Pedia Pain Focus

Nothing sums up the challenges of sickle cell pain better than what our guest, Dr. Zempsky, quotes in the interview, "like having a thousand heart attacks". Anyone who's been involved in taking care of a sickle cell patient in pain, knows that this expression can easily describe the experience of patients and healthcare providers alike! Todays episode is focused on understanding the nature of pain in sickle cell disease, simplifying and improving the care of these patients, resulting in better outcomes.

Takeaways in This Episode:

• The most common types of pain presentations in Sickle cell patients and how to differentiate them.
• What challenges do clinicians face in taking care of sickle cell patients
• There's more to sickle cell pain than what we've long believed (Hint:It's not just sickling)
• Do the the inflammatory markers play any role in sickle cell?
• Why are sickle cell disease patients having "heart attacks"?
• Should we treat sickle cell crisis pain like post-operative pain?
• The added challenges with improved sickle cell disease care and increased life expectancy of sickle cell patients.
• What specific benefits does aggressive early management of vaso-occlusive episodes offer?
• Are there early changes or signs that indicate transition from acute to chronic sickle cell pain?
• What our ethical mandate as clinicians is, for our pain patients.
• Where does the evidence for non-opioid analgesics in management of sickle cell pain fall?
• Should sickle cell patients be following any particular dietary and nutritional supplements guidelines?
• What he says about the role of vitamin D or glutamine and other supplements in sickle cell pain
• What advice have we, as medical community, given our sickle cell patients and their parents that we are having to reverse the course on that now?
• What his recommendations on activity for hospitalized sickle cell patients are.
• What should our goal(s) be for sickle cell patients?
• What crucial steps in care of sickle cell patients when presenting to the urgent care or emergency room lead to improved healthcare outcomes.
• Quality care indicators for care of sickle cell patients in ER.
• Utility of Individualized Care Plans in the care of sickle cell patients

Links Mentioned:

A Parent's Pain Relief Toolkit

William Zempsky, MD

AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain.

Evaluation and Treatment of Sickle Cell Pain in the Emergency Department

In this episode, our guest Peter Shankman, an entrepreneur and major influencer, shares his expertise, tips and hacks on skyrocketing your productivity "getting hours back in your day", customer satisfaction, and using the power of being neuroatypical to your advantage.

Takeaways In This Episode:

How growth within our company highlighted the relevance of this topic even more

The elements of Strategic Listening, why it is relevant in medicine,

how we tend to listen wrong, and how we can change that

What "Hippie-Dippie" sounding concept makes all the difference in the quality of care you provide

(Hint: It' not only sounds sounds simple, it IS very simple!)

How to grow an effective conversation with patients and make your clinical encounter productive even when your patients go off on tangents

A simple, effortless thing you could do to change the health outcomes for your patients.

How his own experience with the medical world as a teenager shaped his career and perspective on communication

How you can use your patient interactions to enhance your own growth as a successful healthcare provider.

How he harnesses the power of his ADHD to use it to his advantage

How you can get enough hours in your day despite your numerous tasks and hectic schedule

How to find your "zone of focus" and direct your own hyperfocus to allow most productivity,

Importance of finding your triggers for optimal performance

How to best help our patients, or colleagues or ourselves when they/we are neuroatypical, (ADD or ADHD)

Ways you can communicate with your supervisor/boss and create a supportive work environment to maximize productivity.

Links Included in This Episode:

Peter Shankman

https://www.shankminds.com/

Faster Than Normal Podcast

Faster Than Normal Book

Peter Shankman Books

Help a Reporter Out (HARO)

This episode delves into various factors that contribute to disparities in pediatric pain medicine. Discover:

Differences in pain care practices between developed and developing countries

Differences in pain experiences of racial minority patients

Factors contributing to disparities in pediatric pain

System level drivers of differences in pain experiences

Why asking parents to advocate for their children's pain may not be an effective approach to better pain care (Hint: It has much to do with assumptions, instead we need to ask better questions)

What their research findings reveal about disparities around pain assessment and treatment practices among racially diverse patients

What pediatric populations are particularly at risk for under-treatment of pain

Patients and family, clinician and institutional level measures to address disparities

Why the concept of "Equal Care" is flawed when it comes to pain care disparities (Hint: Think equitable care!)

Dynamics of personalized medicine and disparities in pain care

What is her advice for clinicians as well as patients and families that will help move the needle forward for better pediatric pain care.

The obvious benefits of a strong, healthy partnership with patients and families in pediatric pain care are undeniable. But, in a time when a clinician may be held responsible for everything, criminal negligence, or child abuse related to undertreatment of pain or contributing to prescription drug abuse because they treated their patients' pain with medication, a better understanding of the fine and murky line of a clinician's ethical obligations becomes essential. Dr Douglas Diekema sheds light on the ethical concepts and guidelines for clinicians to effectively navigate these issues providing best possible care for their pediatric patients.

Takeaways in This Episode

• What is the ''best interest'' principle in care of pediatric patients
• Where does the ''best interest'' principle fall short?
• What's the role of the "harm principle? Who does it affect?
• The parameters around "autonomy" in care of pediatric patients
• Is there such a thing as "the Mature Minor" and where does it come into play in pediatric care?
• Controversies around opioids prescriptions
• Role and obligations of clinicians in prescriptions of opioids
• Considerations when a clinician is faced with request for medical marijuana for a pediatric patient
• The bottomline on marijuana use in pediatric patients

Links Mentioned

Douglas Diekema MD, MPH

Treuman Katz Center for Pediatric Bioethics

Podcast Episode 5

AAP Poster on Safe Storage and Disposal of Medications

AAP Policy Statement on Marijuana

Pediatric Bioethics Conference 2018

If you have ever found yourself wondering about the gap between what you said and what your patient or families heard, you would not want to miss this episode, with great insights from Ms. Pamela Block, a mother to a child chronic pain and CEO of a community for patients and families with a rare complex condition. She shares her own contrasting experiences with complex medical care for her daughter, including pain and leaving us with terrific little tweaks that will augment our quality of clinical care and outcomes.

Takeaways From This Episode

• What made her jump both feet into creating a patient and family community supported by healthcare providers
• What patients and families see and hear during their medical encounters
• Factors leading to success or failure in outcomes of chronic or complex pain care
• Things that parents value, need and want in the care of their children's pain
• Priorities of patients and families with chronic pain
• The shifts that happen when parents feel heard and understand the goals
• What providers can do to become more effective in helping the patients and families with complex pain, even during their routine care
• What does a "quarterback" have to do with pain care
• Challenges with complex and chronic pain care

Links Mentioned in this Episode

Free training for parents of children with pain

Association for the Bladder Exstrophy Community

Pamela Block

This episode is all about creating winning strategies in healthcare and pain management when faced with rare, refractory and poorly understood diagnoses, that may not have any great treatment options. Story shared by the parents of my then 4 y/o patient with a rare and extremely painful condition, Erythromelalgia, highlights some of the elements that returned normalcy into their child's life despite this life long condition.

Takeaways in This Episode

How parents' early insights help with prompt and accurate diagnosis

How to proceed when little is known about a disease

What parents value even more than accurate diagnosis or treatment

What a parent sees, hears or feels when many specialists care for their child

What allowing parents to become active participants in healthcare can accomplish

Links Mentioned

Erythromelalgia

Fairytale's Daughter

We continue our series on technological innovations designed to enhance the way we provide clinical care, deliver and receive information and education to and from our patients and families, leading to increased engagement, compliance and ownership by them. Today we talk to Rachel Trobman, Founder and CEO of OUCHIE an online platform for tracking and effectively managing chronic pain using multimodal treatments.

Takeaways From This Episode

• How a FREE online platform is used for tracking pain, mood, function etc., how it's used for education, pain management and creation of community for chronic pain patients.

• How this platform can be used by any HCP for better care of their pain patients and how it can be customized to their particular needs and therapies.

• What they do to ensure that patients, despite their pain, focus on what they CAN DO, rather than what they can't.

Links Mentioned in this Episode

Ouchie

Rachel Trobman

Pedia Pain Focus Episode 3

Pedia Pain Focus Episode 4

US Pain Foundation

American Pain Society

This brief bonus episode is packed with tips for safe prescribing, storage and disposal of opioids, and other controlled substances with misuse potential.

DEA National Prescription Take Back Day

CDC Guidelines for prescribing Opioids

FDA Information on Opioids

In this episode Dr. Christine Chambers a prolific researcher, clinician, and academician, delves into the issues healthcare providers face with Social Media and online information, how they can effectively use SM for knowledge translation, and effective clinical partnerships.

Takeaways in This Episode:

• How a 2.5 minute video revolutionized the way Knowledge sharing and translation occurs in medicine
• What 3 factors led to development of this revolutionary work and how this paves the way for future knowledge sharing with patients and families
• Unanticipated challenges in putting her ideas into practice and how she found an effective solution to create a video that went viral in multiple languages and continents
• Obligation of HCP regarding SM, online content and communication
• Effective strategies for HCP to help parent in navigating this ocean of online information

Links Mentioned in This Episode:

It Doesn't Have to Hurt

It Doesn't Have to Hurt Video

The Center for Pediatric Pain Research

Limited access to pain care, especially in remote and rural areas, is no surprise and when it comes to pediatric pain care, it's even more sporadic. My today's guest, Ardith Doorenbos, MSN, PhD, shares her extensive work using Telemedicine for education, research and clinical care. Also included is your FREE Guide to Setting up Telemedicine Services.

Takeaways from this episode

• What made her invested in Telemedicine
• What are some of the expected and unexpected outcomes (cherry on top) and efficiencies of Telemedicine delivered pain care (Hint: it's way more than just solving the access problem!)
• How Telemedicine changed the outcomes, and QOL for both the patients AND healthcare providers
• What 3 specific benefits resulted for healthcare providers
• Economics of telemedicine for pain care
• Considerations to determine what model of telemedicine is best for your setting