It's Not in Your Head
It's Not in Your Head
with Juz and Dan.
“The challenge of chronic pain is deciphering how much is due to underlying drivers that may or may not be treatable, co-existing diseases, psychosocial or metabolic factors, and other amplifiers of sensitization that all add to the output of symptoms.”
Justine Feitelson, BA, CCP
Justine is a chronic pain patient, pain coach, and movement professional. She lives with Complex Regional Pain Syndrome, hEDS, and other common co-existing conditions, working with complex pain patients, educating and advocating through her coaching services and mentorship programs.
Justine felt an immense void in patient education around CRPS, how complex pain manifests, available treatment options, and how to work more collaboratively with physicians in the traditional pain space. She is passionate about bridging the gap in understanding and expectations between patients and providers by empowering patients to be their own advocates and take control of the pieces of their pain management journey they impact through her MARSMethod, as well as helping physicians better understand the very real challenges patients with complex, chronic diseases face and improving empathy and inclusion.
Dr. Dan Bates, MD
Dan is passionate about breaking down barriers between patients and providers and helping patients take back what brings them meaning and purpose in life. He is a Sports and Exercise Medicine Specialist. He is the Managing Director at Metro Pain Group and Monash Clinical Research and is the Chairman of the Board at Monash House Private Hospital. Dr. Bates works full time with people suffering back, neck and joint pain. Prior to this he has worked extensively in Sports Medicine and for multiple professional and national sporting teams. He was the head doctor at Australian Football League teams Melbourne and North Melbourne.
His research career has been broad covering exercise induced asthma, examination techniques, biologics, osteoarthritis, chronic pain and neuromodulation. He lectures nationally and internationally regularly, has 3 kids and the worlds most tolerant wife.
We We both work with patients every day who have been told damaging things about pain, how it works, and why they feel the way they do. Who have been to many doctors and tried everything that was asked of them, yet weren’t empowered to change the things right at their fingertips or given the most appropriate treatments for their diagnosis. This frustrates both of us in different ways and has fueled our why’s in developing our own practices and perspectives on pain we want to share with you.
What chronic pain patients too often feel is hopelessness, desperation, shame, grief, and a lack of accountability from providers for providing better information and guidance.
We felt obligated to create this podcast to better bridge the gap between patients and providers, and change the way chronic pain is approached and treated.
By breaking down the mechanisms of pain, causes, contributing factors, amplifiers and more, we can link them to the best treatments based upon diagnosis/type of pain and how to most effectively implement them.
What most people miss is that pain education can be empowering for patients - but only if explained in a non-offensive way - so patients can make the connections without feeling so blamed for the state they are in that they lose the agency to create change. Blaming others for our health or lack of improvement takes our control away as patients. But how do navigate the medical system in a way we can also get the help we need?
At the heart of the challenge are guilt and blame. A lack of empathy on both sides that leads to no one being happy with the way things currently are.
From a blame perspective, doctors are expected to do too much and blamed when pain won’t go away. Patients are blamed and cast as resource wasting malingerers when pain isn’t because of something identifiable. And each party struggles with guilt and shame. The patient feels guilty for being sick, and the doctor feels shame for not knowing or being able to help. This is where for the physician, this disconnect too often leads to, it must be because of the patient, because that’s easier to say than ‘I’m sorry, I don’t know.’
This is not a recipe for healing. It leaves too many patients hopeless and helpless, and clinicians frustrated at the realistic therapeutic, diagnostic, and skill based limitations they come up against. How do we fix this? A few simple rules we challenge you with:
On the physician side:
It’s OK to not know, with caveats.
Don’t blame the patient.
Don’t use explanations that indirectly blame the patient.
On the patient side:
Work on the guilt of having the disease. It’s not your fault.
That being said, don’t blame others for the situation. You have to own it to change what you can.
The current environment we treat chronic pain in has made this very difficult. Different schools of thought and positions on the therapeutic spectrum are pitted against one another. The reality is we have to find ways around this. The way things currently are clearly is not working for most patients. It's Not in Your Head podcast is about educating patients and clinicians so we can truly improve outcomes on a large scale. THIS is how we create meaningful change, together.
At the heart of all change is purpose. Dan and Juz are on a mission to educate and empower more pain patients to take back control of their lives despite challenging diagnosis, and give clinicians the tools to better help them.
We can’t wait for you to join us.
Living with chronic pain and difficult to treat or poorly understood diseases is unfortunately beyond what the medical system is designed to support. It often lacks the communication and individualized attention to detail that help patients understand what is going on in their bodies, what they can control, and what they need to impact or further outsource.
Doctors don’t have the time or ability to cover and address many of the variables in patients lives that are dramatically impacting their quality of life with chronic pain. But it’s not because they don’t care. There are diagnostic and therapeutic limitations clinicians encounter that set everyone up for frustration, and your position on the therapeutic spectrum is driven by your diagnostic and therapeutic limitations as a provider. What you believe in centers around what you have access to and the inherent biases that develop as you practice over time.
We are biased by our own successes who come back, the successes of others we never see, our failures who never come back, and the failures of others we see. It’s not about fighting over what perspective is the best, it’s about recognizing what patients benefit from what strategies.
The challenge with chronic pain is having the frameworks and thinking tools to tease out all the inputs resulting in the outputs the patent is experiencing, and matching the approach (from conservative management to more invasive options) to the presentation most effectively.
Physicians job is to diagnose, manage treatments and perform interventions. Patients job is to manage everything else about their life that contributes to and amplifies pain. Our job on this podcast is to help you identify what those things are, and teach you how to communicate and impact them more effectively so you can shave off more pain as a patient, and improve your skillset as a provider so you get better outcomes.
What will you learn on It's Not In Your Head?
We are not bringing you another run of the mill podcast on pain. We are not industry talking heads sponsored by medical device companies. We’re a pain doctor and pain patient/clinician putting our experience and expertise together so we can solve some of the most challenging aspects of managing chronic pain, bring patients and clinicians together, and improve outcomes for complex patients.
Both of us have ended up specializing in complex pain. Though Dan primarily treats back, neck and joint pain, his deep interest around more complicated pain related disorders that are often completely ignored like hEDS, or deeply misunderstood like CRPS, have led us down some epic rabbit holes of conversation and research that has resulted in this mutual passion and project that is It’s Not in Your Head.
Our goal with @iniyhpodcast, is to teach you about all the different pieces and types of pain, and help you work through addressing your pain puzzle if you’re a patient. For clinicians, we want to give better thinking tools and ways to approach persistent chronic pain and hard to treat presentations like central sensitization. Persistent pain is not in patients head. Give us a listen for more information to fill this crucial gap in understanding so you can create better outcomes - whether a pain patient or clinician.