[Music] hi so welcome and you said my name is
hi so welcome and you said my name is
hi so welcome and you said my name is Meredith drainie and I’m here to talk
Meredith drainie and I’m here to talk
Meredith drainie and I’m here to talk about something that I’m very passionate
about something that I’m very passionate
about something that I’m very passionate about I love my job I’m passionate about
about I love my job I’m passionate about
about I love my job I’m passionate about it I’ve learned a lot about talking to
it I’ve learned a lot about talking to
it I’ve learned a lot about talking to people helping me some anxieties and
people helping me some anxieties and
people helping me some anxieties and fear of the unknown and managing pain
fear of the unknown and managing pain
fear of the unknown and managing pain and managing expectations so gained a
and managing expectations so gained a
and managing expectations so gained a little bit of a different perspective I
little bit of a different perspective I
little bit of a different perspective I think I’m very birdly honest with my
think I’m very birdly honest with my
think I’m very birdly honest with my patients sometimes so much so that it
patients sometimes so much so that it
patients sometimes so much so that it puts them off initially until they kind
puts them off initially until they kind
puts them off initially until they kind of get the program and get what I’m
of get the program and get what I’m
of get the program and get what I’m saying and wrap their head around it so
saying and wrap their head around it so
saying and wrap their head around it so just want to share a little bit about
just want to share a little bit about
just want to share a little bit about what I’ve learned with you this doesn’t
what I’ve learned with you this doesn’t
what I’ve learned with you this doesn’t want to start off by saying that pain
want to start off by saying that pain
want to start off by saying that pain does not have to control you there are
does not have to control you there are
does not have to control you there are millions of people every single day
millions of people every single day
millions of people every single day dealing with pain in some aspect in some
dealing with pain in some aspect in some
dealing with pain in some aspect in some form in some regard physical pain mental
form in some regard physical pain mental
form in some regard physical pain mental pain emotional pain in my area in my
pain emotional pain in my area in my
pain emotional pain in my area in my world in the hospital where I see
world in the hospital where I see
world in the hospital where I see surgical pain it’s primarily what we’re
surgical pain it’s primarily what we’re
surgical pain it’s primarily what we’re talking about people come in for surgery
talking about people come in for surgery
talking about people come in for surgery and have an operation it hurts we fix
and have an operation it hurts we fix
and have an operation it hurts we fix them we send them home right that’s
them we send them home right that’s
them we send them home right that’s anyhow but it’s not just the pain itself
anyhow but it’s not just the pain itself
anyhow but it’s not just the pain itself that we struggle with it’s the fear of
that we struggle with it’s the fear of
that we struggle with it’s the fear of the unknown
the unknown
the unknown the anxiety that’s surrounding this pain
the anxiety that’s surrounding this pain
the anxiety that’s surrounding this pain that’s the real struggle that’s what we
that’s the real struggle that’s what we
that’s the real struggle that’s what we have to overcome and contend with
have to overcome and contend with
have to overcome and contend with especially people they’ve never had
especially people they’ve never had
especially people they’ve never had surgery before maybe they’ve never
surgery before maybe they’ve never
surgery before maybe they’ve never encountered something that’s so
encountered something that’s so
encountered something that’s so traumatic or so problematic they don’t
traumatic or so problematic they don’t
traumatic or so problematic they don’t know how to process this amount of pain
know how to process this amount of pain
know how to process this amount of pain I don’t know what to expect
part of the key or the whole key with
part of the key or the whole key with this solution is removing the barriers
this solution is removing the barriers
this solution is removing the barriers because pain is unavoidable but it does
because pain is unavoidable but it does
because pain is unavoidable but it does not have to control you so like Nick
not have to control you so like Nick
not have to control you so like Nick said every week I stand up and I talked
said every week I stand up and I talked
said every week I stand up and I talked to 18 patients and their family members
to 18 patients and their family members
to 18 patients and their family members and their caregivers and I try as hard
and their caregivers and I try as hard
and their caregivers and I try as hard as I can sometimes it’s harder than
as I can sometimes it’s harder than
as I can sometimes it’s harder than others sometimes it’s a little bit
others sometimes it’s a little bit
others sometimes it’s a little bit harder than others to try and convince
harder than others to try and convince
harder than others to try and convince them that what they’re going through is
them that what they’re going through is
them that what they’re going through is okay and it’s not going to kill them
okay and it’s not going to kill them
okay and it’s not going to kill them we’re all gonna get through it but we
we’re all gonna get through it but we
we’re all gonna get through it but we take this time and talk about the whole
take this time and talk about the whole
take this time and talk about the whole surgical process so we talked about prea
surgical process so we talked about prea
surgical process so we talked about prea post-op what’s a pack in their overnight
post-op what’s a pack in their overnight
post-op what’s a pack in their overnight bag what tests they have to do
bag what tests they have to do
bag what tests they have to do beforehand to get ready for surgery
beforehand to get ready for surgery
beforehand to get ready for surgery what the members are on a team that are
what the members are on a team that are
what the members are on a team that are going to be taking care of them what the
going to be taking care of them what the
going to be taking care of them what the physical therapy part of surgeries like
physical therapy part of surgeries like
physical therapy part of surgeries like both after and when patients
both after and when patients
both after and when patients at home so I’ve done about 70 of these
at home so I’ve done about 70 of these
at home so I’ve done about 70 of these talks in my current role
talks in my current role
talks in my current role so I’d say I have it down to a pretty
so I’d say I have it down to a pretty
so I’d say I have it down to a pretty good science as far as the amount of
good science as far as the amount of
good science as far as the amount of time we spend on each topic cuz I only
time we spend on each topic cuz I only
time we spend on each topic cuz I only have about sixty five minutes to get my
have about sixty five minutes to get my
have about sixty five minutes to get my point across to make sure we’re all on
point across to make sure we’re all on
point across to make sure we’re all on the same page and everyone’s feeling
the same page and everyone’s feeling
the same page and everyone’s feeling really good when they walk out those
really good when they walk out those
really good when they walk out those doors so of all the topics that we talk
doors so of all the topics that we talk
doors so of all the topics that we talk about and then number one singular topic
about and then number one singular topic
about and then number one singular topic that devotes the most time and attention
that devotes the most time and attention
that devotes the most time and attention it’s pain management that’s when you see
it’s pain management that’s when you see
it’s pain management that’s when you see a still graph up here old question mark
a still graph up here old question mark
a still graph up here old question mark up there that little sliver that’s
up there that little sliver that’s
up there that little sliver that’s unidentified it’s pain management that’s
unidentified it’s pain management that’s
unidentified it’s pain management that’s the most amount of questions that I get
the most amount of questions that I get
the most amount of questions that I get people don’t ask things like what
people don’t ask things like what
people don’t ask things like what exactly happens on surgery my doctor
exactly happens on surgery my doctor
exactly happens on surgery my doctor didn’t explain it well or I really want
didn’t explain it well or I really want
didn’t explain it well or I really want to have my wife or husband spend the
to have my wife or husband spend the
to have my wife or husband spend the night with me cuz I’m anxious is that
night with me cuz I’m anxious is that
night with me cuz I’m anxious is that allowed or hey what’s the password is a
allowed or hey what’s the password is a
allowed or hey what’s the password is a free Wi-Fi because that’d be my question
free Wi-Fi because that’d be my question
free Wi-Fi because that’d be my question about that I’m searching and I get those
about that I’m searching and I get those
about that I’m searching and I get those questions sometimes but usually the
questions sometimes but usually the
questions sometimes but usually the questions are about paying people ask me
questions are about paying people ask me
questions are about paying people ask me is it going to her after surgery I’ve
is it going to her after surgery I’ve
is it going to her after surgery I’ve had I told my doctor that I don’t want
had I told my doctor that I don’t want
had I told my doctor that I don’t want to feel any pain after surgery I don’t
to feel any pain after surgery I don’t
to feel any pain after surgery I don’t want it to hurt I told him I’m telling
want it to hurt I told him I’m telling
want it to hurt I told him I’m telling you who else do I need to tell to make
you who else do I need to tell to make
you who else do I need to tell to make sure that happens how bad does joint
sure that happens how bad does joint
sure that happens how bad does joint replacement hurt get all of these
replacement hurt get all of these
replacement hurt get all of these questions all the time and sometimes I
questions all the time and sometimes I
questions all the time and sometimes I laugh and the whole class was together
laugh and the whole class was together
laugh and the whole class was together and I answer the same way yes this is
and I answer the same way yes this is
and I answer the same way yes this is going to hurt it is going to be
going to hurt it is going to be
going to hurt it is going to be uncomfortable you are going to get
uncomfortable you are going to get
uncomfortable you are going to get through it will you be in agony no are
through it will you be in agony no are
through it will you be in agony no are you going to suffer absolutely not
you going to suffer absolutely not
you going to suffer absolutely not it’s your entire medical team going to
it’s your entire medical team going to
it’s your entire medical team going to do everything they can to take care of
do everything they can to take care of
do everything they can to take care of you
you
you and manager pain in a responsible
and manager pain in a responsible
and manager pain in a responsible conservative way yeah definitely and are
conservative way yeah definitely and are
conservative way yeah definitely and are you going to get through it absolutely
you going to get through it absolutely
you going to get through it absolutely and here’s how we are going to set
and here’s how we are going to set
and here’s how we are going to set realistic expectations that’s step one
realistic expectations that’s step one
realistic expectations that’s step one anytime you’re talking about pain again
anytime you’re talking about pain again
anytime you’re talking about pain again no matter what kind of pain you are
no matter what kind of pain you are
no matter what kind of pain you are experiencing if you’re having surgery if
experiencing if you’re having surgery if
experiencing if you’re having surgery if you’re going through divorce if you just
you’re going through divorce if you just
you’re going through divorce if you just got fired from your job it is going to
got fired from your job it is going to
got fired from your job it is going to hurt it is going to be painful it’s not
hurt it is going to be painful it’s not
hurt it is going to be painful it’s not pretty and nice I mean when is it ever
pretty and nice I mean when is it ever
pretty and nice I mean when is it ever but if you can accept that and wrap your
but if you can accept that and wrap your
but if you can accept that and wrap your head around it I promise you you’re
head around it I promise you you’re
head around it I promise you you’re going to be so much better off and it’s
going to be so much better off and it’s
going to be so much better off and it’s when I say that that I see people’s
when I say that that I see people’s
when I say that that I see people’s faces start to soften and it’s kind of
faces start to soften and it’s kind of
faces start to soften and it’s kind of this aha moment where they go okay well
this aha moment where they go okay well
this aha moment where they go okay well yeah at least she was honest it’s gonna
yeah at least she was honest it’s gonna
yeah at least she was honest it’s gonna hurt a little bit but it’s gonna be okay
hurt a little bit but it’s gonna be okay
hurt a little bit but it’s gonna be okay two days later I’ll be home and then
two days later I’ll be home and then
two days later I’ll be home and then I’ll get beyond it so studying realistic
I’ll get beyond it so studying realistic
I’ll get beyond it so studying realistic expectations it’s the number one key and
expectations it’s the number one key and
expectations it’s the number one key and overcoming this hurdle and complicated
overcoming this hurdle and complicated
overcoming this hurdle and complicated pain management okay when you think
pain management okay when you think
pain management okay when you think about realistic expectations whenever
about realistic expectations whenever
about realistic expectations whenever you set them too high or they’re not
you set them too high or they’re not
you set them too high or they’re not based in reality
based in reality
based in reality they are often unmet did you know that
they are often unmet did you know that
they are often unmet did you know that people say anyhow it’s pretty common
people say anyhow it’s pretty common
people say anyhow it’s pretty common that unmet expectations are the number
that unmet expectations are the number
that unmet expectations are the number one reason for divorce yeah I believe it
one reason for divorce yeah I believe it
one reason for divorce yeah I believe it makes sense unmet expectations lead to
makes sense unmet expectations lead to
makes sense unmet expectations lead to dissolution of the
dissolution of the
dissolution of the they lead to people sniffing their tab
they lead to people sniffing their tab
they lead to people sniffing their tab for a nice expensive dinner because it
for a nice expensive dinner because it
for a nice expensive dinner because it didn’t meet their expectations of the
didn’t meet their expectations of the
didn’t meet their expectations of the quality met expectations can kill your
quality met expectations can kill your
quality met expectations can kill your sex life mmm by in my world unmet
sex life mmm by in my world unmet
sex life mmm by in my world unmet expectations lead to poor patient
expectations lead to poor patient
expectations lead to poor patient outcomes patients are just satisfied
outcomes patients are just satisfied
outcomes patients are just satisfied they’re discouraged in their providers
they’re discouraged in their providers
they’re discouraged in their providers and themselves and their recovery so if
and themselves and their recovery so if
and themselves and their recovery so if we set those realistic expectations from
we set those realistic expectations from
we set those realistic expectations from the beginning outline what’s gonna
the beginning outline what’s gonna
the beginning outline what’s gonna happen and how real it’s going to be
happen and how real it’s going to be
happen and how real it’s going to be it’s a night and day difference
it’s a night and day difference
it’s a night and day difference so once we’ve set those expectations the
so once we’ve set those expectations the
so once we’ve set those expectations the next step in the process is trying our
next step in the process is trying our
next step in the process is trying our best to reconcile perception with
best to reconcile perception with
best to reconcile perception with reality so we have this little scale
reality so we have this little scale
reality so we have this little scale here we use this at any Hospital if
here we use this at any Hospital if
here we use this at any Hospital if you’ve ever been in the hospital or the
you’ve ever been in the hospital or the
you’ve ever been in the hospital or the doctor’s office and last 10 years you’ve
doctor’s office and last 10 years you’ve
doctor’s office and last 10 years you’ve probably seen it so this is a skill we
probably seen it so this is a skill we
probably seen it so this is a skill we use to let patients measure and then not
use to let patients measure and then not
use to let patients measure and then not have pain they’re having now the scale
have pain they’re having now the scale
have pain they’re having now the scale is pretty basic when you look at it okay
is pretty basic when you look at it okay
is pretty basic when you look at it okay it’s simple
it’s simple
it’s simple zero is no pain right 10 is the worst
zero is no pain right 10 is the worst
zero is no pain right 10 is the worst pain possible attending right up there
pain possible attending right up there
pain possible attending right up there by the little frowny face with the tears
by the little frowny face with the tears
by the little frowny face with the tears coming down where’s maybe possible so
coming down where’s maybe possible so
coming down where’s maybe possible so this does not mean the worst pain
this does not mean the worst pain
this does not mean the worst pain compared to last like an hour ago when
compared to last like an hour ago when
compared to last like an hour ago when we asked you or the pain compared to
we asked you or the pain compared to
we asked you or the pain compared to yesterday when you first hurt yourself
yesterday when you first hurt yourself
yesterday when you first hurt yourself or first sustained an injury this is the
or first sustained an injury this is the
or first sustained an injury this is the worst paying possible that you could
worst paying possible that you could
worst paying possible that you could ever experience or an indoor in your
ever experience or an indoor in your
ever experience or an indoor in your entire lifetime so when we put it in
entire lifetime so when we put it in
entire lifetime so when we put it in that perspective and explain it to
that perspective and explain it to
that perspective and explain it to patients in a way they can understand
patients in a way they can understand
patients in a way they can understand it’s another aha moment suddenly 10 out
it’s another aha moment suddenly 10 out
it’s another aha moment suddenly 10 out of 10 seems a little silly right because
of 10 seems a little silly right because
of 10 seems a little silly right because it’s a hangnail so it’s probably not the
it’s a hangnail so it’s probably not the
it’s a hangnail so it’s probably not the worst pain that your and we’re going to
worst pain that your and we’re going to
worst pain that your and we’re going to in your lifetime if it is good for you
in your lifetime if it is good for you
in your lifetime if it is good for you because you live a really nice life
because you live a really nice life
because you live a really nice life so when we marry in that perception with
so when we marry in that perception with
so when we marry in that perception with reality our our outcomes are better when
reality our our outcomes are better when
reality our our outcomes are better when you are able to perceive what is
you are able to perceive what is
you are able to perceive what is happening to you and that sort of scale
happening to you and that sort of scale
happening to you and that sort of scale and you can put it into context you
and you can put it into context you
and you can put it into context you actually require less energy to overcome
actually require less energy to overcome
actually require less energy to overcome what you’re going through
what you’re going through
what you’re going through it becomes less traumatic less of the
it becomes less traumatic less of the
it becomes less traumatic less of the fight less of a struggle when you can
fight less of a struggle when you can
fight less of a struggle when you can perceive it and understand it and see
perceive it and understand it and see
perceive it and understand it and see how it fits with the expectations that
how it fits with the expectations that
how it fits with the expectations that you had going into whatever you’re
you had going into whatever you’re
you had going into whatever you’re experiencing
here’s where it gets a little tricky the
here’s where it gets a little tricky the expectations have been said our
expectations have been said our
expectations have been said our perception is based in reality the next
perception is based in reality the next
perception is based in reality the next step in the process is treatment okay
step in the process is treatment okay
step in the process is treatment okay because everybody’s pain is subjective
because everybody’s pain is subjective
because everybody’s pain is subjective that’s a really huge take away with this
that’s a really huge take away with this
that’s a really huge take away with this everybody’s going to experience things
everybody’s going to experience things
everybody’s going to experience things differently
differently
differently your hangnail might be the worst thing
your hangnail might be the worst thing
your hangnail might be the worst thing you’ve ever experienced right but this
you’ve ever experienced right but this
you’ve ever experienced right but this guy’s broken ankle is way worse okay or
guy’s broken ankle is way worse okay or
guy’s broken ankle is way worse okay or he thinks you’re hanging out was really
he thinks you’re hanging out was really
he thinks you’re hanging out was really bad and his ankles not that bad so
bad and his ankles not that bad so
bad and his ankles not that bad so everybody’s perception is going to be a
everybody’s perception is going to be a
everybody’s perception is going to be a little bit different the problem with
little bit different the problem with
little bit different the problem with our healthcare today is that pain is
our healthcare today is that pain is
our healthcare today is that pain is subjective and treatment is not
subjective and treatment is not
subjective and treatment is not treatment is objective if this then that
treatment is objective if this then that
treatment is objective if this then that if your pain is a six here’s what you’re
if your pain is a six here’s what you’re
if your pain is a six here’s what you’re going to get so that’s where people in
going to get so that’s where people in
going to get so that’s where people in patients have to take ownership in what
patients have to take ownership in what
patients have to take ownership in what they’re experiencing and going through
they’re experiencing and going through
they’re experiencing and going through so that way their treatment is actually
so that way their treatment is actually
so that way their treatment is actually appropriate for what they’re
appropriate for what they’re
appropriate for what they’re experiencing so in my case a lot of the
experiencing so in my case a lot of the
experiencing so in my case a lot of the treatment is medication related but it
treatment is medication related but it
treatment is medication related but it also is things like massage or touch
also is things like massage or touch
also is things like massage or touch therapy sometimes we do nutritional
therapy sometimes we do nutritional
therapy sometimes we do nutritional coaching or weight loss coaching for
coaching or weight loss coaching for
coaching or weight loss coaching for arthritis type pain distraction
arthritis type pain distraction
arthritis type pain distraction techniques relaxation that sort of thing
techniques relaxation that sort of thing
techniques relaxation that sort of thing but if you have been abreast of the news
but if you have been abreast of the news
but if you have been abreast of the news and you know what’s going on in the
and you know what’s going on in the
and you know what’s going on in the world today it’s pretty easy to think
world today it’s pretty easy to think
world today it’s pretty easy to think about how the majority of people
about how the majority of people
about how the majority of people associate pain with narcotic medication
associate pain with narcotic medication
associate pain with narcotic medication I’m in pain I want it drugs that’s the
I’m in pain I want it drugs that’s the
I’m in pain I want it drugs that’s the culture that we have grown into and I
culture that we have grown into and I
culture that we have grown into and I want to explain why and how this came
want to explain why and how this came
want to explain why and how this came about and what we’re doing and trying
about and what we’re doing and trying
about and what we’re doing and trying so in 1991 something happened that
so in 1991 something happened that
so in 1991 something happened that started us on this upward trend of
started us on this upward trend of
started us on this upward trend of opioid use so this graph illustrates the
opioid use so this graph illustrates the
opioid use so this graph illustrates the amount of opioid prescriptions that were
amount of opioid prescriptions that were
amount of opioid prescriptions that were filled at commercial pharmacies between
filled at commercial pharmacies between
filled at commercial pharmacies between 1991 and 2013 anybody have any guesses
1991 and 2013 anybody have any guesses
1991 and 2013 anybody have any guesses what happened in 1991 in the medical
what happened in 1991 in the medical
what happened in 1991 in the medical community regarding pain that started
community regarding pain that started
community regarding pain that started this upward trend
this upward trend
this upward trend anybody know know yeah I’ve got somebody
anybody know know yeah I’ve got somebody
anybody know know yeah I’ve got somebody in the back has an idea pain as the
in the back has an idea pain as the
in the back has an idea pain as the fifth vital sign thank you that’s
fifth vital sign thank you that’s
fifth vital sign thank you that’s correct so in 1991 the American Pain
correct so in 1991 the American Pain
correct so in 1991 the American Pain Society came out and said in a response
Society came out and said in a response
Society came out and said in a response to patients having pain in the hospital
to patients having pain in the hospital
to patients having pain in the hospital than surgery we want to do something to
than surgery we want to do something to
than surgery we want to do something to make sure that they’re getting really
make sure that they’re getting really
make sure that they’re getting really great care so we are going to declare
great care so we are going to declare
great care so we are going to declare that pain should be a vital sign if we
that pain should be a vital sign if we
that pain should be a vital sign if we aren’t sure what vital signs are we’re
aren’t sure what vital signs are we’re
aren’t sure what vital signs are we’re talking about things like heart rate
talking about things like heart rate
talking about things like heart rate blood pressure the amount of
blood pressure the amount of
blood pressure the amount of respirations you take per minute so
respirations you take per minute so
respirations you take per minute so these are things that keep you alive so
these are things that keep you alive so
these are things that keep you alive so when pain to the fifth vital sign is
when pain to the fifth vital sign is
when pain to the fifth vital sign is introduced all of a sudden providers on
introduced all of a sudden providers on
introduced all of a sudden providers on every single encounter are assessing
every single encounter are assessing
every single encounter are assessing patients for pain and asking what is
patients for pain and asking what is
patients for pain and asking what is your level of pain on a scale from zero
your level of pain on a scale from zero
your level of pain on a scale from zero to ten so when you have a situation like
to ten so when you have a situation like
to ten so when you have a situation like that and you have a patient population
that and you have a patient population
that and you have a patient population if they’re lacking the education on
if they’re lacking the education on
if they’re lacking the education on these expectations and their perception
these expectations and their perception
these expectations and their perception of reality on this scale of 0
of reality on this scale of 0
of reality on this scale of 0 the 10 of course they’re gonna say yeah
the 10 of course they’re gonna say yeah
the 10 of course they’re gonna say yeah I’m gonna ten out of ten
I’m gonna ten out of ten
I’m gonna ten out of ten I want those really good drugs this
I want those really good drugs this
I want those really good drugs this hangnail is killing me and I’ve been in
hangnail is killing me and I’ve been in
hangnail is killing me and I’ve been in the ER for nine hours and I could use
the ER for nine hours and I could use
the ER for nine hours and I could use some dilaudid so that’s how this process
some dilaudid so that’s how this process
some dilaudid so that’s how this process started so without proper education
started so without proper education
started so without proper education without patient awareness of the risks
without patient awareness of the risks
without patient awareness of the risks and the side effects of these
and the side effects of these
and the side effects of these medications the use of these opioid
medications the use of these opioid
medications the use of these opioid prescriptions started to skyrocket
prescriptions started to skyrocket
prescriptions started to skyrocket between 1991 and 2013 these
between 1991 and 2013 these
between 1991 and 2013 these prescriptions a percentage rate of use
prescriptions a percentage rate of use
prescriptions a percentage rate of use went up a hundred and seventy two
went up a hundred and seventy two
went up a hundred and seventy two percent a hundred and seventy two
percent a hundred and seventy two
percent a hundred and seventy two percent increase in the amount of opioid
percent increase in the amount of opioid
percent increase in the amount of opioid prescriptions being filled at pharmacies
prescriptions being filled at pharmacies
prescriptions being filled at pharmacies in this time frame so this is the battle
in this time frame so this is the battle
in this time frame so this is the battle that we are now fighting what’s
that we are now fighting what’s
that we are now fighting what’s happening is healthcare providers are
happening is healthcare providers are
happening is healthcare providers are now trying to backpedal and go wait wait
now trying to backpedal and go wait wait
now trying to backpedal and go wait wait wait wait wait wait maybe it wasn’t such
wait wait wait wait maybe it wasn’t such
wait wait wait wait maybe it wasn’t such a good idea we need to assess pain maybe
a good idea we need to assess pain maybe
a good idea we need to assess pain maybe not so rigidly but we need to look at it
not so rigidly but we need to look at it
not so rigidly but we need to look at it another way so we’ve started to do non
another way so we’ve started to do non
another way so we’ve started to do non pharmacological means of managing these
pharmacological means of managing these
pharmacological means of managing these patients pain all these other things I
patients pain all these other things I
patients pain all these other things I mentioned like sometimes nerve
mentioned like sometimes nerve
mentioned like sometimes nerve stimulators for back pain and you sort
stimulators for back pain and you sort
stimulators for back pain and you sort of light therapy for migraines anything
of light therapy for migraines anything
of light therapy for migraines anything new and upcoming that’s not a narcotic
new and upcoming that’s not a narcotic
new and upcoming that’s not a narcotic with these heavy side effects so the
with these heavy side effects so the
with these heavy side effects so the medical community is spending millions
medical community is spending millions
medical community is spending millions on research trying to figure out ways
on research trying to figure out ways
on research trying to figure out ways that we can manage pain without causing
that we can manage pain without causing
that we can manage pain without causing all of this high opioid use and that an
all of this high opioid use and that an
all of this high opioid use and that an opioid epidemic and addiction that we’re
opioid epidemic and addiction that we’re
opioid epidemic and addiction that we’re seeing now so I don’t know about you but
seeing now so I don’t know about you but
seeing now so I don’t know about you but I find it strangely ironic that now
I find it strangely ironic that now
I find it strangely ironic that now we’re trying to revert back to the pain
we’re trying to revert back to the pain
we’re trying to revert back to the pain method that we used before all this
method that we used before all this
method that we used before all this started and said
started and said
started and said probably wasn’t such a good idea so
probably wasn’t such a good idea so
probably wasn’t such a good idea so that’s a lot of what we’re doing in my
that’s a lot of what we’re doing in my
that’s a lot of what we’re doing in my job anyhow to try and find alternatives
job anyhow to try and find alternatives
job anyhow to try and find alternatives that get us out of this situation that
that get us out of this situation that
that get us out of this situation that we’ve created and I don’t know you can
we’ve created and I don’t know you can
we’ve created and I don’t know you can see this very well but I should probably
see this very well but I should probably
see this very well but I should probably point out that that denominator is in
point out that that denominator is in
point out that that denominator is in millions so that number in 2013 is 207
millions so that number in 2013 is 207
millions so that number in 2013 is 207 million prescriptions so our the problem
million prescriptions so our the problem
million prescriptions so our the problem so what we have found in our program
so what we have found in our program
so what we have found in our program have we kind of bring this all together
have we kind of bring this all together
have we kind of bring this all together is that for this education piece through
is that for this education piece through
is that for this education piece through helping patients understand these
helping patients understand these
helping patients understand these expectations and set them from the
expectations and set them from the
expectations and set them from the beginning and let them know what they’re
beginning and let them know what they’re
beginning and let them know what they’re in store for and what’s coming ahead
in store for and what’s coming ahead
in store for and what’s coming ahead when we do that help them understand the
when we do that help them understand the
when we do that help them understand the scale and ground their perception in
scale and ground their perception in
scale and ground their perception in some realm neighborhood of reality and
some realm neighborhood of reality and
some realm neighborhood of reality and then find a treatment that’s
then find a treatment that’s
then find a treatment that’s conservative as possible while still
conservative as possible while still
conservative as possible while still managing their pain and keeping them
managing their pain and keeping them
managing their pain and keeping them comfortable after surgery when we take
comfortable after surgery when we take
comfortable after surgery when we take all those things combined we’ve
all those things combined we’ve
all those things combined we’ve increased our satisfaction scores
increased our satisfaction scores
increased our satisfaction scores meaning the amount of patients that say
meaning the amount of patients that say
meaning the amount of patients that say they’re satisfied with their pain
they’re satisfied with their pain
they’re satisfied with their pain management after surgery it was exactly
management after surgery it was exactly
management after surgery it was exactly what they expected and they got what
what they expected and they got what
what they expected and they got what they were looking for for their
they were looking for for their
they were looking for for their providers by doing all of that we
providers by doing all of that we
providers by doing all of that we increase the percentage of satisfaction
increase the percentage of satisfaction
increase the percentage of satisfaction from 42 to 90 percent which is
from 42 to 90 percent which is
from 42 to 90 percent which is incredible 90% of patients after surgery
incredible 90% of patients after surgery
incredible 90% of patients after surgery saying yeah you know I knew what all
saying yeah you know I knew what all
saying yeah you know I knew what all this ahead of time it’s exactly what I
this ahead of time it’s exactly what I
this ahead of time it’s exactly what I was expecting so this knowledge not only
was expecting so this knowledge not only
was expecting so this knowledge not only is great for the satisfaction of
is great for the satisfaction of
is great for the satisfaction of patients
patients
patients more important to me especially these
more important to me especially these
more important to me especially these individuals are grateful they come to me
individuals are grateful they come to me
individuals are grateful they come to me and they come to their providers and say
and they come to their providers and say
and they come to their providers and say thank you thank you for giving us this
thank you thank you for giving us this
thank you thank you for giving us this knowledge that helped bridge that gap
knowledge that helped bridge that gap
knowledge that helped bridge that gap between the unknown and reality it took
between the unknown and reality it took
between the unknown and reality it took away my fear and it took away my anxiety
away my fear and it took away my anxiety
away my fear and it took away my anxiety so when we apply those principles across
so when we apply those principles across
so when we apply those principles across the spectrum because as I’m talk about
the spectrum because as I’m talk about
the spectrum because as I’m talk about paying in a hospital because that’s my
paying in a hospital because that’s my
paying in a hospital because that’s my specialty like I said in the beginning
specialty like I said in the beginning
specialty like I said in the beginning pain is not limited to the hospital
pain is not limited to the hospital
pain is not limited to the hospital we’re talking about pain that you
we’re talking about pain that you
we’re talking about pain that you experience every day divorce loss of a
experience every day divorce loss of a
experience every day divorce loss of a loved one you know getting fired from a
loved one you know getting fired from a
loved one you know getting fired from a job or losing a promotion that you’ve
job or losing a promotion that you’ve
job or losing a promotion that you’ve been working so hard for for the last 10
been working so hard for for the last 10
been working so hard for for the last 10 years it’s all painful we all experience
years it’s all painful we all experience
years it’s all painful we all experience pain on some different level but if we
pain on some different level but if we
pain on some different level but if we set our expectations a reasonable level
set our expectations a reasonable level
set our expectations a reasonable level we perceive what’s happening to us in a
we perceive what’s happening to us in a
we perceive what’s happening to us in a realistic way I’m lucky enough to have
realistic way I’m lucky enough to have
realistic way I’m lucky enough to have somebody there to kind of walk us
somebody there to kind of walk us
somebody there to kind of walk us through it and we have better outcomes
through it and we have better outcomes
through it and we have better outcomes pain is you know no different whoever
pain is you know no different whoever
pain is you know no different whoever you’re talking to I mean I’ve been
you’re talking to I mean I’ve been
you’re talking to I mean I’ve been willing to guess that the pain of a
willing to guess that the pain of a
willing to guess that the pain of a broken arm probably using that much
broken arm probably using that much
broken arm probably using that much different and then pain of a broken
different and then pain of a broken
different and then pain of a broken heart okay
heart okay
heart okay pain is unavoidable but it does not have
pain is unavoidable but it does not have
pain is unavoidable but it does not have to control you and with my patients it
to control you and with my patients it
to control you and with my patients it does not have to control their recovery
does not have to control their recovery
does not have to control their recovery so that’s what I wanted to share with
so that’s what I wanted to share with
so that’s what I wanted to share with you today thank you
”
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