about time that I reported to you on my progress.
With the recommendation of Dr. Jeanette Potts, Cleveland Clinic, you agreed to give me instruction by phone detailing your wonderful program on pelvic pain. At that time in my life I could not possibly have flown to California since my pain was so constant and intense. I regret that, of course, and know that I would have benefitted greatly.
However, I want you to know that since 2004 I literally immersed myself in the tapes, exercises and your book. I did a tape and exercises every day and a therapeutic massage nearly every week until the end of 2007. My whole mindset has changed. The more knowledge I gained the more my body calmed down. My lifelong pattern of trying to be perfect has eased considerably. Looking back over the years I can see the tension I created for myself. And I finally admitted that I was the one who had to change and take the time to retrain myself. And it has taken time. I have been free of pain for over five months. This is totally wonderful since I began this situation in 1988.
I continue to do the tapes and exercises several times a week and from time to time read a few pages of your book. These things seem to be necessary to maintain my good health, etc. now that I am approaching 81 (!) there will hopefully be a few more good years!
My sincere thanks to you and Dr. Potts, as well as Betsy O’D. and my massage therapist. You all have contributed to my well-being so greatly. I appreciate all of you and pray that your good work will continue to help others. I neglected to mention how supportive my wonderful husband is. He has gone through a lot with me.
I attended the clinic you held this past December and I wanted to take the time to update you on how I’m doing.
When I came to you I was in dire straits. I had seen probably 20 doctors, spent months in physical therapy, and had a “pelvic floor repair” operation, all without any positive results and increasing frustration and depression. I had played football my whole life and had always been a physically active person. I was unable to do anything involving exercise for about two and a half years since the symptoms got to their worst point. I had to stop playing football and eventually left college altogether. Attending your clinic was truly going to be my last attempt at getting better before I planned on resigning to a life of inactivity and unbearable depression.
I’m still somewhat astounded at my own focus in staying with the protocol even when after a month or two I wasn’t feeling better. I actually don’t even want to give a summary of my recovery because I don’t feel far enough away from it to revisit it. But a couple months ago I started to notice improvement and now I feel almost back to normal. As I’ve told the friend from the clinic I’ve stayed in touch with, if I was about 50% when I arrived in California, I’d say I’m about 90-95% now, and still getting better. I’ve rekindled most of the relationships that I cut off during my time with the symptoms and it seems like there’s only good things ahead. I’m going back to college this fall and plan on playing football for the school. There’s no way to express how thankful I am for you and your staff. I really don’t know what to say other than I honestly believe this protocol saved me from going to a bad place emotionally, to say the least. I know saying thank you doesn’t even begin to cover it, but thank you.
In the summer of 1998 at the age of twenty-one, I started to experience urinary frequency. It started out mild. In the mornings I would wake up to urinate and then lie back down in bed and not feel that I had completely emptied my bladder. I ignored it at first but after it persisted for a couple of weeks I decided something must be wrong and went to see a urologist. He was unable to culture anything from my prostatic fluid, the extraction of which was the first of many uncomfortable and unnecessary procedures. He decided anyway that I must have a lowlevel infection of the prostate. I started taking antibiotics and it seemed to help initially — the first of a myriad of expensive and unnecessary medications which seemed to help at the outset. Before I finished the medication the symptoms returned and after it was finished they remained.
The urologist was unable to provide any further recommendations. The next urologist I saw in December of 1998 had me pee into a uroflow device to measure my flow rate. He printed out a nice little graph to show me how my flow rate was lower than average and informed me that I had a urethral stricture which would require a dilation under general anesthesia and a prescription to Hytrin®. Anxious to be rid of my symptoms, I eagerly underwent the procedure. Improvement lasted only about 2 weeks.
When I called the urologist several weeks later to ask about my returning symptoms he instructed me to keep taking the Hytrin®, which I did for several months to no avail. My symptoms gradually worsened, but I did not experience any pain — only frequency.
I moved to San Francisco in August of 1999 and made an appointment to see a doctor at a prominent university whose specialties included chronic pelvic pain syndromes.
He suggested that I might have interstitial cystitis and recommended I undergo a hydrodistention under general anesthesia to verify this. In February of 2000 I underwent the procedure and the results were uncertain. It was a “soft call” as to whether I had IC. I definitely lacked classic IC symptoms (no pain, no prominent food sensitivities) but the doctor could think of nothing else it was likely to be.
Soon I began a cycle of trying out new medications, becoming excited that they were working at first and then quickly becoming disappointed as my symptoms returned and remained. The frequency gradually became worse than it had ever been before, but still it was only frequency and not pain. There was some extremely uncomfortable frequency at times (bathroom visits 15-20 times a day and 4-6 times a night) but nothing I would describe as pain ever manifested. Also at this time I was beginning a new job which was significantly stressful. In retrospect I think this was a major factor in the worsening of my symptoms, along with a spiral of hopelessness as each new medicine I tried failed to help. I tried the usual battery of meds that is prescribed for IC and after 6 months when it seemed they were not working at all I began to try other things such as numerous over-the-counter herbs, additional prescription antibiotics of different types, the hypertension drug Amlodipine®, etc.
I estimate I tried 20-25 different medicines or products over the life of my symptoms, none of which helped me to any significant degree. I tried transcutaneous electrical nerve stimulation. I underwent two urodynamic evaluations at two universities (both requiring catheterization while awake) and there were no remarkable insights gleaned from either study. I spent countless hours combing the Internet and the university medical library for some additional scrap of information that might prove useful.
Eventually I stumbled onto an article written by David Wise on www. prostatitis.org called “The New Theory of Prostatitis as a Tension Disorder.” I contacted David and since he was in my area I went to see him in November of 2000. I made some half-hearted attempts to start the relaxation therapy at home but didn’t really begin it in earnest until early January, 2001. It was very difficult to sit through an entire tape at first and I squirmed and fidgeted throughout most of the tape. The therapy certainly teaches you patience. At this time I also began seeing a physical therapist recommended by David who specializes in CPPS.
With the combination of relaxation twice a day and physical therapy once a week I slowly began to see some steady improvement in my frequency over many weeks” time. It was always the case that I felt better for a day or two and then felt worse again for a stretch of days, but over time the good days began to outweigh the bad. The good days that I did have were the best days that I’d experienced in over a year. These days were extremely encouraging and the memory of them is what carried me through the bad stretches, although after many bad days in a row it was often easy to think that I had been fooling myself.
When a good stretch occurred, though, it seemed unmistakable that my symptoms were improving. I had many good stretches that occurred with increasing frequency throughout March, April, and May, and by June ̕01 for the first time since they had begun I felt that I had a solid handle on my symptoms — that I was on the sure path to healing myself completely. I would definitely become cocky at times and stop doing the relaxation or stretches. My symptoms would not immediately return but if I persisted in a chronic state of stress for some time without paying attention to what was going on in my pelvis then they would creep back and suddenly demand my attention. In fact I can still say that this is the case — that I experience low-level symptoms from time to time but they are not something I fear anymore because I understand the factors that lead to their appearance and the factors that lead to their abatement. In addition, the intensity is very, very minor compared to what it was at the height of my misery. When symptoms do occur they are so subtle that they hardly enter my consciousness and I experience myself as having completely normal bladder behavior.
I practice the formal relaxation less frequently now (2-5 times a week depending on how things are going) and my pelvis seems to be perfectly happy with that. I live my life in a more relaxed state overall and that makes all the difference.
I consider myself lucky when I read other peoples” accounts of their experiences with CPPS. However I would not hesitate at all to describe my own experience as a waking nightmare. I remember in the midst of it coming home from work exhausted and collapsing onto my couch in tears, not sure if I could hold down my job, if I would have to move back home with my mother, etc. My social life was severely impacted. I skipped countless activities on account of how uncomfortable I felt and because I dreaded having to go to the bathroom every 30 minutes in public. I didn’t date for 3 years. I sunk further and further into misery and desperation and I believe my symptoms would have continued to worsen had I not found David’s article online.
The relaxation techniques were a godsend for me. They have helped me in more ways than in just the abatement of my symptoms. I feel more centered now, more at peace in general. In one way of looking at it I can consider my symptoms to have been a gift, because they are the only thing that could have led me to devote so much of my time to the relaxation, which in retrospect I desperately needed though I have never thought of myself as an uptight person. I have never battled with depression except as a result of my symptoms. I have only experienced mild anxiety from time to time and always as a result of outside circumstances. However I believe now that I am genetically predisposed to holding the tension that I do feel in my pelvic muscles. I say it’s a genetic predisposition because of the fact of my maternal grandfather’s identical symptoms and the existence of bladder problems in general on my mom’s side of the family.
A metaphor I have found useful is that one’s pain can be like a compass it’s trying to lead you to where you need to be. The story of my own struggle has in a sense been the story of learning to read my personal compass and to trust it and check in with it every now and then, with the goal of not having to check in with it at all because I am following it all the time without effort. When I was physically suffering it’s like the compass was shoved in my face and I would get really gung-ho about the relaxation. When the symptoms abated I started to wander off the path, but like I said this was necessary for learning. Now the compass is much clearer to me even when I’m not suffering and I can detect the path intuitively.
In sum, I suffered from prostatitis/CPPS for three years and my life became absolutely miserable. I received four different diagnoses from four urologists, tried over 20 prescription medications, vitamins, and herbs, and underwent several very uncomfortable and expensive procedures, all of which did hardly anything to help my symptoms which had slowly been increasing in intensity over time. Using the protocol described in A Headache in the Pelvis, I slowly began to heal myself, without any medication. Six months later my symptoms were diminished significantly and nine months later I felt I was healed. It is now 2½ years after I first started to practice these methods and I feel that I have been freed of this horrific condition.
There are many schools of thought regarding this syndrome and I studied all of them obsessively at one time. I feel very strongly however that over the coming years the ideas in this book will eclipse the other models of this disease and come to be recognized as the most powerful method for dealing with it as more and more people are seen to have solid and long-lasting benefits. Mine is not the last testimonial you will see. I should say however that it is not a simple or quick solution and it requires a lot of devotion, but chances are the end-result will be your freedom. My advice to those who are still suffering is “best of luck; do not abandon hope until you have given these methods your most sincere effort.”
I am a 35-year-old male who, until recently, suffered from chronic prostatitis for over fifteen years. I am writing to share my experience in hope that someone else currently suffering from my predicament can heal as I have.
Starting at about age eighteen, I began to notice symptoms of high urinary frequency and a great sense of urgency when I felt the need to urinate. By the time I was twenty-four, the symptoms reached the point where I was uncomfortable much of the day. I went to see multiple doctors, including several urologists who did several invasive procedures. I had diagnoses that ranged from chronic prostatitis to a narrow bladder neck. Other than taking alpha-blockers, doctors told me they could not do much to help me.
I somehow learned to get by with my symptoms. I always sat on the aisle row of a movie theater or airplane to facilitate my many visits to the restroom. I would map out the restrooms first upon entering a new mall or other unfamiliar place. I tried to avoid any event where I would not be assured access to a restroom hourly. I typically felt the urge to urinate every hour during the day. Multiple visits to the restroom at night were not uncommon. I budgeted more time to sleep because the quality of my sleep was so poor.
In October of 2002, the inconvenient and annoying symptoms of my condition turned into a persistent pain. Urinating no longer relieved, even temporarily, the pain and sense of urgency to urinate. I felt pain in and around my urethra, my bladder, and my prostate. Multiple visits to several urologists resulted in a diagnosis of “chronic prostatitis.” I started taking any pharmaceutical that the doctors suggested, including antibiotics, alpha-blockers, Ambien® to sleep at night, muscle relaxants, and anti-inflammatory drugs. None of these helped. By Thanksgiving, I wasn’t able to sleep more than a few hours per night. I began missing work. I spent entire days in tears. I suffered from panic attacks. I went to the emergency room. I started to avoid people as much as possible. My increasing anxiety made the pain even worse.
I can remember thinking in December 2002 that everything I had spent my whole life trying to achieve was coming to an end. I had an MBA from Harvard Business School. I had a great job. I had a loving wife and two children. I had a strong relationship with God. Yet, I couldn’t see how I was going to survive. I didn’t see how I could possibly maintain my job with this pain. I didn’t even think I would be able to enjoy watching my children grow older. Sex was out of the question because it just exacerbated the symptoms. I would have gladly given up all my money and material possessions to be cured of the acute pain that plagued my every moment.
In desperation, I turned to the Internet. Fortunately, I learned about the work of Drs. Wise and Anderson. Contrary to many other approaches I read about on the Internet, their approach appealed to me because:
- It had a fundamental basis. In other words, it made sense that the pain I was feeling was the result of constriction of the pelvic region.
- It did not entail pharmaceuticals or surgery. Surgery is permanent. Pharmaceuticals were not working and had bad side-effects. I was intent on not resorting to narcotics of any kind.
- Their approach allowed me to be proactive about my pain. Some Internet sites claim that chronic prostatitis is caused by an as-yet unidentified and untreatable infection. What good would it have done me to convince myself that I had an untreatable infection?
- The symptoms I felt and the way I felt them matched those described in A Headache in the Pelvis.
- My symptoms historically have been linked to stress. Having increased tension in the pelvis during times of stress seemed to fit my profile as well.
My wife drove me to San Francisco to start therapy. I first saw a urologist who ruled out other possibilities and confirmed that I might benefit from this course of therapy. I attended daily physical therapy with a therapist trained in the techniques. In addition to internal stretching performed by the therapist, I was put on a program to stretch various muscles and fascia daily. I began learning “moment to moment” relaxation. I also began learning and practicing the Paradoxical Relaxation technique. Within a week, I was much better. My wife drove me home to Los Angeles, where I continued physical therapy twice a week and later once a week for about three months. I became better and better at “moment to moment” relaxation of the pelvic muscles, to the point that I didn’t need to think about relaxing those muscles any more. I continue daily Paradoxical Relaxation using tapes provided by Dr. Wise. Amazingly, the pain has diminished with each week that has passed. While there are occasional flare-ups the general trend was and continues to be in one direction–better.
It has now been eight months since I started this program. I have had to dedicate significant time to this effort. However, I feel like a miracle has been granted to me. My urinary frequency has dropped to only once per night and once per two hours, at most, during the day. I feel little, if any, pain. I feel almost no pain following sex. I am better than I have been in over 15 years. Miraculously, the pain went away! Now of course, this does not mean there was no effort involved, or that it happened overnight. But the one thing that is clear is this: the less helpless I felt towards my situation, the more it improved. Basically, the first step was just plain knowing that nothing was wrong, and the second step was making a concerted effort to relax and work through and accept the pain, even when it was still there. By learning to see the pain as acceptable, so to speak, I managed to put it out of mind. Once I had gotten into a pattern of really being able to stop thinking about it (which is much easier once you know it has no real physical basis, at least not in the form of a virus), it just plain vanished! Basically, I am now free of prostatitis.
In October of 2000 I had a vasectomy performed by a urologist in Toronto. Before the operation I inquired about its safety and the possibility of side effects. I was told the operation was routine and there was no possibility of any problems. In June of 2001, I began to experience severe pains in my testicles. These pains were severe enough to force me to give up employment. For several months I was unable to do much more than stay in bed. In addition to the pain I was unable to ejaculate. I saw a urologist at Mt. Sinai Hospital in Toronto who recommended a vasectomy reversal. It was scheduled, but as the pain spread from the testicles to the perineum and the entire pelvic area, my urologist felt that the reversal might do more harm than good.
He instead put me under the care of the pain clinic at the hospital. I was given large doses of opiates, 36 mg of hydromorphine contin per day, which lessened the pain but did nothing for the underlying condition. In November 2001, I came upon your article, “The New Theory That Prostatitis is a Tension Disorder.” I spoke to Dr. Wise a number of times on the phone and in December 2001 went to California. I was seen by Dr. Rodney Anderson, urologist and Tim Sawyer, physiotherapist.
My wife accompanied me on the visit and learned the technique of myofascial release inside the pelvic floor from Tim Sawyer.
At first my wife was unable to perform the internal massage because it was too painful, but after a month of external massaging, she was gradually able to do the internal work. She did this twice a week for about two months. It gradually became easier to do and eventually the frequency of the massages was much reduced. At the same time, I began daily relaxation exercises, using a course on tape. I also did various stretches recommended by Tim Sawyer.
The pain grew gradually less severe during 2002 and I gradually reduced the number of grams of painkiller I was taking. By the late months of 2002, I was taking only one mg. per day. Since January 2003 I have taken no painkillers on a regular basis. I visited Dr. Wise and Tim Sawyer again in March 2003. Tim was able to confirm a significant loosening inside the pelvic floor. I continue to feel some pain every day but rarely is the pain severe enough to take any opiate. The degree of pain from day-to-day varies a great deal. Some days are entirely pain-free except for occasional discomfort in the pelvic area; some days involve pain for longer periods and more intensely. There is usually some pain during and after sexual intercourse, but ejaculations are normal. Occasionally I use aspirin or ibuprofen.
In general I would say I am pain-free about three-quarters to seven- eighths of the time. For the other quarter or eighth the pain is present but bearable. For a long while I was taking a drug called Imovane to help me sleep at night. I discontinued the Imovane about a month ago, but I am now frequently awakened by the need to urinate during the night, which is a disturbing problem. I have been advised to try Flomax, which I used at the height of the problem but discontinued about a year ago.
The relaxation exercises, myofascial release, and stretches seem to have helped me reduce my pain very significantly. Although I am not back at a full-time job I have been able to work part-time as a consultant and university lecturer. The alleviation of the pain has of course made life much more worth living for me. I am grateful for your patient and understanding help.
Beginning in about 1992 (age 27), I experienced occasional pelvic pain, primarily the right side in an area stretching from my groin and extending upward. It was a dull ache. I am a military lawyer. I saw a civilian urologist who conducted a thorough pelvic and prostate exam and concluded there was nothing wrong with me (except a small, benign, and unremarkable spermatocele resting on the top of the right testicle). He examined my prostate fluid under a microscope with negative results. The pelvic pain was worse just above and to the right of the pubic bone and in the lower abdominal area.
When I was stationed overseas from 1994-1996, the pain became progressively worse. I tended to usually have a dull ache in the pelvis just above the pubic bone and to the right. The pain was worse if I had to stand for a long time (e.g. in a courtroom or on a subway). I got to where I would want to sit down and “rest” to relieve the ache, even though I was physically fit and not tired. I didn’t want to walk anywhere. In concert with the pelvic pain, I experienced pain that would radiate down my right inner leg and back thigh and rear, sometimes as far down my leg as the calf.
Another symptom was that my urine flow was typically very, very slow. It would sometimes slow to an intermittent trickle, and I learned that if I took a deep breathe and exhaled while standing at the urinal, the flow rate would accelerate a bit.
Usually, it took me a long time to urinate, and after going, my bladder still felt full. I remember during some of my first court trials in 1995, I had an intense urge to urinate, even after I just went, and it would feel as though I had to urinate virtually the entire day. During this time I started feeling an occasional, sudden, sharp pain somewhere inside the rectum. This pain would last for up to 10 seconds and would slowly release on its own. It was sometimes so intense and sharp that I was seized with pain and couldn’t move until it subsided. (Imagine a severe toe cramp in your rectum). The pelvic pain level would fluctuate from between 0 to 4 or 5 on a scale of 10, and it was usually between a 1 to 3.
In addition to the pelvic pain, the pain in the inside thigh, and slow urination, I usually also felt a tight feeling in the area between the testicles and rectum for about an hour after sex, as though the path for the sperm had been tightened or blocked. In 1996, I moved to the West Coast, and these symptoms continued.
I went to several military urologists, both overseas and in California, who diagnosed me with chronic prostatitis. In 1997 I experienced these symptoms on and off. In 1998, the symptoms became worse. I was prescribed Ciprofloxin® 500 for about 75 days for chronic prostatitis. The doctors never found any evidence of a microbe infection in my prostate fluid. One doctor also inserted a lighted camera into my urethra and examined the path leading up to my kidneys and bladder – all tissue was healthy. After the antibiotics and tests, I still had an aching pelvis, and was still “double eliminating” (on the advice of one of the doctors, urinating 10 minutes after I urinated in order to try to make the bladder fully empty). My side ached nearly all the time and no one knew why.
Fortunately, the military urologist had heard a paper delivered by Dr. Rodney Anderson at a conference on prostate massage. The urologist thought Dr. Anderson might be able to help me, so he referred me to
Stanford Medical Center. Dr. Anderson did a complete physical examination. That exam found the unremarkable spermatocele, but more importantly, some “pressure points” of pain. Dr. Anderson sent me immediately to see Dr. David Wise.
When I first began the treatment I was skeptical; I could not believe that my pain was unwittingly a self-inflicted wound. After I learned to be conscious of my body, and to reflect on the holding and tightness in my pelvis and the pain I felt, I became convinced. It took some time — months, and I cannot recall when I crossed the line, but I became absolutely certain that my symptoms were relieved by the protocol.
Over the course of my year of training in progressive (paradoxical) relaxation, I learned to totally relax my mind and body. When I received myofascial release therapy from a physical therapist prescribed by Dr. Wise, I could actually feel when the tension inside was released by stretching the tissue; it was instant and soothing relief when a “tight” spot was stretched. It got to where I could feel where the pressure point was and could direct the therapist to it quickly. My wife has also been trained in the myofascial release therapy, and she occasionally treated me in 1999 and early 2000, but stopped after the pain subsided. She stands willing to continue that protocol if the pain flares-up.
In the last four years, I have integrated this relaxation method into my life. Each day, I practice momentary relaxation and the deep relaxation, stretching taught by the physical therapist, and breathing in concert with relaxation. I try to make time for one complete session of progressive (paradoxical) relaxation session each day, but in my current position I cannot always do so.
At the present time, I do a complete session of 45-55 minutes 2-3 times per week, and a shorter session of 15-25 minutes on all other days. I also practice conscious effortlessness throughout the day by relaxing the pelvis, and practice contractions, and stretches, which were taught by the physical therapist. I also do a continuous, almost subconscious series of checks throughout the day to search for and release any tightness and holding in my body, particularly in my pelvis and the sides of my face. When I practice relaxing my body, my head and neck become so relaxed that my head bobs gently and unconsciously with the flow of the blood to the head. As a result of this relaxation, the blood vessels in my body relax and widen, and after a few minutes, my hands and feet become flush with blood.
Because of my military job and lack of privacy in Washington, D.C., I have adapted and learned to practice a full session of progressive (paradoxical) relaxation while lying with my head on a towel in the building gym—with a loud game of basketball taking place on the court next to me, or while laying on the sidewalk or grass as planes landing at National Airport roar overhead. These conditions are not ideal for relaxation, but it does work well. Because I have been taught to effectively abandon effort, I can focus on my breathe and heartbeat rather than the noise. I don’t fight or stress about the noise around me, but just let it be there as I drift away. I have done the same thing on a ship—with bells clanging and announcements being made over the loudspeaker. I have learned to be profoundly relaxed.
Usually I have no pelvic pain. It is usually nonexistent, but will fairly rarely be present at a low level if I become very stressed or busy at work. This stands in stark contrast to before I began the protocol when the pain was there all the time and occasionally severe.
One of the most important benefits is that I am certain of the source of the pain, conscious of the feeling and aware of the tendency to subconsciously tighten or hold the pelvis. I now feel how I tighten (and can focus on releasing) the tension. I am also aware of how the level of pain is linked to the pace of stress in my life. One more thing: until I wrote this, I had forgotten the emotional and mental worry, and fear that I had over what was mysterious pain and symptoms. Now I feel I am in control, the worry and fear have vanished. I know the recipe for getting well—discipline for exercising daily relaxation.
Until I wrote this I had also forgotten the slow urine flow that I used to have — standing at a urinal taking as long as four or five other men to urinate. My urine flow is now strong. I had also forgotten how I always had the feeling that I had to urinate soon after I already went. Now, I have a feeling of a totally empty and comfortable bladder. The discomfort after sex has now abated except for rare instances — it now occurs about twice a year. This treatment and protocol has changed my life.
My 20-year-old son took your seminar last June. I just wanted to thank all of you for giving him the tools to get his life back.
Today he just ran out of the house to go the beach with friends. He teaches sailing to young people at a local club and attends college in NYC. He uses the meditation tapes and other exercises, but his episodes of discomfort are farther and farther apart. Since last June he has gained about 10 pounds and is enjoying most foods again. He still finds certain foods irritating like onions, tomatoes, and beer. He also exercises regularly and is getting very fit.
Thanks a million!
I wanted to drop you a line to let you know that I gave birth to a healthy baby boy on 6/1/2011. He came just slightly early (12 days) but thankfully full term. He was born via C-section which turns out was the right thing for me (my first born was delivered naturally with much trauma to my pelvic floor). I am recovering very well from surgery and have not had any flare ups of pelvic pain. In fact, my pain level declined significantly during pregnancy after I was put on bed-rest at 30 weeks due to a shortened cervix… I want to thank you for your support during a trying time. I was really scared once my flare up started but luckily as intense as the pain was, it had no impact on the progress of my pregnancy. I hope I can be a source of hope for women with my condition who plan to have children. So far, I haven’t resumed internal work yet cause I’m still not reached 6 weeks postpartum (when pelvic rest is prescribed). However, I plan to resume after my 6 week OB visit. I may give you a call then to see if you have any thoughts on how I should start up again.
Thanks again for everything you have done towards helping people with our condition. With all honesty I can say that without the Stanford protocol, I may not have had the courage to try again for another baby.
Just like to drop a thank you for all that you have done for me and ongoing support throughout my recovery.
For my gratitude I did this small video review to show my experience and how I managed to get my health back. Today I am very fit and healthy and I exercise daily and I take no drugs.
I will be forever grateful for your help and it is a pleasure to have been able know you. Hopefully some day we will meet again.
In late September of 1997, two years after retiring, I started having problems with urination. Some brownish colored “sediment” started showing up at the end of urination and then pelvic pain started. My pain was in the rectum and prostate areas. When I woke up in the morning there was generally no pain, but it built up during the day and was worst in the evenings. My internist prescribed an antibiotic and referred me to a urologist. The urologist prescribed traditional treatment for prostate infection including antibiotic and ibuprofen. After six weeks of treatment virtually no progress was made. I observed during this period that pain killers provided no relief but muscle relaxants did help. Naps on the floor were the only other thing that seemed to help.
The symptoms were ruining my life and at times I was depressed. I was losing weight and there didn’t seem to be any light at the end of the tunnel.
A close friend got me an appointment in mid-December 1997 with Dr. Tom Stamey, the pioneer of urology who was still at Stanford. Dr. Stamey determined in one hour that I had no evidence of infection in the prostate gland and referred me to Dr. Anderson and Dr. Wise. I had no idea what form of treatment they would provide.
Dr. Anderson had me see a physical therapist that specialized in myofascial pelvic floor muscle pain relief. He relieved “trigger points” in various pelvic floor muscles and even taught the procedure to my wife who happens to also be a PT. I bought medical textbooks on myofascial pain and read extensively about the subject.
Dr. Wise started to teach me Paradoxical Relaxation. Gradually I started to make progress. One of the difficulties is that progress is an up and down process. I remember several times getting discouraged and phoning Dr. Wise. His calm, steady, reassurance was very helpful. One day, a few months after starting his therapy I asked him how long it would take to perfect his technique. He hesitated for a while but finally said “about two years.”
After two months I had made enough progress to know that things were on the right track. Oddly, knowing it might take two years was encouraging as I knew what to expect and not to think that I would be all cured in a month. My progress steadily got better and after a year I was 80% better. After two years I felt like I had reduced my symptoms by 90%.
It is now about five years since I first started treatment with Drs. Anderson and Wise. I feel that my symptoms are 99% gone but more important I know how to deal with symptoms if they occur. Happily, I seldom think about the problem any more.
I first met Dr. Wise at age 44 with a fifteen-year history of constant urinary urgency and suprapubic discomfort. My symptoms were exacerbated by any exercise requiring sitting in a squatted position such as rowing and biking including a recumbent bike. Also constipation and sex could worsen my symptoms in addition to ill-fitting seats, including car seats. I had been on multiple antibiotics, Hytrin, Elavil and Flomax without improvement. I did have a cystoscopy with hydrodistension and was told that I had mild interstitial cystitis. The Cysto gave me temporary severe urethritis, but it did improve my symptoms about 75% for two months.
After meeting Dr. Wise I began to see a massage therapist every two weeks for external pelvic deep tissue work which helped somewhat. I also got some internal work from a therapist in weekly blocks for a month at a time — total of about ten sessions over a year with continued mild improvement. I was slow to take to the tapes but did manage to listen. Approximately one year ago I had two back-to-back sessions with Marilyn Freedman and had marked improvement. She also added some stretches and core strength exercises. I fell somewhat back, yet did see Marilyn again in December 2005 for two additional sessions which again helped a lot. I do some sort of cardio workout every day and also light weight training four days a week. I have added squats (not heavy weights) to my regimen and I believe strengthening my quads takes weight bearing pressure off my pelvis as I spend most of my day standing at work. I am religious about stretching out my pelvis and have combined it with relaxation techniques each night before bed. I do four or five deep stretches including a child’s pose, gluteal stretches, and sitting in a deep squat. This process is combined with quiet breathing and takes approximately twenty minutes. Overall I believe there is a 90%+ improvement for me and after 15+ years of pelvic pain I am very grateful.