Pedia Pain Focus

What does pain look like? In today's episode, I discuss different ways in which our biases and experiences can often overshadow the experience of the patient, impact clinician-patient encounters and the importance of context in every situation.

Is there a specific look to pain? Have you ever wondered if a patient is exaggerating their pain? It is common for chronic pain sufferers to hear comments like, "But you look so normal, you can't be in that much pain." These comments can be especially detrimental coming from a physician.

I also discuss the "Catch 22 of pain" where we emphasize improvement in function over reduction in pain scores for the optimal outcomes, and also undermine patient's pain intensity watching them follow that advice!

• The automatic assumptions about pain
• When should you believe the self report of pain. How accurate is the statement "When someone says they're in pain, they're in pain" ?
• Considering the context of the situation, the patients' previous experiences and other influences on pain experience and pain behaviors
• Impact of bias on pain {Hint: It's not just the patients/families!}
• "Catch 22 of pain" - Patients can receive contradictory and diverse messages
• Stop considering pain solely as a symptom of some other illness and give it the due recognition as a disease process in itself, even in cases of acute pain
• Finding out what is driving your patient's behaviors, their illnesses; understanding what is underneath

Managing Disagreement and Misalignment of Opinions in Pediatric Pain Care Episode 41

Manage Memory, Manage Pain! Episode 26

Disparities in Pediatric Pain Care Episode 10

Dr. Hans Killian's book, Facies Dolorosa

Proactive Pain Solutions Academy

Proactive Pain Solutions

Clinicians Pain Evaluation Toolkit

Dr. Clara Cohen experienced the magic of acupuncture from a young age when she was able to recover from scoliosis related pain as a child.

She initially worked as a personal trainer, but felt a strong desire to help her clients in an even more impactful way. That's when she discovered acupuncture.

Now a doctorate of Traditional Chinese Medicine and in practice for 18 years, she offers the introduction to acupuncture as something that doesn't cure or treat anything!

Her abundant passion for natural medicine and harnessing the body's healing ability drives her practice. Dr. Cohen says, "I'm an acupuncturist by day, but I'm a naturopathic doctor-wannabe by night."

In this episode, Dr. Cohen shares some incredible stories of success from her pediatric patients over the years. We explore the use of acupuncture for pain management, her best practices for treating children, how she promotes healing at all ages and what healthcare professionals need to know about acupuncture and counseling their patients around its use for pain management and in the broader health and wellness context.

• What acupuncture is and what it does for our bodies. She discusses the 3 R's of acupuncture: Reset, Restart, and Regulate.
• What needs to be and what she emphasizes as the goal with her patients; optimal health, and what it takes to achieve (Hint: It's more than acupuncture, it takes efforts from the patients!)
• What conditions, ages and types of patients can and should Acupuncture be used for; acute vs. chronic, babies vs. older children vs. adults.
• Specific acupuncture techniques for babies and children including non needle methods, and acupressure
• What things should your patients consider and how you can advice your patients to find the right acupuncturist
• What conditions should acupuncture be considered for and what factors influence the effectiveness of acupuncture therapy
• Setting the right expectations for acupuncture or any treatment modality for that matter.
• Using acupuncture for pediatric patients
• Different modalities of acupuncture and non-needle options
• Contraindications and caution around use of acupuncture therapy
• Dr. Cohen's advice for healthcare professionals

Clara Cohen B.Sc, L.Ac, DTCM

Connect with Clara Cohen to find more helpful resources:

Website Facebook Instagram YouTube

Proactive Pain Solutions Academy

Proactive Pain Solutions

Clinicians Pain Evaluation Toolkit

Clara Cohen is a graduate of the International College of Traditional Chinese Medicine of Vancouver, where she completed a 5 year program as the Doctor of Traditional Chinese Medicine level. She has been a B.C. registered Acupuncturist with CTCMA since 2003, and focuses mainly in gynecology and mental health. She has been part of the Port Moody & Coquitlam Acupuncture community for many years.

She has successfully treated uterus cancer, ovarian cysts & fibroids, dysmenorrhea, fertility issues, anxiety, depression, insomnia, as well as assisted many patients with IVF and IUI support.

Clara Cohen has been a professor at the Boucher Institute of Naturopathic Medicine in New Westminster, since 2008 and enjoys every minute of it. She also keeps taking seminars and workshops on Chinese medicine & natural health to further improve her knowledge and to help her patients with their healing process. Over the years, she has taken extensive training under well-known specialists such as Sharon Weizenbaum, Jane Littleton and Robert Chu.

Clara has been a presenter and speaker at many conferences. She spoke at the 2011 & 2013 BCNA conference in Vancouver, about Chinese medicine and fertility, and acupuncture during pregnancy. She was also a speaker at the first Cancer Symposium presented by the Boucher Institute in February 2011, about the benefits of Chinese medicine as part of cancer treatments.

Clara originally comes from the French Alps, where her family used Chiropractic, Acupuncture, Homeopathy, Physiotherapy and Massage as their main healing sources. She graduated from Grenoble University with a Bachelor in Applied Nutrition. When she moved to Canada she became a Personal Trainer, and managed 2 fitness clubs in Vancouver and West Vancouver for 8 years. She has extensive training in exercise physiology, sports nutrition and weight issues. She has appeared on Breakfast Television twice, and has conducted countless workshops on natural health for many corporations, schools and community centers.

We all know of Botox use to reduce signs of aging. Approved in 2010 to treat migraines in adults, it's now also being explored (as an off-label treatment) for management of pediatric migraines.

In this episode, Dr. Shalini Shah, MD, MBA, the Vice-Chair for the Department of Anesthesiology & Perioperative Care and Enterprise Director of Pain Services at UC Irvine Health, shares their clinical and reseach findings, as well as the indications, caution, nuances, and protocol for use of botox in pediatric migraine. Her work on the effectiveness of Botox in pediatric patients experiencing migraines has been published in peer reviewed journals and been featured in Time Magazine and on NBC Nightly News.

We discuss her landmark work, the results of her study, protocols, indications and how you can best advocate for your patients to receive the same treatment.

• How Dr. Shah became interested in use of botox for pediatric headaches.
• Findings of her pediatric study including longitudnal data for Botox treatments in pediatric migraine.
• Dosage and protocol for Botox injection for peditaric migraine (Hint: You'll be surprisedby the dosage used in kids!)
• FDA's stance on Botox for children's migrainesand how to navigate the approval of this off label treatment with insurance companies.
• Indications, contraindications and precautions when using OnabotulinumtoxinA for headaches. (Hint: No allergy butuse of caution in certain conditions is crucial!)
• Outcomes and patients' response after the treatment with botox; improvement in all spheres.
• Strategies for preauthorization or approval by the insurance company.
• Dr Shah's message to healthcare professionals treating pediatric headaches

Shalini Shah, MD, MBA

Connect with Dr. Shah - Twitter Linkedin

Dr. Shah's articles on Botox -

Effectiveness of Botox in Pediatric Migraines

Botox for Prophylactic Treatment of Pediatric Migraines

Proactive Pain Solutions Academy

Proactive Pain Solutions

Clinicians Pain Evaluation Toolkit

Recommended Listening: Pedia Pain Focus Episode #21: How to Counsel Your Patients on Off-Label Medication Use

Other Recommended Reading:

PREEMPT Trial 1

PREEMPT Trial 2

Shalini Shah, MD, MBA, Associate Professor is Vice-Chair for the Department of Anesthesiology & Perioperative Care and Enterprise Director of Pain Services for University of California Irvine Health. Dr. Shah completed her residency in anesthesiology from Cornell University and a combined fellowship in adult and pediatric chronic pain at Harvard Medical School.

She is the founder of the Pediatric Pain Program at UC Irvine and has previously served as Associate Program Director for the Pain medicine fellowship. Dr. Shah is the recipient of the ASRA Chronic Pain Grant Award in 2017 for her landmark work in onabotulinumtoxinA (Botox) use in pediatric migraine pain. She has been featured in Time Magazine, The Doctors, NBC Nightly News, Business Insider and is a frequent guest on NPR on the topic of safe pain care options. Dr. Shah is an internationally invited lecturer and leads several industry and peer-reviewed NIH funded clinical trials in pediatric and adult pain medicine.

Dr. Shah currently serves as the Founding Chair, Committee of Pain Medicine at the California Society of Anesthesiologists (CSA) and President-Elect, CA Society of Interventional Pain Physicians (CALSIPP). Dr. Shah is strongly committed to pain advocacy and healthcare regulatory reform both in the state of California and nationally to improve healthcare experiences for patients.

Pediatric pain has been left on the back burner for decades now-- where many clinicians 30 years ago thought that infants did not feel pain. With the progress made, both in pain management and technology, it's about time that we call institutions to shift the culture, so we can work towards making pain visible-- so we can provide comfort to children patients that they desire and deserve.

In this episode, I've brought back Dr. Neil Schechter, to discuss his endeavor, ChildKind International. This passion project of his aims to have an open-access library to serve as a clearinghouse for information on pediatric pain research, and can serve as a reference to improve children's pain management.

ChildKind offers a certification for hospitals based on their commitment to and availability of certain measures to address pediatric pain and comfort adequately. Being certified, fosters trust from parents, promoting a positive experience for both patient and parent. In addition, with a pain management system throughout the institution contributes to higher staff retention and lower healthcare provider burnout.

With this huge step forward in creating accessible pain care, it's up to us as clinicians to offer the same amount of care for our patients regardless of where they present for their care -- because it is not only the pain team or service's responsibility. It is all our responsibility.

Takeaways In This Episode

• The current practices of handling pediatric pain
• What Childkind International is and what led to its creation
• How to enact change within the institution
• ChildKind's mission and 5 Principles
• ChildKind's role in promoting change and its benefits
• The importance of change from the top-down and bottom-up
• Pediatric pain is everyone's responsibility
• Dr. Schechter's hopes for ChildKind and all healthcare institutions

Links

Neil Schechter MD

ChildKind International

Connect with ChildKind International: Facebook Instagram

LinkedIn

Pedia Pain Focus Epi # 53. Are you making the most of your "Golden Half-Hour" with your pain patients?

Proactive Pain Solutions Physicians Academy

Clinicians' Pain Evaluation Toolkit

Proactive Pain Solutions

About the Guest

Neil Schechter, MD

He is the President and CEO of ChildKind, an international organization dedicated to improving the quality of pediatric care. Currently, he directs the Chronic Pain Program at Boston Children's Hospital and is an Associate Professor of Anesthesia at Harvard Medical School. Dr. Schechter graduated with a medical degree and completed pediatric training at the University of Connecticut. He also did his fellowships at Children's Hospital and Harvard University in Boston.

His research initially focused on documenting the under-treatment of pain in children and issues of pain that are associated with chronic disease. His research, later on, shifted to the common pains connected to pediatric practice and to create procedures to improve pain-related practice patterns in health care providers and institutions.

Dr. Schechter is a passionate advocate for the betterment of pediatric pain care which allowed him to serve as a member of editorial boards and experts committees including the World Health Organization Committee and Palliative Care and the Task Force on Chronic Pain in Children of American Pain Society. He has also been the recipient of the Jeffrey Lawson Award for Advocacy in Children's Pain Relief from the American Pain Society.

pain is the most common and devastating symptom of Sickle Cell Disease. Despite the slow and elusive developement of therapeutic intervention in Sickle cell disease that would halt the vasocclusive crisis and the related pain, last few decades have brought about good progress with successful hemopoetic stem cell transplant as well as several therapeutic agents targeting various aspect of teh pathophysiliogy of SCD.

In this episode, I review the 4 major targets in the pathophysiology of SCD and approved therapeutic interventions and agents as well as those that are further along clinical trial with very promising results.

Takeaways in This Episode

• What prompted me to do this update
• How this episode is different from and how it complements the earlier published episode about sickle cell disease
• The challenges presented by sickle cell disease
• The major presentation and impact of sickle cell disease
• 4 main therapeutic targets with advances and ongoing trials
• Newer FDA approved agents in management of vasocclusive crisis and pain
• The success and challenges of stem cell transplant for SCD

Links

Pedia Pain Focus Episode #12. Master Your Sickle Cell Pain Care Skills

Pedia Pain Focus Episode #62. Metaphors for Better Pediatric Pain Management

Pedia Pain Focus Episode #21. How to Counsel your Patients on Off-Label Medication Use

Proactive Pain Solutions Physicians Academy

Proactive Pain Solutions

Yoga is much more than just a physical exercise. It's an ancient mind and body based practice that involves self-paced physical movement, meditation, and breathing techniques. Practicing Yoga can change your and your patient's life in ways you never imagined!

An array of incredible benefits from yoga have become evident in healthcare, professional sports and our day-to-day lives promoting physical and mental well being. But how does it actually work? How does one heal through yoga? When is it appropriate to do yoga if you/your patient has pain?

Join me in this episode as I talk more about yoga with Ms. Amanda Machado, MPH. Not only is she a certified yoga teacher and entrepreneur, but she's also a public health epidemiologist with over a decade of experience in disease prevention!

Amanda brings even her personal perspective to the practice of yoga, as she shares with us how it helped her heal from anxiety and trauma!

In addition, she shares the how yoga is beneficial for your pain patients, how to counsel your patients around yoga for pain and even how it's beneficial to you and your patients above and beyond pain conditions!

Takeaways In This Episode

• The role yoga played in Amanda's personal healing journey
• Tangible and intangible benefits from yoga including its role in our relationships with others
• Applications and implications of yoga for pain management
• Uniques aspects of yoga for pediatric patients including preventive and therapeutic benefits
• What exactly does yoga entail and how to know which yoga is right for you/your patient (Hint: So much more than physical exercise!)
• Finding the right yoga therapy, teacher and therapist (Yes there is such a thing!)
• How to determine whether a patient should do physical therapy versus yoga
• Ms. Machado's advice to healthcare professionals around yoga

Links

Amanda Machado

Connect with Amanda - Instagram Linkedin

Passage Studios | Yoga + HIIT + Spin

Pedia Pain Focus Epi# 63. Integrative Pediatric Pain Management with Dr. Lonnie Zeltzer

Clinicians Pain Evaluation Toolkit

Proactive Pain Solutions

About the Guest

Amanda Machado, MPH, is a Public Health Epidemiologist who has worked in healthcare for a decade, she is trained in both kinesiology as well as epidemiology, she researches root causes of disease, associations, and preventative intervention. Amanda is also a certified Yoga Teacher and entrepreneur and has her own business where she focuses on holistic wellness, helping people live a more conscious life, where they can heal, and grow. She also does business mentorship for practitioners looking to integrate evidence into their work, and those who want to bridge spiritual, emotional well-being with evidence based and scientific insights. She has published studies on happiness, high cost users of the health system and health behaviors that lead to illness, as well as on other clinical and prevention based topics. In her free time you can find her hiking a mountain in the Rockies, gardening, and spending time with her husband and dog Willow.

Many factors contribute to children's pain being under estimated, under-recognized and inadequately treated. Kathryn Birnie, PhD shares her work identifying the top priorities essential for improvement in pediatric pain management.

Join me in this episode as she shares her patient-oriented research which includes them in priority setting and recognizing the areas where we need to focus on.

Her work is grounded in empowering the disempowered; the pediatric pain patients and their caregivers, working alongside and in concert with the clinicians, making the small and big shifts in doing so especially when there is a power differential.

Dr Birnie discusses the top 10 priorities identified in pediatric pain management, how they went about doing so, especially having to distill them down to 10 from >500 identified at the start. She shares which one or ones of them should be prioritized to the top of the line, how that is relevant to each one of us caring for children, and what surprising elements, perspectives or shifts they encountered in the course of this work.

We also explore her role as the Assistant Scientific Director of Solutions for Kids in Pain (SKIP), a knowledge mobilization initiative and how healthcare professionals and patients and families can participate in and benefit from SKIP.

Dr. Birnie is an Assistant Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at the University of Calgary and a clinical psychologist at Alberta Children's Hospital.

Tune in to learn more about how she is contributing to shaping pain research, education and clinical care for kids with pain and how that influences us as healthcare professionals in our day to day work!

Takeaways In This Episode

• How Dr. Birnie got involved in pediatric pain management and what fueled the work she's doing right now
• Dr. Birnie shares behind the scenes of her research, Partnering for Pain, and its design involving patients and families alongside the clinicians and other stakeholders in improving pain care of children.
• The top 10 priorities in pediatric pain that Dr. Birnie and partners found
• What priorities we should be focusing on
• The gaps that various stakeholders need to be aware of in managing children's pain
• Work that SKIP is doing to advance pediatric pain care
• How institutions or healthcare professionals can be the beneficiaries of SKIP and how they may contribute to this important work
• Dr. Birnie's words of advice to healthcare professionals taking care of children with pain

Links

Kathryn Birnie, PhD

Connect with Dr. Birnie - Linkedin Twitter @katebirnie

Partnering for Pain

Partnering for Pain Video

Keeping Up with Today - Dr Christine Chamber's Podcast

There's an App for that - Dr Jennifer Stinson's Podcast episode

Making Pediatric Pain Matter - Dr Christopher Eccleston's podcast Episode

Role of Epigenetics in Post-surgical Pain - Dr. Vidya Chidambaran's podcast episode

Manage Memory, Manage Pain - Dr Melanie Noel's podcast episode

Solutions for Kids in Pain (SKIP)

Clinicians Pain Evaluation Toolkit

Proactive Pain Solutions

About the Guest

Katie Birnie, Phd

Dr. Birnie completed her Ph.D. in Clinical Psychology at Dalhousie University in 2016, including a predoctoral residency in Pediatric Health Psychology at the IWK Health Centre. She completed a CIHR-funded postdoctoral fellowship at the University of Toronto and The Hospital for Sick Children. Dr. Birnie also spent time as a clinical research postdoctoral fellow and clinical psychologist at the University Health Network, including with the Transitional Pain Service at Toronto General Hospital and the Interventional Pain Program at Toronto Western Hospital. Dr. Birnie joined Alberta Children's Hospital as a medical psychologist in 2018, where she continues to provide clinical care through the Vi Riddell Children's Pain and Rehabilitation Program.

Dr. Birnie is a recognized leader in pain research and patient partnership, for which she has received a number of national and international accolades. She was the recipient of the 2020 Pain Awareness Award from the Canadian Pain Society and was selected as a 2020-2021 MAYDAY Fellow, a prestigious fellowship focused on communications and advocacy for improved pain care. Previously highlighted awards include the Dr. John T. Goodman Award for Trainee Research in Pediatric Pain, the Brain Star Award from the CIHR Institute of Neurosciences, Mental Health and Addiction, and a Vanier Canada Graduate Scholarship.

Did you know that he pediatric pain patients rate feeling of isolation as the absolute worst thing, even above their pain?

Georgia Weston, MSW, endured years of isolation as a teen, suffering through her chronic pain alone, feeling not being believed. Now, she's the Executive Director of Creative Healing for Youth in Pain (CHYP), a nonprofit that helps youths suffering from chronic pain by focusing on creative healing experiences. We discuss her firsthand experiences with her own pain, her work as the director of CHYP and the simple steps healthcare providers can take that will make a world of difference to their patients.

Takeaways in This Episode

• Georgia's experiences with chronic pain as a child and how she became interested in pediatric pain management
• Her journey to becoming the Executive Director of CHYP
• Aspects of chronic pain that are worse than the physical pain itself
• Barriers to accessibility of pain care for youth with chronic pain
• What is CHYP, what they offer the youth and their families
• How has CHYP helps bridge the gap of accessibility to pain care
• Who/how the programs and services offered in CHYP are curated
• Unique aspects of CHYP compared with other pediatric pain management support services, programs and organizations
• How healthcare professionals, patients and families can access these resources
• Georgia's advice to healthcare professionals dealing with pediatric pain issues.

Links

Georgia Weston, MSW

• www.mychyp.org
• Linkedin
• Twitter
• Facebook
• Instagram
• YouTube: Creative Healing for Youth in Pain

Pedia Pain Focus Epi#62. Metaphors for Better Pediatric Pain Management

Clinicians Pain Evaluation Toolkit

Proactive Pain Solutions

Books by Georgia Huston Weston

PAIN: An Owner's Manual: Intimate conversations about pain

Vienna's Waiting: A teenage girl's battle with pain

About the Guest

Georgia Weston, MSW

Georgia Weston is the author of two books, Vienna's Waiting and PAIN: An Owner's Manual, where she provides insight into the mysterious world of chronic pain through her own story and the stories of others. In 2011, she founded the Teen Pain Help Foundation, a 501(c)3 charitable corporation created to help children and adolescents with chronic pain. Since founding the Teen Pain Help Foundation, Georgia has served as the Executive Director, raising funds for treatment, research, education, and increased public awareness of pediatric chronic pain. She also co-founded and was the Director of Programming for Art Rx, strengthening the partnership between the USC Suzanne Dworak-Peck School of Social Work and the USC Keck School of Medicine, specifically to better understand how art impacts pain. Georgia has experience creating and leading programs for organizations that provide therapeutic services for struggling individuals and families. She also has clinical social work experience, both as an outpatient therapist and residential therapist, for youth dealing with complex cognitive, behavioral, and social needs. In addition to her work with chyp, Georgia is a Research Associate on a Rally grant for an adolescent/young adult cancer pain telemedicine intervention study with the UCLA Pediatric Pain Research Program. Georgia has a Bachelor of Arts in psychology, with a minor in art, from St. Edward's University. She has a Master of Social Work degree from the University of Southern California, with a concentration in Children, Youth, and Families, as well as a focus in Child and Adolescent Mental Health. In recognition of her humanitarian services, Georgia received the David Chow Humanitarian Foundation Award for 2019. Georgia is dedicated to empowering youth with chronic pain and their families through creative healing techniques and social support.

Every child inevitably would experience pain in the course of their life, but if not addresses appropriately, these experiences can have long-lasting and detrimental effects which carry into adulthood. What's even more remarkable is that healthcare experiences including what we do as part of healthcare as professionals is often a significant part of what causes pain and anxiety for children.

Efforts to minimize distress, discomfort, pain and related anxiety should be a priority in healthcare. What can healthcare professionals do to prevent, minimize, and ease a child's fear, anxiety and pain over the medical procedures that they need to undergo as part of their treatment and care?

Join me in this episode as I talk about the prevention and treatment of pain caused by procedures within the hospital and healthcare settings with Stefan Friedrichsdorf, MD, medical director of the Center of Pain, Palliative and Integrative Medicine at the UCSF Benioff Children's Hospitals in Oakland and San Francisco!

Dr. Stefan Friedrichsdorf, MD, FAAP is a Professor of Pediatrics at the University of California at San Francisco (UCSF).

Find out about his "Comfort Promise" and 4 simple steps that every healthcare professional should ensure to relieve or decrease pain and anxiety among kids who are undergoing treatment and minor or major procedures. Dr Friedrichsdorf shares his experiences, findings, outcomes, implementation plan and even some of the common barriers as well as ways to address them often overlooked

Takeaways In This Episode:

• How Dr. Stefan got involved in pediatric pain
• Dr. Stefan talks about the prevention and treatment of pain caused by procedures in our hospital, and the staffs
• Situations where children in hospitalized settings are experiencing pain and anxiety from their treatment procedures
• The prevention and treatment of pain and anxiety caused by needles
• What is the "comfort promise"?
• The four steps to decrease pain and anxiety caused by vaccinations?
• How to get past the barrier of having our colleagues recognize that this issue of fear and anxiety brought about by treatment procedures is an important issue?

Links

Stefan Friedrichsdorf, MD FAAP

LinkedIn

Twitter

Hospital-wide initiative to eliminate or reduce needle pain

Clinicians Pain Evaluation Toolkit

Proactive Pain Solutions

About the guest:

Stefan Friedrichsdorf, MD FAAP

Stefan Friedrichsdorf is the medical director of the Center of Pain Medicine, Palliative Care and Integrative Medicine at the UCSF Benioff Children's Hospitals in Oakland and San Francisco. He's a Professor of Pediatric at the UCSF.

Dr. Friedrichsdorf received the 2016 "Elizabeth Narcessian Award for Outstanding Educational Achievements in the Field of Pain" by the American Pain Society and the 2011 "Hastings Center Cunniff-Dixon Physician Award". He was the medical director of the department of pain medicine, palliative care & integrative medicine at Children's Minnesota from 2005-2020 and under his leadership the department grew into one of the largest and most comprehensive in the country. It received the "Circle of Life Award" by the American Hospital Association in 2008 and was the 2013 recipient of the "Clinical Centers of Excellence in Pain Management Award" by the American Pain Society and in 2018 the Albert Bandura Influencer Award from VitalSmarts.

He was the associate editor of the Journal of Pain and Symptom Management until 2020, the principal investigator of a National Institutes of Health (NIH) / National Cancer Institute (NCI) multisite study on the creation, implementation and evaluation of the Pediatric Palliative Care Curriculum "Education in Palliative and End-of-Life Care (EPEC)-Pediatrics". In 2008 he founded and since then directs the annual Pediatric Pain Master Class, a unique week-long intensive course for interdisciplinary health professionals.

Dr. Friedrichsdorf has presented more than 750 lectures about pediatric pain medicine, palliative care and integrative medicine and has a track record of research and publications in the field, including more than 60 peer-reviewed articles and contributions to more than 25 books on the subject. He is president-elect of the Special Interest Group on Pain in Childhood of the International Association for the Study of Pain (IASP).

Dr. Friedrichsdorf received his MD degree from the Medical University of Lübeck, Germany, completed his pediatric residency at the University of Witten/Herdecke, Germany (Children's Hospital Datteln), and undertook his fellowship in Pediatric Pain Medicine and Palliative Care at the University of Sydney, Australia (Children's Hospital at Westmead). He is double boarded in Pediatrics in Germany and the United States, a Diplomate of the American Board of Pediatrics, and trained in pediatric clinical hypnosis.

Chronic pain is the result of dynamic interactions between psychological, biological, and social factors. In this episode, Dr. Lonnie Zeltzer, a veteran and pioneer of the best practices in pediatric pain medicine talks about the approaches you can take in assessing and treating complex chronic pediatric pain issues to ensure best outcomes!

Dr. Zeltzer has shared her decades of experience, research and wisdom in this episode. It's like getting a masterclass in all you want to know about taking acre of a pediatric pain patient.

There are many barriers when it comes to treating children's pain. However, Dr Zeltzer shows you how to overcome them and how to choose the appropriate approaches that will be embraced by your patients and families when treating complex chronic pain in children.

Tune in to this episode as Dr. Lonnie talks about the integrated approach to pediatric pain management with a cohesive team of clinicians regardless of their geographic proximity.

Takeaways In This Episode:

• What integrative medicine is and how it differs from the alternative medicine
• What an integrated medical model looks like
• What therapies are appropriate for your patient
• How to decide which ones to pick when there are competing priorities and issues of cost, effectiveness, and beliefs
• Harnessing the power of mind for pediatric pain care
• The importance and practice of rebalancing your autonomic nervous system
• The differences between complementary alternative therapies and integrative therapies
• Dr. Zeltzer explains how to create an integrative pain care team
• The framework Dr. Zeltzer use to decide which patients may need therapies with seemingly similar impact ( e.g. yoga vs. PT or CBT versus hypnotherapy)

Links

Lonnie Zeltzer, MD

Linkedin

Complementary, Alternative or Integrative Medicine: NCCIH Definitions

Conquering Your Child's Chronic Pain: A Pediatrician's Guide for Reclaiming a Normal Childhood

Clinicians Pain Evaluation Toolkit

Proactive Pain Solutions

About the Guest:

Dr. Lonnie Zeltzer

Dr. Zeltzer is a Professor of Pediatrics, Anesthesiology, Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA, Director of the Pediatric Pain Program at UCLA Mattel Children's Hospital, and Past-Medical Director of Trinity KidsCare pediatric hospice.

She is also Associate Director of the Patients and Survivors Program in the UCLA Jonsson Comprehensive Cancer Center, on the steering committee of the UCLA Centers for Integrative Medicine, the UCLA Psychoneuroimmunology Program, and the Center for Neurovisceral Sciences.

Dr. Zeltzer's pain program integrates complementary and traditional therapies for the treatment of chronic and cancer pain in children, and she studies the development of chronic pain, mind-body-pain connections, and the impact of complementary therapies on chronic pain.

She has over 200 publications, including her book, "Conquering your Child's Chronic Pain: a Pediatrician's Guide for Reclaiming a Normal Childhood,"(HarperCollins, 2016).