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In this episode of the Wealth Planning for the Modern Physician podcast, host David Mandell sits down with two highly respected medical leaders—Dr. Mark Figgie, Chief Emeritus of the Surgical Arthritis Service at the Hospital for Special Surgery (HSS), and Dr. Joel Press, Physiatrist-in-Chief at HSS—to explore their personal and professional journeys in medicine. Dr. Press shares how his diverse early experiences led him to physiatry, while Dr. Figgie recounts his balance between science, business, and a lifelong pursuit of education, including earning an MBA during his fellowship. The conversation shifts into a discussion of mentorship at the Hospital for Special Surgery, where both physicians have played key roles in developing a cross-disciplinary mentorship model to support younger doctors. Their focus extends beyond clinical guidance to include career development, personal financial planning, and wellness—areas often overlooked in traditional medical training. This approach fosters institutional collaboration and a stronger culture at HSS. Finally, the episode dives into physicians' relationships with industry. Dr. Figgie offers candid advice on contracts, intellectual property rights, and ethical considerations when working with device manufacturers. He emphasizes the importance of legal review and staying true to what benefits patients. Dr. Press adds insight into personal financial trust, suggesting that doctors build a "board of directors" for trusted guidance. The episode closes with a preview of future initiatives aimed at supporting physicians earlier in their careers through financial education and mentorship. Key Insights: Dr. Press discovered physiatry through a unique summer program, showing the value of early exposure to diverse specialties. Dr. Figgie pursued an MBA during fellowship, believing in the power of financial literacy for physicians. Mentorship at HSS now includes financial, administrative, and personal development components—not just clinical. A cross-specialty mentorship program allows different departments (e.g., orthopedics and radiology) to learn from one another. Many young physicians lack basic financial planning tools, leading to under-preparedness later in their careers. HSS has created a repository of recorded educational sessions covering mortgages, insurance, investing, and more. Dr. Figgie cautions against blindly signing industry contracts without legal review, especially when IP is involved. Relationships with medical device companies often include consulting, design input, or teaching—but require transparency. Dr. Press emphasizes the importance of building a trusted "personal board of directors" to help with life and career decisions. Future initiatives at HSS may include subsidized financial checkups for new physicians to kickstart long-term planning. Learn more, including additional show notes, links, and detailed key takeaways, by visiting physicianswealthpodcast.com. Click here to get your FREE copy of our latest book, Wealth Strategies for Today's Physician!
Podcast Show Notes: Peripheral Vascular Disease in PainManagement Episode Highlights: - Host: Dr. David Rosenblum - Podcast: Pain Exam Podcast - Focus: Peripheral Arterial Disease (PAD) in Pain Management Download the App Key Topics Covered: 1. Peripheral Arterial Disease (PAD) Overview - Definition: Arterial sclerosis condition developing over long term - WHO Definition: Exercise-related pain or ankle-brachial index (ABI) < 0.9 - Prevalence: * 3-4% in 60-65 year olds * Increases to 15-20% in 85-90 year olds * Up to 50% of patients may progress to symptomatic stages 2. Diagnostic Considerations Diagnostic Tests: - Ankle Brachial Index (ABI) - Ultrasound - CT Angiography - Physical examination - Pulse volume recordings - Transcutaneous oximetry ABI Interpretation: - 1.0-1.4: Normal - 0.9-1.0: Acceptable - 0.8-0.9: Some arterial disease - 0.5-0.8: Moderate arterial disease - < 0.5: Severe arterial disease 3. Pain Characteristics Types of Pain: - Intermittent claudication - Chronic limb ischemia - Nociceptive pain - Neuropathic pain - Mixed pain syndrome 4. Pain Management Strategies Pharmacological Approaches: - Mild Pain: Paracetamol, NSAIDs - Neuropathic Pain: Lidocaine patches, gabapentin, duloxetine - Severe Pain: Morphine, fentanyl, ketamine Non-Pharmacological Interventions: - Music therapy - Aromatherapy - Psychotherapy - Massage - Acupuncture - TENS - Intermittent pneumatic compression Upcoming Conferences Mentioned: - ASPN - ASIPP - Pain Week - Latin American Pain Society Additional Resources: - Pain Exam newsletter: painexam.com - Virtual pain fellowship at nrappain.org Disclaimer: Always consult with a healthcare professional for personalized medical advice. Reference Garba Rimamskep Shamaki, Favour Markson, Demilade Soji-Ayoade, Chibuike Charles Agwuegbo, Michael Olaseni Bamgbose, Bob-Manuel Tamunoinemi, Peripheral Artery Disease: A Comprehensive Updated Review, Current Problems in Cardiology, Volume 47, Issue 11, 2022,101082, Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512 Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512
Summary At some point this medication may show its face on the Physiatry boards. Whether or not Suzetrigine will appear on the Physical Medicine and Rehabilitation boards, all of us need to know about this new class of analgesic. Brought to you by NRAP Academy, home of the PMRExam Board Prep Here, Dr. David Rosenblum delivered a comprehensive lecture about a new pain medication called Journavx (Suzetrigine). He discussed its mechanism of action as a NAV 1.8 receptor inhibitor, its clinical applications, contraindications, and dosing guidelines. Dr. Rosenblum emphasized that this non-opioid medication represents a new class of pain management drugs with no addiction potential. He also shared information about upcoming educational events, including ultrasound courses and various pain management conferences. The lecture included detailed information about drug interactions, safety considerations, and clinical trial results comparing Journavx to placebo and hydrocodone-acetaminophen combinations. Key findings from clinical trials showed that Jornavix achieved pain relief in 119 minutes compared to 480 minutes for placebo in abdominoplasty trials, and 240 minutes versus 480 minutes in bunionectomy trials. The recommended dosing is 50mg tablets twice daily, with an initial loading dose of 100mg. While the drug showed promising results for moderate to severe acute pain management, it did not demonstrate superiority over hydrocodone in clinical trials. Important contraindications include CYP3A inhibitors, and special considerations are needed for patients with hepatic impairment or those taking hormonal contraceptives. The medication should be taken on an empty stomach, either one hour before or two hours after food, and patients should avoid grapefruit juice while on this medication. For more infomation.... Chapters Introduction and Upcoming Events Dr. Rosenblum announced several upcoming events, including an ultrasound course in New York City on May 17th, 2025. He mentioned offering ultrasound and IV training for healthcare professionals, particularly nurses, ICUs, PAs, and hospital doctors. He also highlighted upcoming conferences including ASPN, Pain Week, Latin American Pain Society, New York, New Jersey Pain Congress, ASIPP, and EPA. Introduction to Journavx (Suzetrigine) Dr. Rosenblum introduced Suzetrigine (Journavx), a new 50mg tablet medication. He emphasized that this discussion was not sponsored by any pharmaceutical company but rather focused on educating about a new class of pain medication. He noted its potential importance as a future board examination topic. Mechanism of Action Dr. Rosenblum explained that Jornavx works by inhibiting the NAV 1.8 receptor. He detailed how the drug blocks sodium ions from entering pain-sensing neurons, disrupting action potential initiation and propagation. He emphasized that the drug is highly selective, binding over 31,000 times more selectively to NAV 1.8 than other NAV subtypes. Contraindications and Drug Interactions Dr. Rosenblum outlined various contraindications, particularly focusing on CYP3A inhibitors and inducers. He listed specific medications in each category and emphasized the importance of careful monitoring when prescribing Journavx alongside these medications. Clinical Trial Results and Dosing Guidelines Dr. Rosenblum presented clinical trial results showing Journavx's effectiveness in treating moderate to severe acute pain. He detailed the dosing guidelines: 50mg tablets twice daily, with an initial loading dose of 100mg. He emphasized the importance of taking the medication on an empty stomach and avoiding grapefruit juice. Q&A No Q&A session in this lecture
We welcome Dr. Jennifer Miller. She specializes in physical medicine and rehabilitation at Albany Medical Center. Dr. Miller sees adult and pediatric patients for new or long-standing muscle, nerve or tendon problems. Ray Graf hosts.
Episode Summary: In this episode of NRAP's PainExam Podcast, host David Rosenblum, MD, interviews Dr. Thomas Strouse about his extensive experience with Scrambler Therapy and the evidence supporting its use in treating chronic pain. They delve into the intricacies of this innovative therapy, discussing treatment protocols, patient responses, and the overall effectiveness of Scrambler Therapy for various pain conditions. Key Topics Discussed: - Overview of Scrambler Therapy and its analgesic response. - The importance of adjusting treatment intensity based on patient feedback. - Sensations experienced by patients during therapy (from burning to tapping). - Safety considerations for patients with pacemakers during treatment. - Insights into the effectiveness of Scrambler Therapy for conditions such as discogenic back pain and peripheral neuropathy. - Discussion on treatment costs for patients and providers. - Experiences with patients who have experienced pain recurrence after treatment. - The role of booster sessions in maintaining pain relief. - Challenges faced by failed back surgery patients and the potential benefits of Scrambler Therapy. Resources Mentioned: - Contact information for Stefan Erickson at stefan@mail.scramblertherapy.com to integrate Scrambler therapy into your practice. Links to additional resources and research on Scrambler Therapy. Info] Additional Information: - For more information about upcoming webinars, including the next session on cervical ultrasound, visit www.NRAPpain.org Thank you for tuning in to NRAP's PainExam Podcast! We hope you find the insights shared in this episode valuable in your journey toward understanding and managing chronic pain. NY based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Creators Biography: David Rosenblum, MD, currently treats patients in Garden City and Brooklyn. He serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn , NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures. Dr. Rosenblum has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is working closely with the American Society of Interventional Pain Physicians (ASIPP), Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, and various state societies, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures. He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more! Doctor Rosenblum is a co-founder of the International Pain Academy and created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques. Office based Pain Physicians, Physiatrists, Emergency Room Physicians, Anesthesiologists, Neurologists and Orthopedics who treat pain, utilize Neuromodulation and use PRP, Bone Marrow Aspirate or any other Biologics will benefit from this course. #longislandpaindoctor #interventionalpain #paindoctor #scrambler #scramblertherapy
Dr. Monica Verduzco-Gutierrez is an accomplished academic Physiatrist and currently serves as Professor and Chair of the Department of Rehabilitation Medicine at the Long School of Medicine at UT Health San Antonio. Her area of clinical expertise is the care of patients with traumatic brain injury, stroke rehabilitation, and interventional spasticity management. Most recently, she has developed a Post-COVID Recovery Clinic to help those who were diagnosed with COVID-19 and suffer from various physical, cognitive, and functional difficulties. In this episode, medical student Sanjana Ayyagari explores how a physiatrist approaches COVID rehabilitation and clinical practice in a post-COVID world. Music Credits: "Tribe" by SENSHO. License code: 9KKZQYKXLF6SDHKH
In this episode of Career Chats, RFC tech committee member Kyle Cullin, DO talks with Dr. Miguel Escalón, MD. Dr. Escalón is the current Program Director for Icahn School of Medicine PM&R Residency program at Mount Sinai Hospital. Fellowship trained in Brain Injury and Spinal Cord Injury Medicine; he has gone on to be the Fellowship Director of Brain Injury Medicine at Mount Sinai as well. Dr. Escalón offers his insights and experiences from his beginnings in PM&R to fellowship choices, life advice for his younger self, as well as present day goals, aspirations, and more. Host: Kyle Cullin, DO, Guest: Dr. Miguel Escalón, MD Recorded and Edited by: Kyle Cullin, DO
Dr. Daniel Daneshvar is a renowned researcher in the world of traumatic brain injury, having authored or co-authored numerous publications contributing to our understanding of the causes of CTE and other neurodegenerative diseases as well as their long-term effects. Tune in as medical student Brian Gu interviews Dr. Daneshvar about the highlights of his research, education and advocacy efforts for brain injury awareness in sports, and day-to-day as a physician-scientist in physiatry. This Is Physiatry is a podcast that aims to spread awareness of the wonderful specialty of Physical Medicine and Rehabilitation (PM&R). This podcast is brought to you by the AAP's Medical Student Council (MSC).
We welcome Dr. Matthew Erby, a physiatrist with St. Peter's Sports & Spine and Sunnyview Rehabilitation Hospital. Ray Graf hosts.
Exploring the Efficacy of Autologous Platelet Leukocyte Rich Plasma Injections in Chronic Low Back Pain & Understanding Degenerative Lumbar Spinal Stenosis Host David Rosenblum, MD Episode Date: October 25, 2024 In this episode, Dr. David Rosenblum discusses two significant studies related to chronic low back pain and degenerative lumbar conditions. The first study focuses on the use of autologous platelet leukocyte rich plasma (PLRP) injections for treating atrophied lumbar multifidus muscles, while the second study investigates the correlation between muscle atrophy and the severity of degenerative lumbar spinal stenosis (DLSS). Featured Article 1: - Effect of Autologous Platelet Leukocyte Rich Plasma Injections on Atrophied Lumbar Multifidus Muscle in Low Back Pain Patients with Monosegmental Degenerative Disc Disease - **Authors:** Mohamed Hussein, Tamer Hussein Key Points Discussed 1. Background: Correlation between lumbar multifidus muscle dysfunction and chronic low back pain. 2. Study Overview: 115 patients treated with weekly PLRP injections for six weeks, followed for 24 months. 3. Outcome Measures: Significant improvements in NRS and ODI scores, with high patient satisfaction. 4. Conclusions: PLRP injections into the atrophied multifidus muscle are safe and effective for managing chronic low back pain. Featured Article 2: - Degenerative Lumbar Spinal Stenosis Authors:* Gen Xia, Xueru Li, Yanbing Shang, Bin Fu, Feng Jiang, Huan Liu, Yongdong Qiao Key Points Discussed 1. Background: DLSS is a common condition in older adults, often leading to muscle atrophy and disability. 2. Study Overview: A retrospective analysis involving 232 patients to investigate the correlation between muscle atrophy and spinal stenosis severity. 3. Results: - Significant differences in the ratio of fat-free multifidus muscle cross-sectional area between stenotic and non-stenotic segments. - A strong positive correlation was found between multifidus atrophy and the severity of spinal stenosis. - The atrophy was more pronounced on symptomatic sides of the spine compared to contralateral sides. 4. Conclusions: The findings suggest that more severe spinal stenosis is associated with greater muscle atrophy, emphasizing the importance of addressing muscle health in DLSS patients. Discussion: Dr. Rosenblum provides insights into how these studies inform clinical practices for treating chronic low back pain and managing degenerative conditions. He emphasizes the need for comprehensive treatment strategies that consider both muscle health and spinal integrity which may be achieved via peripheral nerve stimulation of the medial branch nerve and multifidus muscle or PRP injection in to the multifidus muscle. Closing Remarks: Listeners are encouraged to stay informed about innovative treatment options and the importance of muscle assessment in managing spinal disorders. **Follow Us:** - Subscribe to the Painexam Podcast for more episodes discussing the latest in pain management research and treatments. - Connect with us on social media [insert social media links]. NRAP Academy also offers: Board Review Anesthesiology Pain Management Physical Medicine and Rehabilitation Regenerative Medicine Training Live Workshops Online Training The Virtual Pain Fellowship (online training program with discount to live workshops) Regional Anesthesia & Pain Ultrasound Course Private Training Available Email Info@NRAPpain.org **Disclaimer:** The information presented in this podcast is for educational purposes only and should not be considered medical advice. Always consult a healthcare professional for medical concerns. References Xia, G., Li, X., Shang, Y. et al. Correlation between severity of spinal stenosis and multifidus atrophy in degenerative lumbar spinal stenosis. BMC Musculoskelet Disord 22, 536 (2021). https://doi.org/10.1186/s12891-021-04411-5 Hussein M, Hussein T. Effect of autologous platelet leukocyte rich plasma injections on atrophied lumbar multifidus muscle in low back pain patients with monosegmental degenerative disc disease. SICOT J. 2016 Mar 22;2:12. doi: 10.1051/sicotj/2016002. PMID: 27163101; PMCID: PMC4849261.
Colin O'Gara, Head of Addiction Services at St John of God Hospital in Dublin and Clinical Professor of Physiatry at UCD, reacts to the latest data from the Health Research Board on drug-related deaths and gives an overview of today's current trends when it comes to drug use.
Dr. Rosenblum serves at AMETD's 2024 Conference as faculty and discusses the safe and accurate usage of Ultrasound to Guide PRP injecitons Discussed in this lecure: Knee, Hip, Shoudler, Ligament and Tendon Targets, the ultrasound technique, the evidence for PRP and controversy. Controversy with respect to the Achilles Tendon! Other Announcements from NRAP Academy: PainExam App is ready for iphone Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://rapm.bmj.com/content/rapm/early/2024/07/16/rapm-2024-105593.full.pdf Disclaimer Disclaimer: This Podcast, website and any content from NRAP Academy (NRAPpain.org) otherwise known as Qbazaar.com, LLC is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.
Tune in to the latest This Is Physiatry episode as medical student Ellese Lupori talks with Dr. Nicholas Elwert, DO, MS on all things from patient education to keeping an open mind during medical training. This Is Physiatry is a podcast that aims to spread awareness for the wonderful specialty of Physical Medicine and Rehabilitation (PM&R). This podcast is brought to you by the AAP's Medical Student Council (MSC).
Podcast Show Note Summary: Episode Title: "New Guidelines for Corticosteroid Injections in Chronic Pain Management" This podcast is a discussion about the recent review article Use of corticosteroids for adult chronic pain interventions: sympathetic and peripheral nerve blocks, trigger point injections - guidelines from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, the American Society of Interventional Pain Physicians, the International Pain and Spine Intervention Society, and the North American Spine Society In this episode, we dive into the recently published guidelines on the use of corticosteroid injections for managing chronic pain, developed by the American Society of Regional Anesthesia and Pain Medicine, along with several other prominent pain societies. These guidelines address the safety and efficacy of corticosteroid injections for sympathetic and peripheral nerve blocks, as well as trigger point injections. Key Discussion Points: Background and Need for Guidelines: Overview of potential adverse events from corticosteroid injections, such as increased blood glucose levels, decreased bone mineral density, and suppression of the hypothalamic–pituitary axis. Importance of using lower doses of corticosteroids, which studies have found to be just as effective as higher doses. Development of the Guidelines: The guidelines were approved by multiple pain societies and structured into three categories: sympathetic and peripheral nerve blocks, joint injections, and neuraxial injections. Extensive literature review and consensus-building through a modified Delphi process. Key Recommendations: The addition of corticosteroids to local anesthetics is recommended for certain nerve blocks, such as the greater occipital nerve block for cluster headaches and ilioinguinal/iliohypogastric nerve blocks for post-herniorrhaphy pain. Corticosteroid addition is not recommended for sympathetic nerve blocks, greater occipital nerve blocks for migraines, and pudendal nerve blocks for pudendal neuralgia. Imaging guidance (ultrasound or fluoroscopy) improves the safety and accuracy of certain procedures. Efficacy and Safety: Detailed analysis of various studies on the effectiveness of corticosteroid injections for different types of chronic pain. Discussion on the minimal benefit of corticosteroids in trigger point injections and the potential risks associated with their use. Clinical Implications: https://form.jotform.com/240446610837052How these guidelines can assist clinicians in making informed decisions regarding corticosteroid use in chronic pain management. Emphasis on the need for personalized treatment plans based on individual patient characteristics and clinical data. Future Directions: Identification of gaps in the current research and the need for well-designed studies to further assess the benefits and risks of corticosteroid injections. Join us as we explore these comprehensive guidelines and their potential impact on improving chronic pain management practices. Resources: Link to the full guidelines: Journal Online Other Announcements from NRAP Academy: PainExam App is ready for iphone Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://rapm.bmj.com/content/rapm/early/2024/07/16/rapm-2024-105593.full.pdf Disclaimer Disclaimer: This Podcast, website and any content from NRAP Academy (NRAPpain.org) otherwise known as Qbazaar.com, LLC is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.
Interviewees: Raffi Najarian and Justin Ramsey Interviewer: Lisa Meeks Description: In this conversation, Lisa Meeks interviews Raffi Najarian and Justin Ramsey, both pediatric rehabilitation physicians with cerebral palsy. They discuss their journey to medical school and the challenges they faced along the way. Raffi shares his experience of applying to medical school and the support he received from his family. Justin talks about the internal barriers he faced and the importance of finding the right mentor. They also discuss the challenges they encountered during medical school, including access barriers. In this conversation, Raffi Najarian and Justin Ramsey discuss their experiences as medical students with disabilities. They share the challenges they faced in anatomy lab and how they overcame them. They also talk about dealing with difficult faculty members and the importance of kindness and feedback in medical training. Raffi and Justin explain why they chose physiatry as their specialty and the impact they have on their patients. They emphasize the importance of visibility and representation for individuals with disabilities in the medical field. Finally, they offer advice for students with disabilities who are considering a career in medicine. Keywords: physiatry, medical education, doctors with disabilities, cerebral palsy, pediatric rehabilitation, med school applications, accessibility, accommodations, disability representation Transcript: https://bit.ly/3yuxJf8 Bios: Justin Ramsey, M.D. is board certified in Physical Medicine and Rehabilitation and is sub-specialty boarded in Pediatric Rehabilitation Medicine. He graduated from the Kansas University School of Medicine. He then completed his Physical Medicine and Rehabilitation training at the Kansas University Medical Center and a fellowship program in Pediatric Rehabilitation Medicine at Children's Mercy Hospital (Kansas City, MO). Dr. Ramsey spent several years as faculty with the Pediatric Rehabilitation Medicine fellowship program at Children's Mercy Hospital and the Kansas University Medical Center's Physical Medicine and Rehabilitation Department. He has served as chair of the Advocacy Committee for the American Academy for Cerebral Palsy and Developmental Medicine and has served on its Communications Committee. Currently, he works at a private pediatric rehabilitation hospital (Bethany Children's Health Center) near Oklahoma City, which specializes in the care of children with disabilities. In collaboration with neurology and OU Health Science Center's neurosurgery department, he has created Oklahoma's joint pediatric movement clinic. He currently serves as the Associate Medical Director for the Movement clinic and Cerebral Palsy. He volunteers as a Clinical Associate Professor of Neurology at The University of Oklahoma Health Sciences Center. Justin has hemiparetic cerebral palsy and is active in local advocacy. He is married to his wife (Kendra) and has 2 beautiful young children (Ryan and Reese), who keep his family busy. Medical and disability education are some of his major subjects of interest. He is grateful for early college experiences in working with individuals with disabilities while volunteering at Hetlinger Developmental Services, Inc in his hometown of Emporia, KS. Dr. Raffi Najarian has been in practice since 2013. He is a pediatric physiatrist and director of the Spasticity Clinic at Akron Children's Hospital. A graduate of the University of Michigan and Wayne State University School of Medicine in Detroit, MI, he completed his residency in physical medicine and rehabilitation at MetroHealth Rehabilitation Institute of Ohio in Cleveland. He then completed a fellowship in Pediatric Rehabilitation Medicine at Gillette Children's Specialty Healthcare in Saint Paul, MN. Dr. Najarian has a special interest in cerebral palsy, spasticity management, brain injury, stroke, spinal cord injury, spina bifida, acute inpatient and outpatient rehabilitation and concussion management. He is certified by the American Board of Physical Medicine and Rehabilitation and subspecialty certified in Pediatric Rehabilitation Medicine. He is a member of the American Academy of Physical Medicine and Rehabilitation and the American Academy for Cerebral Palsy and Developmental Medicine, and served on the latter's Lifespan Committee. He is an Associate Professor of Pediatrics at Northeast Ohio Medical University (NEOMED). Raffi has diplegic cerebral palsy and is an advocate for children and adults with disabilities. He serves as a member of the United Cerebral Palsy Research Committee and on the board of directors for Adaptive Sports Ohio, while participating as an active member of the Akron Rhinos wheelchair rugby team. Produced by: Gabe Abrams and Dr. Lisa Meeks. Audio editor: Jacob Feeman Digital Media: Katie Sullivan Resources: Professional Learning Series - United Cerebral Palsy, UCP Research Initiative & Committee - United Cerebral Palsy, Physicians' Perceptions Of People With Disability And Their Health Care https://www.yourcpf.org https://cprn.org
Dr. Vijay Vad is a double board certified physician in physical medicine and rehabilitation (physiatry) and sports medicine. He focuses on minimally invasive non-surgical treatments for such conditions especially for spine related problems, arthritis, and various sports injuries. Dr. Vad has published a 15-minute simple outpatient procedure called capsular distention for restoring motion and eliminating pain in frozen shoulder. In addition to treating patients at the Hospital for Special Surgery, Dr. Vad has previously served as the physician for the professional men's tennis circuit (Association of Tennis Professionals, ATP) as well as the physician for the Westchester Classic of the PGA Tour, and MSG Tennis Showdown. His current research focuses on developing simple solutions to stay active. His integrative approach is designed to empower patients to heal themselves. Dr. Vad will take a look at the latest advancements in pain management and rejuvenation therapies while discussing his groundbreaking invention, carboplasty, a revolutionary technique for knee arthritis using a patient's own stem cells. He will also delve into the hot-button issue of age reversal and the potential of emerging therapies. He will discuss cutting edge possibilities in healthcare and aging gracefully, that could change the way you view health and longevity. For More Information on Dr. Vijay Vad: https://vijayvad.com/
In this episode of the 'Brain and Body Things' podcast, hosted by physiatrist Dr. Natasha Mehta, guests Dr. Ali Mesiwala, a neurosurgeon, and Dr. Leia Rispoli, a pain medicine specialist, join for an enriching roundtable discussion. They delve into the collaborative nature of their fields, share personal experiences and challenges in balancing professional and personal lives, and discuss the impact of their work on patient care. The conversation covers a wide range of topics including the stereotypes and misconceptions of their professions, the importance of lifestyle modifications in patient care, and the complexities of making difficult medical decisions. They also touch upon the emotional aspects of dealing with life-threatening conditions, the necessity of a collaborative approach in healthcare, and the personal coping mechanisms they've developed through their experiences in the medical field. This podcast provides valuable insights into the interconnectedness of physical and mental health, the dedication of healthcare professionals, and the unpredictable nature of life and health.00:37 Introducing the Experts: A Roundtable Discussion00:50 Exploring the Intersections of Physiatry, Pain Medicine, and Neurosurgery03:28 The Power of Collaboration in Healthcare07:08 Navigating Life and Death Decisions in Medicine12:10 Quality of Life and Returning to Normal Activities15:43 The Aging Athlete: Balancing Activity and Health21:00 Reflections on Retirement and Continuing to Make a Difference23:01 Exploring the Future of Medicine and Personal Fulfillment24:07 Navigating the Uncertainties of Medical Practice28:37 The Realities of Maintaining Personal Health as a Doctor34:12 Balancing Career and Family: A Modern Woman's Challenge37:05 Addressing Common Health Concerns and Myths39:25 Coping with the Emotional Toll of Medicine44:40 Reflecting on Personal and Professional GrowthThe podcast episodes drop weekly on Monday's in seasonal chunks. Subscribe to stay up to date, and tune in when you can! Be sure to rate, review, and follow on your favorite podcast app and let me know what other brain & body things you'd like to hear about. For more information about me, check out my website.Follow me on Instagram or Tik Tok @drnatashamehta. Follow Dr. Ali Mesiwala on Instagram. Here is his practice website.Follow Dr. Leia Rispoli on Instagram. Here is her practice website.This episode is not sponsored.
Gillian Mathews sits down with Dr. Yein Lee, DO to discuss the harmony between physiatry and performing arts. #ThisIsPhysiatry is a podcast that aims to spread awareness for the wonderful specialty of Physical Medicine and Rehabilitation (PM&R). This podcast is brought to you by AAP's Medical Student Council (MSC).
Join us on this episode of the PainExam Podcast where rising star, Christopher Robinson, MD PhD discusses his upcoming paper on exosomes featuring some of the largest names in pain managment. Dr. Rosenblum also alludes to degenerative disc disease being a partially infectious podcast. Other topics discussed on this podcast: The Anesthesiology Job Market Pain Management Fellowship Duration of Pain Management Fellowships Should Pain Management be an Independent Residency? Other Announcements from NRAP Academy: PainExam App almost ready Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here!
Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comThis week on the podcast Mikki speaks to Dr Asare Christian about chronic pain, chronic pain management and migraines. As a doctor of Physiatry (which IS a medical doctor!), they discuss what chronic pain actually is, the connection between the mind and the body, the important questions that Dr Asare asks his patients to understand their pain better and more specifically they delve into migraine pain. Triggers, treatments and supplements are discussed.Dr Asare Christian is a board-certified physical medicine and rehabilitation physician. He specializes in pain and musculoskeletal medicine. With a previous role as outpatient medical director of Good Shepherd Rehabilitation Network in Lehigh Valley, PA, and an academic appointment at the University of Pennsylvania Department of PM&R, Dr. Christian has the expertise to provide the best possible care. He earned his board certification through the American Board of Physical Medicine and Rehabilitation and is the owner and medical director of Aether Medicine in the Wayne, Mainline Philadelphia, PA area.Aether Medicine https://aethermedicine.com/ Contact Mikki:https://mikkiwilliden.com/https://www.facebook.com/mikkiwillidennutritionhttps://www.instagram.com/mikkiwilliden/https://linktr.ee/mikkiwillidenCurranz supplement: MIKKI saves you 25% at www.curranz.co.nz or www.curranz.co.uk off your first order
Carla P. Watson, MD, FAAPMR, Inclusion & Engagement Committee Chair, is joined by one of AAPM&R's Innovators & Influencers Honorees, Jessica Tse Cheng, MD, FAAPMR to discuss her career path and contributions to cancer rehabilitation medicine.
Dr. Rosenblum reviews an article by Dr. Reuben Ingber regarding the use of iliopsoas trigger point dry needling and therapeutic stretching in the treatement of 6 consecutive patients wiht acute lumbar radiculitis and foot drop. Other Announcements from NRAP Academy: PainExam App almost ready Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References Reuben S. Ingber, Iliopsoas trigger point dry needling and therapeutic stretching in the treatment of a series of six consecutive patients presenting with acute lumbar radiculitis and foot drop, Journal of Bodywork and Movement Therapies, Volume 36, 2023, Pages 1-4, ISSN 1360-8592, https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57702#:~:text=No%20more%20than%203%20Trigger,group%20are%20not%20billed%20separately. CMS National Coverage Policy
In this episode of Career Chat, resident Derek Day, MD, talks with Dr. Heechin Chae. Dr. Chae's 24-year career in physiatry has included multiple subspecialties (Interventional Pain Management, Brain Injury Rehabilitation, Functional Medicine) across the spectrum of settings (academic, private practice, Department of Defense, international medical missions). In this episode, he describes these experiences and shares how a sense of purpose and calling has guided every step, shaping who he is in and out of medicine.
Dr. Amy West, a Sports Medicine Physiatrist, is at the forefront of a paradigm shift in understanding the root causes of joint pain, tendon issues, and other musculoskeletal problems. Sponsored Message: Support your Intermittent Fasting lifestyle with the Berberine Fasting Accelerator by MYOXCIENCE: https://bit.ly/berberine-fasting-accelerator Save with code podcast at checkout Link to Video Interview, Research and Show Notes: https://bit.ly/3U5RIaS Show Notes: 02:00 CrossFit trains all three energy pathways: glycolytic, anaerobic, and aerobic. It is based on function. Physiatry and CrossFit focus on function and living better. 08:00 Metabolic health impacts recovery, injury propensity, pain levels and physical function. Leptin worsens osteoarthritis and pain issues. 12:15 Osteoarthritis is from the dysfunction of chondrocytes within the joint from inflammation and fragility of cartilage within the joint. Metabolic disease causes a downward spiral. There is more inflammation and more cartilage damage and more boney hypertrophy. 14:00 Trigger finger is often a first sign of metabolic disease. Tendons are also impacted by the inflammation of metabolic disease. Healing process is impacted by the chronic inflammation of metabolic disease. 14:54 Bone and bone density are impacted inflammation. This can appear as stress fractures. Treat the fracture and the reason why. 17:00 Hemoglobin A1C is a marker of overall glycation in the body. Non-painful things become painful with increased glycation. 17:30 The burden of age-related changes is dependent upon your metabolic state and physical wellbeing. 96% of American adults have some sort of metabolic dysfunction, making them predisposed to accelerated aging and physical decline. 23:00 Time is a major reason for not exercising. Short 20-minute bouts of more intense exercise are easier to fit in and you get the same metabolic benefits in a shorter time. 23:40 Functional movement training increases strength and supports life functions. It uses multiple joints and practices coordination. 24:30 Heavy resistance training induces the benefits of bone density and muscle integrity. 24:45 Osteosarcopenic obesity: as you gain weight, you lose muscle mass and bone. 26:00 Weakened tendons, tendonitis, and fibrosis are often a result of chronic inflammation from metabolic dysfunction like diabetes. Arthritis is the leading cause of disability in the US. 27:25 Cortisone is a potent anti-inflammatory that brings short-term pain relief. It can raise blood sugar. Repeated cortisone injections can further degrade cartilage, worsening arthritis. You can build up a tolerance to it. 29:00 Hormones affect joint pain. Menopausal decreased estrogen levels correlate to increased joint pain. 29:40 Turmeric, omega 3s, vitamin D anti-inflammatory effects can be effective in a person with a small amount of inflammation. 31:00 PRP can be beneficial in the right patient with mild arthritis or chronic tendinopathy. It is only as good as whatever is attached to it. PRP efficacy depends upon your metabolic health. 34:10 Athletes have more muscle mass around the joints making the joint more functional and eases the load bearing on the joint. Muscle secretes myokines, which affect pain perception. 34:50 Chronic inflammation from metabolic disease around your joints can affect levels of inflammation and how the inflammation is received by your brain. It can affect brain serotonin signaling. 36:00 Low carb diets produce less leptin signaling which reduces pain and inflammation signaling. 39:50 Dr. West prioritizes protein. Traditional medicine protein recommendations are just enough to keep you alive. Protein helps with satiety and powers workout gains. 41:25 Animal protein, over plant protein, can help you feel stronger. It is challenging to get enough plant protein without eating a lot of carbs. Chronic vegan/vegetarian dieting can cause collagen and bone breakdown. 50:30 Eccentric loading of the Achilles tendon can help build capacity and be more effective than chronic stretching. Tight hamstrings can be addressed with hip extension, pelvic tilting, and hip adduction. 55:25 There can be some risk to doing isolated heavy bicep work. You can develop bicep tendonitis. Over time, it can result in rupture of the bicep tendon. 58:36 Shoulder: Drill down on technique before adding load or intensity. 01:00:10 Hanging is important for grip strength and being able to manage your own body load. 01:01:10 Deadlift/hip hinge can be done using a platform to limit range of motion to maintain form. Push with your legs rather than pulling with your back. 01:02:30 Have a physical biomarker. Do an annual measure of functional movement or movements to track your strength and fitness, along with your labs. Continue to improve. Physical goals are important. 01:06:30 Coca Cola/Gatorade has invested heavily in healthcare, exercise science and exercise guidelines. Fitness professionals are pressured not to make nutritional recommendations. Coca Cola is involved in the American Cancer Society and American College of Cardiology.
Dr. Rosenblum describes a patient with chronic shoulder pain who failed shoulder replacement, steroid injections, nerve blocks, cryotherapy, and peripheral nerve stimulation of the axillary and suprascapular nerve block. In this podcast, he discusses his perfomance of Shoulder Radiofrequency Ablation targeting the articular branches of the suprascapular nerve, axillary nerve, nerve to subscapularis and lateral pectoral nerve. Reference: https://www.asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2020/11/01/how-i-do-it-shoulder-articular-nerve-blockade-and-radiofrequency-ablation Other Announcements from NRAP Academy: PainExam App almost ready Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here!
Advocating for Transparency and Oversight in Pain Management Introduction: Welcome back to Painexam, where we delve into the latest advancements and challenges in pain management. Today's episode highlights a significant advocacy effort made by leading Interventional Pain Physicians and industry experts. Summary of Lobbying Effort: On March 20, 2024, a group of widely known and respected pain physicians and industry leaders, including Drs. Sean Li, Peter Staats, Mehul J. Desai, David Reece, Hemant Kalia, and David Rosenblum, alongside industry figures Mark Stultz, Christopher Conrad, and Cecelia Ruble, visited Capitol Hill to advocate for greater oversight and transparency in independent review organizations. Despite their busy schedules, they recognized the critical need to address the 0% turnover rate in appeals for denied treatments, which disproportionately affects patients seeking alternatives to surgery and opioid medication. Importance of Transparency: The issue extends beyond pain management, impacting patients across various medical fields. While opioid therapy may seem economically favorable initially, the long-term consequences, including delayed care and medication side effects, often outweigh the costs. The group emphasized the importance of an unbiased review for accessible, cutting-edge treatments to improve patient outcomes and reduce overall healthcare expenses. Purpose of the Lobbying Effort: Contrary to pushing any specific company agenda, the initiative aims to highlight the challenges patients and physicians encounter in securing optimal treatment outcomes. For Board Prep, Ultrasound Training and more, visit: Dr. David Rosenblum, a pioneer in interventional pain medicine, particularly in ultrasound- guided procedures and regenerative pain medicine, underscores the necessity of addressing these issues for the benefit of countless patients suffering from chronic pain. Conclusion and Actionable Steps: To schedule a consultation with Dr. Rosenblum, patients can visit www.AABPpain.com or contact the Brooklyn Office at 718-436-7246 or the Garden City Office at 516-482-7246. Stay tuned for more updates on advancements and advocacy efforts in pain management. Outro: Thank you for joining us on this episode of Painexam. Be sure to subscribe for future discussions on navigating the complexities of pain management.
In the 50th episode of #RehabCast, host Dr. Bill Niehaus engages in a thought-provoking discussion with Julia To Dutka, EdD, Bruce M. Gans, MD, and Richard Oliver, PhD about their study, "Delivering Rehabilitation Care Around the World: Voices From the Field" (https://doi.org/10.1016/j.apmr.2023.03.009). This conversation sheds light on global rehabilitation efforts and the power of collaborative care. Following this enriching dialogue, Dr. Niehaus shifts focus to the innovative research conducted by Andrew C. Smith, PT, DPT, PhD, and Kenneth A. Weber II, DC, PhD, exploring "A Single Dermatome Clinical Prediction Rule for Independent Walking 1 Year After Spinal Cord Injury" (https://doi.org/10.1016/j.apmr.2023.06.015), an impactful study that offers new insights into predicting mobility outcomes after SCI. #RehabCast is the PM&R podcast for all of rehabilitation medicine: #Physiatry, #OccupationalTherapy, #PhysicalTherapy, #SpeechTherapy, #Neuropsychology, #RehabilitationNursing, and more.
Atira Kaplan, MD is a board-certified physiatrist. She received her medical degree from SUNY Downstate Medical Center; and completed residency in Physical Medicine and Rehabilitation, and fellowship in Women's Health Rehabilitation, at Montefiore Medical Center. Dr. Kaplan works in two private practices, Maxwell Medical in Manhattan, and Millennium Medical and Rehabilitation in Westchester, where she treats patients with a wide variety of musculoskeletal and neuromuscular conditions including pelvic floor dysfunction. Brenda Neuman is a fourth-year medical student at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. She is originally from the Orthodox Jewish Community of Brooklyn, NY. Brenda graduated Summa Cum Laude from CUNY Brooklyn College in 2019 with a BA in Chemistry. She is actively involved in hosting specialty spotlight podcasts and serves on the board of the JOWMA Premed committee. Brenda currently resides in Long Island with her husband, Dr. Michael Lovihayeem. _______________________________________________________ Sponsor the JOWMA Podcast! Email digitalcontent@jowma.org Become a JOWMA Member! www.jowma.org Follow us on Instagram! www.instagram.com/JOWMA_org Follow us on Twitter! www.twitter.com/JOWMA_med Follow us on Facebook! https://www.facebook.com/JOWMAorg/ Stay up-to-date with JOWMA news! Sign up for the JOWMA newsletter! https://jowma.us6.list-manage.com/subscribe?u=9b4e9beb287874f9dc7f80289&id=ea3ef44644&mc_cid=dfb442d2a7&mc_eid=e9eee6e41e
We welcome Dr. Jennifer Miller. Dr. Miller specializes in physical medicine and rehabilitation at Albany Medical Center. She sees adult and pediatric patients for new or long-standing muscle, nerve or tendon problems. She also aids in the rehabilitation needs of patients with amputation, spinal cord injury, stroke, brain injury, neurologic disease, and cerebral palsy. Ray Graf hosts.
What is physiatry? What options are there in regenerative medicine? How does a physiatrist evaluate you for sciatica pain? We learn this and more with Dr. Nikhil Verma, M.D a physiatrist and owner of Essential Sports and Spine Solutions in Ohio. Dr. Verma shares with us the inner workings of a physiatrist, how they help patients, and the options available for regenerative medicine. You can get in touch with Dr. Verma's clinic at: https://www.essentialsportsspine.com/ and https://www.instagram.com/essentialsportsspine/Check out the patient advocate program here: ptpatientadvocate.comHere's the self cheat sheet for symptom management: https://ifixyoursciatica.gymleadmachine.co/self-treatment-cheat-sheet-8707Book a free strategy call: https://msgsndr.com/widget/appointment/ifixyoursciatica/strategy-callSupport this podcast at — https://redcircle.com/fix-your-sciatica-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
AAPM&R Physiatrist in Training (PHiT) Council Board President Alpha Anders, MD, joins Dr. Michelle Gittler and Dr. Prakash Jayabalan to discuss PM&R residency and fellowship, advocacy including making a bigger table, and the ways networking can change your career trajectory.
As a physician-scientist, sports medicine physiatrist, health policy advocate, and mentor, Dr. Prakash Jayabalan is a multi-faceted expert and leader. Medical student Charis Turner sits down with Dr. Jayabalan to discuss his path to PM&R, how to write an exercise prescription, foundations and research within osteoarthritis, and advocacy opportunities for medical students.
AAPM&R President, DJ Kennedy, MD, FAAPMR, joins Dr. Michelle Gittler and Dr. Prakash Jayabalan to discuss the year ahead and how the Academy is focused on supporting the individual physiatrist while strengthening the specialty. They also discuss volunteerism, leadership, and gathering together at the Annual Assembly.
PainExam Podcast Show Notes: Exploring Traumeel as an Alternative for Back Pain Relief Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/HoEWFd Board Prep and Continuing Education Introduction: Today, Long Island Based Pain Physician David Rosenblum, MD delves into the latest advancements and alternative treatments for pain management. In today's episode, we shine a spotlight on Traumeel®, a homeopathic alternative gaining traction for its anti-inflammatory properties, with fewer reported side effects compared to corticosteroids. Understanding Traumeel: Traumeel, a fixed combination of diluted plant and mineral extracts, has been available over-the-counter in Europe for over 60 years. Contrary to corticosteroids, Traumeel's popularity has surged due to its limited side effect profile, with reported contraindications primarily linked to allergies [9]. View Full Calendar Scientific Insights: A study by Lussignoli et al. demonstrated Traumeel's efficacy in decreasing systemic interleukin-6 production and reducing edema, countering an unregulated inflammatory response [10]. In vitro studies revealed Traumeel's inhibition of pro-inflammatory mediators (IL-1β, TNFα, IL-8) in immune cells, suggesting its potential in stabilizing the immune system [8]. Notably, Traumeel's effectiveness seems to surpass the sum of its individual components, indicating a synergistic interaction [9-10]. Clinical Applications: Traumeel has shown efficacy comparable to nonsteroidal anti-inflammatory drugs (NSAIDs) in treating various inflammatory conditions. It is available in oral, topical, and injectable preparations, making it a versatile option for pain relief [8-9]. Research Gaps and Potential: Despite its established use, current research lacks information on Traumeel's efficacy in epidural injections for short-term back pain relief. No studies have compared Traumeel to corticosteroid injections, although the TRARO study protocol proposes a potential avenue for comparison in rotator cuff syndrome patients [11]. Pain Management Board Prep Clinical Cases: Five patients seeking back pain relief opted for Traumeel injections due to either a contraindication to or a preference against steroids. This real-world scenario lays the groundwork for further exploration into Traumeel's efficacy in epidural injections, providing additional pain-relieving options for patients unable to tolerate corticosteroid injections. Conclusion: Traumeel presents a promising alternative for pain management, particularly in cases where corticosteroids may be unsuitable, however the FDA has yet to approve it and therefore it has failed to gain traction in the US. [14] As we wrap up, stay tuned for future developments in the research landscape surrounding Traumeel and its potential role in enhancing pain relief options. Disclaimer: Consult with a healthcare professional before considering any alternative treatments. The information provided in this podcast is for educational purposes only and does not replace medical advice. David Rosenblum, MD President, NRAP Academy Clinical Assistant Professor Department of Anesthesiology SUNY Downstate Medical Center Director of Pain Management Maimonides Medical Center References 1. Cassidy JD, Carroll LJ, Côté P: The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998, 23:1860-66. 10.1097/00007632-199809010-00012 2. Rudy TE, Weiner DK, Lieber SJ, Slaboda J, Boston JR: The impact of chronic low back pain on older adults: a comparative study of patients and controls. Pain. 2007, 131:293-301. 10.1016/j.pain.2007.01.012 3. Fyneface-Ogan S: Anatomy and Clinical Importance of the Epidural Space. Epidural Analgesia - Current Views and Approaches. IntechOpen. IntechOpen (ed): IntechOpen, Internet; 2012. 1-14. 10.5772/39091 4. Waldman SD: Complications of cervical epidural nerve blocks with steroids: a prospective study of 790 consecutive blocks. Reg Anesth. 1989, 14:149-51. 5. McGrath JM, Schaefer MP, Malkamaki DM: Incidence and characteristics of complications from epidural steroid injections. Pain Med. 2011, 12:726-31. 10.1111/j.1526-4637.2011.01077.x 6. Watters WC 3rd, Resnick DK, Eck JC, et al.: Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: injection therapies, low-back pain, and lumbar fusion. J Neurosurg Spine. 2014, 21:79-90. 10.3171/2014.4.SPINE14281 7. Understanding Potential Complications Of Epidural Steroid Injections . (2011). Accessed: October 1, 2019: https://www.practicalpainmanagement.com/treatments/interventional/injections/understanding-potentialcomplications-ep…. 8. Schneider C: Traumeel - an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med. 2011, 4:225-34. 10.2147/IJGM.S16709 9. Grech D, Velagala J, Dembek DJ, Tabaac B: Critical literature review of the homeopathic compound Traumeel for treatment of inflammation. Pharmacology & Pharmacy. 2018, 9:67-83. 10. Lussignoli S, Bertani S, Metelmann H, Bellavite P, Conforti A: Effect of Traumeel S®, a homeopathic formulation, on blood-induced inflammation in rats. Complement Ther Med. 1999, 7:225-30. 10.1016/S0965-2299(99)80006-5 11. Vanden Bossche L, Vanderstraeten G: A multi-center, double-blind, randomized, placebo-controlled trial protocol to assess Traumeel injection vs dexamethasone injection in rotator cuff syndrome: the TRAumeel in ROtator cuff syndrome (TRARO) study protocol. BMC Musculoskelet Disord. 2015, 16:8. 10.1186/s12891- 015-0471-z 12. Birnesser H, Oberbaum M, Klein P, Weiser M: The homeopathic preparation Traumeel® S compared with NSAIDS for symptomatic treatment of epicondylitis 13. Ehlert, Dianna, and Ariel Majjhoo. "Traumeel® Epidural Injection: A Viable Alternative to Corticosteroids-A Five-Patient Case Study." Cureus 11.11 (2019) 14. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/medinatura-inc-596269-06112020
Welcome to the Frontier Psychiatrist…. Podcast. It's a podcast with myself, Dr. Owen Muir, as your host, and it's a companion podcast to FrontierPsychiatrist.com, a sassy Substack about health-related things. This is a conversation between Jazz (Glastra) and me. She is the senior director at Brain Futures, which is a 501c3 not-for-profit. She got to be the interviewer in this one! I'm a big Jazz fan, as a person, in full disclosure. I also enjoy the art form of the same name, but that is a different story.We are thrilled to have BrainFutures as partners in sponsoring Rapid Acting Mental Health Treatment 2024. It's in San Fran on the 7th of January! Join us! (that is a ticket link!)In this conversation, we try to get to a shared understanding of what we actually might mean by mental health, the mental health crisis, and whatnot. This means accepting that other people's minds might not be thinking the same things that we're thinking, and so trying to get to the same understandings is a process that we have to take seriously. We need to build trust, and that's really, at the end of the day, what this conversation is about. The transcript follows…Jazz Glastra I'm Jazz Glastra, and I'm the Senior Director at Brain Futures, which is a nonprofit that advances access to new treatments and technologies in brain health. Owen Muir, M.D.I'm Owen Scott Muir. I'm a child, adolescent, and adult psychiatrist by board certification. I identify as an interventional brain medicine doctor because I don't really love... the branding of psychiatry or the expectations. Much of this goes back to me constantly thinking about the role of trust and expectations in any conversation. Jazz Glastra What is the difference between a neurological disorder, a psychiatric disorder, and a neuropsychiatric disorder?Owen Muir, M.D.In the beginning, there were only humors. And that's a little bit of a joke, but We had neurology as a medical specialty,Sigmund Freud, whom we think of as a psychiatrist, was a neurologist. Because we didn't have psychiatry as a separate medical discipline, to this day, the American Board of Psychiatry and Neurology is one board, ABPN. What ends up in what bucket in medicine has a lot of historical ness to it? Neurology used to be all of it? If it was a brain or a nerve, That was neurology, and then Freud came along with an explanatory model for problems people had that didn't involve localizing the lesion,? Neurology took over things where you could point at where it was, and psychiatry took over things where you couldn't point at where it was. If you end up having a thyroid problem, then you go to endocrinology, and you're not managed primarily by psychiatry. The accident of history is nonlocalizable Neurology ended up as psychiatry.And here I am, talking all the time about fMRI-guided treatment, so I'm getting myself in trouble. One of the people who brought this bridge back was Dr. Nolan Williams, who trained initially as a neurologist. He did neurology first, then got board certified in behavioral neurology, and that not being enough residencies, he did an entire other residency in psychiatry.And three board certifications in, he's a neurologist and a psychiatrist, and blah blah blah. It ends up being, “Who's got the most practice in their training program with whatever the problem is to own it.” It's an accident of history is the answer.Jazz Glastra So, are we in a mental health crisis?Owen Muir, M.D.Yes, in that we have no idea what that means, and we feel very crisis-y about it.Jazz Glastra I feel crisis-y about it, usually.Owen Muir, M.D.What is mental health? I have no idea. It is the worst term because it means nothing. Which is really good for charlatans and hucksters and bad for people who are suffering. I would agree we're in a mental health crisis if, in the same question, you let me say, are we in a mobility crisis?Yes. When we only fill cars with water that should have taken gas, that's a mobility crisis, and we can have the same response to the mobility crisis of filling up gasoline-powered cars with water as we do to the mental health crisis. I'd say those are similarly crisis y. The cars wouldn't move.And you could talk about what a problem it was all day long, but the car still wouldn't go because you filled it with water, not gas. That's how I think of the mental health crisis. It's a crisis of misunderstanding; the problem is you don't understand the problem, and then you don't apply the right solutions, and you act like it's a crisis, not an actual understandable and solvable problem.Jazz Glastra What do you see as the problem?Owen Muir, M.D.If you don't know what a mental illness is, or that there are different ones, and that's important, is there a problem with people who are, for example, dying by completing suicide? Yes. That is one version of looking at the problem.Is there a problem with people having tremendous suffering? Needlessly throughout their day. Yes. Is there a problem of people being disconnected from each other and hopeless? Yes. Is there a problem of death by drug overdose? Yes. Is there a problem of many people feeling anxious and worried? Yes. Is there a problem? Many people are traumatized and thus have sequelae of that problem.A lot of different problems. Schizophrenia. Homelessness. Having a poor definition for a problem creates. More problems than accurately understanding?And so my argument is for starting with understanding and saying okay, if the problem is defined as X, then what? Because the mental health crisis doesn't define anything enough for me to have an answer for you.Jazz Glastra You gotta do something!Owen Muir, M.D.We have to do something is one of the worst things for anyone who's not a huckster.If you are a huckster, it's great because just misdirected energy to do something “comma,” anything is a cash grab, and that's awesome.Jazz Glastra I think what people probably mean when they say there's a mental health crisis is like the old adage about recessions versus depressions, where a recession is when your neighbor loses their job, and a depression is when you lose your job. When people say there's a mental health crisis, they mean that my immediate family and friends are suffering. People know more people who are struggling or in crisis.Maybe the question could be, is the incidence of diagnosable mental health conditions rising? Is the incidence of completed suicide rising? Are all these things you listed before, are they getting worse?Owen Muir, M.D.Yes, completed suicide is measurable and well-tracked, and definitively, more people are dying by suicide in the United States, at the very least, now than previously. Yes.Jazz Glastra What do you think about the term death of despair?Owen Muir, M.D.I think it's an attempt at good branding. It's lumping together—death from overdose, death from suicide, and death from alcohol use disorder. Death from problems associated with psychiatric illness is an attempt to draw a circle around something in a way that.It is trying to be helpful. I appreciate both attempts to understand and define a problem. Does that definition empirically hold up? Nate Silver doesn't think so. And Nate Silver is good at numbers.Jazz Glastra What's the difference between being in remission and being cured? Why don't you ever hear people talking about cures and mental health?Owen Muir, M.D.We don't use the word cure because, essentially, the FDA won't let us. I'm a doctor, saying the word cure has a very specific meaning—definition, which is more rigorous than the dictionary definition.So, the dictionary definition of cure is having “no signs or symptoms of a disease.” I would argue many of the things I do to treat, say, depression, Stanford accelerated intelligent neuromodulation as an example, leads to what could be defined as a cure. However, because of years of hucksterism, We had too many things offered up as cures that weren't.You end up having to asterisk yourself into incoherence. Could it come back? Yes. I have athlete's foot powder that says it will cure athlete's foot. But that claim was adjudicated by the FDA a long time ago. Meconazole nitrate, a cure. That's a claim on a treatment that they would have to approve. And saying cure makes you sound like a charlatan. Until the FDA agrees with the label that says cure, I'm not going to say cure. Even though people would love that.Remission is defined as... no signs or symptoms of a disease, which is different from recovery, which I prefer conceptually, which is no signs or symptoms of a disease. And At least one meaningful friendship outside the family and meaningful work or school.Jazz Glastra You're getting more into well-being and just whole-person wellness territory there.Owen Muir, M.D.I do we need to use that many words to say human? Life anyone would want? Jazz Glastra Is that the purview of a psychiatrist or a neuropsychiatrist?Owen Muir, M.D.If you imagine the job of a physician stops at no signs or symptoms of a disease no. If you imagine the job of a physician is to help people. optimize full, rich, fulfilling lives and get and stay well, then yes. I tend to be in the latter camp. It's a little bit like trauma surgeons doing advocacy work to reduce gun violence,they got really good at sewing up bullet holes, but would rather do less of that, thanks. Because there's only so much you can do in the O. R. I trained in Rochester, for med school, where the trauma surgeons were working with the police in the community to set up shot spotter systems and educate youth about gun violence …to reduce the number of bullet holes they'd have to sew up. Trauma surgeons have been thinking about how to do this in the community better than psychiatrists have, by a lot, would be my argument.Jazz Glastra I've seen this stat bandied about that something like psychiatry hasn't had a new class of drugs in 30 years or 50 years. And we've been doing all this work and research, but the mortality and morbidity rates. are not coming down in our discipline. So I want to know what you think about why psychiatry has been stuck in this rut for so long…Owen Muir, M.D.2023 is a year when new things have come to market. The job of a physician is to understand first and then offer treatment help,We have an entire medical discipline called Physical Medicine and Rehabilitation, which looks to help people restore their physical functioning. And it's called Physiatry, the actual name of the discipline. Now, Psychiatry. is restoring the function of one's mind and psyche, right? And physiatry helps you move your knee.Whether it's referring you to a physical therapist, or a psychiatric therapist, or a psychological therapist, or, the right number of walks for you, or a medicine to make the walks easier, I see those as very similar. We have a real dichotomy between functional problems, like problems of how something moves over time, and kind of structural problems.And it's a lot easier to think your arm is broken, let's fix it, than the way your arm moves is broken, let's fix it. Or the way you think about something is broken, let's fix the movement of your thoughts. such that they function better in your life. And, GI gets this, PM& R is a whole discipline for this, and orthopedic surgery is not the same as physical medicine and rehabilitation, but they both deal with that back pain.Jazz Glastra Why has innovation been so hard in behavioral health?Owen Muir, M.D.We Changed the term to behavioral health and mental health. Whenever we feel uncomfortable, we come up with a new label for what we're doing. None of them are as good as feeling okay. Do you need behavioral health care? I don't know. Do you want to have a good life?Oh yeah. Are you freaking out? Definitely, I'd like that to stop. Part of the problem is, again, a lack of definitions. Dan Carlin at Mind Medicine Now would say, We spent 30 years perfecting algorithms to make drugs as safe as water. And we got a generation of compounds with the efficacy profile of water. We were obsessed with errors of commission, like we didn't want to do any harm. It's in the Hippocratic Oath. But we also didn't want to risk helping people. Not too much, anyway. Which is an error of omission. We weren't willing to call a spade and to admit that the suffering we were seeing was unacceptable.And could you do something about it? We limited ourselves only to things that were not harmful, which excluded many things that might have been helpful. Thus, our vision was narrowed. And so if your expectation is, let's pursue treatments that might get people 50 percent better, you're not going to only look at things that get you a hundred percent better. If your endpoint is remission, and that's all you'll accept, then you spend your time on different stuff. So, we spent our time on half measures because it made sense to do so given the constraints we set for ourselves, which were flawed.Jazz Glastra How unusual do you think that focus on remission is in your field?Very rare. If you don't know it's possible, then why would you do it?Jazz Glastra Do you think most of your colleagues don't know what's possible?I think they know it's possible, but they don't have it, as that's not the expectation. Look, I have drugs to prescribe. I'm a prescriber. I'm going to prescribe them. Those drugs are evidence-based, but to do what? To reduce suffering by 50%. Not studied to eliminate all the symptoms of the much less, heaven forbid, something that could get you even better.Jazz Glastra So you and I chatted a little bit this week about the prevention of mental health and substance use disorders, mostly mental health disorders, I think. I'm curious if you could talk about wanting to reduce suffering but not eliminate it. Owen Muir, M.D.One of the reasons I worry about Eliminating disorders as someone who's enthusiastic about doing so, there's a reason they had a predisposition to have that problem in the first place.It is like having a Lamborghini as your car but moving to Colorado. And it won't perform well up the hill in the snow. In the context of living in Denver in the winter, a Lamborghini is a poorly adapted car, and you are a terrible driver. And so if you imagine everyone just rags on you for how well your car performs, ignoring what car it is, then I'm a terrible driver.It happens to me because I have a Lamborghini, and there's snow, and it's not a good snow car, right? My Subaru friends will rip on me. I'm just better adapted to driving around L.A. That goes, wow, you can sit on the 405 at five miles an hour in style.It's a context issue. Some people do better in the cold; some people do better in the heat. That's what we're prepared for. Some people do better in high novelty environments. Some people do poorly in low novelty environments. Some people are very careful. Some people are very reckless.We need a variety of people around. Unfortunately, some of those people are more vulnerable in some contexts. So in a high cocaine environment, people with the predisposition to be more curious and novelty seeking which often shows up as adhd Are more likely to use and get a lot of reward from cocaine and develop a cocaine use disorder if you're Some people are predisposed to have a problem in a context, some people gain more weight from McDonald's and you put them in a high McDonald's environment, they get obese.Some people are more likely to become depressed when things get bad, and they're more likely to be depressed in a highly depressogenic environment. It's our pre-existing vulnerabilities, which are boons in other contexts. You want some people around who are more curious and look under the rock for the extra thing because they can't help themselves. We evolved together in a tribe, and when you lose track of the fact that we need each other, each of these individual vulnerabilities. Thus, I don't want to think about eliminating people with mental illness.I do want to eliminate the distress. People have, and sometimes that means environmental modifications. And sometimes, it means acknowledging that this environment is one in which you are maladapted. We need to be able to help you function better in this very difficult environment in which you find yourself.But there's a classic ad for Valium that I think makes us cringe now but should. And it's a woman in a broom closet. “We can't eliminate her drudgery; we can help the anxiety. Valium,” or some such thing. It's a woman with a rag on her head, and like a bunch of brooms, and it's super sexist.And it's just ugh. You make, you want to die, and no, stop doing that! Stop, let me, but not everyone has that option. It's about being honest with ourselves. We could eliminate anxiety or make the world a better place so people wouldn't feel trapped. And I don't know that eliminating anxiety is the goal so much as can you, can we help you be untrapped?Jazz GlastraWe don't need to eliminate people who have a predisposition to anxiety, depression, or schizophrenia, But could we prevent them from having their disorder triggered?So, I will give you one of the easiest examples of this I can come up with, which is cannabis and schizophrenia. So we have really strong data, mostly from Christoph Carell's work with other people as well, that ultra-high risk for schizophrenia individuals who smoke cannabis are highly more likely to convert to schizophrenia. And so if you wanted to prevent schizophrenia, the easiest thing to do, in quotes around the word easiest, is get young people not to smoke any cannabis. That would prevent a lot of schizophrenia. Good luck with that, by the way.Jazz Glastra I think we can have a separate conversation about public health messaging around schizophrenia and cannabis and how effective it could be. Owen Muir, M.D.You could prevent schizophrenia by reducing the rates of cannabis use.Jazz Glastra I think that would be a nice thing. —fin—Thank you for listening to the Frontier Psychiatrist podcast. Leave us five stars on whatever platform you're listening to. It helps discovery and lets other people know that it's a great podcast. I highly recommend sharing it with your friends. If you have enemies to whom you would like to send podcasts, you can do that too.If you've enjoyed hearing Jazz and I talk, there'll be more of it. , Brain Futures is co-sponsoring an event I'm hosting on January 7th called Rapid Acting Mental Health Treatment 2024. You can get your tickets on Eventbrite. It's in San Francisco, right before the JPM Health Conference. A special shout out to my friend Grady Hannah, the CEO of Nightware, whose idea it was in the first place.He and other exciting innovators will be there and talking to each other and to you at this reception. (ticket link) This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit thefrontierpsychiatrists.substack.com/subscribe
Sarah Hwang, MD, FAAPMR, Program Planning Committee Chair is joined by Rachel Brakke Holman, MD, FAAPMR to discuss this year's AAPM&R Annual Assembly and to look ahead to next year. Listen in to hear highlights and some sneak peeks of next year's plans!
Sarah Hwang, MD, FAAPMR, Program Planning Committee Chair is joined by David Cheng, MD, FAAPMR, and Eric Wisotzky, MD, FAAPMR to discuss this year's AAPM&R Annual Assembly and our 8th annual #PhysiatryDay. Their discussion includes what we love about our specialty, our Physiatry Day plans, and a discussion about the fun here at #AAPMR23!
#ThisisPhysiatry is a podcast that aims to spread awareness for the wonderful specialty of Physical Medicine and Rehabilitation (PM&R). This podcast is brought to you by AAP's Medical Student Council (MSC).
Hydroxyapatite Deposition Disease Dr. Rosenblum discusses shoulder pain, and the pathophysiology of Hydroxyapatite Deposition Disease. He discusses personal experience with infraspinatous tendon tear, and treatments such as NSAIDs, Lidocaine patch and steroid injections of the infraspinatous tendon. Dr. Rosenblum discusses his experience with a failed suprascapular nerve block as well as evidence to support PRP injections and ethical safe care. Dr. Rosenbum also is the NRAP Academy Course director for Ultrasound, Regenerative Pain Medicine and Regional Anesthesia CME Workshops and developed online PainExam, AnesthesiaExam and PMRExam Board Reviews Pain Management Board Review Upcoming Workshops and Events NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, December 16, 2023 7:30 AM NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, January 6, 2024 7:30 AM For up to date Calendar, Click Here! References Valerio Sansone, Emanuele Maiorano, Alessandro Galluzzo & Valerio Pascale (2018) Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment, Orthopedic Research and Reviews, 10:, 63-72, DOI: 10.2147/ORR.S138225 Seijas R, Ares O, Alvarez P, Cusco X, Garcia-Balletbo M, Cugat R. Platelet-Rich Plasma for Calcific Tendinitis of the Shoulder: A Case Report. Journal of Orthopaedic Surgery. 2012;20(1):126-130. doi:10.1177/230949901202000128 Hegazi T. Hydroxyapatite Deposition Disease: A Comprehensive Review of Pathogenesis, Radiological Findings, and Treatment Strategies. Diagnostics (Basel). 2023 Aug 15;13(16):2678. doi: 10.3390/diagnostics13162678. PMID: 37627938; PMCID: PMC10453434.
Sarah Hwang, MD, FAAPMR, Program Planning Committee Chair is joined by Adele Meron, MD, FAAPMR, and Aaron Yang, MD, FAAPMR to discuss all the fun and networking coming up at this year's AAPM&R Annual Assembly. Their discussion includes highlights of the assembly, tips for starting conversations, and a quick-fire section on networking opportunities for every career stage!
Meet Michelle Gittler, MD, FAAPMRand Prakash Jayabalan, MD, PhD, FAAPMR, thehosts of Advancing PM&R, a podcast by AAPM&R. During our first episode, learn more about the hosts as they learn more about each other, how they entered physiatry and what they are now up to in their career.
Join our hosts as they hear from Academy volunteer and Assistant Professor at University of Missouri-Columbia, Vovanti Jones, MD, FAAPMR as she discusses her training, leadership roles and life outside of medicine.
Drs. Gittler and Jayabalan are joined by Matthew Grierson, MD, FAAPMR an Academy volunteer who recently opened a private practice andcurrently serves on the AMA RVS Update Committee (RUC).
Dr. Rosenblum reviews an ASRA Newsletter article discussing the technique, relevant anatomy and more for performing Shoulder Articular Branch Radiofrequency ablation for chronic pain. David Rosenblum, MD practices Interventional Pain Medicine in New York. To schedule a conusultation call 718 436 7246 for Brooklyn and 516 482 7246 for Garden City locations or go to www.AABPpain.com The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/PFcXGy Upcoming Workshops and Events NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, October 28, 2023 8:00 AM NRAP Academy: Regenerative Pain Medicine Course NYC Saturday, November 11, 2023 8:00 AM NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, December 16, 2023 7:30 AM NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, January 6, 2024 7:30 AM For up to date Calendar, Click Here! Reference https://www.asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2020/11/01/how-i-do-it-shoulder-articular-nerve-blockade-and-radiofrequency-ablation
There is still much to learn about the optimal training methods to employ to improve function in horses to both prevent injury and when returning from a musculoskeletal issue. In this episode, we speak with returning guest Dr. Bart Halsberghe about equine sports physiatry, which emphasizes the prevention, diagnosis, treatment, and rehabilitation of physical impairments or disabilities. Sport Horse Podcast Guests and Links Episode 40:Hosts: Nicole Lakin and Dr. Tim Worden of the Equine High-Performance Sports GroupPodcast Website: Sport Horse PodcastPresenting Sponsor: Equine High-Performance Sports GroupGuest: Dr. Bart Halsberghe | LinkedInLink: What is sports physiatry?
There is still much to learn about the optimal training methods to employ to improve function in horses to both prevent injury and when returning from a musculoskeletal issue. In this episode, we speak with returning guest Dr. Bart Halsberghe about equine sports physiatry, which emphasizes the prevention, diagnosis, treatment, and rehabilitation of physical impairments or disabilities. Sport Horse Podcast Guests and Links Episode 40:Hosts: Nicole Lakin and Dr. Tim Worden of the Equine High-Performance Sports GroupPodcast Website: Sport Horse PodcastPresenting Sponsor: Equine High-Performance Sports GroupGuest: Dr. Bart Halsberghe | LinkedInLink: What is sports physiatry?
Do you ever wonder why pain feels the way it does? Or how to manage it effectively? We're pulling back the curtain on these questions with our esteemed guest, Dr. Jonathan Reisman, a board-certified physiatrist from the Kayal Orthopaedic Center. Together, we navigate the elusive world of pain management, shining a light on the different types of pain - nociceptive, neuropathic, somatic, and visceral - and unveiling the intricate network of nerve fibers transmitting these signals to our brains. But it's not just about the physical. We also delve into the psychological aspect of pain, underlining the integral role the doctor-patient relationship plays in addressing secondary gain issues. Understanding pain isn't merely a medical exercise; it's a human one too. We delve into the power of patient education, setting expectations before surgery, and addressing possible roadblocks that could hinder recovery. We wrap up by impressing upon you the critical importance of multimodal pain management. From early and aggressive treatment to prevent chronic pain, to the application of preemptive anesthesia and regional blocks, we leave no stone unturned. We also explore the role of radiofrequency ablation, medication, and the often underplayed value of exercise, physical therapy, acupuncture and chiropractic in improving mobility and reducing pain. Tune in as we demystify the fascinating world of interventional pain management with Dr. Reisman. Support the show
Episode at a glance:Relation to autoimmune arthritis: Dr. Furlan is a physician at a pain clinic, a scientist at the rehab institute, and assistant faculty at the University of Toronto. She is a physiatrist who specializes in pain.Understanding Pain: Dr. Furlan explains how pain science is continually advancing and more information about how the brain processes pain is being discovered. There are different types of pain, and multiple systems in the body involved with the sensation/perception of pain.Your pain is valid: Some people might not see your pain, and you may be stigmatized, but what you say is pain, IS pain. If other people say you're not in pain, it's because they don't understand the pain system.Language around pain: The words we use about pain can make a difference too. Cheryl and Dr. Furlan discusses different ways of approaching words like “conquer” or “defeat” in the context of living with a painful autoimmune condition.8 steps for living better with pain: Dr Furlan explains strategies for exercise, sleep and more. For example, she recommends breaking up exercise into smaller “snacks” or movement breaks. She also shares the importance of quality sleep is important too, since it gives you energy for other lifestyle factors. Investigate if you have a treatable sleep condition (like sleep apnea), and then address your sleep hygiene/routines - including making sure you're not sleeping too little or too much. Lifestyle factors are often interconnected, and taking care of your mental health and nutrition can also support sleep and exercise.Dr. Furlan's best advice for newly diagnosed: Doing it alone is HARD. Find support, someone knowledgeable who's climbed their mountain or helped others do it, who've traveled this road before - they can be your guide.Medical disclaimer: All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, an online course and group support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now! Full Episode Details plus Audio Transcription: Please go to the episode page on the Arthritis Life website for all the details!
We welcome Dr. Lucas First, a physiatrist with St. Peter's Musculoskeletal Medicine. Dr. First is a physical medicine and rehabilitation (PM&R) physician, specializing in interventional pain medicine. Call in at show time (2pm) with your question. 800-348-2551. Ray Graf hosts.