We Can Stop Pain, So Why Don't We? | With Dr. Amy Baxter and Dr. Marty Makary
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- čas přidán 14. 01. 2020
- Dr. Marty Makary and I interview Dr. Amy Baxter about ways we can better alleviate pain (like needle pain) and the prevent the fear and trauma that results.
We actually go deep in this interview on multiple topics related to pain, childhood trauma, the opioid epidemic, medical device challenges, the JPM Health Conference, venture capital, speaking up in healthcare, and much more.
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I WANT ONE! I developed Guillain Barre following flu vaccine in 2012 - long story but took 3 years to use a fork and knife again - and have flaming neuropathy on my entire body and no longer am allowed to take methadone (which worked but now patients have been demonized). But I am in pain, all the time and the only thing that makes me go on is that, each day, I know that I am one day closer to the end of my life. Pain is the center of my existence. I would love to try this! COLD THERAPY is the best thing ever. I hold my arms in ice water, hang my hands out the window in a car (winter) and hold my fingers in AC vents in cars (summer). What a concept - PRE-Therapy, a plan for pain.
Hi Donna. GBS survivalist here, also.
Suffered a nightmare. Never took pain meds. Live with 'learned' pain. All the best to you!
Regarding controlling your heart rate variability with diaphragmatic breathing - this is the first step in the HeartMath program called "Heart-Focused Breathing". Bring in an emotion that bring you joy and you've got "Quick Coherence". (I am a HeartMath Certified Trainer ). We are teaching this in my health system to nurses and physicians to help with stress management, communication and anxiety. How cool would it be to teach this to our pre-op patients to help with the anxiety and pain management! What a great idea! Thanks, I'm gonna run with it!
Hahah this is both hilarious and educational. Loving this!
Sidebar on not charging a billion bucks for a buzzy...we can keep one in the department for 3 years for $0.10 a day amortized and sanitize it. We don't bill extra for it because we don't need to. If it's not reimbursable, at least it's low cost.
I'd been on the fence about ordering the Buzzy, and listening to her talk about the research on pain led me to finally do it. Here's hoping it helps my son with vaccinations!
There is a psychosomatic aspect to traumatic pain that I would like to see discussed more - the residual presence of unconscious trauma. That young kids don’t remember early pain does not make it OK. I mean who of us would choose to have major surgery with no anesthetic , tied down and screaming, if we could be given a shot afterward that made us completely forget the whole thing? So there is a deeper reason for numbing pain like circumcision etc.
I have a suggestion, let's all spam joe rogan's DM at once to host zdog, i'd love to see him on the JRE!
My mother is from Paducah Ky. I fall into that last category of uninsured, given up, depressed and listening to zdogg. I know that was meant as a joke, but it is real.
Upvote for "needle phobia is an access issue."
Plus medical devices not on formularies or invested in by venture capital unless they're disposable or extremely expensive
And "prevention saves money for the competitor, because people change insurance" [because they change jobs, although with only five meaningful nationwide players, they're not -that- likely to switch]
I remember being taught about the gate theory of pain and that stimulating larger nerves than the pin nerves would take the pain away. For example hit your thumb with a hammer and you rub it and suck on it to stimulate bigger nerves to reduce the pain. Buzzy makes perfect sense. I’m down to buy one just to use for my patients, reimbursement be damned.
This is outstanding. Such an important topic. Hope it gets wide exposure.
I would be interested in seeing that study with the 5 opioid take home pills repeated with a different number. From a data set of one, I went through an acute painful medical event on the first of the year, and was given 8 take home pills... I also used exactly 5. I'm wondering if there is really a binary "all or none" in play, or if there's a commonality in using 5 since that's how many you would take in 1 day assuming you missed one of 6 potential Q4 hour doses in the middle of sleeping. Maybe there's something significant about 1 full day that would stop some people after the 5 even if they had a few more.
Any chance there are one or two good articles, papers, etc. you or your guest can point us to on using Magnesium in combination with opiates?
What would the dosage on the Magnesium look like? Titration? Sorry if my "muggle" terminology is off. I am fairly academic though and do pretty well at reading scientific articles and literature.
I am looking for something I can print out, read, and also hand to a pain management specialist without him thinking I am playing "Dr. Google."
We hand out Mg infusions like hotcakes for migraine - it works pretty well, even if only temporary. I would start with that literature. It's also a staple now in the Anesthesia literature and gaining more and more traction: www.ncbi.nlm.nih.gov/books/NBK507245/
We use them for asthma and any type of smooth muscle pain like menstral pain
I would love to see a dedicated YT Channel by doc/medical professionals showcasing new innovative healthcare products (by docs, scientists, nurses, patients, etc.) to the medical community & patients.
Btw, everyone in my family has needle phobia (no worries, we still vaccinate, etc.) & I’m definitely going to try Buzzy & pitch it to our Pediatrician. I know my needle phobia started when I was 4yrs old, got terribly ill-that quickly escaped to hospitalization for kidney failure. I remember multiple nurses needing to hold me down *every time* they needed to poke n prod me. I’ve been super anxious about needles n hospitals ever since.
Another quality show. Thank you for this informative program.
Wonderful analogies as explanations.
Nice work, thank you!
When I was getting injections in my face the nurse tapped my forehead to reduce the pain. I had never heard of such a thing and was shocked that it worked. After that, I asked for the tapping. Her only explanation was that it distracted me.
Great guests! I remember the original Buzzy talk, Cool stuff. The three of you need to get together at least twice a year. This has to happen!!!
Although anecdotal, only one of my five children was frightened of a needle throughout their early years. He was not circumcised.
This 'phobia' faded as he aged.
Great talk. Love the mention of magnesium. I would love to use this device on our patients and maybe we'd have an increased vaccine adherence!
Pain memories-any type of childhood/prior experience with pain sensations and associated procedural trauma-?possible prediction of dual diagnosis? (Trauma+pain=pain memory?). What does everyone think?
I have Daily Chronic Hemiplegic Migraine and IIH. The way my pain is treated is a joke.
Im another one with traumatic incident with needles as a child but im sure you guys have access to the stats that many people was
I looked up the buzzy on Amazon. Is there an official site to show to our infection control? How do you clean these between patients?
Same as for stethoscopes and BP cuffs?
It seems like you could just put the Buzzy in a nitrile glove to use during the needle cannulation. After the cannulation is done, remove the glove and clean with 1:100 bleach, and you should be okay to use it on the next patient. The glove may be overkill, but it may make healthcare providers feel better about it being next to the needle site.
I used to scream and kick as a kid whenever I needed blood drawn. I know donate blood as much as I can. No idea how that happened.
What about lidocaine cream . The otc cream works instantly amd it works somewhat better for deeper pain . It would definitely work for pediatric Pt’s and I used it for my third tattoo and it really helped compared to my first two without it ?
Where can I find the studies she mentioned about decreased needle fear and increased vaccination rates because I really want to justify getting these for my pediatric clinic but air force needs lots of convincing
Would this buzzy device still work for a patient who has to self inject medication? Really interesting!
Just curious why healthcare providers don't just start ordering these Buzzy devices and using them. Who cares if insurance is going to reimburse for them. They're not that expensive. Just buy a few for your primary care office, buy a dozen for your infusion clinic, but a couple hundred for your hospital. Do the right thing for the patients regardless of the insurance reimbursement. We just need providers to start trying it to see for themselves that it works, and show them the data to backup their positive experiences with it.
Yay!
When I lived in North America, they just wanted to give me stronger meds, or just upping the dose of what I was already on.
Compare that to Germany, where I am taking a nerve blocker for back pain, that's more commonly used for people with epilepsy. I still have pain, but it's not as bad, and I don't have shooting pain anymore.
I think doctors in North America don't want to think outside the box because they're worried (or more so, the employer) is worried about getting sued. Also, more drugs means more profits, and it's less work to scribble on a pad compared to physical therapy.
Definitely the case. You use something off-label and not approved by the FDA and something bad happens... you get sued and don't have anything sunstantial to back up your case. Buhbye license.
It also has to do with what insurance will cover. They won't cover off label use of anything. So the doctor can say we really need to use this for you and the patient can say great and then the insurance refuses to pay for it and the patient gets the astronomical bill
Insurance in general in a for profit system is awful. Doctor diagnoses you with ABC, says they need to do XYZ. You are like okay. Insurance denies it, so patient is left with the huge bill. Like how is this our system?
Help!! Can you please promote genetic testing in regards to pain control? I’ve been in chronic pain all my life.
I’ve used opioids at times but I’ve never been addicted to opioids. I was told, after a total knee replacement that was screwed up and had to be opened up ten days later to be “fixed”, that I was using too many tramadol and I’d get addicted. I took more because I got no help from tramadol! I stopped cold turkey and had no change in my pain.
I need help. So many chronic pain people don’t want to take opioids. We just want to be in less pain so we can do more than just survive.
Eight years after my TKR, I’m still in so much pain that I can’t sleep through the night and I can only walk short distances before the pain overwhelms me.
Please HELP
Sorry for a third comment. But, with the professional version of the Buzzy product only 99 bucks, why would a clinic need insurance to cover it??? Just pay for it as a clinic like you would buy other medical tools like a BP cuff, thermometer, etc. It is made for use with multiple patients. Why would this even be an issue? Wouldn't it be part of the set of clinic equipment just like lots of other things?
It’s about pain education. Doctors did NOT have pain education for many years. The pharmaceutical companies did the education aggressively. It’s sad to me that a lot of this is basic pain and physical medicine and rehabilitation knowledge. How did we (medical profession) miss this? Money isn’t the only explanation.
Take my money!!
Has charitable giving (simply out of generosity) as a major funding source been abandoned in healthcare? It's depressing to hear about important advancements being stymied and left in limbo because they don't look promising to people who want to use them as a way to get rich.
Yes... I would say that "YES! GOOD DOCTOR! you traumatized that kid because you attacked him in his bed. I am shocked and dismayed that YOU would be so uninformed about pediatrics that you would dare do sooooo! Good GOD! Where in the hell was the mother that allowed you to do that? How well would you do if you were asleep and someone that you love and trusted hurt you? THINK !!!!
OMG, FINALLY SOMEONE IN HEALTHCARE WHO KNOWS ABOUT THE LINK BETWEEN WISDOM TEETH REMOVAL AND OPIOID ADDICTION!
I WAS SHOCKED when my 13 yo whose never had Tylenol was prescribed TWENTY VICODIN for her wisdom teeth removal and 600mg ibuprofen- I told the dentist she had never needed to take Tylenol & still used liquid children’s doses for fever/sports injury pain, the dentist argued with me saying that I didn’t understand how much pain she was going to be in and made me feel like I was cruel for not wanting to take the prescription. I slept next to her the 1st 3 nights and gave her 300mg of KIDS ibuprofen every 6 hours, I told her I’d give her something else for pain IF she was hurting, but the Motrin & using an ice pack for 3 days was all she needed.
Is it really that bad to experience SOME pain? Take Ibuprofen, use Ice and if the pain is too intense to sleep it ohh, take 1-2 Benadryl.
I’d love to see a study where non addicted patients with pain from injury or surgery receive a dose of IV Benadryl in place of dilaudid- I bet they’d sleep just as long, IF NOT LONGER and wouldn’t be as irritable or complain of breakthrough pain as often
But what % of your followers are the non-medical professional peanut gallery?
Great guests, talk, from a Social Media Specialist's POV.
What a shame you made this racist. And it's not even true. Which is surprising from you.
What the heck was with the awkward transition from opioid addiction to music history? So random. Stick to the interesting topics.