Brain Fertilizer, Soul Points, and a Bucket of Pain
Pathways & switches of pain affect well-being & productivity. Amy Baxter, MD. explores recent insights about managing pain and learning coping mechanisms. Watch on YouTube Download the printable newsletter here Contents Episode Proem Buzzy, Relief from Needle Pain by Amy Baxter How crazy is it that pain is one of my favorite topics? Not so crazy as pain may be life’s most common symptom. One study pegs the annual cost of pain (as a primary diagnosis) to be between $261 to $300 billion. Yikes. No one I’d rather talk with about pain than Amy Baxter. Amy and I correspond regularly about life and pain. We last recorded a conversation about pain in July 2019, Pain: The Solution – Many Solutions. Our knowledge about the pathways and switches of the brain’s survival system has increased dramatically since 2019. Let’s jump right in. Podcast intro Welcome to Health Hats, the Podcast. I’m Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare. Let’s make some sense of all of this. Learning from lived experience Health Hats: You’ve learned much about pain since we last talked. Tell us about that. Amy Baxter: I broke my neck in 2015 and then got intubated for a while, and then I had a ripped rotator cuff that I ignored until it got horrific. So, I feel grateful that I’ve had the experience to cope with my own acute and chronic pain, mostly chronic. It’s nothing like I imagine having a genetic issue or having an inflammatory ongoing issue, and particularly something like covid or fibromyalgia or an autoimmune system situation where it’s ongoing and systemic. Nonetheless, I’ve had that experience, which has been valuable. I also have been working with the National Institutes of Mental Health, Helping to End Addiction Long-Term Initiative , bridging that place between pain and opioid use because if we didn’t have the issues of post-surgical pain and acute pain that we treated with opioids, we wouldn’t have an opioid problem. I’ve been busy. Health Hats: Goodness, where should we start? Amy Baxter: Let’s start with the stuff I put in the TED Talk because I spent a lot of time trying to encapsulate what I’d learned so people could use and benefit from it, change society and how we deal with healthcare in this company or country—Freudian slip. Oldest and Best Survival System Amy Baxter: Physicians are not taught about pain in medical school. We don’t know what it is. We don’t understand how to treat it. We don’t think it’s our job because we’re supposed to figure out what caused the pain and fix that or inflict pain to diagnose it. But most people go to the doctor for pain. So that was something I hadn’t appreciated. What we have learned about pain in the last 20 years through functional MRI is that it’s not what we do learn about in medical school, which is you poke your finger, and if you had lidocaine in there, it wouldn’t hurt. But if you don’t, it goes up to your brain and hurts. Instead, pain is just the oldest and best survival system, so it’s a full-brain, total symphony of everything you’ve ever associated with something you want to avoid. So, pain is not just the incoming stimulus. It is all the memory, fear, decision-making, and actions, and it’s just this giant response. So sometimes your brain is wrong about how much pain you should feel, and sometimes you can learn how to override the brain and say no, we’re fine. Pain as opportunity Health Hats: I automatically react whenever anybody uses the word should. And I’m wondering if I can frame it as being helpful to you instead of should. Amy Baxter: It’s an option. I always tell my kids that it is an opportunity, not an obligation. So, if we understand that an opportunity is happening that causes us to feel pain, it makes it easier to think about ways to cope with it. Health Hats: Unkn