We're trying something different this week: a full post-show breakdown of every episode in the latest season of Black Mirror! Ari Romero is joined by Tudum's Black Mirror expert, Keisha Hatchett, to give you all the nuance, the insider commentary, and the details you might have missed in this incredible new season. Plus commentary from creator & showrunner Charlie Brooker! SPOILER ALERT: We're talking about the new season in detail and revealing key plot points. If you haven't watched yet, and you don't want to know what happens, turn back now! You can watch all seven seasons of Black Mirror now in your personalized virtual theater . Follow Netflix Podcasts and read more about Black Mirror on Tudum.com .…
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Content provided by Dr. Dan Bates & Justine Feitelson, Dr. Dan Bates, and Justine Feitelson. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Dr. Dan Bates & Justine Feitelson, Dr. Dan Bates, and Justine Feitelson or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Welcome to It's Not in Your Head Podcast, with Dan and Juz. Dr. Dan is a Sports Physician and Justine a Pain Coach and patient. We have come together to find ways to manage complex pain better for both patients and providers. New episodes will come out bi-weekly on all major platforms.
26 episodes
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Content provided by Dr. Dan Bates & Justine Feitelson, Dr. Dan Bates, and Justine Feitelson. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Dr. Dan Bates & Justine Feitelson, Dr. Dan Bates, and Justine Feitelson or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Welcome to It's Not in Your Head Podcast, with Dan and Juz. Dr. Dan is a Sports Physician and Justine a Pain Coach and patient. We have come together to find ways to manage complex pain better for both patients and providers. New episodes will come out bi-weekly on all major platforms.
26 episodes
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It's Not in Your Head
Strategic Empathy: Handling Chronic Pain and Invisible Illnesses In the inaugural Q&A episode of 'It's Not In Your Head,' Dan and Juz discuss strategies for managing chronic pain, addressing both patient and provider perspectives. They tackle how to respond to common misconceptions about chronic pain, offer quick ways to explain one's condition without going into detail, and share methods for recognizing personal capacity and setting boundaries. Additionally, they delve into how doctors can better support chronic pain patients through strategic empathy and acknowledging the limits of medical knowledge. Tune in for practical advice and empathetic approaches to living with and understanding chronic pain. 00:00 Introduction to the Podcast 00:29 Addressing Common Misconceptions About Chronic Pain 03:58 Quick Ways to Communicate Your Condition 07:31 Creating Boundaries and Recognizing Capacity 11:06 Returning to Activities You Love 16:40 How Doctors Can Better Support Chronic Pain Patients 24:48 Conclusion and How to Submit Questions Resources: www.iniyh.com/episodes/ask-us-anything-aua-1 www.resilientwarriorcoachingllc.com/basecamp…
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In this episode of 'It's Not In Your Head' podcast, Dan and Juz explore the myriad of challenges and strategies around traveling with chronic pain. They discuss pre-travel preparation, in-flight strategies, travel management, and post-travel recovery. Justine shares personal anecdotes about her recent trip to Costa Rica, highlighting practical tips and emotional aspects of managing pain while traveling. They also delve into medication management, communicating needs, and creating a tailored 'holiday program' with your Doctor to ensure a smoother travel experience. The episode aims to empower those with chronic pain to reclaim activities they love, like traveling, by sharing actionable insights and boosting confidence in managing their condition during extraordinary times. Tmestamps: 00:00 Introduction and Welcome 00:30 A Lighthearted Start 01:53 Travel and Pain: An Overview 02:29 Building Travel Confidence 04:02 Pre-Travel Strategies 08:12 Medication Management 13:15 The Holiday Program 18:06 Flare Management During Travel 23:41 Travel Tips for Managing Disabilities 24:00 Using Wheelchair Services and Handling Reactions 25:06 Personal Travel Experiences and Benefits 27:06 Managing Symptoms During Flights 39:29 Post-Travel Recovery Strategies 41:40 Final Thoughts on Traveling with Pain Resources: www.iniyh.com/episodes/ep-26-travel-with-chronic-pain INCB - Country Regulations for Travellers incb.org/incb/en/travellers/country-regulations.html…
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1 25 Communicating Better: Owning Your Care & Understanding Your Doctors POV 57:54
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Play Later Play Later Lists Like LikedManaging Complex Chronic Pain: Patient and Provider Strategies In this episode of 'It's Not In Your Head' podcast, Dan and Juz delve into effective strategies for managing complex chronic pain for both patients and providers. The conversation is sparked by Dan's experience at a recent patient-focused conference, where problematic suggestions about managing doctor-patient conflicts arose. This episode aims to provide more constructive tips for patients to own their care, improve communication and information sharing with their doctors, and better navigate the healthcare system with complex diagnosis. They also explore the importance of a structured approach in consultations, the relevance of pre-screening forms, and the role of empathy and humility from the provider side. The goal is to bridge the gap between patients and providers, enhancing mutual understanding leading to more effective outcomes. Tune in for a thoughtful discussion that promises to ease the anxiety around talking with your Doctor, and managing complex patients if you're a provider. 00:00 Introduction to the Podcast 00:28 Dan's Conference Experience and Mental Health 00:50 Challenges in Doctor-Patient Relationships 04:02 Strategies for Complex Patients 04:57 Steps to Own Your Care 05:46 Prioritizing and Matching Problems to Doctors 14:10 Effective Communication with Doctors 14:58 Understanding Doctor's Perspective 16:12 Facilitating Doctor's Hypothesis Generation 28:14 Empathy and Communication Techniques 31:34 Pre-Screening and Diagnostic Tools 32:00 Understanding Central Sensitization Inventory 33:28 The Importance of DAS 21 34:15 Addressing Childhood Trauma in Medical History 35:52 The Role of Trust in Doctor-Patient Relationships 37:36 Barriers to Treatment Adherence 41:48 Recognizing Literacy and Communication Challenges 46:02 Managing Patient Fears and Concerns 51:12 The Value of Admitting Uncertainty 56:33 Bridging the Gap Between Doctors and Patients Website: https://www.iniyh.com/…
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In this episode of 'It's Not In Your Head' podcast, hosts Dr. Dan Bates and Justine Feitelson discuss nociceptive pain, also known as body part pain. The episode delves into their Nociceptive Pain Algorithm, breaking down the different types of somatic pain, including mechanical, inflammatory, myofascial, bony, and vascular pain. It includes discussions on different pain management strategies from first-line to specialist referrals, the interplay of different pain types and overlapping issues when it comes to instability, and emphasizes the importance of proper diagnosis and treatment so you can make effective decisions as a clinician even while you are still working through a patients full presentation. Resources: www.iniyh.com Timestamps: 00:00 Official Intro 00:18 Intro to Nociceptive Pain, ie, Body Part Pain 05:16 Body Part Pain Algorithm 11:34 Mechanical Pain 15:20 Inflammatory Pain 17:15 Myofascial Pain 18:43 Bony Pain 19:51 Vascular Pain 22:39 What do I need to do Next? 24:11 First Line Management 28:59 Ligament Insufficiency 33:55 What's Your Next Line? 37:53 Reviewing & Assessing Responses 41:15 Disclaimer…
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1 23 Sleep and Pain: Anchoring, the Rice Cooker and the Nappucino 59:47
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Play Later Play Later Lists Like LikedIn this Pt. 2 of sleep episode, Dan and Juz cover the conservative measures around improving your sleep, particularly if you struggle with insomnia, or painsomnia, as many pain patients refer to the challenge of falling asleep. They cover external and environmental factors including circadian rhythm, as well as internal or behavioral variables that affect our sleep quality and drive. They dive into special topics and strategies around constructing an effective wind down routine including releases and diaphragmatic breathing, and how to nap in a way that is more helpful than harmful so you can feel tired when you want to, and have energy when you need it. Listen if you're a patient struggling with sleep, or a clinician looking for more effective resources and communication to help your patients improve this piece of pain. Resources: www.iniyh.com/newsletter Timestamps: 00:00 Official Intro 00:18 Intro to Sleep Part 2 02:14 Justine's Sleep Breakdown 03:23 Internal Breakdown: Stress 05:37 Caffeine 07:24 Nicotine 08:00 Alcohol 10:17 CBD/THC 12:59 Exercise 15:00 Screen Time 17:29 Relaxation Techniques 18:51 Napping 23:56 Napping Strategies 29:23 External Environment 35:40 Circadian Rhythm Abnormalities 44:31 Wind Down Strategies 48:22 Breathing 54:15 Release Techniques 58:12 Wrap-up 59:19 Disclaimer…
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Dan and Juz dive into the significant relationship between pain and sleep, and how it drives sensitization. They cover sleep basics, how lack of it long-term negatively impacts patients cognitively, and share a helpful analogy you can use as a patient to better explain what chronic pain feels like - especially with regards to increasing buckets of central sensitization. Dan then delves into the medical side of sleep, covering disorders including snoring, as well as various medications used to treat sleep. On the next episode, Juz will cover the conservative management strategies on the patient end, so you can further improve fatigue and cognitive dysfunction. Resources: www.iniyh.com/newsletter Timestamps: 00:00 Official Intro 00:18 Intro 03:28 Recap of The CS Algorithm 07:32 How do you sleep to explain your pain? 11:36 Sleep Basics 12:16 Sleep Cycles 16:47 Bi-directional effect, sleep architecture and alterations 20:22 Mechanistic Perspective 22:34 Sleep Needs 27:43 Sleep Disorders 35:12 Meds 42:24 Snoring 48:55 Wrap-up 49:47 Disclaimer…
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1 21 Pacing: Flare Prevention & Energy Management 58:24
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Play Later Play Later Lists Like LikedIn this podcast episode, Dan and Juz explore the concept of pacing and give it a bit of a re-brand, going through their structure and personal examples to learn how to break down managing your timing, tasks and tolerance more effectively so you can reclaim activities and passions pain may have limited. Effective pacing includes careful planning, task batching, and managing context variables to adjust to fluctuating physical and emotional demands. Key strategies involve scheduling pressure-release activities, monitoring stress, and using graded exposure techniques to build resilience through movement. The episode emphasizes the importance of built in flexibility, encouraging listeners to shift tasks as needed and recognize that flare-ups are a natural part of the process, learning to adapt routines and lean on support networks to manage setbacks and regain your baseline quicker. Resources: www.iniyh.com www.resilientwarriorcoachingllc.com/cpp Timestamps: 00:00 Official Intro 00:18 Intro to Pacing 04:21 Three Components of Planning 09:22 Task Batching vs. Task Switching 14:06 Juz's Schedule Example 18:10 Tolerance 23:03 Techniques to Execute Pacing 31:25 Juz's Chorus Example 33:25 Graded Exposure 38:09 Activity Pacing 39:04 Awareness & Monitoring 45:21 Zone 2 Cardio 48:10 Flare Management 52:48 Create Rest Around Big Toll Items 54:51 Wrap-up 57:57 Disclaimer…
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In this podcast episode, Dan and Juz explore a step-by-step approach to managing lower back pain. They begin with busting some significant yet persistent myths when it comes to patient recovery, and continue the conversation by identifying key patient concerns, focusing on red flags and understanding their ability to cope. For pain that is manageable and under three months in duration, they dive into the conservative treatment pathway. As pain becomes more long-lasting, they delve into appropriate medications, diagnostic considerations, potential investigations and referrals. The episode concludes with insights on differentiating between leg and back pain, offering targeted treatments based on the pain's location, whether it be hips, nerves, facets, discs, or sacroiliac joints. Listen to be able to better understand and advocate for your presentation as a patient, and more efficiently identify and treat as a physician. Resources: www.iniyh.com www.resilientwarriorcoachingllc.com/neurotechniques Timestamps: 00:00 Official Intro 00:18 Intro 02:14 What the algorithm is based on 03:17 Where are you within the algorithm? 04:07 START 04:41 Conservative Management 05:44 Coping 06:21 5 Point Structure - How are you? 07:23 Red Flags 10:59 Pain less/greater than 3 months 12:30 Where does it come from? 18:17 Consequences of Persistence of Pain 20:25 Next Myth - You can't diagnose lower back pain 22:17 Diagnostic Block 24:26 Conservative Elements: How do you move through it? 25:18 Self-Management 28:02 What's Pacing? 30:31 Goal Setting 32:59 Analgesic Options 34:31 Alter neuropathic component of pain 36:41 Review 37:02 What's going on for the patient? 37:43 Do they have any red flags? 39:50 Diagnosing 43:15 referral to the surgeon 43:54 Back Pain is Worse than Leg Pain 46:15 Back pain rules of thumb 48:03 Different structures refer pain to 48:58 point to their pain 51:54 facet joint pain 55:57 Disc Pain 01:01:49 Sacriliac Joints 01:07:20 hips 01:08:37 Wrapup 01:11:43 Disclaimer…
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1 19 Basics of Conservative Pain Management 1:09:59
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Play Later Play Later Lists Like LikedDan and Justine dive into the basics of conservative pain management, covering the starting points of her MARSMethod and where you need to begin as a patient no matter what types of chronic pain you have. They go through the importance of and give specific recommendations around improving protein amount, fiber intake, hydration totals, sleep quality, and movement. Listen for actionable advice you can immediately implement to begin improving the pieces of pain you impact as a patient. As a clinician, this episode gives you simple, time-effective education and strategies to communicate that support the lifestyle pieces patients need to be working on in parallel to get the most out of their treatment. Resources: www.iniyh.com https://www.resilientwarriorcoachingllc.com/neuromovementclass Timestamps: 00:00 Official Intro 00:17 Intro 04:17 What is the MARS Method: 04:25 M is for Movement 05:56 A is for Awareness 07:46 R is for Recovery 08:25 S is for Stress 09:10 Why these matter? 12:43 Metabolic Changes 17:11 Effects on your Nervous System 18:02 Sedentary Lifestyle 19:43 Why is Protein Important? 21:52 Muscle Loss & Protein 24:16 How much Protein? 27:12 Upgrading Your Protein 34:18 How do you choose? 38:43 Why Fiber? 42:55 Types of Fiber 44:54 Hydration 48:28 Sleep 55:55 Exercise/ Movement 01:03:07 Ligament Laxity and flares 01:06:12 Wrap-up & What's Next on the Pod 01:09:33 Disclaimer…
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In this episode, Justine and Dan go over a number of different assessments tools you can use to define what types of pain you have, what amplifiers may be playing a role, and how symptoms are affecting you functionally. Besides these validated measures, we'll also introduce our sensitization questionnaire so you can look at the information you pull out through the lens we've been looking at central sensitization through, and finish with a discussion on the impact patient mindset has on the ability to improve. To fill out these questionnaires for yourself, and get additional context and information about them, please visit the episode page at our website below. Resources: www.iniyh.com Timestamps: 00:00 Official Intro 00:17 Intro 03:56 Pain Detect 06:45 Central Sensitization Inventory: 25 Questions 12:37 Central Sensitization Inventory: Part B 13:39 Bodily Distress Syndrome Checklist 14:49 Our Central Sensitization Assessment 19:47 DAS 21 24:25 Oswestry Disability Index 28:41 Pain Analog Scale 35:36 Growth vs Fixed Mindset in Patients & Wrap-up 40:06 Disclaimer…
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Dan and Juz cover the neuropathic pain algorithm, taking you through first through fourth-line treatment options from most to least conservative. They cover trialing and combining various medications including opioids, topicals for focal areas of pain, and various interventional options all the way up to neuromodulation (peripheral or spinal cord stimulators), and pain pumps. This episode helps a PCP or other physician have a guide to more efficiently work through treatments for neuropathic pain, and patients better understand their options so they can more effectively advocate for themselves. Visit the episode page at the website below for a link to download the paper with the algorithm. Resources: www.iniyh.com Timestamps: 00:00 Official Intro 00:17 Intro 03:51 Why Did Dan Develop this Algorithm? 06:45 Starting Point - Is It Neuropathic Pain? 09:53 How to Draw Your Pain Diagram (KEY) 12:23 Consequences for Neuropathic Pain 19:04 Medication Perspective 25:09 How to Prescribe Medications 26:26 Second Line Combination Therapy 31:08 Topical Focal Treatments 36:05 Specialist Referral 40:15 Pulsed Radiofrequency 43:43 Adhesiolysis 46:49 Thermal Radiofrequency 47:59 STIM Interventions - Neuromodulation 56:09 Making Difficult Choices 01:01:50 Complications 01:04:30 SCS Pocket Pain 01:08:18 Opioids 01:15:20 Targeted Drug Therapy 01:16:56 Wrap Up 01:19:44 Disclaimer…
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In this episode, Dan and Juz focus on the importance of communicating and assessing pain through the use of pain diagrams, which help both clinicians and patients gain insights into the sources and amplification of their presentation. The hosts go through many different types of back, leg, and neck pain, discussing how this information contributes to goal setting and tracking progress in pain management. Unfortunately, the data on diagrams makes it seems as though they are useless - but that is if they are drawn in such a fashion. Pain diagrams when done with a clear, consistent key can provide a visual representation of the pathologies driving pain, allowing patients to turn the invisible, visible. Clinicians can then better identify underlying nociceptive and neuropathic components, and amplifying factors, so they can more effectively diagnose and treat. Listen to learn how to draw you pain better as a patient and provider. Resources: www.iniyh.com/newsletter Timestamps: 00:00 Official Intro 00:17 Intro to How to Draw Pain Diagrams 03:03 Where is it? What does it feel like? What's made it worse? 04:26 Turn the Invisible, Visible 06:11 Useless Pain Drawings 07:17 Pain Key 08:51 Plain Neuropathy 09:32 Patient that's Sensitized 12:36 Five Major Causes of Lower Back Pain 17:11 Overlap - Medical Blocks & Other pain 20:15 How do we draw backs? 20:26 Facet joint pain 21:40 SI Joint Inflammatory 23:10 SIJ Osteoarthritis 24:05 SI Joint Dysfunction 27:48 S1 Nerve Compression 28:09 L5 Nerve Root 28:49 L4 Nerve Root 29:04 L3 Nerve Root 32:04 C4 Nerve Root 32:26 C5 Nerve Root 32:45 C6 Nerve Root 33:14 C7 Nerve Root 33:46 C8 Nerve Root 34:57 C1 - 2 Facet 35:13 C2 - 3 Facet 35:49 C3 - 4 Facet 36:02 C4 - 5 Facet 36:12 C5 -6 Facet 36:44 C6 - 7 Facet 37:17 C2 - 3 & C5 - 6 Whiplash 37:38 Pathologies of Neuropathic Pain 37:59 Focal Nerve Entrapment 38:28 Peripheral Nerve - Superficial Peroneal 39:22 Diabetic Peripheral Neuropathy 40:28 Myofascial Triggers 41:57 Multiple Diagnoses 44:39 Multiple Sites 46:24 When Patients come back with Pain 48:24 Cervical Instability 49:42 Recap 53:55 Disclaimer…
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Agency is crucial as a chronic pain patient - especially when you feel most helpless and scared with pain at its worst. Flares are always difficult to navigate, but they don't have to make you feel so helpless and reactive. What are the phases of a flare, and how can you manage each one? This episode is a critical resource to learn how to identify and sooner recognize your own flare patterns so you end up in 'the hole' less, and can navigate your way out more effectively when it does happen. As a provider, how can you better explain flares and give patients a prevention strategy so they are empowered to impact all the aspects they can control, and more effectively treat the pieces you can help with when they are most vulnerable? Listen to this episode for more tools and a structure you can implement right away. Resources: www.iniyh.com https://www.instagram.com/iniyhpodcast/ Timestamps: 00:00 Official Intro 00:17 Intro - Flare Management 02:38 Reasons for this episode 03:55 Justine's Most Recent Flare 05:34 Breaking Down the 5 phases 05:43 1st Phase - Trigger or Stressor 09:27 2nd Phase - Loss of Routine 12:05 3rd Phase - Worsening Pain 15:03 4th Phase - The Hole 17:55 5th Phase - Digging Yourself Out 19:35 Phase 1 Strategies 23:34 Phase 2 Strategies 25:30 Phase 3 Strategies 30:43 Why not Opioids? 32:10 Communicating with your provider 34:44 Phase 4 Strategies 38:27 Phase 5 Strategies - The Reach Out 43:08 Pain Flares have a Cycle 46:58 WrapUp 48:54 Disclaimer…
In this episode, Dan and Justine break down how they each set goals and manage expectations with their patients. We dive into why your 'why' matters, how to connect your purpose to your plan, create discipline, tap into motivation, identify your purpose and cultivate confidence, so patients can better tie their actions to their goals and create long-term progress. This episode aims to help patients improve communication and have more effective appointments with their clinicians, and clinicians link their interventions to the goals of the patient in a more compelling way to improve buy-in. Resources: www.iniyh.com https://www.instagram.com/iniyhpodcast/ Timestamps: 00:17 Intro 02:39 Having a Great Why 04:24 Your why matters because this takes time 06:18 Connect your Purpose and your Plan together 08:35 Developing Discipline with a Morning Routine 11:13 Connecting Habits to Discipline to Motivation 12:42 Timeframe - how long will this take? 14:26 How do you identify purpose? 20:47 Finding confidence experiences 27:23 Pain is about loss 30:25 How to talk to your Doctor about this 32:33 Patients need to bring in what they need from Doctors 36:37 Expectation Management 38:38 Disclaimer…
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It's Not in Your Head
1 13 Widespread Pain and Making Sense of Things That Don’t Make Sense 1:00:42
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Play Later Play Later Lists Like LikedIn this episode, Dr. Dan and Justine introduce their 'Central Sensitization Algorithm' designed to help healthcare providers diagnose and treat central sensitization and related neuroinflammatory disorders more effectively. The algorithm categorizes symptoms into distinct buckets of nervous system dysfunction, allowing providers to more quickly and efficiently identify and prioritize their treatment plan. By addressing potential pre-existing diagnoses and symptoms, the sensitization algorithm aims to better streamline assessments and improve outcomes for complex patients by creating a clearer picture of an otherwise confusing presentation. The episode highlights the importance of this tool in reducing diagnostic frustration and inadvertent harm, while also empowering patients to better understand and communicate their symptoms. References: www.iniyh.com Timestamps: 00:00 Official Intro 00:17 Intro - How you start to think about it 01:31 Initial Presentation 03:25 Neuropathic / Nociceptive 04:01 Central Sensitization (Other side) 04:45 What is Sensitization? 05:56 How Dan Got Into Hypermobility 08:44 3 Components of Hypermobile EDS 09:18 Two Sides of Central Sensitization 11:03 Justine's Path to Central Sensitization 16:04 Dan's Frown of Frustration 18:57 Looking at the Literature 20:32 7 Main Categories of CS 22:14 Pre-existing Diagnoses 22:37 Disproportionate, prolonged pain 24:24 Symptoms 25:30 Sensory Hypersensitivity 30:22 Sleep Disturbance 34:38 Fatigue 36:47 Cognitive Impairment 40:02 Mood Disturbance 42:46 Motor Dysfunction 45:33 Dysautonomia - Cardiovascular 47:42 Dysautonomia - Gastrointestinal System 48:34 Dysautonomia - Urinary System 49:47 Dysautonomia - Secretor Motor System 50:49 Dysautonomia - Reproductive System 52:22 Assessment 54:31 What do we do as Doctors? What is driving this patient's CS? 57:57 Final Points 01:00:13 Disclaimer…
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