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Radio. Hello and welcome to Fearless Fabulous You. I am your host,
Melanie Young, and you're listening today on the Women for Women Network W four
w N Radio. You can hear all my shows anytime anywhere on your preferred
podcast channel. I'm happy to be in my tenth season and my mission is
to get inside people's heads, particularly for women, to help them make informed,
comfortable choices about their lives and every aspect of it. Today we're going
to talk about a four letter word, and it's used very loosely, as
in, don't be a pain in the you know what, he's such a
pain. I'm in pain. This pains me. It's pain p ai N.
Pain is used very loosely in a lot of ways and a lot of
you know, dialogues, But it's serious business and a lot of people are
in pain. There's physical pain and there's emotional pain. But get this.
According to the Centers of Disease Control the CDC, which I refer to,
always roughly over twenty percent of adults have chronic pain. Okay, so twenty
that's like fifty million people chronic pain. I also notice non Hispanic white adults
were more likely to have chronic pain compared to non Hispanic blacks, and women
have a higher percentage of pain, and women adults are likely more likely to
have about twenty one percent high impact chronic pain pain compared with men. So
again, women get the brunt of it. You know what's going on.
So we're going to talk about pain. Hopefully you are not in pain,
if you are, but if you are, I'm hoping that the show will
help you. I have a pain expert joining me today. She's a PhD
in m d Doctor Andrea Ferland, an Associate professor in the Department of Medicine
at the University of Toronto and a staff physician and senior scientists at the Toronto
Rehabilitation Institute. She's a pain specialist with a YouTube page. It has more
than four hundred and eighty seven thousand subscribers in more than forty two million views,
so she has a following. She's also author of a book just out
called Eight Steps to Conquer Chronic Pain, A Doctor's Guide to long time,
Long life long sorry, long life, long backwards. I'll do that again.
Eight Steps to Conquer Chronic Pain, A Doctor's Guide to life long relief,
lifelong relief. So we're going to cover pain in all its forms,
and also what's not pain, and also why you shouldn't be using that word
so loosely, because it really there are a lot of people feeling pain.
Doctor Ferlin, Welcome to Fearless Fabulous. You. Thank you so much Malanie
for inviting me. Well, I have been reading an e copy of your
book. There's a lot of interesting information in here because I don't think I
know anyone who doesn't have pain of some kind, and we're going to explain
that of some kind. So I want to get to the you know,
the basics, what is pain, how do you define it? What is
pain? And what is not pain? As you note in your book.
Yeah, I think we all know what is pain. It's an unpleasant sensation.
And we all know acute pain from you know, a toothache, earache,
bruise, a fracture, and inflammation and that hurts. So that is
pain. It's it's defined as an unpleasant sensation that is interpreted in the brain,
and that's mostly acute pain, which is not all humans experienced this,
believe it or not. There is a genetic hereditary condition very rare that the
person is born without the ability to a few pain. And those people they
die in young age because they can't protect themselves from harms and diseases and injuries,
physical pain. And we're talking mainly about physical pain, correct, Yes,
this is a lot of emotional pain, which is a whole other thing.
Now you know they are connected. They are connected. We can't separate
the mind from the body, especially in pain. Well, I want to
get to that because that was my name. You know, how does the
mind and body interact with pain? Because you know, a lot of people
say, oh, it's all on your head, you know, sometime always
on your head, can you you know? But you're very clear it's not.
So why don't you delve in that a little bit more. Yeah,
where when we say the pain is a sensation, it means that it is
interpreted by the brain. So it is in the head in some sense,
because you need the brain to interpret and to tell you that it is pain
or not. But when I think when people are gas lighted or they are
not believed, is when a person has chronic pain, which is different from
acute pain. I will explain that in a minute. But they go to
a healthcare professional and they can't find what is wrong, and they do all
kinds of tests, or they are still they're taking a lot of medications,
they're still pain. That's when you know they hear, oh, you must
be imagining this. It must be psychological. It must be in your head.
That's what it's not. Because nobody imagines pain and say I will be
feeling pain today. I want to feel pain, and then they start imagining
pain. Thought, that's not true. That's the main difference. If they
feel pain. If they say I am in pain. Even if we can't
find anything wrong with the body part that is hurting, they are in pain.
So the pain is always real. You talk about chronic pain and acute
pain, right yes, they're different. So how are they different. They
are different in a sense that there are two different conditions. Acute pain is
a signal that you have an injury. For example, if you have a
if you put your toe on fire, and then the inflammation and damage to
this skin because it will be a burn that will hurt, that's a huge
pain. Now, a person may be feeling pain for a long time in
a part of the body. Usually it's the back muscles. It could be
migraines, it could be abdominal pain, it could be an undefined pain that
nobody knows where it's coming from. That is different because chronic pain is constant,
ongoing pain all the time. They feel the pain a part of the
body. But the pain is different now because the thing is the disease.
Let me let me explain this. I talk about this in the book.
It's the alarm system of the house. I think when I explained the alarm
system, people understand better. So when you install an alarm system in a
house, you wanted to alert if there's a fire, burglar, a leak
in the basement, something wrong. So you install sensors and the sensors can
be like a smoke detector or burglar breaking detector. So acute pain is that
the sensors are working normally and if the aligm makes noise goes off, it's
because something's broken, damage or lesions. There is a problem there. You
need to call the fire truck, the police, or the ambulance. Now,
when a person has pain, chronic pain, it's similar to the alignming
system is malfunctioning. So there is a problem because it needs to be fixed.
They're not imagining there is a real noise. The problem is not that
they don't need to call the ambulance, firetruck, the police. Now they
have to call a different person. They need to call the alarm company to
fix the pain system. In the majority of cases of chronic pain, that's
where the problem is. Because the initial injury has healed, the disease is
gone, it's treated, but they continue feeling pain. It's because the pain
system is sensitized and they need to really train the pain system. So that
that's why we say the treatment for a cute pain is different from from chronic
and some things that work for a cute doesn't work for chronic. It's interesting
and it is a big misconception. I was looking at her. I do
a little research for every show, and I looked at the biggest misconceptions at
pain. That was one of them, because yeah, a lot of people
also think that pain is a thermometer, that something is wrong. And I
think when you ask me what pain is not thing is not a good thermometer
because a person may have a lot of injury not feel any pain and a
lot of another person may not have any injury and feel a lot of pins,
So it's not a good thermometer. That how the amount of damage.
Are sensitivity to pain hereditary or I mean some I know some people like my
mother was sensitive to pain. God loves you know. Other people are not
sensitive to pain. And some people say you have to grin and bear it.
Let's talk about pain sensitivity and when you really it's not called the Grand
and Barret. Yeah, there's a lot of research in this area. It's
very interesting. Women is more Usually women is more sensitive to pain than men.
So we know this in female animals. In humans, it's consistent women
is more sensitive. We don't know why. We don't know if it's because
of these sexual hormones, if it's because of the genetic composition. Actually we
don't know why, but all the laboratory studies they come to the same conclusion.
But there is also big variability in the population in general. They do
some laboratory studies where they provoke pain. Imagine, I don't know who would
come to laboratory to be, you know, subject to pain, but they
do. And they bring these people men, women, all kinds of ages,
and all kinds of background, and then they apply the same painful stimulation
in a laboratory, so they know it's the same thing, but people respond
very differently. Some people will say, wow, this is a one out
of ten. Other people say this is a nine out of ten with the
same simulation. Yes, and as pain get worse as you age, well,
it doesn't get worse as we age. It's just that as we age,
we just accumulate more diseases, more injuries, more lesions to your body.
So the tendency yes, older people. Among older groups, the incidents
prevalence of chronic pain is one in three all the adults. When you mentioned
one in five adults, but it's one in three all the adults. And
that's just because people accumulate during lifetime more conditions health conditions. Diabetes is a
very important cause of chronic pain because diabetes can cause lesion in the nerves,
and the artried is fibrom alga and your pathic pain surgery, surgeries and other
things. That is a very good starter for chronic pain. And so if
people start having more surgeries during a lifetime, they will have a tendency to
have more chronic pain. You know, I didn't think fibro fibro my alga
was as common as it is, and I didn't realize it was like your
entire body and it's just chronic. It's like chronic pain throughout your body.
Yeah. Sometimes I feel like, you know, the weather. I think
weather effects, Like it's raining, where am today? Doctor frown and I
feel more pain today. It's cold and wet, and I'm like, oh,
every little tendon in my body hurts. Not bad. Yeah, but
yeah, I think weather it doesn't make it worse, right, Yeah.
They say the researching this area is very vague because it's hard to prove.
It's hard to pinpoint where the problem is. But we hear this a lot,
especially in people who have a joint problems like our tritees rhumatoried trities.
They tell us that they can be a good forecaster. They know when to
change. The weather is going to change, and it's it seems to be
more related to pressure, biometric pressure than temperature itself. My mother was that
way. My mother acute acute rheumatori arthritis, the worst ever, and she
couldn't you know when it rained. It was a disaster here and it you
know, I feel for people who are in pain because it really affects your
ability to function well. You talk about so if somebody's experiencing pain, they
should seek help. I mean, you know, that's number one message to
everybody out there. Don't just you know, grin and bear it and hide
it, because there could be an underlying condition that has to be addressed.
You have to talk about. You use a method called the Socrates method to
work with your patients and understand the pain and diagnose it. Tell me about
that. Yeah, So when I see people with chronic paining, it's interesting
that they come to my clinic and then they have like a twenty year history
to tell me in thirty minutes. So I want to listen and I want
to give them, you know, all the attention that I can, but
sometimes I have to tell them thieves. Help me help you. I need
to I need to know the details of what is that you're feeling? How
long did it take? And don't tell me everything would started twenty years ago.
And so I help them. And I have this in my book saying
when you go to a doctor or a physiotherapist or a clinician that will help
your paying, try to be objective, try to be give them the details
that they need to help you. And so that's what I talk in my
book. I say, you know, the socratist is just a message of
remembering this. The s is for tell them what is the site? Where
does it hurt? Precisely? And if you can paint a body diagram.
I give my patients a body diagram and I ask them paint here where are
the areas that hurt? And then all of the socaches is the own set.
So tell me how did this pain started? Was this an accident?
Was this a surgery? Or there was no apparent cause that you can remember.
The c is for the characteristics of the pain. So tell me is
this burning? Is this jingling? There is numbness? How would you describe
this with words? Because it can tell me if this is a nerve injury,
if it's more inflammatory or not. They are is for radiating. Tell
me does this pain radiate somewhere else where does it go? Because that will
help me also to make the diagnosis. The A is for associated symptoms.
Tell me what else do you have when you have this pain? Does it
come with a swelling with change in color for example, or redness? And
what makes it better? So ameliorating factors. So if you put a hot
pack doesn't help, if you put an ice pack doesn't help, because those
will give me some hints. This is inflammatory. This is a nerve damage.
The G is for time, So tell me when do you feel pain
most chase it in the morning, Is it in the middle of the night,
is in the end of the day. E is for exacerbating What makes
it worse or better? Because also I need to know if you take a
pain killer, an anti inflammatory medication in your pain is a lot better.
It tells me this is probably inflammation. And as is for the severity,
give me a sense. It gives me a sense of how severe this is.
Are we talking about a pain that is like a one two out of
ten or are we talking about a pain that is like eight? Nine,
ten out of ten. I know it's hard for people to give a number
to that pain, but we have no other way to measure intensity of pain.
If it's not by numbers that they give choice, well, I think
another indicator would be how does the pain impact your ability to do day to
day activities and giving some examples of the impact, like does it hurt to
lift? Does it hurt to use a fork a knife? Does it hurt
to swallow? You know, I'm a cancer surf where I went through chemotherapy,
and I find I find the communication between doctor and patients could be very
tenuous. Many patients don't know how to communicate effectively, and many doctors don't
know how to communicate effectively. And it's important to ask questions, but to
bring to to come in ready to ask questions, and then the doctor also
needs to be ready to ask questions. And somehow everybody has to be honest
with those questions. Because some people don't know how to describe what they're feeling
and experiencing. I always do the context what does that feel like? Give
me an example, um, because I've never been you know, when I
get the one to five, one to ten, it's all yeah, that
is all mad because some people see a pain is a ten you know,
I'm dying, and somebyle's okay, it's that big deal. And I never
know whether I'm being truly honest about pain or not when I put it down,
because it's it's what I think it is. Um. It's very interesting.
Um. You outline in your book eight steps title of your book,
to Conquer Chronic Pain. Uh, and you go through them. Why don't
we touch on them and to give my listeners a sense of what this what's
involved in your book? Yeah? Yeah, So, as I mentioned,
the chronic pain is, um is this chronic disease and I it's a chronic
disease that will probably not go away. So I never tell the patients will
cure your chronic pain and your pain will disappear, although that is possible.
I've seen people they don't have pain anymore, so they don't feel anymore,
but they may have like a relapse here and there, and so they live
really well and they're not feeling pain, but once in a while they might
have a flare app But most people is a chronic disease, and what they
can do is when they say conquering means that they will be able to manage.
They will be able to self manage their thing. They will learn what
works for them, they will learn what their disease is. They will not
be fearful of pain, because another thing that we see a lot is the
fear of being paralyzed. As people, the fear of thing itself has to
be treated. The fear of thing is what's one of the main barriers that
I have in my clinic to get people moving to do the things that I
want them to move to do that will I know will help them to live
a fulfilling life. So conquering pain means you can live a fullfeeling life feeling
something, but that pain doesn't need to dictate what you So the steps,
let's talk about the steps. So the first step is retraining the pain system.
So again that is similar to the alarm system of the house that I
mentioned before. It is let's call the alarm company. Let's call the alarm
company and retrain and fix our pain system. Because the pain system may be
sensitized. The paining system in a person with chronic pain will be telling them
a lot of things that they don't need to hear. For example, the
pain is excruciating. Today I did something wrong to myself. I cannot do
that movement again. So you have to retrain your pain system. You have
to learn that your pain system is just telling you something different today that is
not true. It's almost like an illusion that your paining system is doing.
You know, optical illusions means you see something, but your brain tells something
different. I think we all know. Optical illusions means sometimes a darker shade
in a picture, but when you look closely, oh, it's not darker,
it's actually the same color. That's because the brain is telling you things.
So that's the first step. We're training the pain system. So learning
that you can move, you can do the activities, You're not going to
harm yourself. You can keep going and leaving with this. So that's the
first step because if we stick the pin system, if we regulate the pain
system, it's much easier to treat a like a knee arthritis or a low
back pain because now they are not supersensitive. The second step is about emotions.
Emotions have a big component in pain sensations. They come handing hinge and
why is this Because in the brain they are connected, they are linked the
sensation comes from a body part, let's say from a knee or from a
back, but then in the brain they activate the emotional areas of the brain.
So if a person is such on a day or they are having a
bad day emotionally, they will feel more pain on that day. We know
that there are a lot of laboratory studies showing that if they do the same
pain for stimulation, showing the person like a sad movie or such pictures or
telling them a sad story, and then they measure pain. After the laboratory
people did the thing stimulation, they will feel much more pain. Now,
if you show them a happy movie, tell them a happy story and they
are in a happy mood, they do the same thing for stimulation, they
feel less pain. So we know that emotions have a big component in the
volume of thaying how much pain the person will feel. So of course nobody
wants to feel more pain that you need. So that's what the step number
two is. Let's control or emotion. Let's do an inventory of our emotions.
Are you having did you have a discussion with your children? Are you
mad at someone, are you angry? Are you frustrated? Are you lonely?
Loneless as a big has a big impact on pain. People who are
lonely, they feel pain more intense than people who have some supports people around
them. Holding hands. We know that people who hold hands with another person
they feel less being. So there are a lot of things that you can
just do an inventory of emotions doing journaling. I recommend people to journal their
emotions because once they start putting things on a paper, they realize, oh,
I think because of this arguments that I had with my husband that is
affecting my muscles, I'm feeling more paying my muscles, and that's why my
pain is worse to them. Because again, Melanie, this kind of pain,
emotional pain, we can't treat with medications. We can't take appeal to
treat to them, so you have to treat with emotional support. Step number
three is about sleep. It's very neglected. Sleep quality is so neglected in
the general population. But in my patience, they usually say, well,
I sleep bad because I am in pain. I wake up because I am
in pain. But I tell them, sometimes you are having pain because you
are not sleeping well. So you need to take care of your sleep and
then your sleep quality will be better. And then you will not be waking
up by pain. Pain will not disturb your sleep. There are a lot
of medications that affect sleep and a lot of medications that cause them side effects
that affect sleep. Like we use a lot of untidepressants and unti convulsants to
treat chronic pain, and they may have interference with sleep. Some of them
help, some others don't help. So we need to be careful how we
do this. So that's the step number three. The step number four is
about diet, and I'm not talking here about it just you know obysity.
People think that I'll be talking about the miracle diet that will fix all of
their things. No, I'm talking here about malnourishment. A lot of people
are normal wage or maybe overwege, but they don't know that they are malnourished
because they might be lacking essential ingredients, especially vitamins or omega three. Omega
three is very important to fight inflammation. Also, the way we eat,
we need to eat mindfully. We need to, you know, pay attention
to when we are eating, with whom we are eating, not just put
something our stomach to survive. Eating mindfully is so important human thing. Also,
a healthy diet, what we buy, the habits that we have cooking
at home instead of buying fast food or eating out. The first step is
what about the other people around us? Because pay is a cycle, it's
a biological phenomenon, but alse it's a psychological as we talked about, but
it's also a social phenomenal. We know the pain depends on who is around
us, and also pain affects people around us. A person with conic thing,
they tell us this a lot, that their relationships might be broken,
relationships with their spouses, with their children, with their doctors. Sometimes they've
lost the trust from their doctors, friends, family, for workers, oh
my god, job for workers, bosses, managers at work. Those relationships
are broken and confused, and because of this, they will affect how the
person feels pain. Because if they feel misunderstood, if they have to explain
all the time, all the time that they go to a party like a
family reunion, if they have to explain how they are, what they're feeling,
they maycasions they are, why they're not feeling well, why they need
to leave the party earlier. It's stirring, it's really exhausting. So in
this chapter I talk about how people communicate with others, how they can get
help with others, and how they can communicate their pain with those that are
around them, because that will affect them. The start number six is about
medications. So I talked in this chapter about medicine, the medicine cabinage.
What do you have at home? How do you use those medications? How
do you use pain killers? We talk about opioids, We talk about antiflammatories,
injections, I talk about topical queens. I talk about cannabis, steroids,
anti the presence, and convulsants. Because people are confused to they sometimes
they don't even know why they're taking some medicases. They say, why am
I taking to the present for pain? I'm not depressed. But we use
them to the persons, especially if the person has neuropath pick pain, which
is a kind of chronic pain that affects the nerves, the nerve system.
So it's important for them to understange why they are taking what they're taking and
also discussed with their doctors, pharmacist nurses, the side effective these medications.
Why really need can I stop taking them? You know? Manly? Because
some people are on these medications for decades and they are taking a soup from
medications. It's amazing that we call this polypharmacin and nobody ever questioned them,
why are you taking this medication? Do you still need it? Maybe some
doctor started this fifteen years ago, but maybe you don't need this anymore.
So it's important to talk about them and the medications. Step seven is about
what other things you have in your tool box, the toolbox. I talk
a lot about the tool box in my videos in the book, it's all
the other things that you have to self manage your pain. So medications is
one of them. The pills, the injections. You know, the queens,
the topical queens, but they're not the only one. When you talk
about the emotions, we talk about relaxation, mindfulness, meditation. Those are
excellent tools to retrain the pain system. But there are other things that they
can put in their toolbox. And I talk about the five MS for them
to remember, and the five ms are movement, mind, body interventions,
manual therapies, modalities such as heat code, electrotherapy. And then the medications
of course, the antiflammatories and allgetics must relax and opioids, cannabis based compounds
et cetera. And then the step h The last one is the focusing on
their goals because goal setting is really important, especially for people who have a
long term condition. Chronic pain is a chronic condition, so when you have
a chronic condition, you need to have goals in your life. You need
to have smarter goals things that you can achieve. So for example, going
back to school, getting a job, getting married, those are goals that
people have in life. So we talk about now that you are conquering or
mountain you're conquering, or chronic pain, how you're going to achieve those goals,
and we help them to set smarter goals. For example, if you
want to go back to school, you have to start by creating a routine
that you're going to study one hour a day, maybe five days a week.
That's a small step for you to start, you know, because once
you go back to school, you're going to study a lot. You have
to have a routine. So we have them to reorganize their lives because I
see it's really sad. I see people with chronic pain that they lost a
lot of years lived because of this chronic pain and their dreams. Their goals
were not fulfilled. It's sad, you know. I thank you for the
great explanation of each of date steps. You mentioned medication, and I want
to zoom in on that because doctors are very quick to prescribe medication all the
time, and I always when I see my doctors, I say, what
are my other options besides medication? And you mentioned and tell me if I
missed this, you said something that you don't necessarily need medication, because I
always hear about people becoming addicted to pain medication. Yeah, and you know,
I'm curious, first of all, at one point, you know,
what are some ways to mitigate pain without medication? And at what point do
you really say you need medication? Yeah, so let's go back to those
analogies of the Alliance system. Okay, So if the some people have chronic
pain because they have an ongoing injury to their body, we call this no
susceptive or neuropathic pain. So it's almost like having once in a while you
have a fire in the house and then you do have to call the fire
truck because they will have to come and you know they need to put up
the fire. So in these cases that a person continue to having injuries to
their body, or if they have neuropathic pain, medications are used. So
for example, an anti inflammatory. They have an inflammation in their body like
romatoriatritis is a good example. They do have some time to time those joints
that will inflame and will hurt, and we don't want this inflammation to sensitize
the pain system. And now the aligned system of the body is sensitized.
So before before the pain system gets sensitized, we treat this pain from an
inflammation with at inflammatories or biologics. So they need medications and opioids in acute
pain, all surgical pain are really important because one thing that's sensitized the pain
system and make the alarm system of the house dysfunctional is a cute pain.
So if a person goes to surgery, they're going to feel pain. We
need to treat that ping aggressively. Doesn't mean opioids all the time, but
it means antifomatories, it means eyes. It may mean opioids, but then
we need to stop those medications after the scar is formed and they don't have
the pain from the surgery anymore. When I say we don't need opioids,
we don't need pain medications for a lot of chronic pain is because that initial
injury is healed and they don't have that initial injury anymore. They don't have
that inflammation anymore. That is healed. For chronic pain. If we keep
giving them opioids, it's not going to treat the origin of the pain.
It's only going to mask their pain for a few hours. It's not treating
the origin of the pain because they don't have that injury anymore. That thing
is healed. But then they start having the side effects and they develop tolerance.
We know that opioids creates a tolerance in our body. Tolerance means if
you take let's say three tablets a day of opioids for a couple of days,
then your body will become tolerant to that, and now you need four
tablets a day to have the same effects. And then your body becomes dependent
tolerant to four, and now you need five and they need six. So
you need a higher dose to get the same effects. And that's why people
start increasing the dolls. They may become a dependent on that medication. Dependence
is a very physical thing. Dependence is not psychological. Dependence means if they
stop taking that medication, or if they miss a dose of the opioids,
they get horrible withdrawals. And interesting enough, Melanie withdrawals of opioids caused pain.
So a person. It's really terrible because then the person uses a dose
of the opioids or they try to stop the opioids just to see how their
body responds. But now they have pain, which is confusing because they say,
well, if I am in pain, it needs that I need the
opioid. No, but your pain is just because of the withdrawals. So
that's why opioids is not a good term a good solution for a long term
pain. Yeah, and unfortunately we're just reading more and more about people who
are addicted to pain. I don't like I hate pain, pain medication.
To be very honest, when I have my surgeries, I don't like them
because they can't to pay you. And that's person a lot of things.
You know. There's you know, I'm a big believer, as you mentioned
in your steps, you know, the mind, body finding, meditation,
mindful eating. I think you made a point, well, it touches on
pain. I think it's an important point in general about malnutrition because I think
a lot of people erroneously or mistakenly think malnutrition is because being somewhat is starving,
they're not eating enough. But malnutrition, bad nutrition mall like Latin and
nutrition means poor nutrition. You can be overweight, you can be underweight,
you can be a relatively okay weight, but you can still be malnutrition because
you don't have the proper nutrients in your body. If you live on a
diet of fast food or sugar, or a strange diet because people, you
know, there's this way too many strange diets out there right now, that's
poor nutrition and it will impact your ability to handle pain. It also picked
your whole body. I think that's important to point out because it all goes
hand in hand with your overall health. Right absolutely, you just said,
You just said exactly what I was going to say. Malnutrition means they don't
have the nutrients in their body to create those neurotransmitters that will fight pain,
to fight chronic inflammation, to fight them to give them energy to get up
from bed and do movement and exercise. It's also related to depression. Depressed,
so people need to pay attention a lot what they eat because if they
put a lot of sugar and unhealthy fast in their diet. They will feel
full, they will feels saciated, and then they will say, why do
I need to eat that fish? Why do I need to eat that olive
oil? Why do I need to eat that vegetable if I'm feeling full?
But you know that extra virgin olive oil contains a lot of omega threes that
you need to fight inflammation. And they if they don't buy mindfully. Grocery
shopping is where you start to have a good nutrition. I tell them,
if you would you be able to show me your grocery bills for the home
month, and if I look at your grocery bills, would you be proud
of what you show me? If they say, well, not really,
I know they're not having a good nutrition because they're buying only junk food,
fast food, package food, ready made food, frozen pizzas that I'm not
against those, I love those things, but you know, maybe once a
week, one meal a week, because you can have a junk food,
but the rest of your meals should be really nutritious, should be very well
thought while you're put in your mouth, or how you're feeding your family,
how you are preparing your meals, and people. I don't know what's going
on with our culture. People people want fast and easy is what it is.
I spend a lot of time I try level quite a bit to Europe,
thankfully, and back, and it's a different attitude over there on how
they approach food. Everything is fast and easy and convenient. And I look
at a lot of grocery carts. I'm currently in the Deep South. I
watch a lot of grocery carts and most of them were filled with packaged,
poor, empty, empty calories. And as you get older, it gets
harder. Many my mother died of malnutrition. As a food professional, just
know that my mother died of self induced malnutrition, and I know what it
did to her, and it was because she only wanted each sugar and and
forty. It is a common problem with the elderly, and it has and
it's very hard. You just want them to do anything, and you know
they all eat and you know, I won't say the brand, but there's
you know, protein shakes as we're just going to call them poaching nicks,
and they just filled with sugar. It's something you got to think about because
it all helps keeping the body hopefully, So I'm curious about two things.
We've got about eight minutes left. First, what are your thoughts about the
natest greatest research in the frontiers of pain management? What are you excited about?
Are seeing ahead? Oh? Yeah, I'm glad you asked that,
because there's a lot of things coming in the pipeline. And what I would
say is, I've been doing this for thirty years, Melanie. But I
graduated from medical school and I did choose a specialty that was able to treat
people with chronic pain. So I've been researching and treating people with chronic pain
for thirty years, and it has been a shift. What we were doing
thirty years ago is very different from what we're doing now, and that's because
there's a lot of advances in imaging of the brain of people with chronic pain.
We're understanding much better what happens what brain, what pain does through our
body, because thirty years ago, we always thought that pain is something that
is happening in our body like kneeds hips back head, and then it's just
a sensation that comes through brain and you need to stop that sensation and the
brain. We always thought that the brain is just a passive with seeping of
these information and there could be nothing that you could do at the brain level.
But oh my god, things are changing in this area a lot because
now with a lot of functional MRI and the studies of the brain, because
of the technology that has a brand so much, we can see what pain
does through the brain, and then what the brain does through pain, which
is amazing, amazing. I'm so excited about this because the brain has this
plasticity, this amazing ability to change itself to respond to stressors, and pain
is a strong stressors. The brain has the ability to modify the meaning that
we give to things, to suppress some sensations, to even to create some
sensations. I don't know if you ever heard about phantom pain. A person
has alciated, so the brain is able to create pain. So a person
has an entutated leg, but they continue feeling pain, cruciating pain, very
intense pain in that body part doesn't exist anymore. So the same way that
the brain can create pain, the brain can eraise pains. So that's where
I think we're going to see a lot of advances in the future is using
these areas of our brain. We have an inner pharmacy in our brain,
We have an ability to create our own opioids, cannobinoids, sell toning,
dopamine. It's a potent pharmacy that we have inside of our brain. And
now we are learning how we can stop a coupuncture, for example, is
a way that we can tap into this pharmacy. When a person does a
coupuncture, they stimulate the brain to release those pain killers. So we are
learning more about what the brain can do, and I think the future will
open up to a lot of how we can train or brain, how we
can use these strategies to improve the lives of people with chronic pain. Well,
that's encouraging. And I'm a big believer in holistic approaches to managing all
aspects of your health because, as I said straight on, I'm not big
on medication. I think that eventually, I you know, other than addiction.
I think at some point, don't people become immune to their medication and
we can't be of medication forever. It seems like, yeah, yeah,
we use the term tolerance. We don't use but we call this tolerant.
They develop tolerance, right, and then you got to switch it and whatnot,
and that be dangerous. I've seen that can be very dangerous. As
well, and I think we have to caution my listeners on claims. There
are a lot of supplements. I'm not big on the supplement industry because unregulated
CBD. You know, everybody's promoting CBD. When my mother, my mother
had chronic matory arthritis, people were bringing her so many CBD CBD salves and
I have a drawer of salves for her. You know, my my edits
savir money. I don't really know what's in your head or not with all
that, but it's expensive and I don't see where it helps. Of course,
you know there are people out there, be very famous people promoting them.
What are your thoughts? Yeah, I have not In the beginning,
I think that was a big push for us to try this thing. I
saw a lot of my patients excited with thhc CBG. I have been seeing
a lot of good success stories, and the evidence of scientific evidence is also
kind of getting. The excitement is dying regarding the use of cannabis because they
were not able to achieve like all this pain really especially for pain. Maybe
for other things they may have other uses, but for chronic pain they were
not so successful as we initially thought. Although for neuropathic pain, which is
a kind of pain from the nerve injuries and diseases. For neuropathic pain,
THHC seems to have some effect reducing pain sensations, but for the majority of
chronic pain, they don't have neuropathic pain, so actually doesn't do much for
pain. Well, that's interesting because neuropathic pain is very different. I have
neuropathic pain because I had a double massectomy, so I've had phantom pain.
Neuropathic pain. It's a strange. It's a strange sensation, a much stranger
than like the pain from the stub toe I have right now. Yea,
and as you said, has to be managed very different. So I have
enjoyed it talking to you again for my listeners, We've been talking with doctor
Andrea Farland, Associate professor at the Department of Medicine at the University of Toronto
and a staff physician at the Toronto Rehabilitation Institute. The book is called Eight
Steps to Conquer Chronic Pain, A Doctor's Guide to Lifelong Relief. What is
your YouTube channel that has all this followers. Yeah, it's just my name,
doctor Andrea Bland. I you r l I am well, congratulations,
you know that's that's a pretty nice amount of following, and thank you for
all the work you're doing to help improve people's health and well being. Pain
is an insidious thing to live with because it can, in fact, every
aspect of your life, how you work, how you have relationships, how
you function. And I've witnessed it myself watching my mother deal with pain.
I've witnessed it many times. And as I said, to be careful when
you say the words I feel your pain, because you know you don't.
Most of the time you don't. Everybody's pain is very individual, so you
be considerate when you use that term, because there are people who are in
pain and they need help. And the most important thing always, if you
are experiencing a condition that is making you feel uncomfortable, unhealthy, unwell,
or unable to function normally, seek help. It's a sign of strength to
say I need help, not weakness. Don't grin and bear it, bear
it all. I'm Melanie you. You've been listening to Fearless, Fabulous You,
And as always I like to say, you have the choice and how
you live your life and what you want to do with it. Choose fearless,
choose fabulous, and make an impact on yourself and those around you.
Thank you for joining me, and thank you doctor Furlough. Thank you Melanie.
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