Wise Anderson Clinic July 2011

[gl0342]

Hi everybody

I thought I would share with you my experience at the W-A Clinic. I have found this site, and especially other testimonies about experience of the members at the clinic, so I want to contribute my as well. To be clear, my purpose is to later have it included in the "success stories" sections, but I am patient, let's see first how it goes...

For 6 months I have been suffering from various "classic" symptoms, most of the time moderate, at times bad, but always bad enough to disrupt my life. Constant pain while sitting and pain in penis/burning, reduced urine flow, and intermittent pain in rectum, testicles and low back. Combined with bad sleep, high anxiety and low mood. The only things that helped so far were relaxation, hot baths, reducing stress and walking.

During this time my ability to work has been greatly reduced, and well as my social life. While my pain was almost never of the "unbearable" type, I decided that I could not accept being in my present condition any more, and after extensive research, a lot of which using this forum, as well as reading the Headache in the Pelvis book for 3 times (!), I decided to register for the W-A clinic, and travel to the US with my wife for that purpose. This was not an easy decision, and certainly not a cheap one (we live out the US, quite far away), but I was not ready to continue to "half-live" the rest of my life with this condition.

We flew out yesterday, and after two long flights, difficult but less painful than expected, the adrenaline kick probably helps..., we arrived at the Flamingo Hotel in Santa Rosa (2.5 hour drive from SFO airport), where we will stay and where the clinic sessions will take place.

Day One - Urologist consultation

This morning (Thursday 14th) we drove to Sonoma (40 km from Santa Rosa) to see Dr Smith, the urologist.

Before this I had to fill in about 5 online Web forms (did this 3 weeks ago), which he took time to carefully review (history, symptoms, CPPS/BPH questionnaire, etc..).

The consultation took 45 minutes. First, general info, then survey of the history data. Dr Smith is a very nice and gentle person, he mentioned that he works with W-A for 8 years, and probably saw 1,000 W-A people.

Quick visual examination, followed by external low abdominal ultrasound (prostate size, rule out presence of stones or tumors, etc...). Then rectal exam with finger (DRE) in which he identified several sore points (which I know from the book Headache in Pelvis that they may be associated with my symptoms). No other findings. I also gave an urine sample which he looked at with a microscope and found nothing.

He said he was convinced this is CPPS. Time for questions, my main concerns were about Alpha Blockers (which he does not believe will be necessary later on).

He also said that the combination of PT with relaxation is key, and that while the vast majority of the W-A participants see some improvement, almost all of those who do not have their conditions improved are the ones who do not follow the relaxation part.

At the end he handed over referral letters for Dr Wise and Tim the PT. I finally got written an official confirmation for CPPS...

Sonoma is a nice city, my wife and myself had lunch at a nice Italian restaurant. We also had time for some shopping.

I still feel a little sore in the rectum area, I see that as a good sign .

Tomorrow (Friday 15th) in the morning the first appointment with Tim the "legendary" PT. On one hand I am afraid of the examination, on the other hand I do hope he finds relevant & treatable trigger points.

Then the first session with the group at noon.

Will continue this post tomorrow.

George

[CMT23]

Thanks for posting. I'm going next month so interested to see how it goes for you this month.

[gl0342]

Day Two - First PT Session

As written by many people here, Tim is a very gentle and professional guy. He took time to understand the symptoms, explain every step,using an anatomy model, etc...

He started from the outside - first in the abdomen (obliques), found a few TP I had no idea of, and can refer pain to penis. On the adductors (magnus and longus) - referring pair to testicles. Then on the sides, found several more on the glutes, periformis etc.. which affect sitting pain. So far all 1-2 on a level of 3.

Then we went inside - and found about 15 !... Some Level 2 on the back (all referring to the cocxyx and rectum), and then Level 3+ points on the front part of the levator ani near the prostate, almost all referring to the penis. He needed to apply only a very small amount of pressure to get response. He showed me how much on my hand, this is just a little more than you would to need press a button of a TV remote control!

The bottom line was that all the TPs are textbook, and he said that the fact that I came after just 6 months (and not years as most of the others), will make the treatment easier, provided I do the relaxation. I am relieved as I was afraid that he would not be able to find TPs.

A few things that I specially appreciated with Tim:
- Gradual application of pressure. (I had previous experience with sudden application of pressure, a bad one).
- He was able to feel the TP before I even started to feel a tense or painful sensation, or to tell him about it.
- He used positions which made the experience less stressful and painful, compared to exams by urologists for example.

At the end he got everything marked in a map.

Going now for a coffee. At noon first session with Dr Wise, in the afternoon, a private session with Dara (second PT) about how to treat external PTs.

George

[gl0342]

Day Two - Second Part - Relaxation & Stretch training

Had an intro by Dr Wise to the group. While his book is very extensive and I read most of it twice, hearing him helps to further understand the problem and the approach.

There were 3 relaxation sessions (only 2 for me as I had to go to PT). This is not easy. First time I had difficulty to focus. Then there was an open discussion where everyone asked questions. This is a critical part, as without him addressing the issues, I would have been kind of stuck. For example, what to do if your minds keeps busy with images and sentences - he said this is OK at the beginning, and if those are about you trying to focus on sensation, this is OK, kind of "coaching yourself" that would go away after practice.

At the second session, I could focus much more, and started to see the positive effects of relaxation. In fact, it helped getting rid of the unpleasant flare up I was having since the morning session with Tim.

Last today - 1/2 hour personal training session with Dara the second PT. Training about stretching exercises. I had tried before to do them myself using the HITP book, but found out I was doing them wrong (too much effort, wrong angles). My wife too pictures of all exercises so that we have some reference. She gave us a Theracane, and a leaflet with further details.

For homework this evening we got one of the Paradoxical Relaxation tape to practice.

Still too early to see it works, but learned a lot today, and much more confidence about my ability to do the protocol. Will follow tomorrow. More relaxation sessions, TP release (today was only mapping) with Tim, and personal training by Dara to identify and treat external TPs.

George

[webslave]

This is a valuable thread, George, so thanks for it!

[Jay]

I'd like to add my thanks for your contribution, George, especially concerning what went on at the urologist visit. People have inquired about that before.

I'll look forward to your future update. So far, it sounds like being early and textbook is working out in your favor.

[robertpagen]

I think it would be helpful if you would articulate what it end up costing in total. It would help people evaluate if they can realistically take it upon themselves to go.

Thank You, Be well,

Robert

[gl0342]

Thx to all of you.

Costs:
- 500$ down payment to Dr Wise when you register.
- 2,255$ - three days before it starts, to Dr Wise, and 895$ to Tim Sawyer.
- 300$ to Dr Smith at the time of the consultation.

Subtotal: 3,950.

- Hotel: If you stay at the flamingo, then 99$/night , 159$ for weekend nights. Does not include breakfast.
- Transportation to SFO
- Car rental (to get to Santa Rosa, and on the first day to Sonoma to Dr Smith)
- Meals are not included.

Total 5-6,000 when coming from the US, and 7-8,000 from Europe/Asia.

Hope that helps

George

[gl0342]

Day Three

Started with relaxation sessions. I think I finally got it, was able to deeply relax, and even fall asleep. Guided practice plus being able to ask questions on the spot really helps. I now also understand better the differences (quite substantial in fact) between Paradoxical Relaxation and other forms such as deep breathing relaxation, mindfulness, vipasana etc..

Session with Tim - amazing. Started with abdominal muscles which refer pain to penis, which he had no problem demonstrating. Achieved some release, but those will need more work, mainly self work. Then on adductors, which this evening I feel less tender.

Internal work was quite a surprise. He went back to all the TPs he found yesterday, then pressed them one by one, and many released completely, some partially. He said that I am lucky to be there early in the process (only six months). Also, before treating, he said he found that the area is less tense that yesterday, most probably due to relaxation and stretching.

Back to the group session. Felt some improvement while sitting - less pain, and I am still waiting to see the effect on the urinary symptoms. But I did not feel the flare up I had yesterday. In any case I am optimistic.

Other people in the group had diverse reactions to their first PT session: some had flares (mainly the ones with longer history), most started to feel some level of change.

Personal session with Dara - Training on how to find external TP and release then using fingers, tennis ball/Lacrosse ball, and Therecane. While some exercises are easy, for many others I needed more explanations. It will take me more time to get confidence finding and releasing TP.

One more relaxation session - focus on keeping attention in sensation in a continuous way. Most of the group felt they were improving.

Afternoon - most of the time about introducing the Wand. This is a nice J shape device. Dr Wise reviewed the concept, and in very little details he gave guidelines how to make sure you are effective while using it, how much pressure, where, what to do with flare ups, etc... He gave us a paper which will be included in the 7th edition of the book.

Got for homework some gloves and lubricant, to do internal stretches (just to the rectal sphincter). Did it this evening, was much more easy than I thought (probably due to Tim's work today). Tomorrow Tim will give each of us a Wand, and train us to use it.

Dr Wise also explained what to do about (a) post bowel movement pain (b) Post ejaculation sex.

Will continue tomorrow.

Thx to all for support.

George

[kossmo]

Your post is very helpful for me. Thank you George. I'm very interested what to do about post bowel movement and post ejaculation pain, because these are main issues for me. Maybe you could post what Dr. Wise explained about this. Thank you very much.

Michael

[gl0342]

Michael hi

Basically as you have probably read elsewhere, the Wise Anderson protocol is an "inside job".

If someone feels pain after bowel movement, then it is probably because of the mechanism of how the anal sphincters work - there is one inside and one outside. After bowel movement, the inside one is supposed to release, but if there is tension in pelvis, sometimes the inside sphincter contracts, and there is no volontary way to release. So the recommendation is to stretch the sphincters with lubricated gloved finger, at basically 4 directions - 12 o'clock, 3, 6, and 9. Repeat the sequence a few times.

Post ejaculation - recommendation is similar (except that you do no need to do it right after, it is OK to wait a couple of hours).

Hope this helps.

George

[gl0342]

Day Four

Started with group training by Dara of external TP release, skin rolling and stretches. Was very helpful, again, some of the exercises are not straightforward as they look in the book. This evening I practised the whole series and I am getting more confidence pushing deep and actively looking for muscles, deep into the abdomen, sides, thighs and glutes.

Right after this I had a session with Tim. He gave me the Wand, and coached me how to use it. We started with the internal TPs on the front (Anterior Levator Ani). I played with various pressure levels, various locations. A little stressful, but the coaching was very helpful, I did some practice this evening, was able to do this alone on most of the places, but had to stop after some time as it still feels sore inside, and I feel I need to start slowly.

Several relaxation sessions morning and afternoon, I feel I can reach the "zone" with less effort, and started to enjoy it. I do feel it makes a difference.

Afternoon - a video showing the close relation between stress and TP activity. Quite convincing, especially for skeptics like me who still were suspecting that Trigger Points are unproven fuzzy stuff. And results from another research. This is important, at least for me, as I found myself too many times thinking about cancer etc... Now I can stop with that and just concentrate on the self work.

Discussions on various topics - what to tell to your friends and relatives, at work, etc... Everyone shared his experience. It is comforting to openly discuss those issues with a group of people who can fully understand the difficulties. With only 6 months into this, I am probably an "easy" case, but we have people with pain from 20 to 50 years... This has affected their life tremendously.

Important discussion about how to manage expectations, how to handle flare ups. When you start seeing improvement it is useful to keep a diary, since there will be ups and downs, the downs can be bad, and the diary can help in those moments. Importance of being able to help yourself - the key theme of the clinic.

Sitting is getting better for me now. Today I could sit almost normally. Tim said that urinary symptoms (still present, even a little more burning sensation, probably because of the intensive TP work), will take some time to resolve, and I should not be expecting quick results. I also can feel the change in some of the external TPs (adductors for example), which get softer.

Two days left. Tim will train every one of us to use the Wand on the posterior/back side of the pelvic.

George

[gl0342]

Regarding the Wand.

Dr Wise has already obtained CE approval for it (the device has the CE mark), so that it can be sold in several European countries such as France, etc.. however the full kit is not yet ready, guess this should take a few months. The kit shall also include relaxation sessions recordings (50 different sessions), and video instructions.

If you are interested then best is to call/mail them and ask.

Regarding the US this will take more time (FDA approval ...).

The Wand is so important - it has the right shape and material. Especially it has a pressure monitor, and a special handle to limit the insertion to what is required and safe.

I still need practice but it is very easy to use, to look for TPs and apply pressure.

George

[kossmo]

Michael hi

Basically as you have probably read elsewhere, the Wise Anderson protocol is an "inside job".

If someone feels pain after bowel movement, then it is probably because of the mechanism of how the anal sphincters work - there is one inside and one outside. After bowel movement, the inside one is supposed to release, but if there is tension in pelvis, sometimes the inside sphincter contracts, and there is no volontary way to release. So the recommendation is to stretch the sphincters with lubricated gloved finger, at basically 4 directions - 12 o'clock, 3, 6, and 9. Repeat the sequence a few times.

Post ejaculation - recommendation is similar (except that you do no need to do it right after, it is OK to wait a couple of hours).

Hope this helps.

George

This helps a lot. Thanx George.

[gl0342]

Day Four

More advanced relaxation techniques. To achieve deeper relaxation. Basically same as before, except that the focus is on either (a) the eyes (b) tongue/lips/throat. Based on the research findings that relaxing the eyes helps reduces thoughts coming with mental images, and relaxing the "speaking" organs reduces verbal thoughts. Was not easy but I could see the difference.

Session with Tim - more training on the Wand. Feels MUCH better inside, and easier to "navigate". Tim said the goal is to have a discomfort/pain free internal pelvic floor, same as for any normal external muscle, that you can press and release freely without discomfort at all. Will take some more time but I feel there has been significant progress. After all, this internal stuff seemed so scary at first.

Several people reported today having a significant improvement after today's session (plus yesterday self-training). One guy with >15 years history said he felt almost fully OK for a few hours, first time since a long time, and another woman (20y+) said she was pain free for several hours.

We also had a video conference with John, an ex patient who was in pain for 3 years, did the clinic, started to improve after several months, was "90%" OK after a year, and after 2 years is pain free (except for occasional flares). It was extremely useful to talk to him, ask questions, especially on the psychological side of the process. He decided to study in depth all about TPs, internal and external, and felt full confidence with TP work only after a few months, after starting period when he felt he was doing wrong, flared up from treatment, etc... He kept doing the full protocol for the first year, now he is just doing the relaxation 1/day, moment-to-moment relaxation, and from time to time looks at TP.

It was helpful to me especially since I feel better than when I arrived (and certainly feel more empowered to treat myself) at least with sitting pains, I also feel now 100% confident that the approach is the one I trust most, but I am so impatient to see everything disappear immediately. John said that progress should be measured by the frequency and length of pain-free/reduced discomfort periods, and not "all or nothing".

Tomorrow last day.

George