Matt Connarton Unleashed: Dr. Anh Ngo

0:00 Speaker 1: Good morning, sunshine.

0:02 Speaker 2: Jenny is here at the news tablet for and uh.

0:06 Speaker 2: It's especially good that you're here today because, as you

0:09 Speaker 2: can probably hear, my voice is already failing from my

0:12 Speaker 2: recent fight with asthma sounds apparently I'm not fully recovered

0:17 Speaker 2: from that, as I'm as I'm cracking on this uh,

0:21 Speaker 2: Saturday morning.

0:22 Speaker 3: January fourth, our first show of twenty twenty five.

0:24 Speaker 1: Well, at least you didn't end up on the grassy

0:26 Speaker 1: knoll this.

0:27 Speaker 2: Time, that's right, Yes I did. I did have to

0:29 Speaker 2: go to the emergency room again. Yes, but but I

0:31 Speaker 2: can breathe. I can breathe again.

0:33 Speaker 1: A couple of treatments later, and he's speaking yes.

0:35 Speaker 3: Yes.

0:36 Speaker 2: So so here we are and for our first show

0:40 Speaker 2: of the new year. Happy new year, everybody. Let me

0:43 Speaker 2: get get that make up there. Someone who has not

0:47 Speaker 2: been with us in a long time. Doctor noahs here,

0:49 Speaker 2: welcome doctor now. Oh I cannot hear you. Let me

0:53 Speaker 2: figure out why. I think I know why to change

0:56 Speaker 2: the mind.

0:57 Speaker 1: Oh boy, I know you're gonna get the cobwebs out

1:00 Speaker 1: of you.

1:01 Speaker 3: Oh I think I can hear you now, doctor, Now

1:03 Speaker 3: are you there?

1:04 Speaker 4: I'm here, Good morning man, everybody, mind Jen.

1:07 Speaker 3: I apologize. So, yeah, so welcome. It's been well.

1:12 Speaker 2: Obviously this is your first time in the new studio,

1:14 Speaker 2: so it's certainly been well over a year. I know

1:16 Speaker 2: that probably been probably been a year and a half

1:18 Speaker 2: maybe since you've been with us.

1:19 Speaker 4: It's been a little while. I can tell you that

1:21 Speaker 4: the studio is very impressive.

1:23 Speaker 3: Isn't it nice? We love it.

1:25 Speaker 4: It was it was like a grand entrance walking in,

1:27 Speaker 4: going wow, look at this lobby, Yeah, look at this

1:30 Speaker 4: large you know. I had I had to stop by

1:32 Speaker 4: the facilities, you know, because I drank a bit of

1:34 Speaker 4: too much coffee this morning. But I was like, wow,

1:36 Speaker 4: this is very grand.

1:37 Speaker 3: Yeah, I'm very impressed, Thank you, thank you. No, we

1:39 Speaker 3: love it.

1:40 Speaker 1: It's the new digs are styling.

1:42 Speaker 3: And you can tell from the outside that it's a

1:45 Speaker 3: that there's a radio station in here, you know, because

1:47 Speaker 3: as you know, at the old place, like looking at

1:48 Speaker 3: it from the outside, you would never even know that

1:50 Speaker 3: there was a radio station in the building.

1:51 Speaker 4: The signage is impeccable.

1:53 Speaker 3: Thank you.

1:53 Speaker 4: Even without driving without glasses this morning, although I don't

1:56 Speaker 4: need to drive with glasses, I saw it from afar.

1:59 Speaker 3: And that is good to know. That is good to know. Yes.

2:04 Speaker 4: Wow, Well I just want to say one thing before

2:08 Speaker 4: we get started. Yes, is that that song twenty three

2:11 Speaker 4: that you played this morning?

2:13 Speaker 3: Yes.

2:13 Speaker 4: If there was a rating scale out of twenty four,

2:16 Speaker 4: I would rename it twenty four.

2:17 Speaker 3: Wow.

2:18 Speaker 4: I very much enjoyed it.

2:20 Speaker 3: I really like that.

2:20 Speaker 4: I did, especially when it caught my attension when it

2:23 Speaker 4: said the bus is moving leaving in ten minutes.

2:28 Speaker 3: So this is a little inside for people who don't know.

2:30 Speaker 2: So the building that we're in, of course, this used

2:32 Speaker 2: to be a bus station here in Manchester. This amazing

2:35 Speaker 2: building which was remodeled and refitted is that a term

2:38 Speaker 2: for that turn turned into this amazing facility that it

2:42 Speaker 2: is today. But yeah, we were so we were talking

2:45 Speaker 2: off air because we tell everybody especially it always comes

2:47 Speaker 2: up when when someone says, you know, can I use

2:50 Speaker 2: the restroom, and it's like, yes, enjoy our enjoy our

2:53 Speaker 2: enormous bus station bathroom. But so we were talking about

2:59 Speaker 2: that off air, this used to be a bus station

3:01 Speaker 2: and then I play that song and sure enough there's, uh,

3:03 Speaker 2: there's that bus station announcement.

3:04 Speaker 5: I really like that new song. Yeah, yeah, absolutely nice.

3:07 Speaker 3: Yeah.

3:08 Speaker 2: Absolutely. So Again, if you're if you're looking for that online.

3:10 Speaker 2: The song is called twenty three, the band is Tuesday

3:12 Speaker 2: Night Whites, and just to be very clear for everyone,

3:15 Speaker 2: it's it's named after a football team.

3:16 Speaker 3: There's no racial component to that.

3:18 Speaker 1: I don't want, uh, I don't want well being what

3:20 Speaker 1: we call soccer.

3:21 Speaker 3: I don't want anyone to think, what what is that like? Uh?

3:23 Speaker 3: Are they you know, bad people or something?

3:27 Speaker 1: No talking to you about sports and this is not

3:30 Speaker 1: a good thing.

3:30 Speaker 3: Right right.

3:31 Speaker 2: I'm not a I'm not a fan of the of

3:34 Speaker 2: the sports ball as we say, so.

3:39 Speaker 3: Doctor no, uh tell us about uh.

3:42 Speaker 2: For those who don't know, who haven't heard your previous interviews,

3:44 Speaker 2: you've been on with us two or three times before.

3:47 Speaker 3: I think at the old at the old studio, I.

3:49 Speaker 4: Think we've been on, yeah, about two or three times

3:53 Speaker 4: span of last what was it maybe four years?

3:55 Speaker 5: Oh yeah, four or five years now. Yes, he's on

3:58 Speaker 5: his way to the five timers.

4:00 Speaker 4: Yeah. I feel like I'm an aged entity here, you know.

4:05 Speaker 4: But every time it's it's you know, it's it's been

4:07 Speaker 4: an honor to come on because I you know, there's

4:08 Speaker 4: a lot of changes that have occurred, and it feels

4:12 Speaker 4: like it's a it's a fresh start, and especially with

4:14 Speaker 4: this new station too. It's just it's very, very very refreshing.

4:18 Speaker 3: Yes, yes, thank you. Yeah, well of course we met

4:21 Speaker 3: you because.

4:21 Speaker 5: Of Jenny, right, and I'm excited to have you on

4:24 Speaker 5: and share something that's important in my life. I am

4:27 Speaker 5: a pain patient, as you guys know, and you hear

4:29 Speaker 5: the stories all the time. I have CRPS, complex visional

4:32 Speaker 5: pain syndrome, and small fibron aeropathy.

4:35 Speaker 1: And thanks to doctor No, I.

4:37 Speaker 5: Have quality of life because the hardest thing about having CRPS,

4:42 Speaker 5: because it is the most painful disease known to modern medicine,

4:45 Speaker 5: is that it's very difficult to control that pain and

4:49 Speaker 5: have a quality of life. And doctor No from the

4:52 Speaker 5: Pain Specialty group is who makes my life quality wise

4:56 Speaker 5: because of the treatments that I get, which is a

4:58 Speaker 5: combination of different treatments you do. In my case, I

5:01 Speaker 5: have oblasions or different injections or say you sometime a

5:05 Speaker 5: different medication to keep things in check. And I want

5:09 Speaker 5: to share that with people because so many people out

5:12 Speaker 5: there are suffering and pain and you don't have to suffer.

5:15 Speaker 5: That's the biggest thing. You don't have to be the

5:17 Speaker 5: one suffering about it. So just just because I want

5:23 Speaker 5: to be as open as possible. A doctor no is

5:25 Speaker 5: my doctor, and I am happy to be here with

5:28 Speaker 5: him and openly talk about pain care because I do

5:31 Speaker 5: want people to know that there are solutions.

5:33 Speaker 1: You don't have to suffer and you can have a

5:36 Speaker 1: quality life.

5:36 Speaker 4: Yeah, and Jenny, I just want to say, you know,

5:39 Speaker 4: it's an honor to help you, you know, do the

5:42 Speaker 4: things you want to do in life. And I'm touched

5:46 Speaker 4: to hear all of this, and I will also, I

5:49 Speaker 4: know we're on air, but I will also protect your

5:50 Speaker 4: privacy and whatever you know, let you disclose. But if

5:54 Speaker 4: you want me to comment on something, I mean, just

5:56 Speaker 4: let me know. I'm happy to but again, you know,

5:58 Speaker 4: also protect your privacy. But I'm touch to hear all

6:00 Speaker 4: this and it makes me makes me happy to know

6:04 Speaker 4: that I've at least been able to help you, you know,

6:07 Speaker 4: get along your path in life and do the things

6:10 Speaker 4: that you want to do in the way you want

6:12 Speaker 4: to do it. And that means a lot to me.

6:14 Speaker 1: Thank you, Thank you.

6:15 Speaker 2: Well, I can I can tell you, you know, as someone's

6:17 Speaker 2: who's uh you know, had a front row seat for

6:19 Speaker 2: this journey that Jenny's been on. I mean, you've You've

6:22 Speaker 2: made an enormous difference in her life. I mean this,

6:25 Speaker 2: you know, no denying it, huge, huge difference.

6:27 Speaker 5: I'm a lot bedbound for over two years, and even

6:31 Speaker 5: when I started getting treatments, I was still using wheelchair

6:34 Speaker 5: and having a hard time. And at one point I

6:37 Speaker 5: started to get better and I was with a practice

6:39 Speaker 5: that all of a sudden closed their doors, no warning,

6:41 Speaker 5: no notice, just closed its doors. And I was in

6:45 Speaker 5: a pretty bad situation at the time and doctor No

6:48 Speaker 5: actually was coming into a practice here in New Campshire

6:51 Speaker 5: at the time and I was lucky enough to meet

6:54 Speaker 5: this practice because I was literally left with I don't

6:57 Speaker 5: know what to do. I have no provider, and you

7:00 Speaker 5: did come in and you ended up taking over my care.

7:02 Speaker 1: And it's been.

7:03 Speaker 5: Well over three years, probably four. I'm not even sure

7:07 Speaker 5: how many years I've been a patient of yours.

7:08 Speaker 4: Now, Yeah, it's been a while. Uh. I do want

7:11 Speaker 4: to say that, you know, Jenny again, I'm very happy

7:14 Speaker 4: and grateful and touch that you know we were able

7:16 Speaker 4: to help you, because we do hear the story a

7:18 Speaker 4: lot with you know, the shifting of providers, shifting of

7:22 Speaker 4: practices that that patients are left in kind of a

7:27 Speaker 4: no person's land. I don't want to say no man's land,

7:29 Speaker 4: but no person's land, and and and it's unfortunate and

7:33 Speaker 4: it's a very hard place to be. So again, very

7:36 Speaker 4: very touched, very honored to be able to help you

7:38 Speaker 4: along the way. And look at you now, you're you're

7:41 Speaker 4: you're doing great things for not just the New Hampshire, Manchester,

7:44 Speaker 4: the people of the Northeast, but you know, even the nation.

7:47 Speaker 4: So you know, very impressed.

7:50 Speaker 1: Yeah, and it is a huge part of that.

7:52 Speaker 5: And that's one of that's why I want to share

7:54 Speaker 5: this aspect is there is so much stuffering out there

7:57 Speaker 5: that doesn't have to happen.

7:58 Speaker 1: So, like.

8:00 Speaker 5: You offer a lot of different treatments for a lot

8:02 Speaker 5: of different things. And I have significant lower back pain.

8:05 Speaker 5: I have like three deaths that are bulging and they

8:08 Speaker 5: have to be controlled or I'm in awful pain. So

8:11 Speaker 5: some of the things that you do aren't about medication

8:15 Speaker 5: as much as a treatment. One of the things you

8:17 Speaker 5: do for me is called an ablation, and that has

8:20 Speaker 5: a great effect. And I know that you do other

8:22 Speaker 5: things types of injections and stuff, but you know, just

8:25 Speaker 5: talking about like the lower back issue, what are the

8:28 Speaker 5: kind of things that you do for.

8:30 Speaker 1: Other people to help with their their back issues, because

8:32 Speaker 1: we're not all the same.

8:33 Speaker 4: Yeah, so it's a great question. Let me let me

8:35 Speaker 4: just kind of reorganize and kind of preface the thinking

8:39 Speaker 4: of how we approach pain management. But at both of

8:44 Speaker 4: our our locations, know, in new Market, which is the

8:47 Speaker 4: newer one, and also in Newington, our philosophy has always been, look,

8:54 Speaker 4: you're you're we're all going through life. You know, we

8:57 Speaker 4: all go through life as a as a as a child,

9:00 Speaker 4: a youth, a young adult, you know, a midlife adult,

9:04 Speaker 4: an older adult, and as an elderly person. And during

9:07 Speaker 4: that journey our body changes, not just you know our

9:11 Speaker 4: life situation, you know, our economics, our social engagements, but

9:18 Speaker 4: our body changes and with those changes come how we

9:22 Speaker 4: experience those changes. And pain is a very very prevalent

9:29 Speaker 4: aspect of those changes. So what we do in our

9:33 Speaker 4: philosophy is that we can't really care or change those

9:39 Speaker 4: changes or reverse those changes. What we can do is

9:42 Speaker 4: help you adapt, deal with, accommodate with how we perceive

9:50 Speaker 4: or experience those changes. And if you take that perspective

9:54 Speaker 4: of pain management, that's where we come in. And and

9:58 Speaker 4: and Jenny, you mentioned about. You know, so how do

10:00 Speaker 4: we deal with What tools do we have to deal

10:02 Speaker 4: with pain?

10:03 Speaker 2: Right?

10:05 Speaker 4: I can count them off of probably both hands and toes,

10:08 Speaker 4: but I'm gonna try to generalize it into two boxes.

10:13 Speaker 4: We have conservative therapies, right, which include you know, you know,

10:18 Speaker 4: activities like physical therapy, pool therapy, chiropractic care, uh, you know,

10:27 Speaker 4: you know, psychosocial therapy, cognitive behavioral therapy. We have medication therapy,

10:33 Speaker 4: lots of different classes of medications. Yeah, you know, we

10:36 Speaker 4: always hear about one certain class of medication which has

10:38 Speaker 4: always been the easiest to go to, but it's also

10:41 Speaker 4: caused a lot of headaches personally for not for me,

10:45 Speaker 4: for for individuals, socially, economically, and even legally. And that's

10:50 Speaker 4: what I'm talking about opiates and controlled substances. We have

10:53 Speaker 4: lots of different other classes that help mitigate pain, and

10:58 Speaker 4: and those kind of leak into other are disciplines of medicine,

11:01 Speaker 4: and that's why pain management is so broad. We have

11:06 Speaker 4: interventional therapies like you mentioned. Some of those therapies, as

11:11 Speaker 4: you mentioned, include radio frequency elations, you know, steroid injection,

11:15 Speaker 4: nerve injections. When people hear the term injection or oblasion.

11:19 Speaker 4: They think it's just one area, one type of treatment,

11:22 Speaker 4: but there's so many different caveats and ways to how.

11:28 Speaker 1: Do you say it.

11:31 Speaker 4: Approach those classifications. For example, when they say I get

11:36 Speaker 4: a steroid injection or cortisone injection, we hear that a lot.

11:40 Speaker 4: One is there's different classifications of steroids. Two is there's

11:42 Speaker 4: different areas that we inject. Three is there's different reasons

11:47 Speaker 4: to why we approach an injection, and there's different potential outcomes.

11:54 Speaker 4: Some of those are therapeutic, which what you experience. Some

11:56 Speaker 4: of those are diagnostic, which tell us, okay, this work,

12:00 Speaker 4: but it's not gonna last, but we could do something

12:01 Speaker 4: else that lasts longer. And some of those are therapeutic

12:04 Speaker 4: and diagnostic. And there are even some injections that some

12:07 Speaker 4: of those may be potentially longer lasting, are terminally therapeutic,

12:16 Speaker 4: such as you know injectables that cause nerve destruction. Some

12:20 Speaker 4: of those injections are are lubricating. So there's lots of

12:23 Speaker 4: different types. Yeah, and then the next classification, of course,

12:27 Speaker 4: is advance interventions, where we do a lot of minimally

12:31 Speaker 4: invasive implantables or removal of tissue under X ray or

12:38 Speaker 4: fluoroscopy and imaging. Those again, you know, tend to be

12:43 Speaker 4: the cutting edge of pain management. Those those tend to

12:46 Speaker 4: be those that are a little more innovative, spend the

12:50 Speaker 4: time to get trained and learned, trained by multiple disciplines,

12:54 Speaker 4: not just pain management physicians. But you know, we end

12:56 Speaker 4: up having spine surgery involved, orthopedics involved, neurology involved, psychiatry involved,

13:02 Speaker 4: there's indiventional psychiatry. So a lot of the little you know,

13:07 Speaker 4: interventional advanced therapy, some of those where we put in

13:11 Speaker 4: plants and some of those where we don't. And then

13:14 Speaker 4: and then of course to the classical sense, now we

13:16 Speaker 4: go to open cavity, open spine, open area surgery and

13:21 Speaker 4: those can treat. So pay management is actually very wide.

13:25 Speaker 4: The whole concept is, again, how do we help you

13:29 Speaker 4: along your journey given that you've you've hit this this bump,

13:33 Speaker 4: this road bump along the road, or this pothole, and

13:36 Speaker 4: how do we get you to go above that and

13:38 Speaker 4: go beyond that? And that's and that's where our job is. Okay,

13:41 Speaker 4: So I hope that kind of helps, oh, per.

13:44 Speaker 1: And it's fine.

13:44 Speaker 5: And that's what's what's a thing about pay management is

13:47 Speaker 5: it's individualized. No, the medication that works for me might

13:51 Speaker 5: not work for somebody else. But we found a combination

13:54 Speaker 5: of medications and treatments that have worked for me.

13:57 Speaker 1: And it's all and sometimes it's trial and error. Sometimes

13:59 Speaker 1: you try one thing and see if that works.

14:02 Speaker 5: You know, there are medications I did well on medications

14:04 Speaker 5: I haven't done right. And as life changes and time changes,

14:08 Speaker 5: maybe something needs an adjustment or a tweak. And you know,

14:13 Speaker 5: as long as the end result is to have a

14:15 Speaker 5: quality life that's worth living. To be able to participate

14:18 Speaker 5: with things with family members or friends, to be able

14:21 Speaker 5: to enjoy an outing, you know, and not have to

14:24 Speaker 5: sit there and be like, oh, I can't go to that.

14:26 Speaker 5: I'll be intowitch agony, I won't be able to sit there.

14:29 Speaker 5: But to be able to go, yeah, I can go

14:31 Speaker 5: to that. I can go to that show for a

14:32 Speaker 5: few hours, you know. And and that is what makes

14:36 Speaker 5: life work living right is to have those experiences with

14:39 Speaker 5: one another.

14:41 Speaker 4: Absolutely, I mean, just me showing up this morning and

14:44 Speaker 4: have this experience with you and Matt has been phenomenal. Already,

14:47 Speaker 4: Oh thank you, Well, we're glad you're here. Usually around

14:49 Speaker 4: this time already spending it taking the kids and driving

14:52 Speaker 4: them on shopping you off to So I got my

14:55 Speaker 4: alibi this morning.

14:56 Speaker 1: You got a alibi.

14:58 Speaker 3: Yeah, no, so.

14:59 Speaker 4: Thank you, But no, I just wanted to add to

15:01 Speaker 4: your comment about individualization of care ideally, right, ideally, and

15:08 Speaker 4: and if you think about it in terms of efficiency, Ideally,

15:15 Speaker 4: if pain management was a one one type of treatment

15:19 Speaker 4: for all, like a Nike shoe factory, just keep on

15:22 Speaker 4: stamping out all those Nike airs one by one by one.

15:24 Speaker 4: We could do ten an hour, we do twenty an hour,

15:26 Speaker 4: you do five one hundred an hour because factory capacity, right,

15:31 Speaker 4: I would be at a different place. I would be

15:32 Speaker 4: sitting in a very tall, high rise building, you know,

15:37 Speaker 4: in Manhattan somewhere, or downtown Manchester somewhere. But no, it's

15:42 Speaker 4: very individualized because what works for for Matt, what works

15:48 Speaker 4: for Mike, what works for Steve, may not work for

15:51 Speaker 4: Gen and what works for Gen, you know, and it's

15:55 Speaker 4: and it's unfortunate that we have to try on different

15:58 Speaker 4: shoes and we have to you know, the shoe pairs

16:00 Speaker 4: with this pair of sock or this pair of cushion,

16:04 Speaker 4: and and oh the only worked for for you know,

16:07 Speaker 4: three months and now the shoes aren't good anymore, and

16:10 Speaker 4: we have to change up the shoe because because the

16:13 Speaker 4: padding has shifted because you have a bone spur now

16:16 Speaker 4: and your foot, you know. So so yeah, it's very individualized.

16:20 Speaker 4: And that's the unfortunate part is that, you know, we're

16:22 Speaker 4: all we're all such individualized entities that we have to

16:27 Speaker 4: kind of tweak things. And your body's constantly changing, so

16:29 Speaker 4: we always have to change change how we algorithmically or

16:33 Speaker 4: think about and approach how can we make you a

16:35 Speaker 4: little more comfortable so you can do things you want

16:37 Speaker 4: to do.

16:37 Speaker 2: I would imagine that's that's the biggest challenge with new patients,

16:41 Speaker 2: right It's just figuring out what the best solution is

16:44 Speaker 2: for them, And then.

16:45 Speaker 3: There's probably a lot of well, we're going to try this.

16:47 Speaker 2: And then if this doesn't work, well then we're going

16:49 Speaker 2: to try this, and you know, and then you know,

16:52 Speaker 2: hopefully they can hang in there, you know, and and

16:55 Speaker 2: and you know they have to trust you that you

16:57 Speaker 2: know you're on this journey with them and that you're

16:59 Speaker 2: going to help them find the solution.

17:00 Speaker 4: But yeah, so so I'm glad you brought that up

17:03 Speaker 4: because because now now you're trying to get into the

17:05 Speaker 4: mind of like how I'm thinking during the day.

17:07 Speaker 1: Yeah, and and.

17:08 Speaker 4: This is gonna be good. So that gives some insight

17:10 Speaker 4: to patients. So every patient comes with a unique situation.

17:13 Speaker 4: And when you when when you when a provider walks

17:16 Speaker 4: into an encounter with the patient, not only have we

17:20 Speaker 4: relied on the experience and knowledge of what we know

17:22 Speaker 4: about the patient, we also rely on the additional information

17:26 Speaker 4: that we've gathered during the interim between the visits. And

17:31 Speaker 4: you know, we we go on what the patient's communicating

17:34 Speaker 4: to us based on prior visits versus this visit. And

17:39 Speaker 4: so we're calculating all these things and thinking all these

17:42 Speaker 4: things and trying to go down algorithmically and even just

17:45 Speaker 4: non algorithmy or but creatively, what's the status of that

17:50 Speaker 4: patient and how can we tweak it to make it

17:52 Speaker 4: a little better. So so you can imagine that with

17:56 Speaker 4: this new healthcare environment where where it's difficult to survive

18:03 Speaker 4: as a healthcare provider if you don't you know, become efficient.

18:07 Speaker 4: So you know, like time slots are probably fifteen twenty

18:10 Speaker 4: minute time slots, thirty minute time slots. So we're sitting

18:13 Speaker 4: there thinking of how do we accommodate these patients based

18:16 Speaker 4: on the information that we have, and how do we

18:19 Speaker 4: tweak it and make it better for them, and then

18:22 Speaker 4: you know, follow up afterwards. So you can see that

18:25 Speaker 4: everyone's very individualized. There's a lot of different factors that

18:29 Speaker 4: you have to think about, including side effects, right, and risks,

18:33 Speaker 4: and how do we follow that up and to make

18:36 Speaker 4: sure that you know decision making is appropriate and effective.

18:39 Speaker 3: Yeah, yeah, that makes sense.

18:41 Speaker 4: Yeah, so yeah, but I think I think what we've

18:45 Speaker 4: figured out as a team in our practice is that

18:50 Speaker 4: you know, there's certain certain approaches that we have to

18:54 Speaker 4: help mitigate pain for patients, and a lot of those

18:58 Speaker 4: is let's figure out what's causing you the pain. And

19:03 Speaker 4: for a lot of patients, when you come in in

19:04 Speaker 4: your experience O pain, you're like, I'm just in so

19:06 Speaker 4: much pain. It's everywhere. I don't know where it is,

19:08 Speaker 4: but it's also here and here, you know, algorithm Lee

19:13 Speaker 4: or in our thinking, it's it's like, okay, so where

19:16 Speaker 4: are those areas that we can identify and how can

19:19 Speaker 4: we approach each of those areas in a safe and

19:23 Speaker 4: appropriate manner that would minimize the risks and side effects

19:28 Speaker 4: but maximize the benefits.

19:31 Speaker 1: Yeah, so that's a huge thing too.

19:34 Speaker 5: I mean, years ago, before I was the patient of yours,

19:37 Speaker 5: I had a different pain care situation where I was

19:40 Speaker 5: getting injections and it was scary, but it was also

19:43 Speaker 5: super painful. Matt would be in the waiting room listening

19:46 Speaker 5: to me scream like and I've talked about that on

19:49 Speaker 5: air many times. We've talked about, you know, the experience

19:53 Speaker 5: and having somebody going, oh, no, nobody heard you. And

19:55 Speaker 5: then I go out there and Matt's like, oh, okay,

19:57 Speaker 5: I can hear you screaming. And that's not what pain

19:59 Speaker 5: care is be. And that's one of the things that

20:03 Speaker 5: I very much love about you and your office and

20:06 Speaker 5: your practice and the way that you do things is

20:08 Speaker 5: that I have never ever, ever suffered through a treatment.

20:11 Speaker 5: You always make sure that the patient is comfortable, that

20:16 Speaker 5: I'm comfortable. You use numbing agents. You don't go just okay,

20:21 Speaker 5: sucking up, but a coffee we go and in checked away,

20:24 Speaker 5: which is what I had previously experienced. And I know

20:27 Speaker 5: that we were kind of talking about it before the show,

20:30 Speaker 5: but you were talking about how your approach is uniquely

20:35 Speaker 5: different when it comes to doing those kinds of injections,

20:38 Speaker 5: and I'd really like people to know about that, because

20:41 Speaker 5: I know it sounds scary, but it's actually been one

20:44 Speaker 5: of the best things that I get done is to

20:47 Speaker 5: have them done, and I'm never afraid because of the

20:49 Speaker 5: way you do it.

20:50 Speaker 1: So I wonder if you could talk about that a bit.

20:52 Speaker 4: Sure, thank you, Jenny. But before I kind of expand

20:56 Speaker 4: on this, I just want to say that it's not

20:59 Speaker 4: just me, it's the entire team. And let me explain

21:03 Speaker 4: that the entire team here at Paints Best Regroup. We

21:07 Speaker 4: we've adopted this philosophy and so I have to give

21:09 Speaker 4: credit to my staff. We want the patient to experience

21:16 Speaker 4: a pleasant journey right when they step into our centers,

21:21 Speaker 4: and that includes, you know, coming into a calming environment.

21:24 Speaker 4: And that's why we have music and we try to

21:26 Speaker 4: have you know, light, pleasant engaging music. You know, we

21:31 Speaker 4: try to make it a kind of a soothing visual experience,

21:35 Speaker 4: even with you know, dimmer lights, but you know, not

21:38 Speaker 4: not too dim that you fall trip and fall. You know,

21:41 Speaker 4: you know, we want to make sure you feel safe.

21:43 Speaker 4: It's clean. Staff is you know, impeccably friendly and caring.

21:49 Speaker 4: I get a lot of those comments and I'm grateful

21:52 Speaker 4: because the staff is really really adopted this this approach

21:55 Speaker 4: to making patients feel welcome and safe when they come in.

21:58 Speaker 4: So again, it starts not just with the injections, but

22:02 Speaker 4: it's it's a whole thoughtful process of what the patient

22:06 Speaker 4: is going to experience as they come through the door,

22:08 Speaker 4: from the beginning throughout. And that's why we have a

22:11 Speaker 4: little piano there.

22:12 Speaker 3: Right.

22:13 Speaker 4: Some patients come in and they they they tinker around

22:15 Speaker 4: the baby grand piano.

22:16 Speaker 3: Yeah, I was curious about that. If anyone ever actually

22:18 Speaker 3: plays it.

22:19 Speaker 4: Oh, it's amazing. We have concert pianists that come in

22:22 Speaker 4: and just start jamming. We have people that play at

22:25 Speaker 4: restaurants that come in and jam. Oh it's people have

22:29 Speaker 4: their own recordings, and we have some of those artists

22:31 Speaker 4: that that come in with their own recordings and they

22:34 Speaker 4: and they jam. Every want to meet with them for

22:36 Speaker 4: your show.

22:36 Speaker 5: We're happy to make the musicians any day.

22:39 Speaker 4: But it's amazing and and and they come in and

22:41 Speaker 4: they make it a pleasant environment for the patients. You know.

22:45 Speaker 4: I I try to come out sometimes and play, but

22:47 Speaker 4: my piano skills are very limited now that I'm aged,

22:50 Speaker 4: and I haven't played a lot through years. But you know,

22:53 Speaker 4: I I tinker, but my kids play a lot better.

22:55 Speaker 1: Than I do. I was gonna say to your kids.

22:57 Speaker 4: Play, Yeah, they do. But it's for the patients, right,

23:00 Speaker 4: So we put that out there for the patients. We

23:03 Speaker 4: uh talk about instruments. We also have a pain gong,

23:05 Speaker 4: by the way, I just wanted to make Oh yes.

23:08 Speaker 2: Yes, does that Does that get used much? I've never

23:11 Speaker 2: witnessed the gong.

23:12 Speaker 4: It does, actually, So I think we're the only pain

23:17 Speaker 4: practice in the nation that has a pain gong. And

23:20 Speaker 4: we actually have a sign right by the exit that says,

23:23 Speaker 4: please share if your pain is gong. And I did

23:27 Speaker 4: that on purpose because I always tell patients like I

23:29 Speaker 4: can kind of get away.

23:30 Speaker 5: With that, yeah, because yeah, yeah, I think I know

23:33 Speaker 5: it is, and I think you are.

23:35 Speaker 1: I've seen bells. Everybody has a bell, but nobody has

23:38 Speaker 1: a gong.

23:38 Speaker 3: Yeah.

23:39 Speaker 4: Well, I'll tell you the origin of that, by the way,

23:41 Speaker 4: but let me explain the gong first. I'll tell the

23:42 Speaker 4: origin of that, Okay. So the gong is basically for

23:45 Speaker 4: patients to celebrate if they've had a really good experience,

23:49 Speaker 4: and they want everyone who's inside the center to know

23:52 Speaker 4: they can whack the gong and if they whack the gong, yes, yeah,

23:57 Speaker 4: and what happened.

23:58 Speaker 1: You came around the corner, poked your head out.

24:00 Speaker 5: It was the door of all all of a sudden,

24:02 Speaker 5: there's tart to know going, hey, look at that.

24:04 Speaker 4: Yes, And so we've trained the staff to celebrate and

24:09 Speaker 4: clap and cheer patients when we hear the gong, and

24:11 Speaker 4: it's because it's a celebration for the patient to to

24:14 Speaker 4: to know that that you know, they've been happy with

24:18 Speaker 4: the care, they've received some type of relief. It's possibly

24:20 Speaker 4: helped them on their journey to change their life and

24:23 Speaker 4: doing the things they want to do again. And that's

24:25 Speaker 4: and that's why we have it there. Yeah, yeah, fun yeah.

24:29 Speaker 4: So so again some of the different things the staff,

24:32 Speaker 4: it's the team approach on making the experience for patients

24:36 Speaker 4: a little more comfortable as you're going through this journey

24:39 Speaker 4: of trying to mitigate your experiences of pain so that

24:42 Speaker 4: you can do the things you want to do. Now,

24:44 Speaker 4: going back to your question, what different things we do

24:46 Speaker 4: to help patients kind of go through the journey of

24:49 Speaker 4: like these experiences of injections or procedures. One is in

24:55 Speaker 4: this whole day and age just so much paperwork, and

24:57 Speaker 4: we've tried to streamline it as much as possible and

24:59 Speaker 4: and it's it's been hard, but we've we've you know,

25:01 Speaker 4: we've all these regulatory requirements that we have to go through,

25:05 Speaker 4: so we we we help we have the staff help

25:07 Speaker 4: streamline that. So that's been another thing that we've done.

25:11 Speaker 4: We uh, you know, just even the thinking of getting

25:14 Speaker 4: an injection. You know, patients come in anxious, they don't

25:17 Speaker 4: want to feel the poke, and that's where a lot

25:20 Speaker 4: of the thinking of physiology and chemistry and pharmacology becomes involved.

25:28 Speaker 4: And that's why you know, we we we we advise

25:30 Speaker 4: patients to get certain types of medications beforehand to help

25:34 Speaker 4: mitigate some of your experience with pain. And that's including

25:37 Speaker 4: you know, the the anziolytic, the the you know, like

25:41 Speaker 4: the tile and all to help with you know, mitigating

25:44 Speaker 4: you know, your experience with that first poke. It's also

25:49 Speaker 4: with uh creams. You know, we call in creams to

25:53 Speaker 4: help you mitigate that sensation.

25:55 Speaker 5: Because we want to make it so comfortable for you

25:58 Speaker 5: as much as we can.

25:59 Speaker 1: With that's so unique.

26:01 Speaker 4: Yeah, yeah, and then you know, we we we have

26:04 Speaker 4: you know, and then once you're in the room, we

26:06 Speaker 4: have conversations, right, we have lots of you know, funny conversations.

26:10 Speaker 4: We play music the staff in there, Aiden and uh uh,

26:16 Speaker 4: Julia back there, you know, Bobby back there. You know,

26:19 Speaker 4: they tend to pick the music unless it's a special

26:21 Speaker 4: requests by the patient. And sometimes patient special requests are

26:24 Speaker 4: are phenomenal.

26:26 Speaker 1: Right.

26:26 Speaker 4: We've had, you know, hard rock, We've had gospel music.

26:31 Speaker 4: You know, a couple of the patients of request gospel

26:33 Speaker 4: and sometimes yeah, you can request your music. I mean

26:38 Speaker 4: we try to make it as comfortable as possible. Some

26:40 Speaker 4: patients want it blasting. We do that, and and we

26:43 Speaker 4: crack jokes, you know, we try to make you forget.

26:45 Speaker 4: And as you're giggling, you know, the needle gets poked

26:47 Speaker 4: in and then you know, I use a little diff

26:50 Speaker 4: a you know, I even modify the needle technique where

26:53 Speaker 4: I call the slows the slow squeeze technique. Where again

26:57 Speaker 4: it's it's all physiological, it's neurological. You do it in

27:00 Speaker 4: a way where you know, it's it's quick introduction, slow slow.

27:08 Speaker 4: How do you say it, uh, slow medication introduction. But

27:12 Speaker 4: what it does is it numbs and nerves. So as

27:14 Speaker 4: as the needles getting withdrawn. It's not ass as impactful.

27:19 Speaker 4: And then and then we go in and you know,

27:21 Speaker 4: we use you know, we try to use much more

27:24 Speaker 4: comfortable needling so that patients aren't aren't as impacted. And

27:29 Speaker 4: it's not perfect, but it works on the most part.

27:31 Speaker 1: I can attest to that.

27:33 Speaker 5: I can attest to that for Sartin, and there's a

27:35 Speaker 5: lot of other different I mean, it's it's cool because

27:38 Speaker 5: in pain care it's it's not just okay, here's a

27:41 Speaker 5: we're gonna plug you in here. It's that combination of

27:43 Speaker 5: finding out, you know, whether maybe we're doing this treatment

27:46 Speaker 5: along with this medication or this type of therapy.

27:50 Speaker 1: Like I do pool. I I am in the pool

27:53 Speaker 1: every week.

27:55 Speaker 4: And and I commend you on that because it's funny.

28:00 Speaker 4: But one of the basic elements that we have in

28:03 Speaker 4: this world is water, and water is such a great

28:07 Speaker 4: thing for muscle tone and stress on joints, yep. And

28:11 Speaker 4: for you to engage in pool to at least do

28:14 Speaker 4: the movements that would be hard to do on land,

28:16 Speaker 4: but you can.

28:17 Speaker 5: I can't do what I can do in the pool.

28:18 Speaker 5: I can do jumping jacks in the pool. I do

28:21 Speaker 5: an arthritis class at the why at the local why

28:24 Speaker 5: everybody you know? You got Why's around this classes everywhere

28:27 Speaker 5: and it's great. I get in the water, I'm in

28:30 Speaker 5: there for about fifty minutes. I'm moving every one of

28:32 Speaker 5: my joints. And yeah, it's it's not just about medication.

28:37 Speaker 5: It's a combination of things. You have to Like, I

28:39 Speaker 5: watch my diet. I try to stick to an anti

28:41 Speaker 5: inflammatory diet because I don't want to cause more inflammation

28:45 Speaker 5: because my body just basically could glow in the dark

28:47 Speaker 5: if possible when it comes to inflammation.

28:50 Speaker 4: Jenny, you're such an ideal, ideal model patient. I mean,

28:53 Speaker 4: I don't know about that, no, but you really do

28:55 Speaker 4: embrace the multi modal, you know, approach that we have

28:59 Speaker 4: to encourage patients because there's only so much injections and

29:03 Speaker 4: medications can do, and a lot of it is just

29:06 Speaker 4: to help buy you time so you can engage your

29:08 Speaker 4: body to heal a certain way and adjust a certain

29:12 Speaker 4: way so that you can do the things you want

29:14 Speaker 4: to do. So I really really do commend you on

29:17 Speaker 4: that pool therapy stuff.

29:18 Speaker 1: It's huge.

29:19 Speaker 5: And that's the thing about taking care of yourself. It's

29:22 Speaker 5: you got to take care of yourself in totality. I

29:25 Speaker 5: have a therapist, I get in the pool every week,

29:28 Speaker 5: I watch my diet, I take my medications regularly. I

29:31 Speaker 5: take my treatments regularly most of the time. Sometimes I

29:34 Speaker 5: might try and stretch it out a little bit, and

29:36 Speaker 5: then I get a little vet.

29:37 Speaker 3: You can stretch it and.

29:39 Speaker 1: Then I come in sooner. But there's so much you

29:41 Speaker 1: can do.

29:42 Speaker 5: You don't have to the biggest thing I want people

29:44 Speaker 5: to take away I want you to hear today is

29:46 Speaker 5: you don't have to suffer.

29:49 Speaker 1: You don't have to.

29:50 Speaker 5: There are so many things I missed out on because

29:52 Speaker 5: I was suffering and I couldn't go. But I get

29:55 Speaker 5: regular treatment, and I get to go to the Mosaic

29:59 Speaker 5: Art Gallery.

30:00 Speaker 1: Which we picked up my paintings yesterday.

30:02 Speaker 5: I actually sold one for the first time out of

30:05 Speaker 5: the gallery, which was amazing.

30:07 Speaker 4: An artist, I remember that happens.

30:09 Speaker 5: Yesterday, right, So I would have never gotten to take place,

30:12 Speaker 5: take part in that, go to the opening, stand next

30:15 Speaker 5: to my painting on the wall, and fail pride because

30:17 Speaker 5: I wasn't too much pain right, So you can have

30:22 Speaker 5: It's worth it. It's worth it to get the treatment

30:24 Speaker 5: because you get so much in your life.

30:25 Speaker 4: Back and can I just add to what you're saying, Jenny,

30:28 Speaker 4: And again this also falls within our philosophy is that

30:31 Speaker 4: if we make we help you feel good from say

30:35 Speaker 4: whatever base level to higher level, intermediate level, that mental

30:42 Speaker 4: health aspect that you have from feeling just a little

30:45 Speaker 4: better to be able to go and embrace and do

30:48 Speaker 4: the things you want to do, such as going to

30:51 Speaker 4: the art galleries, you know, going and taking those walks.

30:57 Speaker 4: That is neurochemically gonna reinfor force your feeling of of

31:03 Speaker 4: of reward and feeling better, and that in itself will

31:09 Speaker 4: will basically take you on the path on recovery from pain.

31:12 Speaker 4: So it's not just physic physiological pain, but it's also

31:15 Speaker 4: psychological emotional pain kind of about that we try to

31:19 Speaker 4: help really achieve relief for.

31:22 Speaker 2: Yeah, I'm curious, doctor jo If over the course of

31:26 Speaker 2: your career, have you seen a lot of advancements in

31:28 Speaker 2: terms of techniques or technologies that you know that have

31:33 Speaker 2: that have really kind of helped to enhance what you do?

31:36 Speaker 1: Oh?

31:36 Speaker 4: Oh, phenomenally phenomenally. Uh. I can tell you one thing

31:42 Speaker 4: is that the field of medicine in itself has evolved

31:48 Speaker 4: so tremendously it tends to move a little slower because, like,

31:54 Speaker 4: if you look at the example of telephones, right, the iPhone,

31:58 Speaker 4: I mean, what was it maybe two decades ago? We

32:01 Speaker 4: had the flip phone, right, yeah, So wait what two

32:04 Speaker 4: decades ago? Was two thousands? Right? We had like flip

32:08 Speaker 4: phones back in the two thousands, and I mean I

32:10 Speaker 4: still remember that Motorola, that motoro flipt phone net that, yes,

32:17 Speaker 4: And then there's the BlackBerry with the little keyboard. So

32:22 Speaker 4: if you think of the evolution of the cell phone

32:25 Speaker 4: from you know, or telecommunications from pagers to flip phones

32:31 Speaker 4: to BlackBerry and now to these mini computers that live

32:35 Speaker 4: in your hand and you can talk to it and

32:37 Speaker 4: it talks back, tell it what to do, and it

32:41 Speaker 4: does it for you to throws the map up. Like,

32:43 Speaker 4: that's the evolution of medicine as well, because those technologies

32:46 Speaker 4: do migrate over to medicine. However, medicine tends to adopt

32:51 Speaker 4: it a little slower because providers tend to be a

32:54 Speaker 4: little more cautious because of you know, too aggressive a

32:59 Speaker 4: treatment or too aggressive advancements of adoption without studying the

33:07 Speaker 4: adverse effects of it as as closely could be detrimental

33:11 Speaker 4: for people. And that's why you know, the FDA has

33:13 Speaker 4: been very involved with those things. But in terms of

33:16 Speaker 4: pain management, it is extremely evolutionary, and it's evolutionary not

33:22 Speaker 4: just in medication management, not just in you know, the

33:27 Speaker 4: multidisciplinary approach and thinking about pain and suffering not just

33:33 Speaker 4: from you know, a mechanical but also you know, in emotional, psychological,

33:38 Speaker 4: but also in like techniques. So I say that because

33:43 Speaker 4: they have, for example, needles out there right that you

33:48 Speaker 4: put it into the patient for radio frequency evlations, you

33:50 Speaker 4: push a little lever and all of a sudden, boom,

33:52 Speaker 4: it comes out like a trident, so it covers the

33:55 Speaker 4: larger area. But the problem is those needles are extremely expensive.

33:58 Speaker 4: That it doesn't mean it makes it very difficult to

34:00 Speaker 4: cost cover the cost of treatment they have. You know,

34:07 Speaker 4: they have implants and procedures that the pain doctor does

34:10 Speaker 4: that comes very close to what the spine surgeons somewhat do,

34:14 Speaker 4: but not as good as spine sorts. I would never

34:16 Speaker 4: never detract from what the spine surgeons do because they

34:19 Speaker 4: do excellent work and it's so phenomenal to see the

34:23 Speaker 4: results of what they do. But there's been you know,

34:26 Speaker 4: techniques and devices developed where spine surgeons are are doing it,

34:31 Speaker 4: and they're teaching pain physicians to do an under X

34:33 Speaker 4: ray two and the costs are phenomenally less, really phenomenally less.

34:39 Speaker 4: But you know, what are the results. I don't know, right,

34:42 Speaker 4: They're still being studied. They're probably not as as effective

34:46 Speaker 4: as the current standard, and some maybe even more effective,

34:49 Speaker 4: but we just don't know fully yet. Yeah, I mean,

34:51 Speaker 4: preliminary studies have come out enough to get them approved,

34:55 Speaker 4: but long term studies are not fully there yet to

34:59 Speaker 4: clarify what the advantages and disadvantages are. But again, you know,

35:03 Speaker 4: in this American you know, westernized market environment that we

35:08 Speaker 4: have in America, sometimes those those therapies take precedent because

35:15 Speaker 4: they're cheaper to the insurers and the payers and and

35:17 Speaker 4: and there's you know, better margins to be made by

35:20 Speaker 4: the healthcare systems because of that, right.

35:22 Speaker 3: Right, That's always.

35:25 Speaker 1: One thing that people get a lot.

35:26 Speaker 5: And I was curious to ask you the question on

35:28 Speaker 5: air for every for other people as well, is what

35:31 Speaker 5: do you do to help people with like really bad

35:34 Speaker 5: headaches migrains?

35:37 Speaker 4: Great question. So we we deal with a lot of migraines,

35:42 Speaker 4: and we you know, we deal with a lot of headaches.

35:45 Speaker 4: We have a lot of approaches that you know, are

35:50 Speaker 4: specifically pain management related, and a lot of approaches that

35:53 Speaker 4: you know, we've worked with, uh that are fall within neurology,

35:58 Speaker 4: but neurology also leaks over to pain management. And some

36:01 Speaker 4: of the challenges are some of those therapies we've we've

36:04 Speaker 4: adopted and employed because there's such a shortage of neurologists

36:07 Speaker 4: here in New Hampshire. There's a huge shortage of neurologists.

36:11 Speaker 4: I mean, we get comments all the time that, uh,

36:15 Speaker 4: you know, I can't see my neurologists for another six months.

36:18 Speaker 5: Oh, it took me over a year to get into

36:20 Speaker 5: my neurologist's office on a wait list.

36:23 Speaker 4: And it's insane. And we're like, well, you know, we

36:26 Speaker 4: try to accommodate you. We'll we'll figure it out. We'll

36:28 Speaker 4: we'll try to adopt some of those measures to help

36:32 Speaker 4: with pain management, with migrain and headache management. But again,

36:37 Speaker 4: you know, the the experts on those are the neurologists.

36:40 Speaker 4: But you know, we we've been able to accommodate some

36:43 Speaker 4: of those and some of those include, of course, you know, therapeutics,

36:45 Speaker 4: right like medications. There's been a pardon me, burgeoning class

36:51 Speaker 4: of therapeutics that are pretty effective on migrain management, but

36:56 Speaker 4: again they're more expensive and they're on patents, so there's

36:58 Speaker 4: they don't fall within the insurance algorithms as as readily accessible.

37:03 Speaker 4: And those tend to be the calcitonin gene receptor peptide

37:06 Speaker 4: antagonists to see g RP receptor antagonists, and those include

37:12 Speaker 4: some medications that you can take orally once a month,

37:16 Speaker 4: injections injectables. Those help. We also leak over to just

37:23 Speaker 4: in eventual pay manage itself, is that a lot of

37:25 Speaker 4: the headaches are not just migraines, but they could be

37:28 Speaker 4: related to the cervical spine, and we call those cervicogenic headaches.

37:35 Speaker 4: You know, where where the headaches are are from irritation

37:39 Speaker 4: of the nerves that cut off the cervical spine, that

37:42 Speaker 4: cause spasms of the muscles in the back of the

37:44 Speaker 4: neck upper lower part of the head and then you know,

37:47 Speaker 4: through collateral innervation end up being experienced as a headache.

37:52 Speaker 4: You know, we have occipital nerves, you know, greater and

37:54 Speaker 4: lesser eximpble nerves that tend to be irritated from you know,

37:58 Speaker 4: irritation of some type, whether it's spasm them or just

38:00 Speaker 4: fibers tissue irritation. So so there's a lot of ways

38:04 Speaker 4: that we can deal with headache that kind of overlap

38:09 Speaker 4: somewhat with some of the neurologists. Again, they're the experts,

38:11 Speaker 4: you know. I always love my neurology colleagues. Wish I

38:14 Speaker 4: was able to spend more time with them. Sometimes we

38:16 Speaker 4: do get a special guest that comes to our office

38:19 Speaker 4: to interact with us about neurology. Sometimes we we've touched

38:23 Speaker 4: base with some of the neurologists in in the UH

38:27 Speaker 4: Northeast area that we've got today. Yeah, but again they're

38:30 Speaker 4: they're they're far and few between because somehow there's such

38:36 Speaker 4: a shortage of them. And I know that there's been

38:40 Speaker 4: you know, some dynamics that have occurred with health systems

38:42 Speaker 4: that have uh made some shifts in neurology access as

38:46 Speaker 4: well in the in the New Hampshire area. So it's

38:50 Speaker 4: been interesting. But yes, yes, we have lots of little

38:52 Speaker 4: things we could do for migraines as well.

38:54 Speaker 3: Yeah, headaches, it's pretty common migraines.

38:56 Speaker 4: Migraines and heaches. So one thing I just want to

38:59 Speaker 4: say is that people but when they have a headache.

39:00 Speaker 4: They call it a migraine, but it's not always a migraine.

39:03 Speaker 4: There's there's a specific criteria for migraine. There's specific criteria

39:06 Speaker 4: for different types of headaches, like cluster headaches. Yeah.

39:09 Speaker 2: Oh, I know someone who's who's had to deal with

39:11 Speaker 2: cluster headaches, right, yeah, just.

39:13 Speaker 4: Yeah, they have a whole cervicrogenic headaches. So again, you know,

39:16 Speaker 4: we're there to discern between those things. It's not just

39:19 Speaker 4: you know, one label and it falls within that. We

39:23 Speaker 4: tend to try to tease apart. What's the real root

39:26 Speaker 4: cause of it?

39:26 Speaker 3: Yeah?

39:27 Speaker 2: Yeah, what's the most common back pain? I would assume, right,

39:30 Speaker 2: is the most common back pain.

39:31 Speaker 4: Neck pain, injury related pain is very common. Yeah, just

39:39 Speaker 4: a lot of arthritic pain. Degenerative joint pain is very

39:43 Speaker 4: very common. And and just remember that anytime anyone's in

39:49 Speaker 4: mechanical physiological pain, it evolves into the psychological pain.

39:54 Speaker 3: And we have.

39:55 Speaker 4: That that you know, combinatory source of pain, and it

40:01 Speaker 4: becomes very difficult to break. And so that's that's the

40:03 Speaker 4: art of pain management. How do we break one to

40:06 Speaker 4: help decrease the other, Then how do we break the other.

40:09 Speaker 5: One of the aspects of of pain that I call

40:12 Speaker 5: it is paying gry when I'm in so much pain

40:15 Speaker 5: that it's not it's not about anybody else. But everything

40:19 Speaker 5: is short fused, everything is tight. I'm hurting so much

40:22 Speaker 5: that I might come off like I'm really angry, but

40:25 Speaker 5: it's it's really painger. It's it's it's not it's not

40:29 Speaker 5: a normal sense of anger, if that makes sense. But yeah,

40:32 Speaker 5: that's that's kind of a term that we use.

40:34 Speaker 4: Is paining gree real term because it's not. We should

40:37 Speaker 4: quit it.

40:37 Speaker 5: It isn't It isn't our world. It isn't our world

40:40 Speaker 5: because I've seen it before, I've used it in some

40:42 Speaker 5: of my writings. I don't know where the original coin

40:46 Speaker 5: is come from.

40:47 Speaker 3: I know, I don't take credit for that market.

40:49 Speaker 4: Yeah, I don't know straight on the show.

40:52 Speaker 1: Yeah, it's a real phenomenon.

40:55 Speaker 5: And your your loved ones don't necessarily really oh they're

40:58 Speaker 5: in a bad mood.

40:59 Speaker 1: It's like, oh god, I'm not in a bad mood.

41:01 Speaker 1: I'm really suffering.

41:02 Speaker 5: Yeah you know, but yeah you don't. That's the thing.

41:05 Speaker 5: That's the real thing.

41:05 Speaker 4: And this is why I want to give a positive

41:08 Speaker 4: stroke and a very very you know, highlighted comment to

41:11 Speaker 4: my staff is that they are the front line of

41:16 Speaker 4: dealing with, you know, patients, and a lot of these

41:19 Speaker 4: patients call in and come in with angry syndrome. Yeah, yeah,

41:24 Speaker 4: very angry.

41:25 Speaker 5: Yeah, and it's not them and they're wonderful and they're

41:27 Speaker 5: sitting there taking it and you're like.

41:29 Speaker 1: But I need the appointment.

41:30 Speaker 4: Yes, yes, and so and so I just want to

41:32 Speaker 4: say that, yes, it's it's a very notable occurrence. I

41:36 Speaker 4: can only say that, you know, I'm very grateful for

41:38 Speaker 4: the staff to be able to to, you know, oh

41:42 Speaker 4: humbly and craftily handle those situations without without being too

41:47 Speaker 4: affected by it. But does affect all of us.

41:49 Speaker 1: Of course, Oh yeah.

41:50 Speaker 5: I mean you call up like I've called up and

41:52 Speaker 5: been crying like oh this went wrong and I'm really hurting,

41:56 Speaker 5: and they're just all right, we got you.

41:58 Speaker 1: Yeah, where are we going to let's get a you know.

42:01 Speaker 4: So, So one of my most common words that I

42:03 Speaker 4: use during the day is oo. So you know how

42:08 Speaker 4: you take a breath back and you catch yourself. So,

42:11 Speaker 4: so that's that's one thing I think that could help

42:14 Speaker 4: patients when they go through a paining gree episode or

42:17 Speaker 4: pain paying gry episode is take a step back and

42:20 Speaker 4: just kind of take a deep breath and let it out.

42:24 Speaker 5: You know, like like like you know, like, yes, yes,

42:30 Speaker 5: I do a lot of Yeah.

42:32 Speaker 3: I don't know if you I think you know this

42:33 Speaker 3: about me.

42:33 Speaker 2: I'm a hypnotherapist and I do a lot of what

42:36 Speaker 2: I'm bringing a client in a hypnosis. We do a

42:38 Speaker 2: lot of breathing, ironic given my recent asthma issue, but

42:43 Speaker 2: but we do a lot of you know, deep breathing,

42:45 Speaker 2: and I try to I do a little bit of

42:47 Speaker 2: pain management with that too.

42:49 Speaker 3: Sometimes sometimes with clients just to kind of help.

42:50 Speaker 2: Them, I try to get them to do a visualization

42:53 Speaker 2: where they imagine the pain not as a feeling or

42:55 Speaker 2: a sensation, but as an object that's in them that

42:57 Speaker 2: they can remove, that they can actually push out. And

43:01 Speaker 2: sometimes it's helpful for people. But but we do a

43:03 Speaker 2: lot of breathing stuff, you know. I get them to

43:06 Speaker 2: you know, breathe out any negative energy that they're carrying

43:08 Speaker 2: around and breathing positive energy and all that kind of thing.

43:11 Speaker 4: That's phenomenal. Matt, you should maybe become a hypno therapist

43:15 Speaker 4: for pain. We well, I do.

43:17 Speaker 1: I have to do it with somebody asked about it.

43:19 Speaker 3: Oh, yeah, yeah, really, yeah, I meant most of my clients.

43:22 Speaker 2: It's not something I get approached about much because most

43:24 Speaker 2: of my clients the number one thing is quitting smoking,

43:27 Speaker 2: of course, which is true for any epnotherapist. And I

43:30 Speaker 2: do a lot of you know, stress management and all

43:32 Speaker 2: that kind of thing, weight loss of phobias. So it's

43:35 Speaker 2: not actually very common that anyone that a client approaches

43:39 Speaker 2: me for for help with pain management.

43:41 Speaker 3: But I do it, and I actually have a certification

43:42 Speaker 3: in it.

43:43 Speaker 1: It's really And you also have hypno birthing.

43:46 Speaker 4: I do, yes, hypno birthing, yes, yeah, wow.

43:50 Speaker 1: You can use hypnosis in childbirth.

43:52 Speaker 4: Yep to not feel like the labor pains.

43:54 Speaker 3: Right to be able to.

44:00 Speaker 5: Maybe an Epidurals are amazing. Let me tell you I

44:04 Speaker 5: didn't get one when I gave birth to my son. Unfortunately,

44:07 Speaker 5: by the time I was smart enough to ask, they said.

44:09 Speaker 1: The window was closed.

44:12 Speaker 4: So, just so you know, my latter my prior life

44:15 Speaker 4: before I went into pain management was that I was

44:17 Speaker 4: an upstetric antithesiologist. Oh so, so I know the epidural

44:22 Speaker 4: very well, and I just want to make a comment

44:24 Speaker 4: that that it's always good if there's no major contraindications

44:30 Speaker 4: to get the epidural early, because that epidural not only

44:34 Speaker 4: helps you experience for women that are going through labor,

44:37 Speaker 4: that only helps you experience the birthing process in a

44:40 Speaker 4: much more pleasant manner, especially if it's working well. It's

44:44 Speaker 4: a very from a medical standpoint, it's it's probably one

44:47 Speaker 4: of the best life saving tools that the antiseesiologist and

44:51 Speaker 4: the medical team has to deal with any emergencies that

44:54 Speaker 4: may arise that are so fast paced when you're going

44:58 Speaker 4: through the process. So so I've always been an advocate

45:02 Speaker 4: get it early, Let's make sure it works. And if

45:06 Speaker 4: even if you don't want to receive the the the

45:08 Speaker 4: the relief from it, that's okay. We can shut it off.

45:11 Speaker 4: But as long as it's working and it's there and

45:13 Speaker 4: if something some badness occurs, it's it's one of our

45:18 Speaker 4: best If it's one of our best tools to get

45:22 Speaker 4: you through the whole process safely.

45:24 Speaker 3: Okay.

45:25 Speaker 1: Now you have two.

45:26 Speaker 5: Offices, so you can see people in two different locations. Now, yes,

45:30 Speaker 5: I want to make sure listeners know where you are.

45:32 Speaker 4: Yes, yes, So so we we have our main location

45:35 Speaker 4: in Newington, New Hampshire, and that was the well the

45:39 Speaker 4: original one was actually an Exeter and we started with

45:42 Speaker 4: doctor Sanchez, Manuel Sanchez, and and God bless his soul,

45:46 Speaker 4: he's such as I still love that man so much.

45:53 Speaker 1: He was so nice, he is such.

45:55 Speaker 4: He is such that Spanish European classy flair that that,

46:01 Speaker 4: and and and his teachings. I mean, I can only

46:04 Speaker 4: tell you his teachings still come with me today till today.

46:10 Speaker 4: He he he really really uh impressed on me how

46:15 Speaker 4: to really take care of patients here in New Hampshire.

46:18 Speaker 4: Just so you know, but our original office was actually

46:21 Speaker 4: an Exeter and then when I joined in shortly after

46:24 Speaker 4: we went to Newington and then recently just opened up

46:27 Speaker 4: a new office in new Market.

46:29 Speaker 3: Yeah, congratulations, well, thank you, thank you.

46:31 Speaker 4: It's been a little slow of opening. I'm not there

46:35 Speaker 4: often just because I'm pretty tied down in the Newington location,

46:40 Speaker 4: but my staff is there a lot and and we

46:42 Speaker 4: do a lot of uh we're starting to roll out,

46:45 Speaker 4: you know, a lot more clinical time there. The building

46:48 Speaker 4: is still under development, you know, the section for the

46:50 Speaker 4: paint for the clinic is is already ready to go.

46:54 Speaker 4: But it's beautiful. I mean, I'm sure you've been there

46:55 Speaker 4: right there yet should we should come here.

47:00 Speaker 1: Sometimes we go on to the new one now.

47:02 Speaker 4: Oh yeah, yeah, it's really nice. It's uh.

47:04 Speaker 1: I usually go into the r Yeah.

47:06 Speaker 5: So I'm always at the at the Newington office.

47:10 Speaker 4: Honestly, if my wife let me live up in the

47:13 Speaker 4: new market of them, I have like place where I

47:15 Speaker 4: live at home. Yeah, it's it's new, you know, it's new.

47:19 Speaker 4: It's fresh. You know, we we put new flooring in.

47:23 Speaker 4: It's just pretty. I just think it's really pretty.

47:25 Speaker 3: Yeah, oh very good.

47:26 Speaker 4: Yeah good.

47:27 Speaker 2: Yeah what uh now, did you have any other plans

47:31 Speaker 2: for expansion beyond that in the future.

47:34 Speaker 4: You know, it's a great question. I mean, you know,

47:37 Speaker 4: I'd love to be like Doctor Evil out of uh

47:40 Speaker 4: what's that movie? Uh it's a little world domination. But no,

47:45 Speaker 4: realistically it's slow and steady. Yeah we uh, you know,

47:51 Speaker 4: it's it's basically a staffing and and a patient you know,

47:56 Speaker 4: accommodation issue. It's just we go slow and steady. I

47:59 Speaker 4: think as long as you know, we're able to accommodate

48:03 Speaker 4: patients and we're able to figure out areas that that

48:08 Speaker 4: there is need right like you know, up here near

48:11 Speaker 4: the Manchester area, I think there's more need because I

48:13 Speaker 4: know there's been some shifting in the pain management atmosphere

48:17 Speaker 4: out here in New Hampshire. We would definitely think about

48:22 Speaker 4: expanding more. But again, it's just it's I'm very slow

48:24 Speaker 4: and steady. I've I've always been very conservative, and I know,

48:28 Speaker 4: you know, my administrative staff is always asked, why don't

48:31 Speaker 4: we do this? Why don't we do that? We get

48:32 Speaker 4: vendors all the time coming in and going hey, let's

48:35 Speaker 4: do this and do that. Yeah, and I'm just very

48:38 Speaker 4: slow and steady.

48:39 Speaker 3: I just yeah, I just I think that's probably wise.

48:43 Speaker 4: Well, it's it's only because we have something that works

48:47 Speaker 4: right now, and you know, we we have a lot

48:50 Speaker 4: of positive feedback from the community and from patients, and

48:53 Speaker 4: so to to to add another element into something that

48:57 Speaker 4: works has to take a lot of thought and h

49:01 Speaker 4: and consideration, because you know, we want to make sure

49:04 Speaker 4: that we're still doing the best that we can for

49:06 Speaker 4: people and for patients in the community without without changing

49:10 Speaker 4: it too much. That's why, again, the slow and steady

49:11 Speaker 4: approach has always been my my, my, my mindset.

49:15 Speaker 3: Yeah, no, I think that makes I think that makes sense. Doctor. No.

49:19 Speaker 3: This has been wonderful.

49:20 Speaker 2: We're already approaching the top of the hour that the time,

49:23 Speaker 2: the time goes so quickly.

49:25 Speaker 3: Anything we didn't mention that we should make sure that

49:27 Speaker 3: we Uh.

49:28 Speaker 4: I just want to say, you know, happy new Year

49:31 Speaker 4: to everyone, for both of you, to everyone out there

49:34 Speaker 4: in New Hampshire, to the uh, you know, the general public.

49:40 Speaker 4: I want to say that, uh, you know, we hope

49:46 Speaker 4: from Paint Specialty Group a fruitful and very successful year

49:50 Speaker 4: and we're here to help if there's anything that you need.

49:53 Speaker 4: I want to be thankful to my staff. They've done

49:56 Speaker 4: a wonderful job take helping.

49:58 Speaker 3: You know.

49:59 Speaker 4: The providers take care of the community, and we have

50:02 Speaker 4: lots more exciting things to come.

50:04 Speaker 3: Yeah.

50:04 Speaker 1: Absolutely.

50:05 Speaker 5: You can find out more information at Painspecialtygroup dot com.

50:09 Speaker 5: Pain Specialtygroup dot com will show you all the information

50:13 Speaker 5: about the different treatments they offer, different types of problems

50:16 Speaker 5: that they treat and all the providers. Beautiful pictures are

50:19 Speaker 5: on there so you can see more information about the providers.

50:22 Speaker 5: I am a happy patient and I invite you to

50:24 Speaker 5: have a pain free day.

50:26 Speaker 3: And it's a very nice website.

50:27 Speaker 2: By the way, I'm a web design nerd, so I

50:30 Speaker 2: judge these things and it's a very nice website.

50:32 Speaker 4: Well, thank you, thank you. I don't take any credit

50:34 Speaker 4: for you.

50:36 Speaker 2: You don't have time to design your own website, that's

50:38 Speaker 2: for sure, I know, but no, but it's a great site.

50:41 Speaker 2: And yes, Painspecialtygroup dot com and doctor No, thank you.

50:44 Speaker 4: So much, thank you for having me on.

50:46 Speaker 2: Absolutely we got to do this more often. Okay, like

50:49 Speaker 2: we were talking about earlier, we definitely will