Latest / Giving Pain Purpose with Lyndsay Soprano / Exploring Alternative Methods for Pain Management

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Exploring Alternative Methods for Pain Management · Giving Pain Purpose with Lyndsay Soprano

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Hey, guys and dolls. Before we jump into this episode, a note
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about our content today. This is created for adult audiences only. We advise
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listener discretion, so if you need a breather, take a break and come
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back later. This is Your Pain Game podcast where we talk about the game
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of living in and with chronic pain and trauma, getting to the heart of
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how to heal. I am your host, Lindsay Soprano. On the show,
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I plan on discussing with doctors, chronic pain patients, holistic practitioners,
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loved ones, and anybody that is interested in having their voice heard in the
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chronic pain and trauma world that we live in. Sometimes I wish that I
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lived with an anesthesiologist because I really feel like I need a hot dose at
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night to help me sleep and get through the pain that seems to just rise
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slowly and uncontrollably at about seven thirty to eight pm every single night of my
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life, and it doesn't allow me to sleep. And as a busy body
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that I am, even in the pain that I am, because everybody knows
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that I'm just a wild child, and even still, you would never guess
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that I feel the way that I do, because that's who I am,
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right, I'm a bite on a stick chick when it comes to my pain,
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and you know it's getting old. And I have avoided opiates and pain
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pills entirely for the past decade of this, right with my CRPS and now
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of course all the other wine disease and all the other bs that's going on
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with my bod, because I just will not go down that road. I
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know myself too well. I have an addictive personality, I have addicts in
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my family. I've struggled with addiction myself, and the last thing I would
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want to do is add opiates into my world because I would l v e
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them and I don't want to end up being a statistic that my sweetie has
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to report on because he's in broadcast journalism, right, I probably would make
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the news because of him. So what other roads can we go down to
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help better manage our pain and improve our overall health? Because you know,
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almost every road I've been down with our healthcare system and pain doctors has not
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been ideal. I've been cut open and sliced open, emergency surgeries and pills
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that don't work. I mean, how many times have I been on GABA
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penton, give me a break. It's insane. So what can we do
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here? What can we do better? To communicate with our doctors, to
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communicate with our health care practitioners, and also to communicate with our family members
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and our friends, because they're part of this too, our pain journey,
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right, journey that it is. So today, we'd like to talk about
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making some small practical changes in our daily lives that can empower us in our
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pain community. And that is a community, guys, that's what we're here
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for. It's not just me going through pain. It's not just you going
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through pain. It's our loved ones. It is the people we work with.
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It's our best friends. It's our nieces, our nephews, our children,
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our dogs for crying out loud, you know, certainly one of mine.
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He's my pain puppy. We affect everybody, right, So here we
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are. We're here to empower you, of course, but empower me a
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little bit too. But I like to introduce you to our guests today,
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doctor Sarah Merritt, Hello, darling, Hello, thanks for having me.
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Oh my gosh, it's so wonderful to have you here. Doctor Merritt is
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a bored that's certified anesthesiology, pain medicine, and addiction medicine practitioner. ALA's
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why I wanted announced thesiologists to put me to sleep. Her private practice is
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right outside of the Washington DC metro area in Baltimore and Bowie, and she's
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a huge advocate for patients advocation and empowers that word that we talk about so
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often on this show, to empower us and her patients to get the most
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from their relationship with their pain physicians as well as other doctors, healthcare providers,
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and family. I like she has extensive experience in management of acute and
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chronic pain as well as a diagnosis and treatment of opioid use disorder. All
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right, so I'm rolling out the red carpet for you, babe. I'd
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like to get started by talking about how you got started in pain management,
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what brought you to it, and then let's take it from there. Yeah.
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Well, I think I started with just being wanting to be a doctor,
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and as a kid, I really you know, just having a good
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relationship with my own practitioner. And so it really wasn't until I got into
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medical school that I thought like, oh no, I have to decide which
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type of doctor that I want to be. I did not know that I
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wanted to be a pain doctor when I started and getting to work with patients
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who have a serious pain problem. On the one hand, that can be
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kind of heavy, and it can be a turnoff and not honestly, you
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know, not everybody wants to do it. No, we're a group.
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Yeah. But on the other hand, if you help someone with a serious
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pain problem and you really help them, then you've helped them with their worst
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thing, it's a big deal, you know, and it feels good and
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you know, for me, building those relationships has been a really gratifying part
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of being a pain doctor. And so some of those patients that I've worked
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with, you know, over years and we've been able to either either make
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progress or help them hold steady or help them maybe not lose hope might be
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you know, even just enough to feel like you're accomplishing something. Yeah,
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and hope is a huge thing. We every episode on the show with a
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message of hope. So when we get there, yeah, that's our homework
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running with a message of hope. But I mean, because it is a
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it is a very scary and lonely place when you live in pain and over
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the past couple of weeks, my pain has like skyrocketed to the point that
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my sweetie is like lifting me in an out of the shower and helping me,
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which which is new, which I don't care for. But you know,
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here we go, we wake up, and we keep on trucking.
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Is it easy? No, it is not. But I am hopeful,
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and I'm hopeful because I meet people like you. So let's talk about what
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you do in your practice for people that live in pain. What do you
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guys do? Yeah, so my practice in many ways is similar to other
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pain doctors. You know, as a medical doctor, I can prescribe medications.
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I can also do things like injections or you know, we talked about
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like the implant type of treatments. You know, we offer those type things
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in the practice. And then one of the other things we do in the
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practice that's been really impactful for some of our people with significant cry pain is
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ketamine infusions also, So really, in a nutshell, you know, medications
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and injections are the unique things that maybe only a physician or medical provider can
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do. But then those are not the only things that work for pain or
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for chronic pain, and so obviously, we make a lot of to other
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types of providers, so things like physical therapy, occupational therapy, and working
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with patients to incorporate lifestyle changes possibly into their world also, and I know
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within pain with myself specifically, I can speak to myself and as well as
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some other people in my pain community is nutrition is a huge component of it
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too. I mean for me, I mean my problem is actually eating because
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I'm so nauseous all the time from pain. Right, And we've talked about
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this at infinitum on the show about the importance of nutrition not just an elimination
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diet. Yes, because I've eliminated everything. I like, everything you've asked
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me to eliminate is gone. Yeah. Yeah, So now I'm like,
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great, I don't do any of that shit in my body. But now
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what am I supposed to put in it? And we get I mean with
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all of the diets that it's like paleo and keto and this and that,
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and I mean it's like it is so complicated, and I feel like there's
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ways that we can possibly simplify that. But in your practice when it talks
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to I think you do a lot about education on the best things for you
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and that is something that I have lacked with pain doctors that I've worked with.
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But I have been to so many pain doctors and they spent about seventeen
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seconds with me, and I'm like, here's my list of the things I've
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tried, I've done, I've done this, I've done that, here's my
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thing, here's my synopsis. Do you think it can help me? And
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instantaneously with I would say five, six, seven pain doctors, every single
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one of them was opioids or spinal cord stimulator. For me, I was
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not at a candidate for injections. I don't necessarily believe that that may have
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been true. So I think the educational part of what you do is really
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cool. Can you speak to that a little bit? Yeah, yeah,
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I think. And sometimes it's even helping the patient help themselves, right,
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And that's see empowerment, right, Like I can't do your elimination diet for
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you. I can put you in some directions or sometimes with patients like if
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you know, maybe this is a different situation, but I think there are
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parallels and it comes up a lot if there are patients who need to say,
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lose weight, you know, right, Like we can talk about weight
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may be a factor in your pain, it's probably not the only factor.
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But if we can optimize you, maybe we can optimize some of that pain
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signaling in the body. If you have enough fact that there's excess inflammation,
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maybe we can help improve that. And a lot of times that's such a
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process. So in terms of like weight loss, right, there's no one
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magical weight loss diet that works, right, if that's the person's challenge.
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We don't have like one diet that works for everything. Right, everybody is
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every body. We have our own little system here, we're our own personal
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universe. Yes, your own personal universe. I love that, And so
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I think it's the same for the pain patient who might be exploring just from
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a standpoint of are there dietary things I can do to improve my pain level?
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Right? And so there are people for whom going gluten free will be
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really impactful, or that low food map diet might be really impactful, But
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it's not going to be the same answer for everybody. So for me,
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you know, really in that meeting with the patient, very often I'm just
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trying to maybe acquaint them with those ideas, and also you know, walk
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that line of like I'm not exactly saying that you know, the ideal diet
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will fix every problem, but that it may be worthwhile because like if we
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get to where, hey, I've tried a bunch of medicines, I've tried
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a bunch of injections, and I'm feeling kind of stuck, you know,
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it may be that that's kind of what there is is digging deeper and diving
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deeper on dietary factors, lifestyle factors, et cetera. Yeah, I mean
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what you put in your body is a huge component to how we feel.
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I mean, think about Thanksgiving. Everybody eats so much food on Thanksgiving and
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we all fall asleep and feel like crap. Yeah, because we're so full.
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That is what our body's response to what we just put into our bods.
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Right, And I experience that there are days that I am not perfect
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with my nutrition there far. I'm actually far less good about nutrition only because
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I don't give myself enough. And that's for a different show. But it
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is definitely a challenge because when you're dealing with pain and you're dealing with the
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nausea that comes from pain, and you're dealing with well, everybody's told me
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to do this and none of that works. That hopelessness, that that loneliness
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that comes with pain, especially when you're alone at night with it. So
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within your practice, when you've got people that come to see you, do
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you have a lot of patients that come to you that have used opioids,
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that are dealing with opioid addiction issues that you work with. It does happen
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sometimes. I mean, so we have kind of a branch of the practice
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where we see patients for addiction specifically, and you know, the patient might
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acknowledge, you know, hey, I've been using or over using medication or
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street drugs even and that might be totally separate from a pain issue, right,
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because you can have both, Right, you can have pain absolutely and
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also a separate kind of addiction issue. Yeah, and pain also can be
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a mental pain as well as physical pain. And I think where there's a
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blurred line is between a lot of opioid addiction comes from a lot of mental
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health issues, and then it may have come from an injury that got started
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and then the injury has already resolved itself and now they're addicted to this and
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now they've got this other problem. I mean, I read about it all
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the time, it's such a slippery slope. And in fact, the thing
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I would share is a little statistical info. So twenty percent of Americans would
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tell you they have some amount of chronic pain. That's a lot, you
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know, that's a lot. A lot of people have some amount of chrimeic
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pain. And there's eight percent of Americans have high impact chronic pain. And
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so that eight percent is people who you know are maybe disabled or need significant
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daily medication. And then I think the number is maybe more around three percent
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who maybe take a daily opioid. If you ask people who are in treatment
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for opioid use disorder if they have chroduct pain and or did they have it
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before they started using opioids, that number is like forty or sixty percent of
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those people will say they had pre existing pain and that it had to do
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with them starting to use opioids. Yeah, I mean absolutely. I remember
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there's a girlfriend of mine who just had like just this incredible chronic back pain.
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It was just debilitating, and she ended up after getting on opioids,
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she ended up getting the pain resolved in her back and then ended up like
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skid row style, just didn't the pain was gone. But now she entered
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into a whole different kind of pain. Yeah, it's a tragedy and it
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is. It's very sad. And we hear about, of course in the
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news, our opioids, our opios, our opios, especially here in the
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United States. You know, it's a scary place when you live in pain,
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because you get so desperate, and that desperation is something that you know,
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coupled with CBT and coupled with other strategies and nutrition and having a good
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support system. I am so fortunate that I have an incredible support system.
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And I don't think that I am in the majority. Yes, I mean
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I think, and I am grateful so to everybody that loves me and supports
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me. Thank you. But it is just like one of those things where
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I have girlfriends and friends and all of these people. A lot of this
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happens with women more than men, at least in my experience. We take
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on the world, getting down to the root of why we feel the way
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that we feel, and the reason why we were alone in all of this.
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I mean, there's so many things that I can talk about with them.
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I don't want to go on my own slippery slope on that too.
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There's a lot. There is a lot. There's a lot. And I
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think for people with the high level of pain, right, and say,
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for instance, in your situation, Okay, I have a high level of
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daily pain, I'm not necessarily taking an opioid medication. And I do find,
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you know, in the healthcare world that I work in, you know,
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if I hear the experiences of patients like yourself, you know, going
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to a doctor or going to the er with these big complaints of pain,
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you know, healthcare providers, you know, start to conflate that with like
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you're asking for an opioid, right, Oh, absolutely, And as a
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patient, you know, it's important and helpful for you to be as clear
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as you are about Hey, here's what I'm experiencing, and here's what I
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also maybe don't want. You know, if you're in a situation where you're
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like, I'm not asking for an opioid, and getting really clear on that
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I think can be helpful for the team. Yeah, that's a good tip
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because one of the things that I have made absolutely abundantly clear whenever I have
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met with any doctor, any general prep to anybody, anybody that's working with
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me in my health and my bod, I always am like, I will
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not take a pain till I am completely I am not a pain pill seeker.
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I will not do that. That's not my jam. But if I
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need to, under an emergency situation, need something, what do we do?
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Because for example, oh, this is a good example because like like
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I mentioned earlier in the episode, I could not physically put my feet on
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the ground, like there was absolutely no way. So I'm rolling like a
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corn dog in my bed onto an automan, into my wheelchair and then getting
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on the floor of my bathroom. And then my sweetie is lifting me and
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putting me in the shower. And he's a big farmer guy. He loves
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it. He thinks it's great. I am. He's like, Lindy,
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you seriously need to consider at least having something here on these kind of days.
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Right, what are your what are you? What are your thoughts on
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that? Because it's it's it's such a scary thing for me, and I
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don't want to ask. I don't want to. I don't even know the
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right questions to ask without doctors thinking that I'm seeking. It's tough. I
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mean, I think I would maybe share a little story almost like you know.
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So here's what's not exactly true is like what doctors or what the oxyconton
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folks were saying in the nineties of like, well, as long as you're
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taking it according to your doctor's direction, it's no problem and there's no way
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to develop an issue, right, Okay, we all know now that's not
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true. Yeah, you know. Oh, or if you take the long
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acting medicine, well, those aren't really have it for me. Well,
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that's probably not really true either. I also say ambient doesn't habit for me.
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Yeah, your body can get very used to that. Yeah. You
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know, what I would say is, you know, I treat patients and
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there are people who are able to use an opioid medicine on a sometimes basis,
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And but I would also respect, you know that the patient who really
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knows themselves, who's like, you know, I just don't think that's good
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for me. Okay, Well it's worth a discussion. You know that that
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is one of the options. That doesn't mean it's the option for you.
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You know, I do have patients that will sometimes have you know, a
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small amount of medication that's for you know, emergencies, and it might be
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something they might need to refill on once a year, you know, almost
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like you know, there are certain certain headache medications that you know, maybe
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some neurologists or some pain doctors will give you know, a small amount of
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once a year just for those emergencies, as long as the patient can manage
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that, you know, I think that can be a reasonable option. But
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it also doesn't have to be an opioid medication. You know, I have
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a perchance who can use you know, certain muscle relaxers like that, or
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even like a high potency anti inflammatory like catorial ac or tour itt all two
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medicines I've never heard of, Okay with all of my years, right,
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and so this is exactly my fricking point. You giving us tips on questions
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that we need to ask. And also it's expectations that we have for these
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doctors that are like, well, do all of this and this is what
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you're supposed to do. Well, you're the doctor, so you know everything.
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I'm like, wait a second, I know me better than you will
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ever know me, and that is not something that I want to do.
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That's not the paths. Can you talk to us about alternatives to opiates because
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that is like ding ding I'm in. Yeah, So I think you know
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with patients, you know, talking through you know, if I'm seeing a
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patient and you say, hey, I've never heard of either of those things.
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Okay, well, catorilac or a tourtole those are the tourtal is a
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intramuscular injection a lot of times, and people will give it in the er
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and it has pretty good data. Sometimes doctors will quote that like tourd all
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is equivalent to ten milligrams of morphine, like in its potency like in there,
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oh, trying to compare like is it effective. Yes, it's quite
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effective. It's super effective, but it's also kind of rough on the kidneys,
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and so it's not a daily medication. And then to your point about
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like I'm having a horrific day, I'm not able to get out of bed.
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Okay, this is looking like a tourt all day. Let me see
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how this goes and try, uh, you know, maybe a dose of
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something like that and see if it could be a difference maker in terms of
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moving things in a better direction. Is that is that something that's prescribed,
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like I give myself a shot. I know, I'm sorry we're getting a
20:03
little bit myopic here, but I'm just curious because because I've never heard I
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mean, this is insane. Yeah, not every doctor. It drives me
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nuts. Yeah, I am like I I this is where we get so
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lost in this because it's like, you're going to do this, do this
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to this because this is what I'm used to doing, and not exploring me
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as a woman and my body and where I am in paramentopause and all this
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other stuff that's going on and how that all works together holistically. Yeah,
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And I think this that's the frustration that many of us have with the healthcare
20:33
system obviously, is that you know, we're really not reimbursed very well for
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the time that we spend with patients. You know, you guys are doing
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a bunch of paperwork. Yeah, it's it's tough. It's really tough.
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And I actually, you know, enjoy spending time with patients, but it's
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tough because you can't. It's hard to balance the needs of like, Okay,
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well I need to see enough patients that you know that we can support
20:55
my staff and support what we do. But then I also want to like
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spend enough time and be impactful in those conversations that we have. So it's
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a balancing act for sure. And you know, we try to just try
21:06
to find our way. But I think it's true, you know, so
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it's it's easy to you know, on the doctor's part, on the provider's
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part, to like write a prescription send the patient on their way. The
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prescription is the intervention, right, and it's it's standardized, and so we
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can know like, oh, well, scientifically we know that this works.
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But again, I think there's just more to it than that. And the
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clinical judgment of picking a good medication for the patient, matching a treatment with
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hey, here's somebody that mostly wants to not take a med but just needs
21:36
something for certain days, and the clinical thinking that goes into that, you
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know, are we really are we really in healthcare like teaching that and transferring
21:45
that the way that we need to be, you know, I'm I'm starting
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to question maybe not. And frankly, the length of time that we have,
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you know, in any one patient interaction is also a limitter in terms
21:56
of how well we you know, communicate and think sure. And one of
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the things that's frustrating, I like to say fuckstrating, but one of the
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things that's fuckstrating is I go in with like a detailed like print out of
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all the things that I've been through with my diagnosis, timeline, things,
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I've tried, things that have worked, things that haven't, so on and
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so forth, and I'm like, please, don't come into the room until
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you've at least like looked at this one page that I'm giving you. It's
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almost like my own personal healthcare media kit, by my own pr for my
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health. And I'm like, can you back? Here's Lindy And I'm like,
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okay, did you look at this? And he's like, oh,
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well, my my whatever, you know whoever didn't give it to me.
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And I'm like, oh my god, just can you read this without asking
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me seventy two thousand questions over and over again when I've just answered all of
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them. So now we've taken fifteen minutes answering questions. I've already provided you
22:48
answers for when you could have spent some time actually getting to know me a
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little bit. And I know I'm a lot, but I'm a fun pain
22:56
patient. I'm not gonna lie. I am fun and I would be stoked
23:00
to be my doctor because I look at things in a different way than a
23:07
lot of pain patients do. Where I've just got this optimism that's in me.
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I have my days where I'm like, fuck it, I'm out,
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I'm out, I can't do this anymore. I do and I reach out
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to my personal board of directors when I have those days, and I say,
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hey, this is where I'm feeling. I'm hopeless, I'm lonely,
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I'm this, I'm that I don't want to be here anymore because I can't
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put up with this kind of pain. And then they immediately shift me back
23:32
in a year and then you know, five hours later, I'm good to
23:34
go. Yeah. Yeah. Do you deal with a lot of issues with
23:40
your patients in regards to like suicidal ideation? What do you do in regards
23:44
to that with your with your practice? Yeah, it's challenging, Yeah,
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it's not. It might be less often that a patient also divulges that,
23:56
frankly, right, because you know, and I think there's you know,
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there's something called like passive suicidal ideation when when you're like, well if I
24:04
was dead, that might be better, you know, but you're not really
24:07
planning to me everything about it, that's right, and don't I just go
24:11
away? Let I just go away. It would be so much easier.
24:14
A lot of people have some kind of low level of that, yeah,
24:17
that we probably don't talk about a lot, And frankly, I would say
24:19
I probably don't ask because you know, it's it's kind of more in that
24:25
mental health realm where where I'm going to start referring you to to those folks,
24:30
you know, So I think we don't necessarily draw that out, if
24:34
I'm honest, But I know that patients sometimes are feeling that way, you
24:37
know, when they're really challenged and when things are bad. I did have
24:42
a patient lately who had gotten to that point and really actually had voice with
24:47
as a young person in her twenty early twenties that lived with her parents and
24:51
had voiced some of that to her mom. And I ended up speaking with
24:55
her doctor who referred her to me, and you know, we kind of
24:57
work together to get her in some other treatment it right away. So that's
25:00
been you know, I think that the things we do it just is just
25:06
taking those next steps, so communicating with other doctors, you know, suggesting
25:10
treatment. I have another patient who's voiced some some of that passive suicidal ideation
25:17
that's it'll work up for ECT actually and going to maybe go down that road
25:21
of you know, just more in depth mental health treatment with a strong mental
25:26
health provider in our area. Yeah, and I think that, you know,
25:30
with with chronic pain, our brain changes, you know, I mean
25:33
we change. I know that I am a very different person than I was
25:36
a decade ago. And they're like imaging not just because I'm older. There's
25:40
like imaging evidence for that too, that like patients and chronic pain have loss
25:44
of of some of the you know, cortical matter of the brain. Frankly,
25:48
that it's it's very taxing on the brain that that brains of patients with
25:52
chronic pain do change over time. Yeah, especially when you're kind of like
25:56
a brain like me that still thinks that I I am a downhill ski racer
26:02
and I'm a yoga instructor, and I'm hiking and biking and walking my dogs
26:04
and doing all these things. That part of me is all here. I
26:08
can't do any of it, not yet. Not yet. We're working on
26:14
it, baby. That's why I'm here. I mean, I'm here for
26:18
everybody that's listening, and I'm here for you too. But the reason I
26:21
started this was because I'm going to get out of a wheelchair and I'm going
26:22
to do all the things that I want to do again, right, And
26:26
so those low days that are very very sad and very scary places, those
26:32
thoughts have come up. And it's something that's fairly new. But I know
26:36
that a lot of medications can cause those thoughts as well. And I experienced
26:41
that early on in my in my pain treatment with the pain doctor in Los
26:45
Angeles who put me on like every trip to Lene Family Medicine that they possibly
26:51
could. It was like touch and go, and I'm like, I don't
26:55
I don't want to kill myself. Why do I feel like killing myself?
26:59
Like I am way too awesome to die right now? This is ridiculous.
27:03
And so that scary part is part of living in pain too, because you
27:08
go in these dark and twisty places that you never would have thought was even
27:11
available within you. Yes, are there within the cdcmsor I'm going to take
27:18
a swift change really quick. When it comes to like the CDC and prescribing
27:23
in all of these medications, what are they doing as far as guidelines in
27:29
regards to you guys prescribing for us? Are they good for the patient or
27:33
are they good for the pharma? M I don't even know who they're good
27:40
for gosh, I mean, good answer. Who is it good for?
27:44
Maybe nobody? Yeah, you know, I think the CDC Guidelines of twenty
27:48
sixteen were very well intentioned, and they were really trying to say, like,
27:52
hey, you know, let's move prescribing. You know, most patients
27:56
should be not in a high dose opioid situation. Let's start with low doses.
28:03
Let's refer people to treatment if they have a problem. Like a lot
28:06
of the basics are like pretty reasonable, but then they got like interpreted in
28:11
such a way that like, these are absolute rules. And the CDC Guidelines
28:17
of twenty sixteen were then put out in a revised form in twenty two where
28:22
they literally had to say, these guidelines are meant to be for the physician
28:26
and the patient, and it's not for insurances, and it's not for state
28:30
boards of medicine. And they really had to kind of come out and say
28:33
that because it suddenly was a very easy crutch, you know, for you
28:38
know, a regulatory body or for an insurance to just be like, oh
28:41
great, we don't need to pay for any opioids over you know, ninety
28:45
milligram morphine equivalents anymore. Because these guidelines, So why don't we just do
28:49
that and save ourselves some money? You know, it seems to me like
28:53
that was like an easy thing for you know, for profit and to incorporate,
29:02
to save a little money. And so in the guidelines weren't meant that
29:04
way, but in some cases that's how they were interpreted or tried to be
29:08
used. Well, it's like we can interpret the Bible as many ways as
29:11
we want to. I mean, any story and the fable, anything we
29:15
can put in anything we want to in between the lines. Well, you
29:19
know, I would say, you know, for doctors who didn't want to
29:23
write any opioids anyway, you know, right there are doctors who are out
29:26
there that just want to do the procedures or just want to do the infusion
29:30
or do the implan or whatever. And look that's fine, but just you
29:34
know, for those doctors that are like, hey, I don't write opioids
29:37
in my practice, at least hopefully if they're upfront about it, right,
29:38
because because there are doctors that say that. But I think where it gets
29:42
challenging is there are all these doctors that do it, but maybe they hold
29:45
their nose or they don't want to, or they don't want to engage with
29:48
it, or they don't believe that it works, you know, and then
29:52
for some of those people, those types of guidelines could could be used,
29:56
you know, also as like an excuse, you know, like hey,
29:59
well we're only doing X Y Z in the practice because this is what the
30:02
CDC guidelines say. Well, okay, you know, and ultimately, you
30:07
know, one of the challenges that I have, you know is you know,
30:11
as a as a prescriber, you know, we should you know,
30:15
I should you know, prescribe in accordance with you know, what I think
30:18
is beneficial to the patient. And it's not necessarily just what the patient thinks
30:22
it's beneficial to the patient, right, and so if and there are times
30:25
we might or might not be able to find common ground. You know,
30:27
if the patient thinks something is beneficial that I don't truly think is beneficial for
30:32
them, there there are going to be times we might not not agree.
30:37
So you're ethical weird, weird, it's like super weird. So you're saying
30:47
that when I go into a doctor's office, I'm not necessarily always right.
30:51
Yeah, Yeah, that's how we can find common ground and you know,
30:55
understand each other or or even you know, maybe we agree to disagree on
30:57
one or two things. You know, I think I think it's challenging sometimes
31:03
though, right patients and doctors to find that common ground. And yeah,
31:07
really, my point I think is really just that I think the CDC guidelines
31:10
have been kind of scapegoaded, as you know, hey, this is the
31:14
whole problem. You know, we've got to obey these guidelines and it's not
31:17
exactly that. And you know, doctors are supposed to use their own clinical
31:21
judgment when treating patients. Yeah, and I think that again to support the
31:25
whole idea of like, we know our own bodies far better than our doctors
31:29
do, but we also don't know what we don't know. And you know,
31:32
I've I've learned. I'm a huge researcher. I mean I have to
31:34
be in order to even just do this show. But I also should have
31:37
like medical degrees on my wall because of how much information I come to a
31:41
doctor with. And I'm like, so I want to know about low dose
31:45
nel trucks and why have I not known about this for eight years with CRPS?
31:49
Just found out about it? What, Like it drives me bonkers,
31:55
And I'm like, it's such a. It's such a tumultuous road that you
32:00
have to walk on, and I really want to make sure that everybody does
32:04
have hope here because people like you that love and are here to really educate
32:12
us and give us tips on how to communicate, because I think that's the
32:14
biggest thing. I'm like, can maybe I've been doing this all wrong on
32:16
how I communicate with doctors. I just gave up. I stopped. I'm
32:20
like, I'm not going to a doctor. I don't even know the last
32:22
time I went to doctor outside of like labs and emergency urgent care kind of
32:25
thing. Because I moved into functional and it's expensive as hell, yeah,
32:30
because our healthcare system won't pay for it. But that's the only place that
32:35
I've started to see benefits in my life and some of that functional medicine concept
32:39
to maybe do specific testing on how your body works and optimizing nutrition yeah,
32:45
I'm a fan, yeah, and how it responds to things, because with
32:49
you, I mean, there's got to be sensitivities and reactions that come with
32:52
pain medication and anesthesia, right, and that's different for people. How do
32:55
you broach that, you know, we're not there yet for the science of
33:01
like the genetic testing to be entirely useful in the field, right, because
33:07
so imagine this you've got like you know, you they were talking about a
33:10
medication and how does your body process it? And how do you feel when
33:14
you take it? And how does your pain respond to it. The trouble
33:17
is like our output with pain, it's not an objective number like a blood
33:21
pressure, right where just like we can then take your blood pressure after that
33:24
pill and that bigger dose, and we know, like here's what it did,
33:28
and there's so much that goes into how you feel and you know,
33:30
okay, there's the pain score number and yeah, we ask people about it.
33:35
Are you a frown face or are you a flat face or a happy
33:37
face? Super scientific? Yeah yeah, And like you know, what science
33:44
will tell you might be more impactful and what patients might tell you to be
33:46
more impactful is like, well what can you do? You know, how's
33:49
your functional status? Like well, you know, I was I was doing
33:52
okay, like walking to the mailbox, and then the last two weeks my
33:54
hip's been really bad and I can't do that. And so the part from
34:00
the the processing of the pill by the body to like what it does to
34:04
your brain part and how you feel. We don't the measures on that end
34:08
are so non existent that we can do those, right. We can do
34:14
those genetic tests and get some information, and I think they are useful sometimes
34:19
in psychiatry and for titrading certain antidepressants. You know, I think they can
34:22
be informative for those providers, but you know, for me, it's just
34:27
not ready for prime time and pain management. Sometimes patients will come to me
34:30
with those results, but it doesn't necessarily mean we, you know, will
34:35
or won't prescribe you a certain thing before we wrap up in everything. I
34:39
one of the takeaways that I had with you in our meet and greet was
34:43
you leaning towards this whole idea of focusing on the yeses in our lives when
34:49
it comes to pain management. So can you speak to us a little bit
34:52
about your philosophy on that, because I think it was pretty cool. Thank
34:54
you. Yeah. I think you know, sometimes there's like you said,
34:59
well, this medication and doesn't work for me, or this this thing doesn't
35:01
work for me, and finding shifting shifting to where we can find things that
35:08
do work, things that are helpful for how we feel, and that may
35:13
be things in our in our lifestyle. Very often. I think that,
35:19
you know, in terms of helping patients with their lifestyle management, it's really
35:22
those like like five factors of well being, just briefly to mention those like
35:28
sleep, diet, movement, community, and stress and helping patients manage those
35:36
items can be so impactful for chroduct pain. Yeah, and that's a lot
35:40
to throw on just a pain doctor. It is. So that's why we
35:45
do need that community. We do need that support network. I am here
35:47
right now as a support network for you. I am here for anybody that
35:52
listens to the show that just wants to. I mean, I get more
35:54
like Instagram messages and emails and stuff, and it's getting more and more.
35:59
So I'm so grateful for because it means I'm touching at least one person every
36:01
day. Yes, oh man, I want to talk to you forever.
36:05
Yeah, so much unpack. But we can't thank you of course. It
36:10
has been so wonderful to be here with you today. So we can find
36:14
doctor Merritt all over the place. She's on Instagram at live stream HC.
36:19
She's on Facebook at live Stream Health Center. I'll put this all in show
36:21
notes, of course, and on social media. She's on YouTube, she's
36:23
on Twitter, akax, whatever, LinkedIn, and but her website you can
36:30
go to first and foremost where you can get all this information about her practice
36:34
is lifestreamhealth dot com. And as you've noticed, she's incredibly wonderful. And
36:38
one of the things I love about your your speaking voice is you make me
36:44
feel calm, and as somebody that never feels calm, clearly, it is
36:50
nice to have a conversation with you because I feel safe with you. I
36:53
know a lot of people that live in pain, deal with a lot of
36:55
fear of unknowns, and you don't make me feel scared, So that's good
37:00
to hear. Yeah, No, I think I would just share this candidly.
37:04
I mean, I think there again, there are these folks in pay
37:07
medicine that don't love it. And I've come to start trying to communicate this
37:13
to patients and relate to doctors like you've got to have your own head on
37:16
straight to like do this type of practice. And so for me, like
37:20
my own journey of just getting my head in the right position, I think
37:23
can really help patients coregulate and you know, get to a better spot.
37:31
Well. Yeah, and trusting interesting. Yeah, yeah, yeah, it's
37:37
a big part is trusting. And when you've gone through doctor after doctor after
37:40
doctor, and surgery after surgery and pill after pill, you start to lose
37:44
hope and you start to lose faith and the people that are supposed to be
37:47
helping you along the way, you know, right, that's why we're here
37:51
to say that we've got people that are out there that can help you.
37:52
Guys. All right, so don't ever give up on you, don't ever
37:55
give up on your life, don't ever give up on your pain management journey,
37:59
whatever that pain might be. This was a physical conversation more so than
38:02
a mental and emotional all of that. But guys, it all kind of
38:06
falls together. You know. Pain is pain is pain. Love is love
38:09
is love, and that is all we are here to do today. So
38:13
thank you so much for being with us today. I appreciate you. It's
38:15
been wonderful to meet you, and I can't wait to see what you're coming
38:20
up with next. You're amazing. Thank you for what you're doing for the
38:22
community. Oh, thank you so much. You are exclusively invited to share
38:27
this falling in Love again with Pain Management v IP pain journey together. Let's
38:31
get to the heart of how to heal with you by my side. Is
38:36
there anybody today in your life that needs to hear this conversation? Or did
38:39
you need to hear this conversation? Are you feeling lonely? Are you feeling
38:43
hopeless? Are you feeling sad? Are you feeling like you there's absolutely no
38:47
way you're gonna get through it. Please reach out to us. Welcome to
38:51
the Pain Game Podcast. That's what we're here for. So let's connect.
38:53
Let's hear your stories of strength and grit and merit. See what I did
38:59
there. I am here to help provide a safe place for you of vulnerable
39:02
and raw and open honest to share your most incredibly powerful stories. So follow
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39:21
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