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Radio. Hello and welcome to Fearless Fabulous You. I am your host, Melanie Young, and you're listening today on the Women for Women Network W four w N Radio. You can hear all my shows anytime anywhere on your preferred podcast channel. I'm happy to be in my tenth season and my mission is to get inside people's heads, particularly for women, to help them make informed,
comfortable choices about their lives and every aspect of it. Today we're going to talk about a four letter word, and it's used very loosely, as in, don't be a pain in the you know what, he's such a pain. I'm in pain. This pains me. It's pain p ai N. Pain is used very loosely in a lot of ways and a lot of you know, dialogues, But it's serious business and a lot of people are in pain. There's physical pain and there's emotional pain. But get this.
According to the Centers of Disease Control the CDC, which I refer to, always roughly over twenty percent of adults have chronic pain. Okay, so twenty that's like fifty million people chronic pain. I also notice non Hispanic white adults were more likely to have chronic pain compared to non Hispanic blacks, and women have a higher percentage of pain, and women adults are likely more likely to have about twenty one percent high impact chronic pain pain compared with men. So
again, women get the brunt of it. You know what's going on. So we're going to talk about pain. Hopefully you are not in pain, if you are, but if you are, I'm hoping that the show will help you. I have a pain expert joining me today. She's a PhD in m d Doctor Andrea Ferland, an Associate professor in the Department of Medicine at the University of Toronto and a staff physician and senior scientists at the Toronto
Rehabilitation Institute. She's a pain specialist with a YouTube page. It has more than four hundred and eighty seven thousand subscribers in more than forty two million views, so she has a following. She's also author of a book just out called Eight Steps to Conquer Chronic Pain, A Doctor's Guide to long time, Long life long sorry, long life, long backwards. I'll do that again. Eight Steps to Conquer Chronic Pain, A Doctor's Guide to life long relief,
lifelong relief. So we're going to cover pain in all its forms, and also what's not pain, and also why you shouldn't be using that word so loosely, because it really there are a lot of people feeling pain. Doctor Ferlin, Welcome to Fearless Fabulous. You. Thank you so much Malanie for inviting me. Well, I have been reading an e copy of your book. There's a lot of interesting information in here because I don't think I know anyone who doesn't have pain of some kind, and we're going to explain
that of some kind. So I want to get to the you know, the basics, what is pain, how do you define it? What is pain? And what is not pain? As you note in your book. Yeah, I think we all know what is pain. It's an unpleasant sensation. And we all know acute pain from you know, a toothache, earache, bruise, a fracture, and inflammation and that hurts. So that is
pain. It's it's defined as an unpleasant sensation that is interpreted in the brain, and that's mostly acute pain, which is not all humans experienced this, believe it or not. There is a genetic hereditary condition very rare that the person is born without the ability to a few pain. And those people they die in young age because they can't protect themselves from harms and diseases and injuries,
physical pain. And we're talking mainly about physical pain, correct, Yes, this is a lot of emotional pain, which is a whole other thing. Now you know they are connected. They are connected. We can't separate the mind from the body, especially in pain. Well, I want to get to that because that was my name. You know, how does the mind and body interact with pain? Because you know, a lot of people say, oh, it's all on your head, you know, sometime always
on your head, can you you know? But you're very clear it's not. So why don't you delve in that a little bit more. Yeah, where when we say the pain is a sensation, it means that it is interpreted by the brain. So it is in the head in some sense, because you need the brain to interpret and to tell you that it is pain or not. But when I think when people are gas lighted or they are not believed, is when a person has chronic pain, which is different from
acute pain. I will explain that in a minute. But they go to a healthcare professional and they can't find what is wrong, and they do all kinds of tests, or they are still they're taking a lot of medications, they're still pain. That's when you know they hear, oh, you must be imagining this. It must be psychological. It must be in your head. That's what it's not. Because nobody imagines pain and say I will be feeling pain today. I want to feel pain, and then they start imagining
pain. Thought, that's not true. That's the main difference. If they feel pain. If they say I am in pain. Even if we can't find anything wrong with the body part that is hurting, they are in pain. So the pain is always real. You talk about chronic pain and acute pain, right yes, they're different. So how are they different. They are different in a sense that there are two different conditions. Acute pain is
a signal that you have an injury. For example, if you have a if you put your toe on fire, and then the inflammation and damage to this skin because it will be a burn that will hurt, that's a huge pain. Now, a person may be feeling pain for a long time in a part of the body. Usually it's the back muscles. It could be migraines, it could be abdominal pain, it could be an undefined pain that nobody knows where it's coming from. That is different because chronic pain is constant,
ongoing pain all the time. They feel the pain a part of the body. But the pain is different now because the thing is the disease. Let me let me explain this. I talk about this in the book. It's the alarm system of the house. I think when I explained the alarm system, people understand better. So when you install an alarm system in a house, you wanted to alert if there's a fire, burglar, a leak in the basement, something wrong. So you install sensors and the sensors can
be like a smoke detector or burglar breaking detector. So acute pain is that the sensors are working normally and if the aligm makes noise goes off, it's because something's broken, damage or lesions. There is a problem there. You need to call the fire truck, the police, or the ambulance. Now, when a person has pain, chronic pain, it's similar to the alignming system is malfunctioning. So there is a problem because it needs to be fixed.
They're not imagining there is a real noise. The problem is not that they don't need to call the ambulance, firetruck, the police. Now they have to call a different person. They need to call the alarm company to fix the pain system. In the majority of cases of chronic pain, that's where the problem is. Because the initial injury has healed, the disease is gone, it's treated, but they continue feeling pain. It's because the pain
system is sensitized and they need to really train the pain system. So that that's why we say the treatment for a cute pain is different from from chronic and some things that work for a cute doesn't work for chronic. It's interesting and it is a big misconception. I was looking at her. I do a little research for every show, and I looked at the biggest misconceptions at pain. That was one of them, because yeah, a lot of people
also think that pain is a thermometer, that something is wrong. And I think when you ask me what pain is not thing is not a good thermometer because a person may have a lot of injury not feel any pain and a lot of another person may not have any injury and feel a lot of pins, So it's not a good thermometer. That how the amount of damage. Are sensitivity to pain hereditary or I mean some I know some people like my mother was sensitive to pain. God loves you know. Other people are not
sensitive to pain. And some people say you have to grin and bear it. Let's talk about pain sensitivity and when you really it's not called the Grand and Barret. Yeah, there's a lot of research in this area. It's very interesting. Women is more Usually women is more sensitive to pain than men. So we know this in female animals. In humans, it's consistent women is more sensitive. We don't know why. We don't know if it's because
of these sexual hormones, if it's because of the genetic composition. Actually we don't know why, but all the laboratory studies they come to the same conclusion. But there is also big variability in the population in general. They do some laboratory studies where they provoke pain. Imagine, I don't know who would come to laboratory to be, you know, subject to pain, but they
do. And they bring these people men, women, all kinds of ages, and all kinds of background, and then they apply the same painful stimulation in a laboratory, so they know it's the same thing, but people respond very differently. Some people will say, wow, this is a one out of ten. Other people say this is a nine out of ten with the same simulation. Yes, and as pain get worse as you age, well,
it doesn't get worse as we age. It's just that as we age, we just accumulate more diseases, more injuries, more lesions to your body. So the tendency yes, older people. Among older groups, the incidents prevalence of chronic pain is one in three all the adults. When you mentioned one in five adults, but it's one in three all the adults. And
that's just because people accumulate during lifetime more conditions health conditions. Diabetes is a very important cause of chronic pain because diabetes can cause lesion in the nerves, and the artried is fibrom alga and your pathic pain surgery, surgeries and other things. That is a very good starter for chronic pain. And so if people start having more surgeries during a lifetime, they will have a tendency to
have more chronic pain. You know, I didn't think fibro fibro my alga was as common as it is, and I didn't realize it was like your entire body and it's just chronic. It's like chronic pain throughout your body. Yeah. Sometimes I feel like, you know, the weather. I think weather effects, Like it's raining, where am today? Doctor frown and I feel more pain today. It's cold and wet, and I'm like, oh,
every little tendon in my body hurts. Not bad. Yeah, but yeah, I think weather it doesn't make it worse, right, Yeah. They say the researching this area is very vague because it's hard to prove. It's hard to pinpoint where the problem is. But we hear this a lot, especially in people who have a joint problems like our tritees rhumatoried trities. They tell us that they can be a good forecaster. They know when to change. The weather is going to change, and it's it seems to be
more related to pressure, biometric pressure than temperature itself. My mother was that way. My mother acute acute rheumatori arthritis, the worst ever, and she couldn't you know when it rained. It was a disaster here and it you know, I feel for people who are in pain because it really affects your ability to function well. You talk about so if somebody's experiencing pain, they should seek help. I mean, you know, that's number one message to
everybody out there. Don't just you know, grin and bear it and hide it, because there could be an underlying condition that has to be addressed. You have to talk about. You use a method called the Socrates method to work with your patients and understand the pain and diagnose it. Tell me about that. Yeah, So when I see people with chronic paining, it's interesting that they come to my clinic and then they have like a twenty year history
to tell me in thirty minutes. So I want to listen and I want to give them, you know, all the attention that I can, but sometimes I have to tell them thieves. Help me help you. I need to I need to know the details of what is that you're feeling? How long did it take? And don't tell me everything would started twenty years ago.
And so I help them. And I have this in my book saying when you go to a doctor or a physiotherapist or a clinician that will help your paying, try to be objective, try to be give them the details that they need to help you. And so that's what I talk in my book. I say, you know, the socratist is just a message of remembering this. The s is for tell them what is the site? Where does it hurt? Precisely? And if you can paint a body diagram.
I give my patients a body diagram and I ask them paint here where are the areas that hurt? And then all of the socaches is the own set. So tell me how did this pain started? Was this an accident? Was this a surgery? Or there was no apparent cause that you can remember. The c is for the characteristics of the pain. So tell me is this burning? Is this jingling? There is numbness? How would you describe this with words? Because it can tell me if this is a nerve injury,
if it's more inflammatory or not. They are is for radiating. Tell me does this pain radiate somewhere else where does it go? Because that will help me also to make the diagnosis. The A is for associated symptoms. Tell me what else do you have when you have this pain? Does it come with a swelling with change in color for example, or redness? And what makes it better? So ameliorating factors. So if you put a hot pack doesn't help, if you put an ice pack doesn't help, because those
will give me some hints. This is inflammatory. This is a nerve damage. The G is for time, So tell me when do you feel pain most chase it in the morning, Is it in the middle of the night, is in the end of the day. E is for exacerbating What makes it worse or better? Because also I need to know if you take a pain killer, an anti inflammatory medication in your pain is a lot better. It tells me this is probably inflammation. And as is for the severity,
give me a sense. It gives me a sense of how severe this is. Are we talking about a pain that is like a one two out of ten or are we talking about a pain that is like eight? Nine, ten out of ten. I know it's hard for people to give a number to that pain, but we have no other way to measure intensity of pain.
If it's not by numbers that they give choice, well, I think another indicator would be how does the pain impact your ability to do day to day activities and giving some examples of the impact, like does it hurt to lift? Does it hurt to use a fork a knife? Does it hurt to swallow? You know, I'm a cancer surf where I went through chemotherapy, and I find I find the communication between doctor and patients could be very
tenuous. Many patients don't know how to communicate effectively, and many doctors don't know how to communicate effectively. And it's important to ask questions, but to bring to to come in ready to ask questions, and then the doctor also needs to be ready to ask questions. And somehow everybody has to be honest with those questions. Because some people don't know how to describe what they're feeling
and experiencing. I always do the context what does that feel like? Give me an example, um, because I've never been you know, when I get the one to five, one to ten, it's all yeah, that is all mad because some people see a pain is a ten you know, I'm dying, and somebyle's okay, it's that big deal. And I never know whether I'm being truly honest about pain or not when I put it down, because it's it's what I think it is. Um. It's very interesting.
Um. You outline in your book eight steps title of your book, to Conquer Chronic Pain. Uh, and you go through them. Why don't we touch on them and to give my listeners a sense of what this what's involved in your book? Yeah? Yeah, So, as I mentioned, the chronic pain is, um is this chronic disease and I it's a chronic disease that will probably not go away. So I never tell the patients will cure your chronic pain and your pain will disappear, although that is possible.
I've seen people they don't have pain anymore, so they don't feel anymore, but they may have like a relapse here and there, and so they live really well and they're not feeling pain, but once in a while they might have a flare app But most people is a chronic disease, and what they can do is when they say conquering means that they will be able to manage. They will be able to self manage their thing. They will learn what
works for them, they will learn what their disease is. They will not be fearful of pain, because another thing that we see a lot is the fear of being paralyzed. As people, the fear of thing itself has to be treated. The fear of thing is what's one of the main barriers that I have in my clinic to get people moving to do the things that I want them to move to do that will I know will help them to live
a fulfilling life. So conquering pain means you can live a fullfeeling life feeling something, but that pain doesn't need to dictate what you So the steps, let's talk about the steps. So the first step is retraining the pain system. So again that is similar to the alarm system of the house that I mentioned before. It is let's call the alarm company. Let's call the alarm company and retrain and fix our pain system. Because the pain system may be
sensitized. The paining system in a person with chronic pain will be telling them a lot of things that they don't need to hear. For example, the pain is excruciating. Today I did something wrong to myself. I cannot do that movement again. So you have to retrain your pain system. You have to learn that your pain system is just telling you something different today that is not true. It's almost like an illusion that your paining system is doing.
You know, optical illusions means you see something, but your brain tells something different. I think we all know. Optical illusions means sometimes a darker shade in a picture, but when you look closely, oh, it's not darker, it's actually the same color. That's because the brain is telling you things. So that's the first step. We're training the pain system. So learning that you can move, you can do the activities, You're not going to
harm yourself. You can keep going and leaving with this. So that's the first step because if we stick the pin system, if we regulate the pain system, it's much easier to treat a like a knee arthritis or a low back pain because now they are not supersensitive. The second step is about emotions.
Emotions have a big component in pain sensations. They come handing hinge and why is this Because in the brain they are connected, they are linked the sensation comes from a body part, let's say from a knee or from a back, but then in the brain they activate the emotional areas of the brain. So if a person is such on a day or they are having a
bad day emotionally, they will feel more pain on that day. We know that there are a lot of laboratory studies showing that if they do the same pain for stimulation, showing the person like a sad movie or such pictures or telling them a sad story, and then they measure pain. After the laboratory people did the thing stimulation, they will feel much more pain. Now, if you show them a happy movie, tell them a happy story and they are in a happy mood, they do the same thing for stimulation, they
feel less pain. So we know that emotions have a big component in the volume of thaying how much pain the person will feel. So of course nobody wants to feel more pain that you need. So that's what the step number two is. Let's control or emotion. Let's do an inventory of our emotions. Are you having did you have a discussion with your children? Are you mad at someone, are you angry? Are you frustrated? Are you lonely?
Loneless as a big has a big impact on pain. People who are lonely, they feel pain more intense than people who have some supports people around them. Holding hands. We know that people who hold hands with another person they feel less being. So there are a lot of things that you can
just do an inventory of emotions doing journaling. I recommend people to journal their emotions because once they start putting things on a paper, they realize, oh, I think because of this arguments that I had with my husband that is affecting my muscles, I'm feeling more paying my muscles, and that's why my pain is worse to them. Because again, Melanie, this kind of pain, emotional pain, we can't treat with medications. We can't take appeal to
treat to them, so you have to treat with emotional support. Step number three is about sleep. It's very neglected. Sleep quality is so neglected in the general population. But in my patience, they usually say, well, I sleep bad because I am in pain. I wake up because I am in pain. But I tell them, sometimes you are having pain because you are not sleeping well. So you need to take care of your sleep and then your sleep quality will be better. And then you will not be waking
up by pain. Pain will not disturb your sleep. There are a lot of medications that affect sleep and a lot of medications that cause them side effects that affect sleep. Like we use a lot of untidepressants and unti convulsants to treat chronic pain, and they may have interference with sleep. Some of them help, some others don't help. So we need to be careful how we
do this. So that's the step number three. The step number four is about diet, and I'm not talking here about it just you know obysity. People think that I'll be talking about the miracle diet that will fix all of their things. No, I'm talking here about malnourishment. A lot of people are normal wage or maybe overwege, but they don't know that they are malnourished because they might be lacking essential ingredients, especially vitamins or omega three. Omega
three is very important to fight inflammation. Also, the way we eat, we need to eat mindfully. We need to, you know, pay attention to when we are eating, with whom we are eating, not just put something our stomach to survive. Eating mindfully is so important human thing. Also, a healthy diet, what we buy, the habits that we have cooking at home instead of buying fast food or eating out. The first step is
what about the other people around us? Because pay is a cycle, it's a biological phenomenon, but alse it's a psychological as we talked about, but it's also a social phenomenal. We know the pain depends on who is around us, and also pain affects people around us. A person with conic thing, they tell us this a lot, that their relationships might be broken,
relationships with their spouses, with their children, with their doctors. Sometimes they've lost the trust from their doctors, friends, family, for workers, oh my god, job for workers, bosses, managers at work. Those relationships are broken and confused, and because of this, they will affect how the
person feels pain. Because if they feel misunderstood, if they have to explain all the time, all the time that they go to a party like a family reunion, if they have to explain how they are, what they're feeling, they maycasions they are, why they're not feeling well, why they need
to leave the party earlier. It's stirring, it's really exhausting. So in this chapter I talk about how people communicate with others, how they can get help with others, and how they can communicate their pain with those that are around them, because that will affect them. The start number six is about medications. So I talked in this chapter about medicine, the medicine cabinage. What do you have at home? How do you use those medications? How
do you use pain killers? We talk about opioids, We talk about antiflammatories, injections, I talk about topical queens. I talk about cannabis, steroids, anti the presence, and convulsants. Because people are confused to they sometimes they don't even know why they're taking some medicases. They say, why am
I taking to the present for pain? I'm not depressed. But we use them to the persons, especially if the person has neuropath pick pain, which is a kind of chronic pain that affects the nerves, the nerve system. So it's important for them to understange why they are taking what they're taking and also discussed with their doctors, pharmacist nurses, the side effective these medications.
Why really need can I stop taking them? You know? Manly? Because some people are on these medications for decades and they are taking a soup from medications. It's amazing that we call this polypharmacin and nobody ever questioned them, why are you taking this medication? Do you still need it? Maybe some doctor started this fifteen years ago, but maybe you don't need this anymore. So it's important to talk about them and the medications. Step seven is about
what other things you have in your tool box, the toolbox. I talk a lot about the tool box in my videos in the book, it's all the other things that you have to self manage your pain. So medications is one of them. The pills, the injections. You know, the queens, the topical queens, but they're not the only one. When you talk about the emotions, we talk about relaxation, mindfulness, meditation. Those are excellent tools to retrain the pain system. But there are other things that they
can put in their toolbox. And I talk about the five MS for them to remember, and the five ms are movement, mind, body interventions, manual therapies, modalities such as heat code, electrotherapy. And then the medications of course, the antiflammatories and allgetics must relax and opioids, cannabis based compounds et cetera. And then the step h The last one is the focusing on their goals because goal setting is really important, especially for people who have a
long term condition. Chronic pain is a chronic condition, so when you have a chronic condition, you need to have goals in your life. You need to have smarter goals things that you can achieve. So for example, going back to school, getting a job, getting married, those are goals that people have in life. So we talk about now that you are conquering or mountain you're conquering, or chronic pain, how you're going to achieve those goals,
and we help them to set smarter goals. For example, if you want to go back to school, you have to start by creating a routine that you're going to study one hour a day, maybe five days a week. That's a small step for you to start, you know, because once you go back to school, you're going to study a lot. You have to have a routine. So we have them to reorganize their lives because I see it's really sad. I see people with chronic pain that they lost a
lot of years lived because of this chronic pain and their dreams. Their goals were not fulfilled. It's sad, you know. I thank you for the great explanation of each of date steps. You mentioned medication, and I want to zoom in on that because doctors are very quick to prescribe medication all the time, and I always when I see my doctors, I say, what
are my other options besides medication? And you mentioned and tell me if I missed this, you said something that you don't necessarily need medication, because I always hear about people becoming addicted to pain medication. Yeah, and you know, I'm curious, first of all, at one point, you know, what are some ways to mitigate pain without medication? And at what point do you really say you need medication? Yeah, so let's go back to those
analogies of the Alliance system. Okay, So if the some people have chronic pain because they have an ongoing injury to their body, we call this no susceptive or neuropathic pain. So it's almost like having once in a while you have a fire in the house and then you do have to call the fire truck because they will have to come and you know they need to put up the fire. So in these cases that a person continue to having injuries to
their body, or if they have neuropathic pain, medications are used. So for example, an anti inflammatory. They have an inflammation in their body like romatoriatritis is a good example. They do have some time to time those joints that will inflame and will hurt, and we don't want this inflammation to sensitize the pain system. And now the aligned system of the body is sensitized. So before before the pain system gets sensitized, we treat this pain from an
inflammation with at inflammatories or biologics. So they need medications and opioids in acute pain, all surgical pain are really important because one thing that's sensitized the pain system and make the alarm system of the house dysfunctional is a cute pain. So if a person goes to surgery, they're going to feel pain. We need to treat that ping aggressively. Doesn't mean opioids all the time, but
it means antifomatories, it means eyes. It may mean opioids, but then we need to stop those medications after the scar is formed and they don't have the pain from the surgery anymore. When I say we don't need opioids, we don't need pain medications for a lot of chronic pain is because that initial injury is healed and they don't have that initial injury anymore. They don't have
that inflammation anymore. That is healed. For chronic pain. If we keep giving them opioids, it's not going to treat the origin of the pain. It's only going to mask their pain for a few hours. It's not treating the origin of the pain because they don't have that injury anymore. That thing is healed. But then they start having the side effects and they develop tolerance.
We know that opioids creates a tolerance in our body. Tolerance means if you take let's say three tablets a day of opioids for a couple of days, then your body will become tolerant to that, and now you need four tablets a day to have the same effects. And then your body becomes dependent tolerant to four, and now you need five and they need six. So you need a higher dose to get the same effects. And that's why people
start increasing the dolls. They may become a dependent on that medication. Dependence is a very physical thing. Dependence is not psychological. Dependence means if they stop taking that medication, or if they miss a dose of the opioids, they get horrible withdrawals. And interesting enough, Melanie withdrawals of opioids caused pain. So a person. It's really terrible because then the person uses a dose of the opioids or they try to stop the opioids just to see how their
body responds. But now they have pain, which is confusing because they say, well, if I am in pain, it needs that I need the opioid. No, but your pain is just because of the withdrawals. So that's why opioids is not a good term a good solution for a long term pain. Yeah, and unfortunately we're just reading more and more about people who are addicted to pain. I don't like I hate pain, pain medication. To be very honest, when I have my surgeries, I don't like them
because they can't to pay you. And that's person a lot of things. You know. There's you know, I'm a big believer, as you mentioned in your steps, you know, the mind, body finding, meditation, mindful eating. I think you made a point, well, it touches on pain. I think it's an important point in general about malnutrition because I think a lot of people erroneously or mistakenly think malnutrition is because being somewhat is starving,
they're not eating enough. But malnutrition, bad nutrition mall like Latin and nutrition means poor nutrition. You can be overweight, you can be underweight, you can be a relatively okay weight, but you can still be malnutrition because you don't have the proper nutrients in your body. If you live on a diet of fast food or sugar, or a strange diet because people, you know, there's this way too many strange diets out there right now, that's
poor nutrition and it will impact your ability to handle pain. It also picked your whole body. I think that's important to point out because it all goes hand in hand with your overall health. Right absolutely, you just said, You just said exactly what I was going to say. Malnutrition means they don't have the nutrients in their body to create those neurotransmitters that will fight pain, to fight chronic inflammation, to fight them to give them energy to get up
from bed and do movement and exercise. It's also related to depression. Depressed, so people need to pay attention a lot what they eat because if they put a lot of sugar and unhealthy fast in their diet. They will feel full, they will feels saciated, and then they will say, why do I need to eat that fish? Why do I need to eat that olive oil? Why do I need to eat that vegetable if I'm feeling full? But you know that extra virgin olive oil contains a lot of omega threes that
you need to fight inflammation. And they if they don't buy mindfully. Grocery shopping is where you start to have a good nutrition. I tell them, if you would you be able to show me your grocery bills for the home month, and if I look at your grocery bills, would you be proud
of what you show me? If they say, well, not really, I know they're not having a good nutrition because they're buying only junk food, fast food, package food, ready made food, frozen pizzas that I'm not against those, I love those things, but you know, maybe once a week, one meal a week, because you can have a junk food, but the rest of your meals should be really nutritious, should be very well thought while you're put in your mouth, or how you're feeding your family,
how you are preparing your meals, and people. I don't know what's going on with our culture. People people want fast and easy is what it is. I spend a lot of time I try level quite a bit to Europe, thankfully, and back, and it's a different attitude over there on how they approach food. Everything is fast and easy and convenient. And I look at a lot of grocery carts. I'm currently in the Deep South. I watch a lot of grocery carts and most of them were filled with packaged,
poor, empty, empty calories. And as you get older, it gets harder. Many my mother died of malnutrition. As a food professional, just know that my mother died of self induced malnutrition, and I know what it did to her, and it was because she only wanted each sugar and and forty. It is a common problem with the elderly, and it has and
it's very hard. You just want them to do anything, and you know they all eat and you know, I won't say the brand, but there's you know, protein shakes as we're just going to call them poaching nicks, and they just filled with sugar. It's something you got to think about because it all helps keeping the body hopefully, So I'm curious about two things. We've got about eight minutes left. First, what are your thoughts about the
natest greatest research in the frontiers of pain management? What are you excited about? Are seeing ahead? Oh? Yeah, I'm glad you asked that, because there's a lot of things coming in the pipeline. And what I would say is, I've been doing this for thirty years, Melanie. But I graduated from medical school and I did choose a specialty that was able to treat people with chronic pain. So I've been researching and treating people with chronic pain
for thirty years, and it has been a shift. What we were doing thirty years ago is very different from what we're doing now, and that's because there's a lot of advances in imaging of the brain of people with chronic pain.
We're understanding much better what happens what brain, what pain does through our body, because thirty years ago, we always thought that pain is something that is happening in our body like kneeds hips back head, and then it's just a sensation that comes through brain and you need to stop that sensation and the brain. We always thought that the brain is just a passive with seeping of these information and there could be nothing that you could do at the brain level.
But oh my god, things are changing in this area a lot because now with a lot of functional MRI and the studies of the brain, because of the technology that has a brand so much, we can see what pain does through the brain, and then what the brain does through pain, which is amazing, amazing. I'm so excited about this because the brain has this plasticity, this amazing ability to change itself to respond to stressors, and pain
is a strong stressors. The brain has the ability to modify the meaning that we give to things, to suppress some sensations, to even to create some sensations. I don't know if you ever heard about phantom pain. A person has alciated, so the brain is able to create pain. So a person has an entutated leg, but they continue feeling pain, cruciating pain, very intense pain in that body part doesn't exist anymore. So the same way that
the brain can create pain, the brain can eraise pains. So that's where I think we're going to see a lot of advances in the future is using these areas of our brain. We have an inner pharmacy in our brain, We have an ability to create our own opioids, cannobinoids, sell toning, dopamine. It's a potent pharmacy that we have inside of our brain. And now we are learning how we can stop a coupuncture, for example, is a way that we can tap into this pharmacy. When a person does a
coupuncture, they stimulate the brain to release those pain killers. So we are learning more about what the brain can do, and I think the future will open up to a lot of how we can train or brain, how we can use these strategies to improve the lives of people with chronic pain. Well, that's encouraging. And I'm a big believer in holistic approaches to managing all aspects of your health because, as I said straight on, I'm not big
on medication. I think that eventually, I you know, other than addiction. I think at some point, don't people become immune to their medication and we can't be of medication forever. It seems like, yeah, yeah, we use the term tolerance. We don't use but we call this tolerant. They develop tolerance, right, and then you got to switch it and whatnot, and that be dangerous. I've seen that can be very dangerous. As well, and I think we have to caution my listeners on claims. There
are a lot of supplements. I'm not big on the supplement industry because unregulated CBD. You know, everybody's promoting CBD. When my mother, my mother had chronic matory arthritis, people were bringing her so many CBD CBD salves and I have a drawer of salves for her. You know, my my edits savir money. I don't really know what's in your head or not with all
that, but it's expensive and I don't see where it helps. Of course, you know there are people out there, be very famous people promoting them. What are your thoughts? Yeah, I have not In the beginning, I think that was a big push for us to try this thing. I saw a lot of my patients excited with thhc CBG. I have been seeing a lot of good success stories, and the evidence of scientific evidence is also kind of getting. The excitement is dying regarding the use of cannabis because they
were not able to achieve like all this pain really especially for pain. Maybe for other things they may have other uses, but for chronic pain they were not so successful as we initially thought. Although for neuropathic pain, which is a kind of pain from the nerve injuries and diseases. For neuropathic pain, THHC seems to have some effect reducing pain sensations, but for the majority of chronic pain, they don't have neuropathic pain, so actually doesn't do much for
pain. Well, that's interesting because neuropathic pain is very different. I have neuropathic pain because I had a double massectomy, so I've had phantom pain. Neuropathic pain. It's a strange. It's a strange sensation, a much stranger than like the pain from the stub toe I have right now. Yea,
and as you said, has to be managed very different. So I have enjoyed it talking to you again for my listeners, We've been talking with doctor Andrea Farland, Associate professor at the Department of Medicine at the University of Toronto and a staff physician at the Toronto Rehabilitation Institute. The book is called Eight Steps to Conquer Chronic Pain, A Doctor's Guide to Lifelong Relief. What is your YouTube channel that has all this followers. Yeah, it's just my name,
doctor Andrea Bland. I you r l I am well, congratulations, you know that's that's a pretty nice amount of following, and thank you for all the work you're doing to help improve people's health and well being. Pain is an insidious thing to live with because it can, in fact, every aspect of your life, how you work, how you have relationships, how you function. And I've witnessed it myself watching my mother deal with pain.
I've witnessed it many times. And as I said, to be careful when you say the words I feel your pain, because you know you don't. Most of the time you don't. Everybody's pain is very individual, so you be considerate when you use that term, because there are people who are in pain and they need help. And the most important thing always, if you are experiencing a condition that is making you feel uncomfortable, unhealthy, unwell, or unable to function normally, seek help. It's a sign of strength to
say I need help, not weakness. Don't grin and bear it, bear it all. I'm Melanie you. You've been listening to Fearless, Fabulous You, And as always I like to say, you have the choice and how you live your life and what you want to do with it. Choose fearless, choose fabulous, and make an impact on yourself and those around you. Thank you for joining me, and thank you doctor Furlough. Thank you Melanie. After time casts used between B