Prioritize and Execute: Managing Overwhelm in Chronic Pain

In this episode of 'It's Not In Your Head' podcast, Dan and Justine discuss strategies to manage feelings of overwhelm often experienced by chronic pain patients. Using their structured pyramid of owning your care, they explain how to prioritize, execute and delegate tasks so you can take control of both medical decisions and daily aspects of managing pain to more effectively deal with complexity and decrease helplessness. Key topics include working through self assessment and monitoring, basic lifestyle habits, mind/body pieces, mainstream diagnostics and treatment, alternative options, and precision medicine. By recognizing their own needs and working closely with their medical teams, patients can improve self-efficacy and overall treatment outcomes. Tune in for practical advice, personal anecdotes, and actionable steps to better manage your chronic pain journey.

Timestamps

00:00 Introduction to the Podcast

00:17 Emergency Podcast: Addressing Overwhelm

01:10 Understanding Overwhelm in Patients

03:43 Strategies to Manage Overwhelm

11:24 Personal Stories and Experiences

16:31 Framework for Pain Management

26:40 Recognizing and Managing Catastrophizing

29:15 Self-Assessment and Monitoring Tools

35:25 Mainstream Diagnostics and Treatments

38:05 Exploring Alternative Options

46:22 Precision Medicine and Personalized Care

48:41 Ownership and Self-Efficacy in Pain Management

50:21 Conclusion and Final Thoughts

Resources

www.iniyh.com/episodes/ep-31-dealing-with-being-overwhelmed

In this episode of 'It's Not In Your Head', Dan and Justine delve into the complex relationship between hypermobile Ehlers-Danlos Syndrome (hEDS) and central sensitization, focusing on hEDS as an example of a metabolic driver. Dan shares personal insights from his practice and elaborates on the common patterns and markers identified in patients with hEDS, how it should be diagnosed and treated, and associated challenges. Justine adds her perspective, particularly on the connection between CRPS and hypermobility, and lifestyle interventions. They explore the underlying mechanisms, preventive strategies and management techniques, emphasizing the importance of protein intake, avoiding certain drugs, and considering genetic predispositions. With expert advice and a touch of humor, this episode provides a comprehensive look at managing the very complicated disorder that is hEDS.

00:00 Introduction to the Podcast

01:00 Diving into Central Sensitization and hEDS

02:25 Understanding EDS Types

03:39 Dan's Journey with Hypermobile EDS Patients

04:50 Identifying Patterns in Complex Patients

05:25 Exploring the Underlying Disease Process

08:39 Mechanisms Behind Hypermobile EDS

09:52 The Role of Protein Metabolism in EDS

11:13 MMPs and Their Impact

18:42 Inflammatory Responses and Immune System Involvement

26:22 Genetic Predispositions and External Triggers

31:13 Understanding Protein Requirements

32:38 Strategies for Increasing Protein Intake

36:20 Choosing the Right Protein Sources

40:47 Long COVID and Hypermobility

46:17 Preventing Disease Progression

54:42 Final Thoughts and Future Directions

Resources:

www.iniyh.com/episodes/ep-30-making-sense-of-heds

Understanding CRPS, Central Sensitization & Neuromodulation | Q&A with Dan and Justine

In this episode of 'It's Not In Your Head,' Dan and Justine answer your questions around various aspects of complex chronic pain management, focusing on Complex Regional Pain Syndrome (CRPS) and central sensitization. They delve into the Budapest criteria for diagnosing CRPS, the overlap with central sensitization, and treatments like spinal cord stimulators (SCS) and their pros and cons. Dan shares insights into managing pocket pain, complications associated with SCS, and innovative treatments like Prolotherapy. They also touch on the role of the sympathetic nervous system in CRPS and potential treatment avenues. It's a comprehensive episode packed with practical advice and cutting-edge information for both patients and providers dealing with complex pain pathologies.

Timestamps

00:00 Introduction to the Podcast

00:18 Technical Difficulties and Banter

00:44 Diving into Q&A

01:09 Understanding CRPS and Central Sensitization

09:11 Neuromodulation for CRPS

10:50 Personal Experiences with Neuromodulation

16:30 Risks and Considerations of Neuromodulation

32:47 Device Malfunction and Lead Migration

34:28 Complications with DRG Leads

39:27 Pocket Pain and Treatment Options

43:20 Exploring Prolotherapy for Pain Management

54:08 Sympathetic Nervous System and CRPS

59:12 Concluding Thoughts and Future Topics

Resources:

www.iniyh.com/episodes/ep-29-ask-us-anything-aua-2

www.drdanbates.com.au

www.resilientwarriorcoachingllc.com

Understanding Central Sensitization and Chronic Pain Drivers | It's Not In Your Head Podcast

In this episode of 'It's Not In Your Head' podcast, Dr. Dan Bates and Justine dive deep into the intricacies of neuroinflammation in chronic pain, focusing on understanding the drivers behind it. They discuss the philosophical challenges in current pain management approaches and how this limits effective communication and treatment. By breaking down central sensitization into seven key areas, they explore how lifestyle changes and metabolic factors like prediabetes can drive this output. This discussion aims to shift the perspective from merely treating the consequences of pain to identifying and addressing more specific underlying causes, offering patients more individualization and agency in managing their pain.

Timestamps
00:00 Introduction to the Podcast
00:35 Central Sensitization and Neuroinflammation
02:56 Linking Lifestyle Changes to Chronic Pain
04:13 Metabolic Drivers of Pain
05:47 Understanding Central Sensitization Symptoms
07:52 Neuroinflammation and Its Impact
11:46 Persistent Injury and Pain Amplification
15:06 Exploring Common Conditions Associated with Central Sensitization
18:32 The Role of Prediabetes in Chronic Pain
21:14 Understanding Insulin and Weight Gain
21:26 The Role of Insulin in Neuropathic Pain
22:25 Investigating Insulin Levels
24:41 Metabolic Drivers and Pain Amplifiers
27:38 Linking Hyperinsulinemia to Chronic Pain
29:38 Lifestyle Changes and Chronic Pain Management
32:00 Neuroinflammation and Treatment Options
36:18 Conclusion and Future Topics

Resources

iniyh.com/episodes/ep-28-if-its-not-in-your-head-where-is-it-coming-from

Strategic Empathy: Handling Chronic Pain and Invisible Illnesses

In the inaugural Q&A episode of 'It's Not In Your Head,' Dan and Juz discuss strategies for managing chronic pain, addressing both patient and provider perspectives. They tackle how to respond to common misconceptions about chronic pain, offer quick ways to explain one's condition without going into detail, and share methods for recognizing personal capacity and setting boundaries. Additionally, they delve into how doctors can better support chronic pain patients through strategic empathy and acknowledging the limits of medical knowledge. Tune in for practical advice and empathetic approaches to living with and understanding chronic pain.

00:00 Introduction to the Podcast

00:29 Addressing Common Misconceptions About Chronic Pain

03:58 Quick Ways to Communicate Your Condition

07:31 Creating Boundaries and Recognizing Capacity

11:06 Returning to Activities You Love

16:40 How Doctors Can Better Support Chronic Pain Patients

24:48 Conclusion and How to Submit Questions

Resources:

www.iniyh.com/episodes/ask-us-anything-aua-1

www.resilientwarriorcoachingllc.com/basecamp

In this episode of 'It's Not In Your Head' podcast, Dan and Juz explore the myriad of challenges and strategies around traveling with chronic pain. They discuss pre-travel preparation, in-flight strategies, travel management, and post-travel recovery. Justine shares personal anecdotes about her recent trip to Costa Rica, highlighting practical tips and emotional aspects of managing pain while traveling. They also delve into medication management, communicating needs, and creating a tailored 'holiday program' with your Doctor to ensure a smoother travel experience. The episode aims to empower those with chronic pain to reclaim activities they love, like traveling, by sharing actionable insights and boosting confidence in managing their condition during extraordinary times.

Tmestamps:

00:00 Introduction and Welcome

00:30 A Lighthearted Start

01:53 Travel and Pain: An Overview

02:29 Building Travel Confidence

04:02 Pre-Travel Strategies

08:12 Medication Management

13:15 The Holiday Program

18:06 Flare Management During Travel

23:41 Travel Tips for Managing Disabilities

24:00 Using Wheelchair Services and Handling Reactions

25:06 Personal Travel Experiences and Benefits

27:06 Managing Symptoms During Flights

39:29 Post-Travel Recovery Strategies

41:40 Final Thoughts on Traveling with Pain

Resources:

www.iniyh.com/episodes/ep-26-travel-with-chronic-pain

INCB - Country Regulations for Travellers

incb.org/incb/en/travellers/country-regulations.html

Managing Complex Chronic Pain: Patient and Provider Strategies

In this episode of 'It's Not In Your Head' podcast, Dan and Juz delve into effective strategies for managing complex chronic pain for both patients and providers. The conversation is sparked by Dan's experience at a recent patient-focused conference, where problematic suggestions about managing doctor-patient conflicts arose. This episode aims to provide more constructive tips for patients to own their care, improve communication and information sharing with their doctors, and better navigate the healthcare system with complex diagnosis. They also explore the importance of a structured approach in consultations, the relevance of pre-screening forms, and the role of empathy and humility from the provider side. The goal is to bridge the gap between patients and providers, enhancing mutual understanding leading to more effective outcomes. Tune in for a thoughtful discussion that promises to ease the anxiety around talking with your Doctor, and managing complex patients if you're a provider.

00:00 Introduction to the Podcast

00:28 Dan's Conference Experience and Mental Health

00:50 Challenges in Doctor-Patient Relationships

04:02 Strategies for Complex Patients

04:57 Steps to Own Your Care

05:46 Prioritizing and Matching Problems to Doctors

14:10 Effective Communication with Doctors

14:58 Understanding Doctor's Perspective

16:12 Facilitating Doctor's Hypothesis Generation

28:14 Empathy and Communication Techniques

31:34 Pre-Screening and Diagnostic Tools

32:00 Understanding Central Sensitization Inventory

33:28 The Importance of DAS 21

34:15 Addressing Childhood Trauma in Medical History

35:52 The Role of Trust in Doctor-Patient Relationships

37:36 Barriers to Treatment Adherence

41:48 Recognizing Literacy and Communication Challenges

46:02 Managing Patient Fears and Concerns

51:12 The Value of Admitting Uncertainty

56:33 Bridging the Gap Between Doctors and Patients

Website: https://www.iniyh.com/

In this episode of 'It's Not In Your Head' podcast, hosts Dr. Dan Bates and Justine Feitelson discuss nociceptive pain, also known as body part pain. The episode delves into their Nociceptive Pain Algorithm, breaking down the different types of somatic pain, including mechanical, inflammatory, myofascial, bony, and vascular pain. It includes discussions on different pain management strategies from first-line to specialist referrals, the interplay of different pain types and overlapping issues when it comes to instability, and emphasizes the importance of proper diagnosis and treatment so you can make effective decisions as a clinician even while you are still working through a patients full presentation.

Resources:

www.iniyh.com

Timestamps:

00:00 Official Intro

00:18 Intro to Nociceptive Pain, ie, Body Part Pain

05:16 Body Part Pain Algorithm

11:34 Mechanical Pain

15:20 Inflammatory Pain

17:15 Myofascial Pain

18:43 Bony Pain

19:51 Vascular Pain

22:39 What do I need to do Next?

24:11 First Line Management

28:59 Ligament Insufficiency

33:55 What's Your Next Line?

37:53 Reviewing & Assessing Responses

41:15 Disclaimer