January 23, 2020
Introduction to the Living Beyond Pain Podcast

Introduction to the Living Beyond Pain Podcast


[Narrator] [Army Capt. Beegen] Stay tuned for [Army]
Capt. Tracy Beegen, of the “Living Beyond Pain” podcast, produced by the Defense Health
Agency. Welcome to the “Living Beyond Pain” podcast. This is a series devoted to helping people
struggling with chronic pain by giving them practical tools to help them manage the intensity,
the frequency, and the duration of their pain flare-ups. So in this episode, we’re going to talk about
what exactly chronic pain is and how it impacts different areas of our lives. And I want to introduce my special guest,
Dr. Dianne Flynn. She’s a pain expert here at the Madigan Army
Medical Center. Welcome, Dr. Flynn. [Dr. Dianne Flynn] Hi, Tracy. [Beegen] Can you tell us a little bit about
your experience working with pain? [Flynn] Oh, yes. I’m a family physician and I also work at
Madigan Army Medical Center, and I work in the interdisciplinary pain management center
at Madigan, and I’ve worked there since 2010 now. [Beegen] So you have a pretty extensive background
in treating patients with pain? [Flynn] Yes, and prior to working in the interdisciplinary
pain management center at Madigan– I’m a family physician, so I worked in primary care
for about 20 years prior to that. [Beegen] So can you tell our audience a little
bit about what chronic pain is? [Flynn] The short answer is, it’s generally
accepted that chronic pain is defined as pain that lasts longer than about 12 weeks or three
months. The longer way to answer that question is
to talk a little bit about the difference between acute pain – which is pain that occurs
in response to an injury – and chronic pain. So acute pain is your body’s response to injury,
and it’s a protective characteristic. When you touch a hot pan, for example, on
a hot stove, your body’s natural tendency is to pull away from that burn and that discomfort. The pain that you have at the site of the
burn, is your body’s way of giving you a chance to heal. It’s letting you know, “Keep that limb or
that finger or hand protected while the body can heal.” Chronic pain, on the other hand, is pain that
in many cases persists after the acute injury has healed, and unlike acute pain, which serves
a purpose, chronic pain really has no purpose and in many cases, the chronic pain leads
to harm such as decreased function, decreased ability to sleep, and decreased ability to
really enjoy life. [Beegen] So chronic pain is really not very
helpful, and it kind of tricks our minds and our body into thinking that there’s still
harm and injury out there when, in reality, that chronic pain is actually keeping them
from engaging in important areas of their life. [Flynn] Absolutely. Yes. It’s not uncommon, when someone has experienced
chronic pain for months, sometimes years, sometimes even decades, for them to be fearful
of physical activities. They may feel like if they went for a walk
they would re-injure their sore back or their sore knee or hip. Whereas physical activity is actually helpful
for most pain conditions, to help the body be as strong and flexible as possible. [Beegen] So we know pain really impacts our
physical abilities and to engage in enjoyable activities or exercise or even just daily
activities like getting out of bed or going to the grocery store. Can you tell us a little bit more about other
areas in someone’s life that pain could impact them? [Flynn] Many people I think believe that pain
is just a physical symptom; it’s the discomfort. But chronic pain really affects many aspects
of an individual’s life in many cases. Pain can be associated with depression, for
example. Anxiety, problems with sleep, problems with
worrying, worrying that the pain won’t get better or the pain could get worse. So it really affects multiple domains of someone’s
life. [Beegen] I’ve also seen that with the patients
I work with, and I think what particularly stands out to me is that having chronic pain
can feel very isolating and people withdraw socially and then, like you said, the anxiety
and the depression. So that really four-pronged approach of you’re
looking at the physical impact, the emotional impact, how it’s impacting the way they think
about their situation, and then also their social interaction which can really lead to
a vicious cycle. [Flynn] Absolutely, yes. [Beegen] Now, if someone out there is listening
and they’re experiencing chronic pain and they might feel frustrated with their current
treatment plan or they don’t even know where to start to address those different areas,
what recommendations would you have as far as effective treatments for pain? [Flynn] Yeah, that’s a great question. The best way to treat chronic pain is with
an interdisciplinary approach. And what that means, simply, is it’s bringing
together medical professionals from many different disciplines, each having their own perspective
on the best way to treat pain, and coming up with a comprehensive plan that includes
aspects of all of their medical disciplines. So for example, Madigan and at every army
medical center, we all have an interdisciplinary pain management center. And at each of these centers, we have conventional
medical care providers – so we have physicians and physical therapists and occupational therapists
and health psychologists, nurses – but in addition, we have practitioners of complementary
and integrative therapy such as chiropractic, acupuncture, yoga, and massage. And our team comes together to develop a treatment
plan for each patient that we see in our centers and meet regularly to discuss how each individual
is responding to the therapeutic approach. And in so doing, we really feel that we bring
the best of all of those disciplines together to accomplish the best outcomes for each individual
who engages in them. [Beegen] So it sounds like the experts have
come together and really decided that a team approach is the best way, so you have the
medical professionals to address the physiological needs or the body’s needs to treat the pain. That could include medications, physical therapy. Then you have the behavioral health piece
to really work on coping skills, stress management, and then also looking at some of the great
resources we have with yoga, with some of the complementary services, and I think there’s
been some research on acupuncture as well. So it sounds like, really, that team approach
has been determined to be the best way to treat pain. [Flynn] Yes, I agree. And you mentioned medications as well; we
also have a pharmacist on our team to help patients understand the benefits and side
effects of the medications that they may have been on. [Beegen] So one of the ways I try to explain
that team approach to my patients is, if you had a car with four flat tires, you wouldn’t
only want to fix one of the flat tires because the other three are still going to keep that
car from moving forward effectively and running at an optimal level. So that’s kind of that team approach that
we have with pain management. Is that accurate? [Flynn] Yeah, I think that’s a great analogy. [Beegen] What would be some resources that
you could recommend for folks that are listening, and maybe they’re a little skeptical about
engaging with their primary care provider or maybe they’re not sure– What are some
resources that we could give them to give them some more information or maybe get them
connected with some of these resources? [Flynn] Well, there are resources available
at the website here. That would be a good place to start. I would also recommend that individuals with
chronic pain who are interested in a more interdisciplinary approach visit their primary
care providers. Their primary care provider can do a thorough
assessment of their pain, of the cause of their pain, and the underlying manifestation
of their pain, and then determine which of the approaches would be the best approach
to help manage their pain. And I also want to say, there’s a huge component
of what we call self-management. So these are resources that any individual
can do on their own at home, either between medical visits or after they’ve had medical
care and are discharged from care for a particular condition. These are tools in their toolbox that they
can carry with them in the future, and many of these resources are available in the show
notes. [Beegen] I just want to say thank you so much
for taking the time to chat with us about your experience in treating chronic pain and
giving us some educational information. And I hope the takeaway here is that, yes,
you have chronic pain, but it doesn’t have to control your life. And we’re really hoping, through this series,
that you can get some tools that’ll help you manage your pain and help you live beyond
your pain. And again, we’re not looking to eliminate
your pain; we’re looking to give you some new coping skills, maybe some new perspective
on how you can manage and continue to have opportunities and a quality of life where
the intensity, the frequency, and the duration of your pain flare-ups are not going to have
as much control as they’ve had in the past. Again, we’re not looking to take away all
your pain. I wish we could; that would be wonderful. But there’s no magic cure for that. But these are some practical resources and
practical tools that folks can use in their daily lives. So thank you again so much for your time,
Dr. Flynn, and thank you for listening. We’ll hope you stay tuned for our next episode
as we discuss breaking through the vicious cycle of chronic pain. We look forward to helping you take back control
of your life and living beyond your pain. Until next time, be well and know you’re not
alone in your battle to manage your chronic pain. The “Living Beyond Pain” podcast is produced
by the Defense Health Agency.

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