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Speaker 1: Good morning, sunshine.

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Speaker 2: Jenny is here at the news tablet for and uh.

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It's especially good that you're here today because, as you

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can probably hear, my voice is already failing from my

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recent fight with asthma sounds apparently I'm not fully recovered

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from that, as I'm as I'm cracking on this uh,

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Saturday morning.

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Speaker 3: January fourth, our first show of twenty twenty five.

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Speaker 1: Well, at least you didn't end up on the grassy

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knoll this.

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Speaker 2: Time, that's right, Yes I did. I did have to

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go to the emergency room again. Yes, but but I

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can breathe. I can breathe again.

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Speaker 1: A couple of treatments later, and he's speaking yes.

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Speaker 3: Yes.

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Speaker 2: So so here we are and for our first show

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of the new year. Happy new year, everybody. Let me

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get get that make up there. Someone who has not

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been with us in a long time. Doctor noahs here,

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welcome doctor now. Oh I cannot hear you. Let me

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figure out why. I think I know why to change

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the mind.

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Speaker 1: Oh boy, I know you're gonna get the cobwebs out

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of you.

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Speaker 3: Oh I think I can hear you now, doctor, Now

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are you there?

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Speaker 4: I'm here, Good morning man, everybody, mind Jen.

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Speaker 3: I apologize. So, yeah, so welcome. It's been well.

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Speaker 2: Obviously this is your first time in the new studio,

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so it's certainly been well over a year. I know

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that probably been probably been a year and a half

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maybe since you've been with us.

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Speaker 4: It's been a little while. I can tell you that

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the studio is very impressive.

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Speaker 3: Isn't it nice? We love it.

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Speaker 4: It was it was like a grand entrance walking in,

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going wow, look at this lobby, Yeah, look at this

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large you know. I had I had to stop by

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the facilities, you know, because I drank a bit of

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too much coffee this morning. But I was like, wow,

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this is very grand.

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Speaker 3: Yeah, I'm very impressed, Thank you, thank you. No, we

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love it.

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Speaker 1: It's the new digs are styling.

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Speaker 3: And you can tell from the outside that it's a

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that there's a radio station in here, you know, because

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as you know, at the old place, like looking at

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it from the outside, you would never even know that

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there was a radio station in the building.

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Speaker 4: The signage is impeccable.

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Speaker 3: Thank you.

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Speaker 4: Even without driving without glasses this morning, although I don't

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need to drive with glasses, I saw it from afar.

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Speaker 3: And that is good to know. That is good to know. Yes.

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Speaker 4: Wow, Well I just want to say one thing before

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we get started. Yes, is that that song twenty three

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that you played this morning?

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Speaker 3: Yes.

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Speaker 4: If there was a rating scale out of twenty four,

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I would rename it twenty four.

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Speaker 3: Wow.

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Speaker 4: I very much enjoyed it.

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Speaker 3: I really like that.

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Speaker 4: I did, especially when it caught my attension when it

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said the bus is moving leaving in ten minutes.

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Speaker 3: So this is a little inside for people who don't know.

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Speaker 2: So the building that we're in, of course, this used

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to be a bus station here in Manchester. This amazing

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building which was remodeled and refitted is that a term

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for that turn turned into this amazing facility that it

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is today. But yeah, we were so we were talking

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off air because we tell everybody especially it always comes

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up when when someone says, you know, can I use

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the restroom, and it's like, yes, enjoy our enjoy our

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enormous bus station bathroom. But so we were talking about

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that off air, this used to be a bus station

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and then I play that song and sure enough there's, uh,

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there's that bus station announcement.

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Speaker 5: I really like that new song. Yeah, yeah, absolutely nice.

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Speaker 3: Yeah.

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Speaker 2: Absolutely. So Again, if you're if you're looking for that online.

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The song is called twenty three, the band is Tuesday

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Night Whites, and just to be very clear for everyone,

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it's it's named after a football team.

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Speaker 3: There's no racial component to that.

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Speaker 1: I don't want, uh, I don't want well being what

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we call soccer.

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Speaker 3: I don't want anyone to think, what what is that like? Uh?

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Are they you know, bad people or something?

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Speaker 1: No talking to you about sports and this is not

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a good thing.

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Speaker 3: Right right.

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Speaker 2: I'm not a I'm not a fan of the of

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the sports ball as we say, so.

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Speaker 3: Doctor no, uh tell us about uh.

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Speaker 2: For those who don't know, who haven't heard your previous interviews,

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you've been on with us two or three times before.

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Speaker 3: I think at the old at the old studio, I.

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Speaker 4: Think we've been on, yeah, about two or three times

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span of last what was it maybe four years?

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Speaker 5: Oh yeah, four or five years now. Yes, he's on

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his way to the five timers.

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Speaker 4: Yeah. I feel like I'm an aged entity here, you know.

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But every time it's it's you know, it's it's been

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an honor to come on because I you know, there's

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a lot of changes that have occurred, and it feels

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like it's a it's a fresh start, and especially with

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this new station too. It's just it's very, very very refreshing.

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Speaker 3: Yes, yes, thank you. Yeah, well of course we met

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you because.

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Speaker 5: Of Jenny, right, and I'm excited to have you on

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and share something that's important in my life. I am

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a pain patient, as you guys know, and you hear

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the stories all the time. I have CRPS, complex visional

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pain syndrome, and small fibron aeropathy.

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Speaker 1: And thanks to doctor No, I.

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Speaker 5: Have quality of life because the hardest thing about having CRPS,

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because it is the most painful disease known to modern medicine,

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is that it's very difficult to control that pain and

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have a quality of life. And doctor No from the

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Pain Specialty group is who makes my life quality wise

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because of the treatments that I get, which is a

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combination of different treatments you do. In my case, I

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have oblasions or different injections or say you sometime a

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different medication to keep things in check. And I want

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to share that with people because so many people out

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there are suffering and pain and you don't have to suffer.

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That's the biggest thing. You don't have to be the

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one suffering about it. So just just because I want

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to be as open as possible. A doctor no is

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my doctor, and I am happy to be here with

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him and openly talk about pain care because I do

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want people to know that there are solutions.

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Speaker 1: You don't have to suffer and you can have a

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quality life.

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Speaker 4: Yeah, and Jenny, I just want to say, you know,

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it's an honor to help you, you know, do the

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things you want to do in life. And I'm touched

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to hear all of this, and I will also, I

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know we're on air, but I will also protect your

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privacy and whatever you know, let you disclose. But if

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you want me to comment on something, I mean, just

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let me know. I'm happy to but again, you know,

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also protect your privacy. But I'm touch to hear all

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this and it makes me makes me happy to know

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that I've at least been able to help you, you know,

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get along your path in life and do the things

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that you want to do in the way you want

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to do it. And that means a lot to me.

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Speaker 1: Thank you, Thank you.

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Speaker 2: Well, I can I can tell you, you know, as someone's

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who's uh you know, had a front row seat for

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this journey that Jenny's been on. I mean, you've You've

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made an enormous difference in her life. I mean this,

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you know, no denying it, huge, huge difference.

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Speaker 5: I'm a lot bedbound for over two years, and even

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when I started getting treatments, I was still using wheelchair

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and having a hard time. And at one point I

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started to get better and I was with a practice

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that all of a sudden closed their doors, no warning,

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no notice, just closed its doors. And I was in

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a pretty bad situation at the time and doctor No

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actually was coming into a practice here in New Campshire

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at the time and I was lucky enough to meet

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this practice because I was literally left with I don't

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know what to do. I have no provider, and you

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did come in and you ended up taking over my care.

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Speaker 1: And it's been.

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Speaker 5: Well over three years, probably four. I'm not even sure

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how many years I've been a patient of yours.

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Speaker 4: Now, Yeah, it's been a while. Uh. I do want

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to say that, you know, Jenny again, I'm very happy

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and grateful and touch that you know we were able

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to help you, because we do hear the story a

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lot with you know, the shifting of providers, shifting of

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practices that that patients are left in kind of a

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no person's land. I don't want to say no man's land,

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but no person's land, and and and it's unfortunate and

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it's a very hard place to be. So again, very

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very touched, very honored to be able to help you

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along the way. And look at you now, you're you're

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you're doing great things for not just the New Hampshire, Manchester,

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the people of the Northeast, but you know, even the nation.

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So you know, very impressed.

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Speaker 1: Yeah, and it is a huge part of that.

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Speaker 5: And that's one of that's why I want to share

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this aspect is there is so much stuffering out there

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that doesn't have to happen.

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Speaker 1: So, like.

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Speaker 5: You offer a lot of different treatments for a lot

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of different things. And I have significant lower back pain.

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I have like three deaths that are bulging and they

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have to be controlled or I'm in awful pain. So

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some of the things that you do aren't about medication

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as much as a treatment. One of the things you

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do for me is called an ablation, and that has

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a great effect. And I know that you do other

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things types of injections and stuff, but you know, just

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talking about like the lower back issue, what are the

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kind of things that you do for.

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Speaker 1: Other people to help with their their back issues, because

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we're not all the same.

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Speaker 4: Yeah, so it's a great question. Let me let me

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just kind of reorganize and kind of preface the thinking

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of how we approach pain management. But at both of

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our our locations, know, in new Market, which is the

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newer one, and also in Newington, our philosophy has always been, look,

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you're you're we're all going through life. You know, we

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all go through life as a as a as a child,

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a youth, a young adult, you know, a midlife adult,

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an older adult, and as an elderly person. And during

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that journey our body changes, not just you know our

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life situation, you know, our economics, our social engagements, but

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our body changes and with those changes come how we

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experience those changes. And pain is a very very prevalent

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aspect of those changes. So what we do in our

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philosophy is that we can't really care or change those

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changes or reverse those changes. What we can do is

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help you adapt, deal with, accommodate with how we perceive

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or experience those changes. And if you take that perspective

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of pain management, that's where we come in. And and

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and Jenny, you mentioned about. You know, so how do

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we deal with What tools do we have to deal

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with pain?

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Speaker 2: Right?

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Speaker 4: I can count them off of probably both hands and toes,

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but I'm gonna try to generalize it into two boxes.

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We have conservative therapies, right, which include you know, you know,

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activities like physical therapy, pool therapy, chiropractic care, uh, you know,

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you know, psychosocial therapy, cognitive behavioral therapy. We have medication therapy,

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lots of different classes of medications. Yeah, you know, we

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always hear about one certain class of medication which has

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always been the easiest to go to, but it's also

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caused a lot of headaches personally for not for me,

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for for individuals, socially, economically, and even legally. And that's

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what I'm talking about opiates and controlled substances. We have

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lots of different other classes that help mitigate pain, and

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and those kind of leak into other are disciplines of medicine,

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and that's why pain management is so broad. We have

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interventional therapies like you mentioned. Some of those therapies, as

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you mentioned, include radio frequency elations, you know, steroid injection,

242
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nerve injections. When people hear the term injection or oblasion.

243
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They think it's just one area, one type of treatment,

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but there's so many different caveats and ways to how.

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Speaker 1: Do you say it.

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Speaker 4: Approach those classifications. For example, when they say I get

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a steroid injection or cortisone injection, we hear that a lot.

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One is there's different classifications of steroids. Two is there's

249
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different areas that we inject. Three is there's different reasons

250
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to why we approach an injection, and there's different potential outcomes.

251
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Some of those are therapeutic, which what you experience. Some

252
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of those are diagnostic, which tell us, okay, this work,

253
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but it's not gonna last, but we could do something

254
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else that lasts longer. And some of those are therapeutic

255
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and diagnostic. And there are even some injections that some

256
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of those may be potentially longer lasting, are terminally therapeutic,

257
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such as you know injectables that cause nerve destruction. Some

258
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of those injections are are lubricating. So there's lots of

259
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different types. Yeah, and then the next classification, of course,

260
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is advance interventions, where we do a lot of minimally

261
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invasive implantables or removal of tissue under X ray or

262
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fluoroscopy and imaging. Those again, you know, tend to be

263
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the cutting edge of pain management. Those those tend to

264
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be those that are a little more innovative, spend the

265
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time to get trained and learned, trained by multiple disciplines,

266
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not just pain management physicians. But you know, we end

267
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up having spine surgery involved, orthopedics involved, neurology involved, psychiatry involved,

268
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there's indiventional psychiatry. So a lot of the little you know,

269
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interventional advanced therapy, some of those where we put in

270
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plants and some of those where we don't. And then

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and then of course to the classical sense, now we

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go to open cavity, open spine, open area surgery and

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those can treat. So pay management is actually very wide.

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The whole concept is, again, how do we help you

275
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along your journey given that you've you've hit this this bump,

276
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this road bump along the road, or this pothole, and

277
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how do we get you to go above that and

278
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go beyond that? And that's and that's where our job is. Okay,

279
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So I hope that kind of helps, oh, per.

280
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Speaker 1: And it's fine.

281
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Speaker 5: And that's what's what's a thing about pay management is

282
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it's individualized. No, the medication that works for me might

283
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not work for somebody else. But we found a combination

284
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of medications and treatments that have worked for me.

285
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Speaker 1: And it's all and sometimes it's trial and error. Sometimes

286
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you try one thing and see if that works.

287
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Speaker 5: You know, there are medications I did well on medications

288
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I haven't done right. And as life changes and time changes,

289
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maybe something needs an adjustment or a tweak. And you know,

290
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as long as the end result is to have a

291
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quality life that's worth living. To be able to participate

292
00:14:18,639 --> 00:14:21,480
with things with family members or friends, to be able

293
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to enjoy an outing, you know, and not have to

294
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sit there and be like, oh, I can't go to that.

295
00:14:26,759 --> 00:14:28,960
I'll be intowitch agony, I won't be able to sit there.

296
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But to be able to go, yeah, I can go

297
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to that. I can go to that show for a

298
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few hours, you know. And and that is what makes

299
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life work living right is to have those experiences with

300
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one another.

301
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Speaker 4: Absolutely, I mean, just me showing up this morning and

302
00:14:44,080 --> 00:14:46,799
have this experience with you and Matt has been phenomenal. Already,

303
00:14:47,080 --> 00:14:49,799
Oh thank you, Well, we're glad you're here. Usually around

304
00:14:49,799 --> 00:14:52,360
this time already spending it taking the kids and driving

305
00:14:52,399 --> 00:14:55,399
them on shopping you off to So I got my

306
00:14:55,480 --> 00:14:56,840
alibi this morning.

307
00:14:56,919 --> 00:14:57,799
Speaker 1: You got a alibi.

308
00:14:58,000 --> 00:14:59,399
Speaker 3: Yeah, no, so.

309
00:14:59,399 --> 00:15:01,879
Speaker 4: Thank you, But no, I just wanted to add to

310
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your comment about individualization of care ideally, right, ideally, and

311
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and if you think about it in terms of efficiency, Ideally,

312
00:15:15,639 --> 00:15:19,320
if pain management was a one one type of treatment

313
00:15:19,440 --> 00:15:22,240
for all, like a Nike shoe factory, just keep on

314
00:15:22,279 --> 00:15:24,480
stamping out all those Nike airs one by one by one.

315
00:15:24,519 --> 00:15:26,399
We could do ten an hour, we do twenty an hour,

316
00:15:26,440 --> 00:15:29,919
you do five one hundred an hour because factory capacity, right,

317
00:15:31,080 --> 00:15:32,759
I would be at a different place. I would be

318
00:15:32,759 --> 00:15:36,759
sitting in a very tall, high rise building, you know,

319
00:15:37,200 --> 00:15:42,600
in Manhattan somewhere, or downtown Manchester somewhere. But no, it's

320
00:15:42,720 --> 00:15:48,039
very individualized because what works for for Matt, what works

321
00:15:48,039 --> 00:15:51,519
for Mike, what works for Steve, may not work for

322
00:15:51,600 --> 00:15:55,559
Gen and what works for Gen, you know, and it's

323
00:15:55,600 --> 00:15:58,000
and it's unfortunate that we have to try on different

324
00:15:58,039 --> 00:16:00,840
shoes and we have to you know, the shoe pairs

325
00:16:00,919 --> 00:16:04,200
with this pair of sock or this pair of cushion,

326
00:16:04,840 --> 00:16:07,759
and and oh the only worked for for you know,

327
00:16:07,879 --> 00:16:10,799
three months and now the shoes aren't good anymore, and

328
00:16:10,799 --> 00:16:13,799
we have to change up the shoe because because the

329
00:16:13,840 --> 00:16:16,759
padding has shifted because you have a bone spur now

330
00:16:16,799 --> 00:16:20,440
and your foot, you know. So so yeah, it's very individualized.

331
00:16:20,440 --> 00:16:22,440
And that's the unfortunate part is that, you know, we're

332
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all we're all such individualized entities that we have to

333
00:16:27,000 --> 00:16:29,600
kind of tweak things. And your body's constantly changing, so

334
00:16:29,600 --> 00:16:33,399
we always have to change change how we algorithmically or

335
00:16:33,519 --> 00:16:35,600
think about and approach how can we make you a

336
00:16:35,600 --> 00:16:37,159
little more comfortable so you can do things you want

337
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to do.

338
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Speaker 2: I would imagine that's that's the biggest challenge with new patients,

339
00:16:41,519 --> 00:16:44,399
right It's just figuring out what the best solution is

340
00:16:44,399 --> 00:16:45,759
for them, And then.

341
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Speaker 3: There's probably a lot of well, we're going to try this.

342
00:16:47,720 --> 00:16:49,399
Speaker 2: And then if this doesn't work, well then we're going

343
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to try this, and you know, and then you know,

344
00:16:52,120 --> 00:16:55,360
hopefully they can hang in there, you know, and and

345
00:16:55,559 --> 00:16:57,360
and you know they have to trust you that you

346
00:16:57,360 --> 00:16:59,120
know you're on this journey with them and that you're

347
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going to help them find the solution.

348
00:17:00,759 --> 00:17:03,039
Speaker 4: But yeah, so so I'm glad you brought that up

349
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because because now now you're trying to get into the

350
00:17:05,000 --> 00:17:07,039
mind of like how I'm thinking during the day.

351
00:17:07,319 --> 00:17:08,720
Speaker 1: Yeah, and and.

352
00:17:08,319 --> 00:17:10,160
Speaker 4: This is gonna be good. So that gives some insight

353
00:17:10,240 --> 00:17:13,279
to patients. So every patient comes with a unique situation.

354
00:17:13,960 --> 00:17:16,839
And when you when when you when a provider walks

355
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into an encounter with the patient, not only have we

356
00:17:20,400 --> 00:17:22,640
relied on the experience and knowledge of what we know

357
00:17:22,680 --> 00:17:25,960
about the patient, we also rely on the additional information

358
00:17:26,079 --> 00:17:31,000
that we've gathered during the interim between the visits. And

359
00:17:31,400 --> 00:17:34,240
you know, we we go on what the patient's communicating

360
00:17:34,319 --> 00:17:39,880
to us based on prior visits versus this visit. And

361
00:17:39,920 --> 00:17:42,319
so we're calculating all these things and thinking all these

362
00:17:42,319 --> 00:17:45,559
things and trying to go down algorithmically and even just

363
00:17:45,680 --> 00:17:50,559
non algorithmy or but creatively, what's the status of that

364
00:17:50,640 --> 00:17:52,519
patient and how can we tweak it to make it

365
00:17:52,519 --> 00:17:56,279
a little better. So so you can imagine that with

366
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this new healthcare environment where where it's difficult to survive

367
00:18:03,119 --> 00:18:07,480
as a healthcare provider if you don't you know, become efficient.

368
00:18:07,599 --> 00:18:10,039
So you know, like time slots are probably fifteen twenty

369
00:18:10,079 --> 00:18:13,480
minute time slots, thirty minute time slots. So we're sitting

370
00:18:13,519 --> 00:18:16,559
there thinking of how do we accommodate these patients based

371
00:18:16,559 --> 00:18:19,839
on the information that we have, and how do we

372
00:18:19,880 --> 00:18:21,920
tweak it and make it better for them, and then

373
00:18:22,200 --> 00:18:25,000
you know, follow up afterwards. So you can see that

374
00:18:25,400 --> 00:18:29,079
everyone's very individualized. There's a lot of different factors that

375
00:18:29,119 --> 00:18:32,559
you have to think about, including side effects, right, and risks,

376
00:18:33,279 --> 00:18:36,000
and how do we follow that up and to make

377
00:18:36,000 --> 00:18:39,720
sure that you know decision making is appropriate and effective.

378
00:18:39,880 --> 00:18:41,519
Speaker 3: Yeah, yeah, that makes sense.

379
00:18:41,640 --> 00:18:45,359
Speaker 4: Yeah, so yeah, but I think I think what we've

380
00:18:45,359 --> 00:18:50,079
figured out as a team in our practice is that

381
00:18:50,759 --> 00:18:54,480
you know, there's certain certain approaches that we have to

382
00:18:54,640 --> 00:18:58,039
help mitigate pain for patients, and a lot of those

383
00:18:58,160 --> 00:19:02,400
is let's figure out what's causing you the pain. And

384
00:19:03,200 --> 00:19:04,640
for a lot of patients, when you come in in

385
00:19:04,680 --> 00:19:06,240
your experience O pain, you're like, I'm just in so

386
00:19:06,319 --> 00:19:08,920
much pain. It's everywhere. I don't know where it is,

387
00:19:08,960 --> 00:19:12,799
but it's also here and here, you know, algorithm Lee

388
00:19:13,240 --> 00:19:16,039
or in our thinking, it's it's like, okay, so where

389
00:19:16,079 --> 00:19:19,400
are those areas that we can identify and how can

390
00:19:19,400 --> 00:19:22,680
we approach each of those areas in a safe and

391
00:19:23,240 --> 00:19:28,440
appropriate manner that would minimize the risks and side effects

392
00:19:28,440 --> 00:19:31,160
but maximize the benefits.

393
00:19:31,279 --> 00:19:34,160
Speaker 1: Yeah, so that's a huge thing too.

394
00:19:34,319 --> 00:19:37,400
Speaker 5: I mean, years ago, before I was the patient of yours,

395
00:19:37,519 --> 00:19:40,279
I had a different pain care situation where I was

396
00:19:40,319 --> 00:19:43,799
getting injections and it was scary, but it was also

397
00:19:43,920 --> 00:19:46,200
super painful. Matt would be in the waiting room listening

398
00:19:46,200 --> 00:19:49,000
to me scream like and I've talked about that on

399
00:19:49,079 --> 00:19:52,960
air many times. We've talked about, you know, the experience

400
00:19:53,000 --> 00:19:55,160
and having somebody going, oh, no, nobody heard you. And

401
00:19:55,200 --> 00:19:57,559
then I go out there and Matt's like, oh, okay,

402
00:19:57,599 --> 00:19:59,720
I can hear you screaming. And that's not what pain

403
00:19:59,720 --> 00:20:02,759
care is be. And that's one of the things that

404
00:20:03,000 --> 00:20:06,359
I very much love about you and your office and

405
00:20:06,400 --> 00:20:08,160
your practice and the way that you do things is

406
00:20:08,160 --> 00:20:11,359
that I have never ever, ever suffered through a treatment.

407
00:20:11,920 --> 00:20:16,039
You always make sure that the patient is comfortable, that

408
00:20:16,119 --> 00:20:20,960
I'm comfortable. You use numbing agents. You don't go just okay,

409
00:20:21,119 --> 00:20:23,960
sucking up, but a coffee we go and in checked away,

410
00:20:24,279 --> 00:20:27,400
which is what I had previously experienced. And I know

411
00:20:27,480 --> 00:20:30,480
that we were kind of talking about it before the show,

412
00:20:30,559 --> 00:20:35,160
but you were talking about how your approach is uniquely

413
00:20:35,200 --> 00:20:38,640
different when it comes to doing those kinds of injections,

414
00:20:38,680 --> 00:20:41,039
and I'd really like people to know about that, because

415
00:20:41,240 --> 00:20:44,519
I know it sounds scary, but it's actually been one

416
00:20:44,559 --> 00:20:47,079
of the best things that I get done is to

417
00:20:47,079 --> 00:20:49,960
have them done, and I'm never afraid because of the

418
00:20:49,960 --> 00:20:50,559
way you do it.

419
00:20:50,599 --> 00:20:52,519
Speaker 1: So I wonder if you could talk about that a bit.

420
00:20:52,599 --> 00:20:56,279
Speaker 4: Sure, thank you, Jenny. But before I kind of expand

421
00:20:56,319 --> 00:20:59,559
on this, I just want to say that it's not

422
00:20:59,680 --> 00:21:03,759
just me, it's the entire team. And let me explain

423
00:21:03,799 --> 00:21:07,799
that the entire team here at Paints Best Regroup. We

424
00:21:07,799 --> 00:21:09,599
we've adopted this philosophy and so I have to give

425
00:21:09,640 --> 00:21:14,720
credit to my staff. We want the patient to experience

426
00:21:16,079 --> 00:21:20,240
a pleasant journey right when they step into our centers,

427
00:21:21,279 --> 00:21:24,559
and that includes, you know, coming into a calming environment.

428
00:21:24,599 --> 00:21:26,400
And that's why we have music and we try to

429
00:21:26,440 --> 00:21:31,400
have you know, light, pleasant engaging music. You know, we

430
00:21:31,440 --> 00:21:35,200
try to make it a kind of a soothing visual experience,

431
00:21:35,200 --> 00:21:38,480
even with you know, dimmer lights, but you know, not

432
00:21:38,480 --> 00:21:40,720
not too dim that you fall trip and fall. You know,

433
00:21:41,160 --> 00:21:43,559
you know, we want to make sure you feel safe.

434
00:21:43,640 --> 00:21:49,440
It's clean. Staff is you know, impeccably friendly and caring.

435
00:21:49,519 --> 00:21:52,000
I get a lot of those comments and I'm grateful

436
00:21:52,039 --> 00:21:55,839
because the staff is really really adopted this this approach

437
00:21:55,880 --> 00:21:58,359
to making patients feel welcome and safe when they come in.

438
00:21:58,599 --> 00:22:02,799
So again, it starts not just with the injections, but

439
00:22:02,839 --> 00:22:06,680
it's it's a whole thoughtful process of what the patient

440
00:22:06,759 --> 00:22:08,680
is going to experience as they come through the door,

441
00:22:08,720 --> 00:22:11,759
from the beginning throughout. And that's why we have a

442
00:22:11,759 --> 00:22:12,680
little piano there.

443
00:22:12,799 --> 00:22:12,920
Speaker 3: Right.

444
00:22:13,200 --> 00:22:15,880
Speaker 4: Some patients come in and they they they tinker around

445
00:22:15,880 --> 00:22:16,839
the baby grand piano.

446
00:22:16,920 --> 00:22:18,880
Speaker 3: Yeah, I was curious about that. If anyone ever actually

447
00:22:18,920 --> 00:22:19,559
plays it.

448
00:22:19,519 --> 00:22:22,039
Speaker 4: Oh, it's amazing. We have concert pianists that come in

449
00:22:22,000 --> 00:22:25,119
and just start jamming. We have people that play at

450
00:22:25,119 --> 00:22:28,960
restaurants that come in and jam. Oh it's people have

451
00:22:29,039 --> 00:22:31,519
their own recordings, and we have some of those artists

452
00:22:31,599 --> 00:22:34,119
that that come in with their own recordings and they

453
00:22:34,200 --> 00:22:36,359
and they jam. Every want to meet with them for

454
00:22:36,400 --> 00:22:36,759
your show.

455
00:22:36,799 --> 00:22:39,599
Speaker 5: We're happy to make the musicians any day.

456
00:22:39,720 --> 00:22:41,680
Speaker 4: But it's amazing and and and they come in and

457
00:22:41,680 --> 00:22:45,319
they make it a pleasant environment for the patients. You know.

458
00:22:45,400 --> 00:22:47,440
I I try to come out sometimes and play, but

459
00:22:47,559 --> 00:22:50,799
my piano skills are very limited now that I'm aged,

460
00:22:50,839 --> 00:22:53,480
and I haven't played a lot through years. But you know,

461
00:22:53,519 --> 00:22:55,640
I I tinker, but my kids play a lot better.

462
00:22:55,440 --> 00:22:57,480
Speaker 1: Than I do. I was gonna say to your kids.

463
00:22:57,200 --> 00:22:59,880
Speaker 4: Play, Yeah, they do. But it's for the patients, right,

464
00:23:00,039 --> 00:23:03,759
So we put that out there for the patients. We

465
00:23:03,920 --> 00:23:05,880
uh talk about instruments. We also have a pain gong,

466
00:23:05,920 --> 00:23:08,440
by the way, I just wanted to make Oh yes.

467
00:23:08,240 --> 00:23:11,200
Speaker 2: Yes, does that Does that get used much? I've never

468
00:23:11,240 --> 00:23:12,359
witnessed the gong.

469
00:23:12,799 --> 00:23:17,799
Speaker 4: It does, actually, So I think we're the only pain

470
00:23:17,880 --> 00:23:20,640
practice in the nation that has a pain gong. And

471
00:23:20,640 --> 00:23:23,200
we actually have a sign right by the exit that says,

472
00:23:23,240 --> 00:23:27,839
please share if your pain is gong. And I did

473
00:23:27,839 --> 00:23:29,759
that on purpose because I always tell patients like I

474
00:23:29,759 --> 00:23:30,799
can kind of get away.

475
00:23:30,559 --> 00:23:33,599
Speaker 5: With that, yeah, because yeah, yeah, I think I know

476
00:23:33,720 --> 00:23:35,200
it is, and I think you are.

477
00:23:35,519 --> 00:23:38,000
Speaker 1: I've seen bells. Everybody has a bell, but nobody has

478
00:23:38,039 --> 00:23:38,480
a gong.

479
00:23:38,599 --> 00:23:38,799
Speaker 3: Yeah.

480
00:23:39,079 --> 00:23:41,160
Speaker 4: Well, I'll tell you the origin of that, by the way,

481
00:23:41,240 --> 00:23:42,839
but let me explain the gong first. I'll tell the

482
00:23:42,839 --> 00:23:45,359
origin of that, Okay. So the gong is basically for

483
00:23:45,480 --> 00:23:49,480
patients to celebrate if they've had a really good experience,

484
00:23:49,599 --> 00:23:52,200
and they want everyone who's inside the center to know

485
00:23:52,720 --> 00:23:57,559
they can whack the gong and if they whack the gong, yes, yeah,

486
00:23:57,720 --> 00:23:58,880
and what happened.

487
00:23:58,799 --> 00:24:00,839
Speaker 1: You came around the corner, poked your head out.

488
00:24:00,839 --> 00:24:02,559
Speaker 5: It was the door of all all of a sudden,

489
00:24:02,559 --> 00:24:04,400
there's tart to know going, hey, look at that.

490
00:24:04,680 --> 00:24:09,240
Speaker 4: Yes, And so we've trained the staff to celebrate and

491
00:24:09,279 --> 00:24:11,559
clap and cheer patients when we hear the gong, and

492
00:24:11,599 --> 00:24:15,319
it's because it's a celebration for the patient to to

493
00:24:14,920 --> 00:24:18,119
to know that that you know, they've been happy with

494
00:24:18,160 --> 00:24:20,839
the care, they've received some type of relief. It's possibly

495
00:24:20,880 --> 00:24:22,960
helped them on their journey to change their life and

496
00:24:23,279 --> 00:24:25,559
doing the things they want to do again. And that's

497
00:24:25,640 --> 00:24:29,400
and that's why we have it there. Yeah, yeah, fun yeah.

498
00:24:29,519 --> 00:24:32,519
So so again some of the different things the staff,

499
00:24:32,559 --> 00:24:36,119
it's the team approach on making the experience for patients

500
00:24:36,200 --> 00:24:39,480
a little more comfortable as you're going through this journey

501
00:24:39,519 --> 00:24:42,279
of trying to mitigate your experiences of pain so that

502
00:24:42,359 --> 00:24:44,599
you can do the things you want to do. Now,

503
00:24:44,640 --> 00:24:46,759
going back to your question, what different things we do

504
00:24:46,839 --> 00:24:49,079
to help patients kind of go through the journey of

505
00:24:49,160 --> 00:24:55,039
like these experiences of injections or procedures. One is in

506
00:24:55,079 --> 00:24:57,079
this whole day and age just so much paperwork, and

507
00:24:57,079 --> 00:24:59,680
we've tried to streamline it as much as possible and

508
00:24:59,680 --> 00:25:01,920
and it's it's been hard, but we've we've you know,

509
00:25:01,960 --> 00:25:04,599
we've all these regulatory requirements that we have to go through,

510
00:25:05,839 --> 00:25:07,559
so we we we help we have the staff help

511
00:25:07,640 --> 00:25:10,480
streamline that. So that's been another thing that we've done.

512
00:25:11,319 --> 00:25:13,960
We uh, you know, just even the thinking of getting

513
00:25:14,480 --> 00:25:17,480
an injection. You know, patients come in anxious, they don't

514
00:25:17,519 --> 00:25:20,799
want to feel the poke, and that's where a lot

515
00:25:20,839 --> 00:25:27,920
of the thinking of physiology and chemistry and pharmacology becomes involved.

516
00:25:28,160 --> 00:25:30,200
And that's why you know, we we we we advise

517
00:25:30,279 --> 00:25:33,960
patients to get certain types of medications beforehand to help

518
00:25:34,079 --> 00:25:37,000
mitigate some of your experience with pain. And that's including

519
00:25:37,039 --> 00:25:41,759
you know, the the anziolytic, the the you know, like

520
00:25:41,799 --> 00:25:44,240
the tile and all to help with you know, mitigating

521
00:25:44,799 --> 00:25:49,319
you know, your experience with that first poke. It's also

522
00:25:49,759 --> 00:25:53,039
with uh creams. You know, we call in creams to

523
00:25:53,079 --> 00:25:55,279
help you mitigate that sensation.

524
00:25:55,000 --> 00:25:58,680
Speaker 5: Because we want to make it so comfortable for you

525
00:25:58,759 --> 00:25:59,759
as much as we can.

526
00:25:59,799 --> 00:26:01,599
Speaker 1: With that's so unique.

527
00:26:01,839 --> 00:26:04,440
Speaker 4: Yeah, yeah, and then you know, we we we have

528
00:26:04,920 --> 00:26:06,240
you know, and then once you're in the room, we

529
00:26:06,880 --> 00:26:10,400
have conversations, right, we have lots of you know, funny conversations.

530
00:26:10,400 --> 00:26:15,960
We play music the staff in there, Aiden and uh uh,

531
00:26:16,559 --> 00:26:19,000
Julia back there, you know, Bobby back there. You know,

532
00:26:19,039 --> 00:26:21,119
they tend to pick the music unless it's a special

533
00:26:21,160 --> 00:26:24,559
requests by the patient. And sometimes patient special requests are

534
00:26:24,599 --> 00:26:25,720
are phenomenal.

535
00:26:26,200 --> 00:26:26,359
Speaker 1: Right.

536
00:26:26,400 --> 00:26:30,400
Speaker 4: We've had, you know, hard rock, We've had gospel music.

537
00:26:31,160 --> 00:26:33,000
You know, a couple of the patients of request gospel

538
00:26:33,000 --> 00:26:38,039
and sometimes yeah, you can request your music. I mean

539
00:26:38,279 --> 00:26:40,720
we try to make it as comfortable as possible. Some

540
00:26:40,799 --> 00:26:43,400
patients want it blasting. We do that, and and we

541
00:26:43,480 --> 00:26:45,319
crack jokes, you know, we try to make you forget.

542
00:26:45,359 --> 00:26:47,319
And as you're giggling, you know, the needle gets poked

543
00:26:47,319 --> 00:26:50,599
in and then you know, I use a little diff

544
00:26:50,720 --> 00:26:53,079
a you know, I even modify the needle technique where

545
00:26:53,079 --> 00:26:57,480
I call the slows the slow squeeze technique. Where again

546
00:26:57,519 --> 00:27:00,880
it's it's all physiological, it's neurological. You do it in

547
00:27:00,960 --> 00:27:07,680
a way where you know, it's it's quick introduction, slow slow.

548
00:27:08,279 --> 00:27:12,039
How do you say it, uh, slow medication introduction. But

549
00:27:12,079 --> 00:27:14,039
what it does is it numbs and nerves. So as

550
00:27:14,640 --> 00:27:19,000
as the needles getting withdrawn. It's not ass as impactful.

551
00:27:19,119 --> 00:27:21,359
And then and then we go in and you know,

552
00:27:21,400 --> 00:27:24,759
we use you know, we try to use much more

553
00:27:24,799 --> 00:27:29,200
comfortable needling so that patients aren't aren't as impacted. And

554
00:27:29,240 --> 00:27:31,440
it's not perfect, but it works on the most part.

555
00:27:31,920 --> 00:27:32,880
Speaker 1: I can attest to that.

556
00:27:33,359 --> 00:27:35,799
Speaker 5: I can attest to that for Sartin, and there's a

557
00:27:35,839 --> 00:27:38,200
lot of other different I mean, it's it's cool because

558
00:27:38,240 --> 00:27:41,200
in pain care it's it's not just okay, here's a

559
00:27:41,400 --> 00:27:43,799
we're gonna plug you in here. It's that combination of

560
00:27:43,880 --> 00:27:46,839
finding out, you know, whether maybe we're doing this treatment

561
00:27:46,920 --> 00:27:50,319
along with this medication or this type of therapy.

562
00:27:50,400 --> 00:27:53,720
Speaker 1: Like I do pool. I I am in the pool

563
00:27:53,839 --> 00:27:54,720
every week.

564
00:27:55,240 --> 00:28:00,240
Speaker 4: And and I commend you on that because it's funny.

565
00:28:00,440 --> 00:28:03,079
But one of the basic elements that we have in

566
00:28:03,079 --> 00:28:07,279
this world is water, and water is such a great

567
00:28:07,359 --> 00:28:10,960
thing for muscle tone and stress on joints, yep. And

568
00:28:11,359 --> 00:28:14,319
for you to engage in pool to at least do

569
00:28:14,440 --> 00:28:16,640
the movements that would be hard to do on land,

570
00:28:16,640 --> 00:28:16,960
but you can.

571
00:28:17,039 --> 00:28:18,640
Speaker 5: I can't do what I can do in the pool.

572
00:28:18,720 --> 00:28:21,279
I can do jumping jacks in the pool. I do

573
00:28:21,319 --> 00:28:24,160
an arthritis class at the why at the local why

574
00:28:24,240 --> 00:28:27,319
everybody you know? You got Why's around this classes everywhere

575
00:28:27,920 --> 00:28:30,359
and it's great. I get in the water, I'm in

576
00:28:30,359 --> 00:28:32,720
there for about fifty minutes. I'm moving every one of

577
00:28:32,759 --> 00:28:36,799
my joints. And yeah, it's it's not just about medication.

578
00:28:37,319 --> 00:28:39,319
It's a combination of things. You have to Like, I

579
00:28:39,359 --> 00:28:41,400
watch my diet. I try to stick to an anti

580
00:28:41,400 --> 00:28:45,200
inflammatory diet because I don't want to cause more inflammation

581
00:28:45,240 --> 00:28:47,559
because my body just basically could glow in the dark

582
00:28:47,640 --> 00:28:49,440
if possible when it comes to inflammation.

583
00:28:50,279 --> 00:28:53,039
Speaker 4: Jenny, you're such an ideal, ideal model patient. I mean,

584
00:28:53,240 --> 00:28:55,839
I don't know about that, no, but you really do

585
00:28:55,920 --> 00:28:59,279
embrace the multi modal, you know, approach that we have

586
00:28:59,440 --> 00:29:03,720
to encourage patients because there's only so much injections and

587
00:29:03,799 --> 00:29:06,440
medications can do, and a lot of it is just

588
00:29:06,720 --> 00:29:08,880
to help buy you time so you can engage your

589
00:29:08,920 --> 00:29:12,720
body to heal a certain way and adjust a certain

590
00:29:12,759 --> 00:29:14,599
way so that you can do the things you want

591
00:29:14,640 --> 00:29:17,000
to do. So I really really do commend you on

592
00:29:17,039 --> 00:29:18,440
that pool therapy stuff.

593
00:29:18,480 --> 00:29:19,200
Speaker 1: It's huge.

594
00:29:19,279 --> 00:29:22,680
Speaker 5: And that's the thing about taking care of yourself. It's

595
00:29:22,920 --> 00:29:25,400
you got to take care of yourself in totality. I

596
00:29:25,440 --> 00:29:28,039
have a therapist, I get in the pool every week,

597
00:29:28,079 --> 00:29:31,119
I watch my diet, I take my medications regularly. I

598
00:29:31,160 --> 00:29:34,839
take my treatments regularly most of the time. Sometimes I

599
00:29:34,920 --> 00:29:36,720
might try and stretch it out a little bit, and

600
00:29:36,759 --> 00:29:37,839
then I get a little vet.

601
00:29:37,920 --> 00:29:39,680
Speaker 3: You can stretch it and.

602
00:29:39,599 --> 00:29:41,759
Speaker 1: Then I come in sooner. But there's so much you

603
00:29:41,799 --> 00:29:42,160
can do.

604
00:29:42,279 --> 00:29:44,559
Speaker 5: You don't have to the biggest thing I want people

605
00:29:44,559 --> 00:29:46,240
to take away I want you to hear today is

606
00:29:46,599 --> 00:29:48,319
you don't have to suffer.

607
00:29:49,039 --> 00:29:50,240
Speaker 1: You don't have to.

608
00:29:50,519 --> 00:29:52,599
Speaker 5: There are so many things I missed out on because

609
00:29:52,640 --> 00:29:55,920
I was suffering and I couldn't go. But I get

610
00:29:55,960 --> 00:29:59,039
regular treatment, and I get to go to the Mosaic

611
00:29:59,160 --> 00:30:00,640
Art Gallery.

612
00:30:00,000 --> 00:30:01,920
Speaker 1: Which we picked up my paintings yesterday.

613
00:30:02,240 --> 00:30:04,960
Speaker 5: I actually sold one for the first time out of

614
00:30:05,000 --> 00:30:06,880
the gallery, which was amazing.

615
00:30:07,200 --> 00:30:09,720
Speaker 4: An artist, I remember that happens.

616
00:30:09,400 --> 00:30:12,119
Speaker 5: Yesterday, right, So I would have never gotten to take place,

617
00:30:12,400 --> 00:30:15,359
take part in that, go to the opening, stand next

618
00:30:15,400 --> 00:30:17,759
to my painting on the wall, and fail pride because

619
00:30:17,799 --> 00:30:21,480
I wasn't too much pain right, So you can have

620
00:30:22,119 --> 00:30:24,000
It's worth it. It's worth it to get the treatment

621
00:30:24,039 --> 00:30:25,599
because you get so much in your life.

622
00:30:25,359 --> 00:30:28,119
Speaker 4: Back and can I just add to what you're saying, Jenny,

623
00:30:28,119 --> 00:30:31,519
And again this also falls within our philosophy is that

624
00:30:31,880 --> 00:30:35,480
if we make we help you feel good from say

625
00:30:35,799 --> 00:30:42,240
whatever base level to higher level, intermediate level, that mental

626
00:30:42,279 --> 00:30:45,720
health aspect that you have from feeling just a little

627
00:30:45,759 --> 00:30:48,599
better to be able to go and embrace and do

628
00:30:48,680 --> 00:30:51,440
the things you want to do, such as going to

629
00:30:51,480 --> 00:30:56,640
the art galleries, you know, going and taking those walks.

630
00:30:57,440 --> 00:31:03,079
That is neurochemically gonna reinfor force your feeling of of

631
00:31:03,079 --> 00:31:07,839
of reward and feeling better, and that in itself will

632
00:31:09,200 --> 00:31:12,200
will basically take you on the path on recovery from pain.

633
00:31:12,279 --> 00:31:15,720
So it's not just physic physiological pain, but it's also

634
00:31:15,839 --> 00:31:19,359
psychological emotional pain kind of about that we try to

635
00:31:19,440 --> 00:31:22,119
help really achieve relief for.

636
00:31:22,799 --> 00:31:26,319
Speaker 2: Yeah, I'm curious, doctor jo If over the course of

637
00:31:26,359 --> 00:31:28,640
your career, have you seen a lot of advancements in

638
00:31:28,720 --> 00:31:33,519
terms of techniques or technologies that you know that have

639
00:31:33,599 --> 00:31:36,160
that have really kind of helped to enhance what you do?

640
00:31:36,319 --> 00:31:36,519
Speaker 1: Oh?

641
00:31:36,599 --> 00:31:42,720
Speaker 4: Oh, phenomenally phenomenally. Uh. I can tell you one thing

642
00:31:42,799 --> 00:31:47,759
is that the field of medicine in itself has evolved

643
00:31:48,119 --> 00:31:54,160
so tremendously it tends to move a little slower because, like,

644
00:31:54,200 --> 00:31:57,720
if you look at the example of telephones, right, the iPhone,

645
00:31:58,720 --> 00:32:01,119
I mean, what was it maybe two decades ago? We

646
00:32:01,160 --> 00:32:04,039
had the flip phone, right, yeah, So wait what two

647
00:32:04,079 --> 00:32:08,000
decades ago? Was two thousands? Right? We had like flip

648
00:32:08,000 --> 00:32:10,880
phones back in the two thousands, and I mean I

649
00:32:10,880 --> 00:32:16,599
still remember that Motorola, that motoro flipt phone net that, yes,

650
00:32:17,279 --> 00:32:22,119
And then there's the BlackBerry with the little keyboard. So

651
00:32:22,160 --> 00:32:25,039
if you think of the evolution of the cell phone

652
00:32:25,599 --> 00:32:30,960
from you know, or telecommunications from pagers to flip phones

653
00:32:31,000 --> 00:32:35,119
to BlackBerry and now to these mini computers that live

654
00:32:35,400 --> 00:32:37,920
in your hand and you can talk to it and

655
00:32:37,960 --> 00:32:41,160
it talks back, tell it what to do, and it

656
00:32:41,240 --> 00:32:42,960
does it for you to throws the map up. Like,

657
00:32:43,599 --> 00:32:46,680
that's the evolution of medicine as well, because those technologies

658
00:32:46,799 --> 00:32:51,599
do migrate over to medicine. However, medicine tends to adopt

659
00:32:51,599 --> 00:32:54,799
it a little slower because providers tend to be a

660
00:32:54,799 --> 00:32:59,559
little more cautious because of you know, too aggressive a

661
00:32:59,680 --> 00:33:07,559
treatment or too aggressive advancements of adoption without studying the

662
00:33:07,680 --> 00:33:11,880
adverse effects of it as as closely could be detrimental

663
00:33:11,880 --> 00:33:13,680
for people. And that's why you know, the FDA has

664
00:33:13,680 --> 00:33:16,119
been very involved with those things. But in terms of

665
00:33:16,119 --> 00:33:22,039
pain management, it is extremely evolutionary, and it's evolutionary not

666
00:33:22,160 --> 00:33:27,519
just in medication management, not just in you know, the

667
00:33:27,640 --> 00:33:33,160
multidisciplinary approach and thinking about pain and suffering not just

668
00:33:33,240 --> 00:33:37,960
from you know, a mechanical but also you know, in emotional, psychological,

669
00:33:38,279 --> 00:33:42,799
but also in like techniques. So I say that because

670
00:33:43,680 --> 00:33:48,079
they have, for example, needles out there right that you

671
00:33:48,160 --> 00:33:50,480
put it into the patient for radio frequency evlations, you

672
00:33:50,519 --> 00:33:52,880
push a little lever and all of a sudden, boom,

673
00:33:52,920 --> 00:33:55,240
it comes out like a trident, so it covers the

674
00:33:55,279 --> 00:33:58,119
larger area. But the problem is those needles are extremely expensive.

675
00:33:58,119 --> 00:34:00,200
That it doesn't mean it makes it very difficult to

676
00:34:00,920 --> 00:34:07,000
cost cover the cost of treatment they have. You know,

677
00:34:07,079 --> 00:34:10,519
they have implants and procedures that the pain doctor does

678
00:34:10,559 --> 00:34:14,320
that comes very close to what the spine surgeons somewhat do,

679
00:34:14,400 --> 00:34:16,199
but not as good as spine sorts. I would never

680
00:34:16,760 --> 00:34:19,800
never detract from what the spine surgeons do because they

681
00:34:19,840 --> 00:34:23,159
do excellent work and it's so phenomenal to see the

682
00:34:23,199 --> 00:34:25,920
results of what they do. But there's been you know,

683
00:34:26,079 --> 00:34:31,719
techniques and devices developed where spine surgeons are are doing it,

684
00:34:31,760 --> 00:34:33,840
and they're teaching pain physicians to do an under X

685
00:34:33,960 --> 00:34:39,000
ray two and the costs are phenomenally less, really phenomenally less.

686
00:34:39,079 --> 00:34:42,280
But you know, what are the results. I don't know, right,

687
00:34:42,320 --> 00:34:46,199
They're still being studied. They're probably not as as effective

688
00:34:46,480 --> 00:34:49,920
as the current standard, and some maybe even more effective,

689
00:34:49,920 --> 00:34:51,920
but we just don't know fully yet. Yeah, I mean,

690
00:34:51,960 --> 00:34:55,239
preliminary studies have come out enough to get them approved,

691
00:34:55,840 --> 00:34:58,800
but long term studies are not fully there yet to

692
00:34:59,440 --> 00:35:03,920
clarify what the advantages and disadvantages are. But again, you know,

693
00:35:03,960 --> 00:35:08,800
in this American you know, westernized market environment that we

694
00:35:08,840 --> 00:35:15,039
have in America, sometimes those those therapies take precedent because

695
00:35:15,039 --> 00:35:17,960
they're cheaper to the insurers and the payers and and

696
00:35:17,960 --> 00:35:20,559
and there's you know, better margins to be made by

697
00:35:20,559 --> 00:35:22,719
the healthcare systems because of that, right.

698
00:35:22,639 --> 00:35:26,000
Speaker 3: Right, That's always.

699
00:35:25,519 --> 00:35:26,800
Speaker 1: One thing that people get a lot.

700
00:35:26,840 --> 00:35:28,599
Speaker 5: And I was curious to ask you the question on

701
00:35:28,639 --> 00:35:31,639
air for every for other people as well, is what

702
00:35:31,679 --> 00:35:34,280
do you do to help people with like really bad

703
00:35:34,280 --> 00:35:35,880
headaches migrains?

704
00:35:37,840 --> 00:35:41,559
Speaker 4: Great question. So we we deal with a lot of migraines,

705
00:35:42,599 --> 00:35:45,519
and we you know, we deal with a lot of headaches.

706
00:35:45,599 --> 00:35:50,039
We have a lot of approaches that you know, are

707
00:35:50,119 --> 00:35:53,920
specifically pain management related, and a lot of approaches that

708
00:35:53,960 --> 00:35:57,920
you know, we've worked with, uh that are fall within neurology,

709
00:35:58,360 --> 00:36:01,599
but neurology also leaks over to pain management. And some

710
00:36:01,679 --> 00:36:04,440
of the challenges are some of those therapies we've we've

711
00:36:04,480 --> 00:36:07,800
adopted and employed because there's such a shortage of neurologists

712
00:36:07,800 --> 00:36:11,599
here in New Hampshire. There's a huge shortage of neurologists.

713
00:36:11,639 --> 00:36:15,480
I mean, we get comments all the time that, uh,

714
00:36:15,599 --> 00:36:17,960
you know, I can't see my neurologists for another six months.

715
00:36:18,119 --> 00:36:20,599
Speaker 5: Oh, it took me over a year to get into

716
00:36:20,639 --> 00:36:22,800
my neurologist's office on a wait list.

717
00:36:23,119 --> 00:36:26,159
Speaker 4: And it's insane. And we're like, well, you know, we

718
00:36:26,239 --> 00:36:28,639
try to accommodate you. We'll we'll figure it out. We'll

719
00:36:28,719 --> 00:36:32,400
we'll try to adopt some of those measures to help

720
00:36:32,440 --> 00:36:36,719
with pain management, with migrain and headache management. But again,

721
00:36:37,599 --> 00:36:40,480
you know, the the experts on those are the neurologists.

722
00:36:40,920 --> 00:36:43,199
But you know, we we've been able to accommodate some

723
00:36:43,239 --> 00:36:45,400
of those and some of those include, of course, you know, therapeutics,

724
00:36:45,440 --> 00:36:51,800
right like medications. There's been a pardon me, burgeoning class

725
00:36:51,880 --> 00:36:56,000
of therapeutics that are pretty effective on migrain management, but

726
00:36:56,000 --> 00:36:58,559
again they're more expensive and they're on patents, so there's

727
00:36:58,599 --> 00:37:03,599
they don't fall within the insurance algorithms as as readily accessible.

728
00:37:03,599 --> 00:37:06,599
And those tend to be the calcitonin gene receptor peptide

729
00:37:06,679 --> 00:37:12,440
antagonists to see g RP receptor antagonists, and those include

730
00:37:12,480 --> 00:37:16,280
some medications that you can take orally once a month,

731
00:37:16,360 --> 00:37:23,559
injections injectables. Those help. We also leak over to just

732
00:37:23,639 --> 00:37:25,639
in eventual pay manage itself, is that a lot of

733
00:37:25,639 --> 00:37:28,039
the headaches are not just migraines, but they could be

734
00:37:28,760 --> 00:37:33,440
related to the cervical spine, and we call those cervicogenic headaches.

735
00:37:35,840 --> 00:37:39,920
You know, where where the headaches are are from irritation

736
00:37:39,960 --> 00:37:42,280
of the nerves that cut off the cervical spine, that

737
00:37:42,360 --> 00:37:44,239
cause spasms of the muscles in the back of the

738
00:37:44,280 --> 00:37:47,119
neck upper lower part of the head and then you know,

739
00:37:47,320 --> 00:37:51,360
through collateral innervation end up being experienced as a headache.

740
00:37:52,360 --> 00:37:54,800
You know, we have occipital nerves, you know, greater and

741
00:37:54,840 --> 00:37:58,000
lesser eximpble nerves that tend to be irritated from you know,

742
00:37:58,280 --> 00:38:00,760
irritation of some type, whether it's spasm them or just

743
00:38:00,880 --> 00:38:04,519
fibers tissue irritation. So so there's a lot of ways

744
00:38:04,519 --> 00:38:09,199
that we can deal with headache that kind of overlap

745
00:38:09,280 --> 00:38:11,599
somewhat with some of the neurologists. Again, they're the experts,

746
00:38:11,639 --> 00:38:14,800
you know. I always love my neurology colleagues. Wish I

747
00:38:14,880 --> 00:38:16,679
was able to spend more time with them. Sometimes we

748
00:38:16,719 --> 00:38:19,000
do get a special guest that comes to our office

749
00:38:19,360 --> 00:38:22,960
to interact with us about neurology. Sometimes we we've touched

750
00:38:23,000 --> 00:38:26,719
base with some of the neurologists in in the UH

751
00:38:27,480 --> 00:38:30,639
Northeast area that we've got today. Yeah, but again they're

752
00:38:30,679 --> 00:38:36,800
they're they're far and few between because somehow there's such

753
00:38:36,800 --> 00:38:40,000
a shortage of them. And I know that there's been

754
00:38:40,039 --> 00:38:42,519
you know, some dynamics that have occurred with health systems

755
00:38:42,519 --> 00:38:46,360
that have uh made some shifts in neurology access as

756
00:38:46,400 --> 00:38:50,000
well in the in the New Hampshire area. So it's

757
00:38:50,039 --> 00:38:52,679
been interesting. But yes, yes, we have lots of little

758
00:38:52,679 --> 00:38:53,920
things we could do for migraines as well.

759
00:38:54,000 --> 00:38:56,880
Speaker 3: Yeah, headaches, it's pretty common migraines.

760
00:38:56,960 --> 00:38:59,000
Speaker 4: Migraines and heaches. So one thing I just want to

761
00:38:59,039 --> 00:39:00,760
say is that people but when they have a headache.

762
00:39:00,760 --> 00:39:03,639
They call it a migraine, but it's not always a migraine.

763
00:39:03,639 --> 00:39:06,639
There's there's a specific criteria for migraine. There's specific criteria

764
00:39:06,679 --> 00:39:09,480
for different types of headaches, like cluster headaches. Yeah.

765
00:39:09,519 --> 00:39:11,440
Speaker 2: Oh, I know someone who's who's had to deal with

766
00:39:11,440 --> 00:39:13,079
cluster headaches, right, yeah, just.

767
00:39:13,159 --> 00:39:16,239
Speaker 4: Yeah, they have a whole cervicrogenic headaches. So again, you know,

768
00:39:16,320 --> 00:39:19,559
we're there to discern between those things. It's not just

769
00:39:19,760 --> 00:39:22,599
you know, one label and it falls within that. We

770
00:39:23,000 --> 00:39:26,000
tend to try to tease apart. What's the real root

771
00:39:26,079 --> 00:39:26,559
cause of it?

772
00:39:26,800 --> 00:39:27,079
Speaker 3: Yeah?

773
00:39:27,199 --> 00:39:30,119
Speaker 2: Yeah, what's the most common back pain? I would assume, right,

774
00:39:30,239 --> 00:39:31,719
is the most common back pain.

775
00:39:31,960 --> 00:39:39,039
Speaker 4: Neck pain, injury related pain is very common. Yeah, just

776
00:39:39,119 --> 00:39:43,760
a lot of arthritic pain. Degenerative joint pain is very

777
00:39:43,880 --> 00:39:48,280
very common. And and just remember that anytime anyone's in

778
00:39:49,239 --> 00:39:54,400
mechanical physiological pain, it evolves into the psychological pain.

779
00:39:54,559 --> 00:39:55,440
Speaker 3: And we have.

780
00:39:55,440 --> 00:40:01,360
Speaker 4: That that you know, combinatory source of pain, and it

781
00:40:01,360 --> 00:40:03,800
becomes very difficult to break. And so that's that's the

782
00:40:03,880 --> 00:40:06,199
art of pain management. How do we break one to

783
00:40:06,280 --> 00:40:08,440
help decrease the other, Then how do we break the other.

784
00:40:09,639 --> 00:40:12,000
Speaker 5: One of the aspects of of pain that I call

785
00:40:12,079 --> 00:40:15,400
it is paying gry when I'm in so much pain

786
00:40:15,599 --> 00:40:19,519
that it's not it's not about anybody else. But everything

787
00:40:19,599 --> 00:40:22,400
is short fused, everything is tight. I'm hurting so much

788
00:40:22,440 --> 00:40:25,320
that I might come off like I'm really angry, but

789
00:40:25,360 --> 00:40:29,360
it's it's really painger. It's it's it's not it's not

790
00:40:29,480 --> 00:40:32,840
a normal sense of anger, if that makes sense. But yeah,

791
00:40:32,880 --> 00:40:34,679
that's that's kind of a term that we use.

792
00:40:34,840 --> 00:40:37,159
Speaker 4: Is paining gree real term because it's not. We should

793
00:40:37,239 --> 00:40:37,480
quit it.

794
00:40:37,639 --> 00:40:40,719
Speaker 5: It isn't It isn't our world. It isn't our world

795
00:40:40,760 --> 00:40:42,679
because I've seen it before, I've used it in some

796
00:40:42,719 --> 00:40:46,199
of my writings. I don't know where the original coin

797
00:40:46,320 --> 00:40:47,119
is come from.

798
00:40:47,239 --> 00:40:49,679
Speaker 3: I know, I don't take credit for that market.

799
00:40:49,960 --> 00:40:52,039
Speaker 4: Yeah, I don't know straight on the show.

800
00:40:52,119 --> 00:40:55,239
Speaker 1: Yeah, it's a real phenomenon.

801
00:40:55,480 --> 00:40:58,400
Speaker 5: And your your loved ones don't necessarily really oh they're

802
00:40:58,400 --> 00:40:59,079
in a bad mood.

803
00:40:59,119 --> 00:41:01,199
Speaker 1: It's like, oh god, I'm not in a bad mood.

804
00:41:01,199 --> 00:41:02,079
I'm really suffering.

805
00:41:02,199 --> 00:41:05,079
Speaker 5: Yeah you know, but yeah you don't. That's the thing.

806
00:41:05,159 --> 00:41:05,880
That's the real thing.

807
00:41:05,960 --> 00:41:08,039
Speaker 4: And this is why I want to give a positive

808
00:41:08,079 --> 00:41:11,679
stroke and a very very you know, highlighted comment to

809
00:41:11,719 --> 00:41:15,400
my staff is that they are the front line of

810
00:41:16,159 --> 00:41:19,480
dealing with, you know, patients, and a lot of these

811
00:41:19,519 --> 00:41:23,519
patients call in and come in with angry syndrome. Yeah, yeah,

812
00:41:24,119 --> 00:41:25,400
very angry.

813
00:41:25,000 --> 00:41:27,760
Speaker 5: Yeah, and it's not them and they're wonderful and they're

814
00:41:27,760 --> 00:41:29,119
sitting there taking it and you're like.

815
00:41:29,079 --> 00:41:30,079
Speaker 1: But I need the appointment.

816
00:41:30,360 --> 00:41:32,320
Speaker 4: Yes, yes, and so and so I just want to

817
00:41:32,360 --> 00:41:36,440
say that, yes, it's it's a very notable occurrence. I

818
00:41:36,480 --> 00:41:38,440
can only say that, you know, I'm very grateful for

819
00:41:38,599 --> 00:41:42,320
the staff to be able to to, you know, oh

820
00:41:42,519 --> 00:41:47,480
humbly and craftily handle those situations without without being too

821
00:41:47,559 --> 00:41:49,480
affected by it. But does affect all of us.

822
00:41:49,559 --> 00:41:50,440
Speaker 1: Of course, Oh yeah.

823
00:41:50,639 --> 00:41:52,800
Speaker 5: I mean you call up like I've called up and

824
00:41:52,880 --> 00:41:56,199
been crying like oh this went wrong and I'm really hurting,

825
00:41:56,480 --> 00:41:58,400
and they're just all right, we got you.

826
00:41:58,800 --> 00:42:00,559
Speaker 1: Yeah, where are we going to let's get a you know.

827
00:42:01,199 --> 00:42:03,079
Speaker 4: So, So one of my most common words that I

828
00:42:03,159 --> 00:42:08,039
use during the day is oo. So you know how

829
00:42:08,039 --> 00:42:11,480
you take a breath back and you catch yourself. So,

830
00:42:11,480 --> 00:42:13,840
so that's that's one thing I think that could help

831
00:42:14,199 --> 00:42:17,639
patients when they go through a paining gree episode or

832
00:42:17,679 --> 00:42:20,119
pain paying gry episode is take a step back and

833
00:42:20,239 --> 00:42:24,199
just kind of take a deep breath and let it out.

834
00:42:24,119 --> 00:42:29,119
Speaker 5: You know, like like like you know, like, yes, yes,

835
00:42:30,280 --> 00:42:31,800
I do a lot of Yeah.

836
00:42:32,079 --> 00:42:33,559
Speaker 3: I don't know if you I think you know this

837
00:42:33,599 --> 00:42:33,880
about me.

838
00:42:33,920 --> 00:42:36,480
Speaker 2: I'm a hypnotherapist and I do a lot of what

839
00:42:36,599 --> 00:42:38,840
I'm bringing a client in a hypnosis. We do a

840
00:42:38,840 --> 00:42:43,320
lot of breathing, ironic given my recent asthma issue, but

841
00:42:43,320 --> 00:42:45,400
but we do a lot of you know, deep breathing,

842
00:42:45,440 --> 00:42:47,519
and I try to I do a little bit of

843
00:42:47,760 --> 00:42:48,920
pain management with that too.

844
00:42:49,000 --> 00:42:51,000
Speaker 3: Sometimes sometimes with clients just to kind of help.

845
00:42:50,880 --> 00:42:53,320
Speaker 2: Them, I try to get them to do a visualization

846
00:42:53,360 --> 00:42:55,679
where they imagine the pain not as a feeling or

847
00:42:55,679 --> 00:42:57,800
a sensation, but as an object that's in them that

848
00:42:57,840 --> 00:43:00,960
they can remove, that they can actually push out. And

849
00:43:01,039 --> 00:43:03,400
sometimes it's helpful for people. But but we do a

850
00:43:03,440 --> 00:43:05,920
lot of breathing stuff, you know. I get them to

851
00:43:06,079 --> 00:43:08,599
you know, breathe out any negative energy that they're carrying

852
00:43:08,639 --> 00:43:11,079
around and breathing positive energy and all that kind of thing.

853
00:43:11,159 --> 00:43:15,000
Speaker 4: That's phenomenal. Matt, you should maybe become a hypno therapist

854
00:43:15,039 --> 00:43:17,119
for pain. We well, I do.

855
00:43:17,199 --> 00:43:19,280
Speaker 1: I have to do it with somebody asked about it.

856
00:43:19,599 --> 00:43:22,440
Speaker 3: Oh, yeah, yeah, really, yeah, I meant most of my clients.

857
00:43:22,480 --> 00:43:24,880
Speaker 2: It's not something I get approached about much because most

858
00:43:24,880 --> 00:43:27,400
of my clients the number one thing is quitting smoking,

859
00:43:27,599 --> 00:43:30,760
of course, which is true for any epnotherapist. And I

860
00:43:30,800 --> 00:43:32,800
do a lot of you know, stress management and all

861
00:43:32,840 --> 00:43:35,760
that kind of thing, weight loss of phobias. So it's

862
00:43:35,880 --> 00:43:39,000
not actually very common that anyone that a client approaches

863
00:43:39,039 --> 00:43:41,079
me for for help with pain management.

864
00:43:41,079 --> 00:43:42,880
Speaker 3: But I do it, and I actually have a certification

865
00:43:42,960 --> 00:43:43,239
in it.

866
00:43:43,239 --> 00:43:46,159
Speaker 1: It's really And you also have hypno birthing.

867
00:43:46,639 --> 00:43:49,840
Speaker 4: I do, yes, hypno birthing, yes, yeah, wow.

868
00:43:50,320 --> 00:43:53,000
Speaker 1: You can use hypnosis in childbirth.

869
00:43:52,519 --> 00:43:54,840
Speaker 4: Yep to not feel like the labor pains.

870
00:43:54,760 --> 00:43:57,280
Speaker 3: Right to be able to.

871
00:44:00,119 --> 00:44:04,880
Speaker 5: Maybe an Epidurals are amazing. Let me tell you I

872
00:44:04,880 --> 00:44:07,719
didn't get one when I gave birth to my son. Unfortunately,

873
00:44:07,760 --> 00:44:09,840
by the time I was smart enough to ask, they said.

874
00:44:09,639 --> 00:44:10,679
Speaker 1: The window was closed.

875
00:44:12,519 --> 00:44:15,920
Speaker 4: So, just so you know, my latter my prior life

876
00:44:15,960 --> 00:44:17,920
before I went into pain management was that I was

877
00:44:17,960 --> 00:44:21,920
an upstetric antithesiologist. Oh so, so I know the epidural

878
00:44:22,119 --> 00:44:24,679
very well, and I just want to make a comment

879
00:44:24,760 --> 00:44:30,280
that that it's always good if there's no major contraindications

880
00:44:30,320 --> 00:44:34,320
to get the epidural early, because that epidural not only

881
00:44:34,360 --> 00:44:37,320
helps you experience for women that are going through labor,

882
00:44:37,679 --> 00:44:40,880
that only helps you experience the birthing process in a

883
00:44:40,960 --> 00:44:44,079
much more pleasant manner, especially if it's working well. It's

884
00:44:44,079 --> 00:44:47,079
a very from a medical standpoint, it's it's probably one

885
00:44:47,079 --> 00:44:51,239
of the best life saving tools that the antiseesiologist and

886
00:44:51,280 --> 00:44:54,840
the medical team has to deal with any emergencies that

887
00:44:54,960 --> 00:44:58,880
may arise that are so fast paced when you're going

888
00:44:58,920 --> 00:45:02,320
through the process. So so I've always been an advocate

889
00:45:02,679 --> 00:45:06,079
get it early, Let's make sure it works. And if

890
00:45:06,159 --> 00:45:08,679
even if you don't want to receive the the the

891
00:45:08,679 --> 00:45:11,159
the relief from it, that's okay. We can shut it off.

892
00:45:11,199 --> 00:45:13,880
But as long as it's working and it's there and

893
00:45:13,920 --> 00:45:18,480
if something some badness occurs, it's it's one of our

894
00:45:18,719 --> 00:45:22,039
best If it's one of our best tools to get

895
00:45:22,079 --> 00:45:23,400
you through the whole process safely.

896
00:45:24,199 --> 00:45:24,920
Speaker 3: Okay.

897
00:45:25,559 --> 00:45:26,639
Speaker 1: Now you have two.

898
00:45:26,440 --> 00:45:30,800
Speaker 5: Offices, so you can see people in two different locations. Now, yes,

899
00:45:30,920 --> 00:45:32,639
I want to make sure listeners know where you are.

900
00:45:32,760 --> 00:45:35,400
Speaker 4: Yes, yes, So so we we have our main location

901
00:45:35,719 --> 00:45:39,360
in Newington, New Hampshire, and that was the well the

902
00:45:39,440 --> 00:45:42,159
original one was actually an Exeter and we started with

903
00:45:42,199 --> 00:45:46,000
doctor Sanchez, Manuel Sanchez, and and God bless his soul,

904
00:45:46,079 --> 00:45:53,239
he's such as I still love that man so much.

905
00:45:53,320 --> 00:45:55,840
Speaker 1: He was so nice, he is such.

906
00:45:55,920 --> 00:46:01,159
Speaker 4: He is such that Spanish European classy flair that that,

907
00:46:01,639 --> 00:46:04,800
and and and his teachings. I mean, I can only

908
00:46:04,800 --> 00:46:10,440
tell you his teachings still come with me today till today.

909
00:46:10,559 --> 00:46:15,559
He he he really really uh impressed on me how

910
00:46:15,880 --> 00:46:18,360
to really take care of patients here in New Hampshire.

911
00:46:18,440 --> 00:46:21,679
Just so you know, but our original office was actually

912
00:46:21,679 --> 00:46:24,840
an Exeter and then when I joined in shortly after

913
00:46:24,880 --> 00:46:27,599
we went to Newington and then recently just opened up

914
00:46:27,599 --> 00:46:29,159
a new office in new Market.

915
00:46:29,239 --> 00:46:31,280
Speaker 3: Yeah, congratulations, well, thank you, thank you.

916
00:46:31,320 --> 00:46:35,320
Speaker 4: It's been a little slow of opening. I'm not there

917
00:46:35,440 --> 00:46:39,800
often just because I'm pretty tied down in the Newington location,

918
00:46:40,119 --> 00:46:42,320
but my staff is there a lot and and we

919
00:46:42,400 --> 00:46:45,039
do a lot of uh we're starting to roll out,

920
00:46:45,119 --> 00:46:48,000
you know, a lot more clinical time there. The building

921
00:46:48,039 --> 00:46:50,480
is still under development, you know, the section for the

922
00:46:50,519 --> 00:46:53,239
paint for the clinic is is already ready to go.

923
00:46:54,119 --> 00:46:55,760
But it's beautiful. I mean, I'm sure you've been there

924
00:46:55,840 --> 00:47:00,760
right there yet should we should come here.

925
00:47:00,800 --> 00:47:02,400
Speaker 1: Sometimes we go on to the new one now.

926
00:47:02,280 --> 00:47:04,400
Speaker 4: Oh yeah, yeah, it's really nice. It's uh.

927
00:47:04,760 --> 00:47:06,920
Speaker 1: I usually go into the r Yeah.

928
00:47:06,960 --> 00:47:09,920
Speaker 5: So I'm always at the at the Newington office.

929
00:47:10,519 --> 00:47:13,000
Speaker 4: Honestly, if my wife let me live up in the

930
00:47:13,119 --> 00:47:15,719
new market of them, I have like place where I

931
00:47:15,719 --> 00:47:19,639
live at home. Yeah, it's it's new, you know, it's new.

932
00:47:19,760 --> 00:47:22,800
It's fresh. You know, we we put new flooring in.

933
00:47:23,239 --> 00:47:25,039
It's just pretty. I just think it's really pretty.

934
00:47:25,199 --> 00:47:26,880
Speaker 3: Yeah, oh very good.

935
00:47:26,960 --> 00:47:27,440
Speaker 4: Yeah good.

936
00:47:27,639 --> 00:47:31,719
Speaker 2: Yeah what uh now, did you have any other plans

937
00:47:31,760 --> 00:47:33,760
for expansion beyond that in the future.

938
00:47:34,000 --> 00:47:36,599
Speaker 4: You know, it's a great question. I mean, you know,

939
00:47:37,480 --> 00:47:39,960
I'd love to be like Doctor Evil out of uh

940
00:47:40,400 --> 00:47:45,400
what's that movie? Uh it's a little world domination. But no,

941
00:47:45,639 --> 00:47:50,440
realistically it's slow and steady. Yeah we uh, you know,

942
00:47:51,119 --> 00:47:55,639
it's it's basically a staffing and and a patient you know,

943
00:47:56,000 --> 00:47:59,519
accommodation issue. It's just we go slow and steady. I

944
00:47:59,719 --> 00:48:03,360
think as long as you know, we're able to accommodate

945
00:48:03,360 --> 00:48:06,400
patients and we're able to figure out areas that that

946
00:48:08,159 --> 00:48:11,400
there is need right like you know, up here near

947
00:48:11,440 --> 00:48:13,559
the Manchester area, I think there's more need because I

948
00:48:13,559 --> 00:48:16,840
know there's been some shifting in the pain management atmosphere

949
00:48:17,199 --> 00:48:22,159
out here in New Hampshire. We would definitely think about

950
00:48:22,159 --> 00:48:24,920
expanding more. But again, it's just it's I'm very slow

951
00:48:24,960 --> 00:48:28,599
and steady. I've I've always been very conservative, and I know,

952
00:48:28,800 --> 00:48:31,519
you know, my administrative staff is always asked, why don't

953
00:48:31,519 --> 00:48:32,920
we do this? Why don't we do that? We get

954
00:48:32,960 --> 00:48:35,440
vendors all the time coming in and going hey, let's

955
00:48:35,440 --> 00:48:38,679
do this and do that. Yeah, and I'm just very

956
00:48:38,679 --> 00:48:39,360
slow and steady.

957
00:48:39,400 --> 00:48:43,159
Speaker 3: I just yeah, I just I think that's probably wise.

958
00:48:43,480 --> 00:48:47,440
Speaker 4: Well, it's it's only because we have something that works

959
00:48:47,519 --> 00:48:50,000
right now, and you know, we we have a lot

960
00:48:50,039 --> 00:48:53,519
of positive feedback from the community and from patients, and

961
00:48:53,639 --> 00:48:57,559
so to to to add another element into something that

962
00:48:57,639 --> 00:49:00,719
works has to take a lot of thought and h

963
00:49:01,880 --> 00:49:04,159
and consideration, because you know, we want to make sure

964
00:49:04,159 --> 00:49:06,119
that we're still doing the best that we can for

965
00:49:06,239 --> 00:49:10,000
people and for patients in the community without without changing

966
00:49:10,039 --> 00:49:11,800
it too much. That's why, again, the slow and steady

967
00:49:11,800 --> 00:49:15,679
approach has always been my my, my, my mindset.

968
00:49:15,800 --> 00:49:19,400
Speaker 3: Yeah, no, I think that makes I think that makes sense. Doctor. No.

969
00:49:19,559 --> 00:49:20,360
This has been wonderful.

970
00:49:20,400 --> 00:49:22,519
Speaker 2: We're already approaching the top of the hour that the time,

971
00:49:23,159 --> 00:49:24,320
the time goes so quickly.

972
00:49:25,079 --> 00:49:27,039
Speaker 3: Anything we didn't mention that we should make sure that

973
00:49:27,079 --> 00:49:27,440
we Uh.

974
00:49:28,559 --> 00:49:31,320
Speaker 4: I just want to say, you know, happy new Year

975
00:49:31,440 --> 00:49:34,800
to everyone, for both of you, to everyone out there

976
00:49:34,800 --> 00:49:39,199
in New Hampshire, to the uh, you know, the general public.

977
00:49:40,920 --> 00:49:46,360
I want to say that, uh, you know, we hope

978
00:49:46,400 --> 00:49:50,159
from Paint Specialty Group a fruitful and very successful year

979
00:49:50,199 --> 00:49:53,119
and we're here to help if there's anything that you need.

980
00:49:53,800 --> 00:49:56,400
I want to be thankful to my staff. They've done

981
00:49:56,440 --> 00:49:58,559
a wonderful job take helping.

982
00:49:58,960 --> 00:49:59,159
Speaker 3: You know.

983
00:49:59,199 --> 00:50:02,440
Speaker 4: The providers take care of the community, and we have

984
00:50:02,559 --> 00:50:04,119
lots more exciting things to come.

985
00:50:04,280 --> 00:50:04,519
Speaker 3: Yeah.

986
00:50:04,559 --> 00:50:05,079
Speaker 1: Absolutely.

987
00:50:05,119 --> 00:50:09,039
Speaker 5: You can find out more information at Painspecialtygroup dot com.

988
00:50:09,039 --> 00:50:13,320
Pain Specialtygroup dot com will show you all the information

989
00:50:13,360 --> 00:50:16,440
about the different treatments they offer, different types of problems

990
00:50:16,480 --> 00:50:19,280
that they treat and all the providers. Beautiful pictures are

991
00:50:19,320 --> 00:50:21,599
on there so you can see more information about the providers.

992
00:50:22,079 --> 00:50:24,679
I am a happy patient and I invite you to

993
00:50:24,679 --> 00:50:25,679
have a pain free day.

994
00:50:26,480 --> 00:50:27,719
Speaker 3: And it's a very nice website.

995
00:50:27,719 --> 00:50:29,639
Speaker 2: By the way, I'm a web design nerd, so I

996
00:50:30,760 --> 00:50:32,760
judge these things and it's a very nice website.

997
00:50:32,840 --> 00:50:34,880
Speaker 4: Well, thank you, thank you. I don't take any credit

998
00:50:34,880 --> 00:50:35,039
for you.

999
00:50:36,840 --> 00:50:38,800
Speaker 2: You don't have time to design your own website, that's

1000
00:50:38,800 --> 00:50:41,199
for sure, I know, but no, but it's a great site.

1001
00:50:41,199 --> 00:50:44,639
And yes, Painspecialtygroup dot com and doctor No, thank you.

1002
00:50:44,639 --> 00:50:46,360
Speaker 4: So much, thank you for having me on.

1003
00:50:46,480 --> 00:50:49,000
Speaker 2: Absolutely we got to do this more often. Okay, like

1004
00:50:49,000 --> 00:50:50,719
we were talking about earlier, we definitely will