The Pain Factor

TPF #26: Nancy Deyo - From perfectionism to pain to true freedom

• A Project Fourtress Podcast • Season 1 • Episode 26

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Nancy Deyo is a former Silicon Valley CEO, author and speaker, and a Stanford Distinguished Careers Institute Fellow. Her forthcoming memoir, Perilous Ascent, chronicles a fifteen-year journey through misdiagnosis, chronic pain, opioid dependence, mania, and a marriage pushed to its limits.​

In this episode, Nancy shares her 15-year journey through chronic pain, opioid dependence, and personal transformation after a life-changing Kilimanjaro climb. Discover insights on pain, resilience, and redefining success beyond failure.

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The Pain Factor is a Project Fourtress podcast.

Project Fourtress is a secular, humanist project, dedicated to find answers to the physical, mental and emotional pain people experience, as well as offer help to deal with these issues. To learn more about Project Fourtress, please visit fourtress.org.

SPEAKER_02

Welcome to the fight. Welcome to the Pain Factor. On this episode of The Pain Factor.

SPEAKER_03

Pain is deeply, deeply individual and deeply personal. And before I tell you what it means to me, I want to tell you what I what it doesn't mean to me. And that is, it is not a number between one and ten that doctors ask me repeatedly where zero is no pain at all. And ten is I can't stand it. But to me, pain for me is simply a signal that my body has sent to my brain that says something is wrong. Pay attention. When your identity is built on roles, the problem starts when one of those roles disappears. And it's not just losing a role, it's like you don't know who you are anymore. Sitting with my best friend one day in my home, I knew I needed a new fentanyl patch. It felt like it was time. And all I could think about during our conversation was, I need a new patch. How am I gonna get a new patch? How am I gonna wait until she leaves? Maybe she'll help me. What am I gonna do? And I was so distracted, I finally said to her, you know, Kathleen, will you do something for me? And she said, you know, anything. What what do you need? And I said, it's time for my medication. In the it's in the bathroom. Will you go up in my drawer and get it for me? And she was, something in her hesitated. She said, maybe I should get Chris. I think I just heard his car enter the driveway. And that made me panic because I realized that he would know that I was trying to, I was basically trying to get drugs earlier than I needed them. And I said, No, don't get my husband. No, no, no, it's okay. And I looked at her and she had tears running down her face. And in that moment, I realized that I had a problem. I started working with a psychotherapist, and for years, she kept floating this idea that she called the new normal. And that was my horizontal, monochromatic, pain and opioid-filled life. And it wasn't that life I used to live, striding through the airport and being with my friends and my husband and traveling. And so I just said to her, I hate the new normal. And she looked at me and she said, you know, it doesn't mean giving up. It means just giving in so you stop fighting yourself.

SPEAKER_02

Pain isn't the enemy. It is information most of us have been taught to ignore. Our guest today is a former Silicon Valley CEO. She's an author and speaker and Stanford Distinguished Careers Institute Fellow. Her forthcoming memoir, Periloose Ascent, chronicles a 15-year journey through misdiagnosis, chronic pain, opio independence, mania, and a marriage pushed to its limits. Nancy Deo, welcome to the Pain Factor. Thank you for joining us today.

SPEAKER_03

Thank you, Gustavo, for having me. It's a pleasure.

SPEAKER_02

How are you? Tell us a little bit about yourself before we dig into our conversation.

SPEAKER_03

Yes, well, I appreciate your introduction. And I would just say to your listeners that my life professionally as a Silicon Valley CEO and entrepreneur, and personally as a as a wife, as a friend, as a daughter, as a sister, was completely flipped upside down by a spine injury that we'll talk about on Mount Kilimajaro that led to 15 years of chronic pain, of opioid dependence termed addiction, of medical uncertainty, and really the collapse of everything that I thought I was. So I look forward to discussing this with you.

SPEAKER_02

Let's start easy. What is pain now?

SPEAKER_03

That's such an interesting question because I would imagine your listeners would agree that pain is deeply, deeply individual and deeply personal. And before I tell you what it means to me, I want to tell you what I what it doesn't mean to me.

SPEAKER_02

Okay.

SPEAKER_03

And this is from my own experience over the 15 years I struggled. And that is, it is not a number between one and 10 that doctors asked me repeatedly where zero is no pain at all. And 10 is I can't stand it. It also isn't something that two scientists came up with called the McGill questionnaire, so that people could give language to their pain and call it things like burning, pulsing, throbbing, aching, searing.

SPEAKER_02

Sharp, yes, dull. Yes.

SPEAKER_03

But to me, because of what I went through, and hopefully your listeners will come to understand this over the course of this show, pain for me is simply a signal that my body has sent to my brain that says something is wrong. Pay attention.

SPEAKER_02

Agreed. That is part of the message that I try to put forward here, which is pain is not the enemy, and pain is not necessarily bad. Of course, sometimes it is hard to handle, sometimes it is overwhelming. But pain is a tool. Pain is something that is letting us know that there is something somewhere that is not working as it's supposed to, or that we are just in danger. So tell us a little bit about your Kilimanjaro story. What were you doing there? What went down there?

SPEAKER_03

Yeah. For me, climbing Mount Kilimanjaro was really more than the ultimate endurance test. It was a chance to redeem myself after the failure of my Silicon Valley startup.

SPEAKER_02

After I was interesting that you use the word redeem.

SPEAKER_03

Yes.

SPEAKER_02

It is very interesting. Yes. Because I usually talk about how there's something redeeming in pain and in challenge. But please, please go on.

SPEAKER_03

Yes. Well, this was my second chance. And I went to the mountain because it was one of the seven summits. And as an avid high-altitude trekker and climber, I wanted to go to Africa and I wanted to go to the tallest mountain in Africa. So there I went to Kilimanjaro. And really truly, I had no business trying to climb that mountain. Not because I wasn't prepared, because I had trained for months to climb that mountain. But because I was already in pain before I started. I had never experienced lower back pain. But I sustained some kind of injury several weeks earlier training on machines in a gym on a stairmaster, which your listeners may remember from from long ago. Uh-huh. And I flared something up, but because I'm an athlete and a runner, I ignored it. And I sublimated the message and I decided I was going to climb the mountain. So up I started to go. And on day one, the pain was so strong that I had to relinquish my pack to one of the porters. On day two, things got so tricky for me that I was having some problems sitting. The feeling of my spine against any surface, even a soft chair, was getting quite difficult. By day three, when I wasn't hiking, I had to lie down. And you can imagine that by day four, the altitude was starting to have an effect too. And you hear all the things about altitude sickness, but what you don't realize is what happens to your decision-making processes. And they get muddled. And the combination of the pain and the altitude were so much for me, yet I still pushed on because pushing as a professional, as a CEO, and all through my life was all I knew. Just push harder, push through, ignore the pain. And by the time I got to 16,000 feet, where the oxygen is half of what it is at sea level, I realized that either I was going to get hurt the next day as we pushed toward the summit, or somebody on the team was going to get injured. And so my husband, Chris, who was with me and I made the decision that I would descend and he would summit. So that seemed completely safe. I figured I would go down, everything would be better at lower altitude. I would take a break. The next day I started to descend with two porters who spoke no English. And because we couldn't reverse our steps for five days, we were traversing across the mountain to meet everybody that was going to summit on the other side. And we were basically breaking trail where there was none, scrambling up rocks and sliding down boulders. And three hours later, I collapsed in the dirt. I couldn't feel my legs. I couldn't use them. I tried to communicate this to the porters who tried to understand me, but the only Swahili I knew was saying my name and asking them how they were. So they carried me to a plateau where we made camp for the night. A small tent for them, a small tent for me. So there I am at 16,000 feet. I'm 41 years old. I'm alone. I'm in this tiny orange and gray tent, completely isolated against the elements. I can't move my legs. They feel disconnected from my body. And when I try to shift to figure out what's happening, the pain is so fierce. It's like somebody drove a steel rod through my spine. And I really had two thoughts. One was, I'm probably dying. I thought I was bleeding out. I'm a doctor's daughter. So I started to diagnose myself. And the other thing I realized is that all my life, all I've ever done is push through and push the pain down. And suddenly that wasn't gonna work anymore. And something fundamental shifted in me. I realized pushing through works until it doesn't. And it doesn't just challenge your body, it challenges who you are. And as we'll talk, what I learned over the medical odyssey in 15 years that I struggled is that resilience for me wasn't about pushing harder. It was about finding a different way to listen to my body and finding a new way to live.

SPEAKER_02

Sometimes I think that we try to go through the forest when we have a pathway around it with no need to go through the forest because it's just not the time. It's the time to preserve our energy, preserve our health. And also I was thinking the other day that you know how much people talk about the only way out is through. And I I I agree with that. Sometimes the only way out of a situation is through, is through the battlefield, is through the forest. But I realized recently that you have to make sure that you are going through the right forest. I have never thought about that question because you say, okay, if I have to go through this, through pain, through sacrifice, I will do it. But wait, am I going through the right set of challenges or am I just pushing through? And that realization that resilience needs to be smart is one that we tend to not pay attention to. And I wanted to ask you regarding that. You wanted that challenge, okay? You were looking to redeem yourself. Would it be fair to ask you if that was more about your own ego, or was it more about finding peace?

SPEAKER_03

At that moment, it was all ego. I was guilty about the people in my company who no longer had employment. I had lost my own job. There was tremendous shame. And because I was an athlete, I was turning to something else that I was good at, figuring, aha, if this didn't work, I will succeed at something that I know how to do. And then for myself, for my peers out there in Silicon Valley, I will have a comeback. I'll rise like a phoenix and be redeemed and be able to get away.

SPEAKER_02

You had something to prove, but not just to yourself.

SPEAKER_03

That's correct.

unknown

Okay.

SPEAKER_03

That's correct.

SPEAKER_02

That is a nasty trap.

SPEAKER_03

It's a it is a horrible trap, and I recognize the the difficulty of even trying to do something like that now. But at the time it seemed all important.

SPEAKER_02

Yes, after we can detect our mistakes, we can talk now that in high sight, but at that moment everything seems just so clear. Things just make sense. And it could be our ego, it could be our desperation, could be the need to prove ourselves something that just blinds us. And we are blinded by that quote unquote need of pushing. Just push, you will be fine. Don't be a coward. It's so hard to find that balance between no pain, no gain, when it is about no pain, no gain, because you need to suffer, you need to commit, you need to sacrifice, you need to be consistent, you need to push. But sometimes it's no pain, yes, gain. Just because it doesn't make any sense to get hurt, whether it is physically or or emotionally. But uh okay, you're there, you're in worlds of pain. How did that climb in and that that for you? You got home, of course, but how did that change in your perception about yourself, about your own capabilities, about your strength affect you? What what happened then? Because the mountain was all only the beginning, right?

SPEAKER_03

The mountain was the very beginning. Even though I thought it would be the penultimate victory, it was just the beginning of something else. And I was piggybacked down the mountain because I couldn't walk. And Kilimanjaro at the time could only get helicopters up to 13,000 feet. So there was no evacuation possible and no time to get a gurney up. When I got down the mountain, and we'll talk about this separately, I'm sure doctors on three continents told me I was fine. And I knew in my heart of hearts and my body that something was very wrong. But the more important thing, I think, to the conversation we're having is what failure does to who you think you are. Because this was clearly another big failure. The first was my business, the second was not summiting the mountain. It failure has this crazy way of completely dismantling the stories that we tell about ourselves. I mean, I had this mental image of myself as a successful CEO. And I had this dark blue suit on and a short haircut, and I would walk through an airport with purpose, with my briefcase slung over my shoulder. And that was my identity, professional first, then everything else, which is very interesting how that changes with a crisis. But after my injury on Kilimanjaro, everything changed. So for 15 years, so incapacitated by pain that I still couldn't sit, there I was, lying in bed in a hoodie and hospital pants, and my hair's flat against my head, and the pillows are soiled with my sweat. So, what that says to me is when your identity's built on roles, the problem starts when one of those roles disappears. And it's not just losing a role, it's like you don't know who you are anymore. It wasn't just a job what I did, it was how I understood myself. And when that collapses, you're completely on unstable ground. But what I finally realized is that in the midst of the mess, it's an opening. Because if you can rebuild from that place, it's less about how we present ourselves to the world and more about who we really are truly as humans.

SPEAKER_02

Would it be fair to say that you were the CEO and everything else around you, everything else in your life was just an accessory for you? Your personal life?

SPEAKER_03

I would say that my priorities were backwards, but I understand that now. I didn't understand it then. But I put that professional role above the others. It just was a notch ahead. It was everything wrapped up in who I was.

SPEAKER_02

During this time, during these 15 years of pain, were you still being told that everything was okay? Or had you already found someone, some doctor that had identified the issue?

SPEAKER_03

It was interesting. For the first nine months, I had doctors in Africa, in Nairobi, Kenya, in the UK, and then in my hometown in the US, in San Francisco, California, take scans, do MRIs and x-rays, and say to me, You're fine. And I still remember how I felt when in the US, in my hometown, my family doctor coming in with the latest films, and there I am lying in a hospital bed, and I feel like my legs are useless. It feels like I'm falling off of a cliff or drowning. And he says to me, It's good news, you're fine. And I just felt like my suffering was being discounted, or maybe it wasn't being believed. And so if you're told like over and over that nothing is wrong, it creates this split where you start to question yourself.

SPEAKER_02

But what was the explanation for your pain? Were they telling you that it was just emotional?

SPEAKER_03

Yeah, or that it was in your head. But interestingly enough, after that long period when the pain got so bad that I was traveling to doctor's appointments by ambulance, they realized that I had a condition called spondylolysthesis, where two vertebrae are misaligned, and those two vertebrae had fractured, and the disc in between had smashed, probably on the mountain, and even possibly in continuing to try to push when I got home and kept getting. Getting told nothing was wrong, I would do physical therapy and I would try to walk and I would continue on and try to desperately get my life back. But what I needed was a fusion, and I needed surgery to bolt those vertebrae back together so that the bone could regrow around them. So that's what ultimately happened that structurally fixed what was wrong with me, why I was in so much pain. But the frightening thing is by the time they operated, the pain was so chronic. I mean, it had been more than six months, that the signals that my brain was receiving were so violent that I was dependent on opioids before I even was operated on.

SPEAKER_02

But the thing is, uh I'm just have so many questions, but to understand your situation more. You had had MRIs. Was that condition, that fracture, not visible? Who missed something there?

SPEAKER_03

Yes, that's such a great question, Gustavo, because in the films they could see the misalignment of the vertebrae, but that's a condition that I probably had since I was born, the spondylolysis. And in 80% of people, it's completely asymptomatic and it almost never requires surgery at the level that mine was displaced. But the fractures were not visible on the earlier scans. It was only with further more detailed testing and a discography that I was able to be diagnosed by the physicians in San Francisco.

SPEAKER_02

Okay. So you've been in pain for six months and you are already dependent on opioids. What does that look like?

SPEAKER_03

And the scariest thing to look back on it is that I took my first opioid in Tanzania. Tanzania when I got off the mountain. A mountain climber who had been filming an IMAX movie on Kilimanjaro gave my husband a couple of Vicodins so that I could make it onto an airplane to get to the hospital in Nairobi from the bush. And that was the beginning of being given those strong narcotics. And by the time the months and months and months passed, your body adapts really quickly. I mean, the scary thing is your tolerance will build. It takes more drugs to feel the same level of pain relief. And they work great at first. They calm the nervous system, they create relief. But once you're dependent, at some level, you stop taking them to feel better. You take them so you don't feel worse. And that was really what happened to me. No matter what I took, the pain was always ever present as a consistent through line in my life. But I knew that this was the only thing that was keeping me from thinking my life was over and possibly hurting myself, was the ability to take the edge off of that. If I fast forward even five years, I was so dependent and addicted on those opioids. At that point, it had moved from Vicadin to oxycontin to fentanyl. And today, fentanyl, of course, I'm I know all your listeners know it's a drug that helps so many, but it's also a drug that is dangerously mixed with many substances that are clear killers out in the dark market. But at the time, it was something that I desperately needed just to survive. I went in a last-ditch effort to the Mayo Clinic in Rochester to a pain rehabilitation program, which is like a drug detox program where they basically rip off all the drugs in the first week. And this was many years ago. So granted, and respectfully, they may not do things the same way right now, but they titrated me off all of the fentanyl, all of the anti-anxiety, antidepressants, anti-muscle spasms, all the drugs I was on. Then they helped to force the function back. So getting me to walk further, getting me to start to move my arms and legs in daily activities like gardening and sweeping and cleaning. And then they tried to encourage me to lift weights. So they were trying to force my body back in a three-week period when what was really needed was very, very slow pacing both of my body into physical function and in titrating off the drugs. It was like ripping a band-aid off a raw wound. I mean, I was nauseous. I couldn't eat. I lost 15 pounds in three weeks. My skin was crawling from the withdrawal of the drugs, and I couldn't sleep. And emotionally, I was just completely a basket case. It was like every sound was like a shriek, and every worry was magnified. It's really, it's it was really terrifying for me.

SPEAKER_02

How or when did you have that aha moment when you realized that you were in trouble, that you were a slave to the opioids? Maybe slave is not the right word, but when do you say, oh, something's wrong here? I'm in trouble.

SPEAKER_03

I have lost control of my I think it's so funny because it didn't come as much in that rehab instance as it did sitting with my best friend one day in my home before I went to this rehab clinic. And I knew I needed a new fentanyl patch. It felt like it was time. And I was lying down as usual. She was sitting next to the bed in a chair. And all I could think about during our conversation was, I need a new patch. How am I gonna get a new patch? How am I gonna wait until she leaves? Maybe she'll help me. What am I gonna do? And I was so distracted. I finally said to her, you know, Kathleen, will you do something for me? And she said, you know, anything. What what do you need? And I said, it's time for my medication. In the it's in the bathroom. Will you go up in my drawer and get it for me? And she was something in her hesitated, even though she would have done anything, walk through fire for me. But she said, maybe I should get Chris. I think I just heard his car enter the driveway. And that made me panic because I realized that he would know that I was trying to, I was basically trying to get drugs earlier than I needed them. And I said, No, don't get my husband. No, no, no, it's okay. And I looked at her and she had tears running down her face. And in that moment I realized that I had a problem.

SPEAKER_02

So you have provided us with some details about what Goodrawal felt like. And you have shared this experience with your best friend. And I cannot imagine how revealing and how hard that must have felt because I am assuming you something inside of you was saying she can see it and and I cannot. Where where where have I been? Something like that, if that makes sense. So from that moment on, what does acceptance look like for someone that has opioid dependence because they are living in pain with chronic pain. What does that moment of reckoning look like?

SPEAKER_03

Yeah. You know, as a woman in pain, and it when women are in pain, sometimes I think we believe that we have two choices. We can fight that pain, which is what I always used to do, just fight it. It was the enemy at first, or surrender, give up. But I think there's a third choice, which is acceptance. And when the pain had forced me to live lying down, and we've been talking about this, I started working with a psychotherapist. And for years, she kept floating this idea that she called the new normal. And that was my horizontal, monochromatic, pain and opioid-filled life. And it wasn't that life I used to live, striding through the airport and being with my friends and my husband and traveling. And so I just said to her, I hate the new normal. And she looked at me and she said, you know, it doesn't mean giving up. It means just giving in so you stop fighting yourself. So for me, acceptance, it wasn't about liking what was happening because I didn't like it. I was ashamed of it. I hated it. But it was not fighting reality. And it meant that I could have a bad day and it wouldn't be a failure, I wouldn't be a failure. It meant being in my body as it was with its pain, with its disability, with its limitations. And then I realized I couldn't outrun it because you can't outrun it. You can't override it. But accepting that was the beginning of what started to create change because I stopped fighting myself, and it gave me more energy to adapt and to try to rebuild a life which I felt like I didn't have around the things that I could do.

SPEAKER_02

So I am assuming it was a long path to recovery, and that is a hard thing to accept too. You were pushing, you had things to prove to yourself. You were a perfectionist. Of the worst sort. I could ask you right now what is dangerous about being a high achiever or a pusher, but we have been talking exactly about that for the last uh 30 minutes. But besides in this case, your physical suffering, uh, the physical th suffering was a consequence of your pushing, of your wanting to prove something to yourself. What are the dangers of living in that mental state of just feeling like you have to push, that you have something to achieve all the time, that when you get somewhere you need to go to the next thing? What is so wrong about being a perfectionist? Because someone could tell you, well, but you are looking for excellence. I don't believe that perfectionism and excellence are the same thing. But regardless of that, what other dangers does perfectionism bring to someone's life?

SPEAKER_03

Yeah. If I have learned anything through this whole world coaster of ambition and collapse and pain, it's that perfection for me is a trap. And because I'm a high achiever, perfection, perfectionism looked like endless striving for goals that were unattainable. My company, Mount Kilimanjaro, getting back to the person that I had been. And I thought I just needed to be smarter, I needed to be faster, I needed to be funnier, I needed to be more successful, I needed to be younger. It just always more. And I think that for all of us who are perfectionists, I mean, it's why teenage girls start themselves to look like, you know, an emaciated Barbie doll, or why an ambitious entrepreneur will go from startup to startup, trying to reach for that brass ring. So I don't think perfection's attainable. I think, yeah, I think it's pretty destructive as well. So it's rigid. You're rigid. You have to be 100% all the time. And if something breaks, everything falls apart. I also think that it links your identity to the way that you perform. So if you can't perform, you are a failure. And, you know, what I learned about resilience is that it's not about getting it right. It's definitely not about being perfect. It's about staying intact when things go off the rails.

SPEAKER_02

I believe that we have words we have good words with bad press. And we have bad words with good press. One word that I feel is a good word that has bad press is failure. Because failure is unavoidable and to me, cheesy as it might sound. If you want to get higher, you are going to need a set of stairs. Those steps are made out of failure. They they are your steps. It's almost like you are insulting someone when you ask Did you fail? Or how are you ha handling failure? We cannot use that word. Do you feel the same way? Do you do you feel that like failure is a good word with bad press?

SPEAKER_03

I think that failure, honestly, is one of the better things that can happen to us as humans. I think it's how we shift, I think it's how we adapt. I think we can stay flexible if we learn how to grow after something unexpected that life hands us. I didn't realize that at the time, but I can see it very clearly now.

SPEAKER_02

Going back to the moment where you realized you were in trouble, that something was wrong, and that you needed to do things differently. You needed to start pacing yourself. How hard was that? Oh my gosh.

SPEAKER_03

For me, pacing, yeah, no, pacing is like the its own kind of discipline. For me, it was so difficult. You have to stop before your body forces you to. And because I built my whole life on pushing, I completely misunderstood what pacing was. And I thought it meant the minute the pain would go from here to here, that meant go. So I would get up and push the minute the pain subsided. And as a result, I had these horrible pain episodes, setbacks. I'm sure your listeners all experienced these. But they were so horrific because they were completely unpredictable. I could never tell when one was going to happen. Sometimes I thought I walked too far, I thought I sat too long, and I would crash, and the pain would be so severe, I'd be in bed for weeks before I could get up. And then I would be stuck at a lower level of function and ability. And sometimes it was something as simple as a little exercise, a glute squeeze, and I would be, I would be done. So you have to learn to stop before you hit the wall, not after. And for somebody like me, it really feels like you're restraining yourself. It doesn't feel like progress. But if I can tell you the ending of the story, it's the only thing that made progress possible for me. And it's how I avoided this never-ending cycle of pushing and crashing and starting over again. And it only worked if you can really tune into your body. So if I may just tell you that the ending of the story, when I figured this out, I was 10 years into my pain journey. And I desperately wanted to figure out who I was and what I was. And I decided that I really wanted to go back to school to change my life and get a graduate degree so that I could do work in international development. Because my company had been dedicated to young girls and technology. And what I really cared about was women and girls. That was really my mission to give them a chance at a better life. But I couldn't go to school because I couldn't sit and I couldn't last through a single class. But what I realized is my brain was okay. It was my body that wasn't functioning. So I went to graduate school, lying down on a portable army cot that I could cart into school, unfold in about a minute, blow up an air mattress. And if you've ever been in a small class or a seminar, there I was in the middle of that room, lying down, not willing to be identified as a disabled person, wanting to be there as a person who had all the capability in the world. I just happened to do it lying down. And that started to shift everything for me.

SPEAKER_02

That is also pushing.

SPEAKER_03

In a different way. Yeah, it was pushing emotionally. It was scary. Looking back, it took a lot of courage. At the time, I just felt like it was the only thing I could do. But I but I wasn't pushing through pain. I was pushing through fear.

SPEAKER_02

Adversity. Yes. Yeah. Yes. Discomfort.

SPEAKER_03

But the interesting thing that happened is my horribly deconditioned body that had laid in bed for 10 years, slowly through the process of just getting to class and setting up that cot and putting it back in the car and getting driven home, I started to get stronger. And I graduated from physical therapy where I was learning to walk again or learning to raise my leg above the bed. I started to work with a trainer who took me from where I was, which was pretty much ground zero, you know, barely able to function. And over the course of five years helped build my strength back. I went back to work. The only way I could do this, because I was traveling, I was working for a women's refugee organization in New York. And the only way I could travel was lying across three seats on an airplane because I couldn't sit up beyond the couple minutes it took to taxi. And so I realized that there are so many ways to be in the world. I would definitely say this to all your listeners out there who might be waiting until they're better to re-enter society. And I started before I was ready. And what I realized is that we're all individual, we're all human, and there are many ways to be. And this was one that wasn't very familiar to society, but it was one that started to work for me until I got strong enough that I didn't need that cot anymore. And I didn't need those three airplane seats.

SPEAKER_02

And in pushing, in a smart way, you got stronger. I mean I did. Now we can say, of course, but at that time, it wasn't that obvious.

SPEAKER_03

I know this is so not true for so many people, but I am mostly pain-free. Once I regained physical function as I strengthened, the pain receded enough that I can manage it. And then the one doctor who diagnosed me, who stuck by me, who was willing to prescribe for me, even though it was really troublesome, he wanted me to get back to physical strength before we took the drugs away. Because I relapsed after the mayo clinic. I didn't succeed. There's 60% of people relapse when they're addicted to opioids. But we finally, finally agreed, and I was terrified because of my experiences before that it was time to get off of the drugs. But we did it just like pacing, we did it really slowly. We titrated millimeter by millimeter every month. We'd peel back the opioid, peel back the fentanyl, and I would go through two weeks of not being able to sleep, of being nauseous, of being anxious. But my body and my brain would regulate. So one thing I would tell people who are struggling is that the body and the brain have amazing ability to recalibrate in time. And then we would start again. And so I'm just really proud to be fentanyl-free, but it was something that I thought I might never achieve. And a lot of people don't. And the interesting thing, Gustavo, is that I saw this doctor when I was writing my book. And we had a long talk about my case because he was with me for all 15 years. And I think that my recovery was surprising to him. And he thought that I was probably one of these patients who would end up finding a way to live with the pain and need to be medicated. That is acceptance. I think I surprised myself.

SPEAKER_02

It's not giving up, it's giving in. This is the new reality, and uh eventually that that's the thing, you know. It takes time. So I could say, well, Nancy, but it's been 13 years. Do you really still believe that you're going to be pain free? It's it's been 14 years. Do you really I mean uh get get real? Get real. And that line between acceptance and defeat is it's a line that no one can draw for you. And you will it sounds simplistic, but you will need to find where that line is. Um after all these 15 years of pain, of acceptance, of defeat and of triumph. As any human being, you face challenges today, you have your better and worse days. How does all this help you, all this achieved collected experience when you have to deal with pain challenges because you're having a worse day pain-wise or emotional challenges? What specific actions or what mindset shift do you use today coming from all those 15 years of fight that help you overcome difficulties?

SPEAKER_03

I think first and foremost, I'm now finally tuned into my body. I know it's gonna tell the truth. Yeah, I know it's gonna tell me the truth. No matter how inconvenient that might be for or how inconvenient it was for the medical system when there was so much uncertainty around why I was still in pain, but it prevailed and it told me what was true. So I listened to my body first and foremost. The second thing I do is I realistically focus on the things I know I will be able to do comfortably and successfully, whether it's taking a walk in nature, whether it's sitting on a bench, whether it's, you know, riding a Peloton on a really good day. But I only do the things that I can do. Because pushing myself into that bad territory, uh it's pointless. I've proven to myself that doing the things that you know are going to cause you problems don't make any sense. You can't push your way through them. You have to navigate them. And the other thing that I do is I realize something I call the third way. I mean, there are a lot of ways to solve a problem and peel the onion back. I feel like I learned by my determination to go to graduate school that there's another way. You know, the interesting thing about that is that I deferred my acceptance the first year, waiting to be normal, waiting to sit like everybody else in the seminar room around the square. But it wasn't going to happen. I had to find a different way. So I would just say to everybody out there that there are different ways if you just open your mind to a possibility of being a different way. It might feel vulnerable, it might feel scary, but there are different ways to live a life, to get things done, to navigate a difficult day. And that it's okay to have a crappy day and to say, you know, I'm just gonna binge watch a TV show today when I get home from work, or I can't work today. I'm gonna do it from home. So find a find a third way.

SPEAKER_02

That brings me to my next question. Do you believe that there is a difference between pain and suffering?

SPEAKER_03

I do. I do. I think for me, as I told you when we talked at the beginning, pain's a signal. It's a physical signal from your body to your brain, and suffering is really how we're gonna choose to react to it emotionally, mentally, how we're gonna respond to it. When I look back on those post Kilimanjaro years, the pain was always worse when I got really anxious about it. When I was suffering the most, when I was scared of it, when all I did was worry about not what it felt like now, but how bad it was gonna be tomorrow. Because if it's this bad today, it's gonna get worse. So I think we all have a choice at some level. You know, I I I want to be respectful, and Lord knows I'm empathic to everybody that's out there because I lived it walking shoulder to shoulder with everybody who's in pain. But I think that there is some kind of choice that we can make that's not overcoming it or sublimating it, but just living with it, but not letting it panic us or or consume us.

SPEAKER_02

What is your pain factor, Nancy? And at the very beginning of this conversation, you mentioned how doctors ask you, hey, zero to ten, one to ten. And so that is not where I'm going with that, but up to this day, what kind of a struggle, challenge, what kind of situation just makes you feel vulnerable makes you feel pain, whether it's emotional, mental, or physical. What is your breakpoint?

SPEAKER_01

Yeah.

SPEAKER_02

If I can use that word.

SPEAKER_03

You know, there's still a couple things that I struggle with despite this entire journey, and I would say the first first and foremost, it's just realizing when I'm just starting to push again, pushing too hard. Even as I went through the process of trying to write a memoir, I found myself all of a sudden, seven days a week, you know, 24-7 in there writing on my computer, thinking, playing old music, talking to people that were part of my life then, talking to doctors. And that kind of pushed through, pushed harder, that hurry sickness, it's hard to break. And so if I'm being really true to myself, I would say that at some level I know it's still there. It's like that ugly devil that rises up in us every now and then that I have to say, stop. This almost ruined you. It almost took your life. Don't let it take over again. And the second thing that I struggle with, of course, is the unattainable perfect. So even though I consider myself a reform perfectionist, I would say that that as I got well again in this last couple of years, that that's a hard thing not to have resurrect itself. So those are the two things that I still know I need to work on today.

SPEAKER_02

But in a way, they are your essence. It's it's a big part of who you are and what you are. I am having big difficulties with knowing well not to push. And I think I have been able, and I might be wrong, to keep my ego on check. But at the end of the day, many times I don't know. And I have many things in my life going on and I am aware that I have to push. I think I I was successful in realizing what was the forest I had to go through. I think I am doing things correctly in that way, but managing my personal pain, my physical pain is extremely hard to say, well, today you're just going to push. And some days, you know what, you are just a millisecond away from being in absolute pain for the next two weeks because of my lower back. And it's just so hard because I am I am still that pusher, like you are. And that devil that we have inside that keep telling us, hey, move, push, you got this. I think it is okay to have one as long as you keep it on check. That's the uh the hard part because it is probably most of what you have achieved, even going to college, in the physical state that you were at that moment, was pushing. And was that Davil telling you, no, no, no, no, we are going, we are going. But it took you years to realize the difference between pushing and being dumb, if you allow me, because that would happen to me. Sometimes I say, that was so dumb. Why that extra rep? Why? Why those extra five pounds? What was the need? Because now we are going to be uh out of order for two weeks for ten days. So I feel a hundred percent identified with what you're saying. And before we wrap up our conversation, um, I'd like to give you some time to add anything that you would like to. Maybe there has been something that I have not asked and you'd like to share some piece of information, some experience or anecdote, anything that you you'd like to say that we have not discussed today.

SPEAKER_03

Well, first of all, thank you. It means a lot to me that you would want to share this story with your listeners. And I feel like we've covered so much, and it's been really a chance for me to be very honest and tell what really happened. I know we talked about being resilient, and I used to think resilience was about bouncing back stronger than ever.

SPEAKER_01

Mm-hmm.

SPEAKER_03

But it's been really redefined for me. It's so much more than that. It's stopping the fight with reality and learning how to live within it. That's kind of what it means to me now. And I hold tight to that definition.

SPEAKER_02

Could we say that resilience is in a way self-control? Sometimes you just have to be tough to not.

SPEAKER_00

Yes.

SPEAKER_03

I mean, resilience is for me now way more than pushing through, pushing harder. So I have learned how to accept what is and live within it. And you know, the only thing I'd say to your listeners, if this resonated with them and you want to hear more, participate more, I'm launching a substack called Life Inside Pain. And it's about resilience beyond pushing through. And it's for anybody that has pain or loss or a big disruption in life that's looking for a better way. Join me if you're interested in this story.

SPEAKER_02

How else can we follow you? When is your memoir coming out?

SPEAKER_03

That's in discussion. I hope I'm hoping that it will be soon.

SPEAKER_02

Okay.

SPEAKER_03

But if I will be reporting on that on Substack when it happens, but I thank you for your willingness to share a bit about it and to at least hear the story, even though the book isn't out yet.

SPEAKER_02

Please let us know because we don't cut ties with our guests. If there is any update, just please share because we want to and we need you to provide people with more information. And even though I'm not a fan of using the word tools and more to share information and personal experiences, some tools are great and are needed. So let us know the moment you have any updates regarding your memoir or any other channels that you open for our listeners and viewers to follow you.

SPEAKER_03

Thank you, Anna.

SPEAKER_02

It's been great having you. It's been great.

SPEAKER_03

Thank you, what a pleasure.

SPEAKER_02

One of my dreams is to know Africa. I don't know if I'm going to climb or if I would like to climb the Kilimanjaro. I'm a runner, not a climber. Uh but uh I'm really, in a way, it makes me feel closer learning about that experience. I don't believe in motivation. Motivation for me doesn't work. I do believe in inspiration. And you are a very inspiring person. That inspiration has taken you 15 years to build. And of course, it is not a path that you finish, it's not a journey that finishes. But I want to thank you for that inspiration. That is something that you cannot buy. I just feel better because I've talked to you. And I realize that one of the things I have to keep pushing harder on is to learn when to push and when to not push. And that is something extremely hard, but I know I have my work out for me, and I will keep doing it. And you will be someone, and your story will be one that will keep providing me with inspirations. This talk has been all I expected it to be anymore, so I hope you feel the same way. And we will keep working, trying to deliver a message of knowledge to people. And who knows, maybe we will have you here with us back to talk about your memoir or your next projects.

SPEAKER_03

That would be such a pleasure, and I think the beautiful thing is that you've you have a community. And that is what we're better out there gain support and learn from each other and learn from you and from your guests. So I really appreciate that. Thank you. It's been a pleasure.

SPEAKER_02

Our pleasure too, Nancy. And for everybody out there listening, we will see you next time when we continue to explore the Pain Factor. Ciao ciao. The Pain Factory is a Project Fortress podcast. Project Fortress is a secular humanist project dedicated to find answers to the physical, mental, and emotional pain people experience, as well as offer help to deal with these issues. To learn more about Project Fortress, please visit Fortress.org. That is F-O-U-R-T-R-E-S-S.org. I'm Gustavo Varela. I'm not a licensed medical professional, nor am I a nutritionist or hold a degree in exercise or sports medicine. All of the advice given on this podcast is what I have learned from my own experiences and mistakes, navigating through depression, anxiety, and chronic physical pain. Project Fortress is not responsible for any actions that may occur as a result of your listening to and implementing the advice we provide. Use all of the information that we give at your own risk.