M 40 Opioid Management 360

a doctors perspective minisode 40 justin trosclair opioids
Minisode 40 Opioid Management 360

Patient education on post surgical expectations of pain, living with low grade pain, 30 day treatment cycles with 4 different specialties are all aspects of how to reduce the opioid crisis.

Dr. Justin coming at you with the Minisode version of a doctor's perspective, Episode 40. More moving right along. If you're curious, not every episode of every podcast I listened to, I'm going to summarize like, I've listened to a few as I man, this isn't, I don't have much to say about this, or I thought about like one episode, one series I listen to they're only like 10 minutes apiece, as well. I guess I could listen to four or five of them and then make one episode out of that. I just haven't done it.

As always, if you have an episode of a show that you like, let me know I've had a few people reply Hey jury, check out this podcast like someone recommended the Choose financial independence. So I downloaded six episodes, and you'll probably hear a little bit of some of those, you know, at some point, I'm a fan of being frugal paying off debt living within your means.

I'm a geo arbitrage type of person. That means you make our wages, but live in a cheap country or your lease, you lower you're you live in an area where your cost of living is lower. I hadn't heard that term before. But it's like yeah, that's me, is a great, who cares if you make $200,000 if you only save 1% of it.

Okay, but today's episode, if you have any thoughts on that, send me a direct message. You can get my email mailto:Justin@adoctorsperspective.net . If you have any concerns, need any help creating a budget, get your health in order, practice management, marketing, all that kind of stuff, obviously get a lot of free stuff on a podcast, but if you need to go deeper in your one on one level seven email, I will definitely help you with it.

Today’s episode is the move forward PT, opioids. Yeah, opioids. 2.4 million people are misusing them. 131 people die per day, I'm gonna repeat that 131 people died per day on opioids. This is the first time in the last decade, not the decade, 30 or 40 years, probably the life expectancy has dropped by two years. Two years. So that's not good.

They did a panel they had, they had influential people in PT government officials. And then a couple of patients who, you know, patients, family victims of people who've died from opioids, and they were just didn't even see it come in, like normal person went in for surgery, got addicted to the painkillers and life spiral down. And now, I don't know if I just hadn't read the research or what it is.

But it's interesting, like some of these people, it's not like they were drug abusers to begin with, or alcoholics or whatever, but somehow they get on this drug. And I don't know if it just ease the pain of life that they weren't talking about, or was just really was just this chemical thing that happened in their brain and just like, Whoa, this is a great feeling or like, no, it doesn't feel great, but then I just mess with me so much like, I can't get off of it like now that pain increases, you know, like they would draw thing. But anyway, they said the pain that these people are going through is real.

The pain is real, just why they're on it. And it's hard to get off of it because they still have pain, like the withdrawal symptoms.

So one of the things that patients kind of complaint about is they didn't know the procedure for post-surgery care. They didn't know what to expect from the surgery. Like as far as pain goes, and pain management, you know, you've got five or six different doctors running in and out of there, whose responsibility was it to talk about that? And they're saying that's what's missing? Because they don't know, I should only take this like two or three days? Should I expect six weeks of pain? What about physical therapy? I got my knee replaced mean, should I take this for the pain of like rehab? Should I just take an incentive? Should I just grin and bear it during the process?

So you don't know you could extend the usage more than expected for yourself and the doctors. So whose responsibility is it? To talk about this? Do we need to figure that out?

And luckily they do they have a guide for non opioid options. And it's taught in most settings these days. I'm guessing there's probably like seminars and hospitals or like Continuing Ed, I don't know if it's like mandatory kind of like with us, we have to have an ethics and moral code class and documentation class, you know, every year every two years have been on your state as a refresher. So maybe they have the same thing and some of these medical conferences? I don't know. But they did. They did say that there are many more classes that you can download, and then you can attend to find out what is the latest on this.

It's not the first choice for chronic pain. I hope your users, not for chronic pain. It's only for like three days after three days is not recommended. There's a blood test now to show abuse. And you should also pair non-opioid options like exercise, massage, chiropractic, yoga, acupuncture, and physical therapy. Now that they mentioned chiropractic on a PT episode, no, but we all know that's the case.

 If you want to bring more legislative action, talk to your local representative so that they know the devastation. They get enough reports of like, wow, this is horrible. I can't believe this is occurring in my little small town of 5000 people. I thought that was a big city issue. They talk about it, they talk about their friends, politicians, and it worked its way up to Congress, or you just talk to those representatives to make the real deal. But it may have to happen on a state level first.

Now, some of the people they had on were like addiction counselors and recovery settings and things. They would have group settings, they will spend an hour with the physical therapist an hour with a pain psychologist an hour dealing with anxiety and sleep issues an hour with occupational therapy and an hour of relaxation training. Now, all of those things together really helped combat the issues that he had. Because it's not just about the opioids, it's all the other stuff in life that they're having to deal with. Like they have pain, they have chronic pain, they could have had pain for 10 years because I'm back injury, nothing's working. I can't cut my grass, I can't stand I can't sit, I can't sleep. I can't make love. If I sneeze if I bend over like so there are too many days living are always dictated by their back pain. And it's debilitating. And it's frustrating and they don't know what to do.

And so all of those things like I said, PT, psychology, sleeping and anxiety, occupational therapy and relaxation. They teach them those things, lots of lots of self-care. So as a PT chiropractor, what can we think of?

You gotta teach them not to overdo it? And to do the proper mechanics of motion, so may take some training and find out what is it that you do all day? What's your job? Okay, you don't have a job? What's your life at home? Like? To find out what they do? and say, Okay, this is how you do these motions better? And then let them know like, Look, you might have three hours of housework do today. But can you spread that out over two or three days? Is it that important to get it done in one day? Like you might want to do it in one day, but can you spread it out? That way, you're not overdoing it. That makes sense. You got a car full of groceries, just take one bag at a time you gotta do a couple of extra trips, that's better than having 50 pounds of groceries and knowing that you're gonna hurt your back.

So a lot of it is mental preparation and counseling to help get off the opioid crisis. A lot of look pain docs, you know, people come in, you know, to when you wake up, you have pain, what your pain scale zero to 10. All right, first thing in the morning after you get off work and little the day before you go to bed at night. Instead of asking questions like that all the time.

A better way could be when you wake up. What do you do when you're at lunch? What do you do when you're at work? What do you do before you go to bed? What's your routine so that you can start to isolate?

 Like I did it the other day, the patient had to four millimeters and six-millimeter dis bulges move a numbness, bilateral and he's getting better? No five visits to it. And the sixth visit is kind of lingering. Sounds like okay, let's break it down. What do you do? I don't have a job. He's like young. He's 20. Like, all right. Do you sit around video games all day? No, no. Turns out, he's sleeping. He sleeps on his side, he was a very thin person. So I was like, okay, sleeping side. And there's this side, that hurts. All right, just put a pillow or a towel between your legs. It'll have your pelvis out, stop with too much stress and the low back and all those muscles. And a few days later, he's like, yeah, cool, that last little bit took care of it, like awesome. I'm not saying it to Steve like that forever. But try to do that for the next couple of weeks, and then remove it and keep doing your exercises for the next month. So things like that, you have to be realistic.

Now again, these are like the pain management doctors. So they're like you have to be realistic about managing the pain, we may not be able to get you out of pain forever. You may not be pain-free, but you're normally hovering around a six. If we can get you at two or three, you think he can handle that? Like this might be your new life, the pain of three all the time. But that's better than a six.

 So do you need the medicine out of three know if you can especially like in a business setting, get some movement experts into your setting into your business and teach people how to do things correctly to prevent some of these injuries from starting to begin with? Sure it cost them a little bit of money in the front end. But it saves them a ton of time talking about chronic low back pain and prevention of programs that teach you that is way less expensive than all that Miss time from work.

Not the end, they did say look, some of these programs, it's not a week or two weeks, these are like 30 days in a row commitment is not a call fixed. You gotta come for 30 days, you might be seeing multiple doctors like that place earlier with four different things that are for co-pays, so they can get expensive. He mentioned four different co-pays every day for 30 days. So that means that is something that has to be considered. They didn't have a solution for that part of it. But things to think about. Even Great.

Thank you so much for tuning in. Spread the word as always say, listen, think, integrate. Check out the regular episodes every Tuesday.  This week show notes for opioids are on the .net/40 We just went #behindthecurtain

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