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  • Patients with chronic pain spend a lot of time on social media looking for answers, looking for help. I personally receive hundreds, if not thousands, of emails a year from patients crying out for help.
  • They’re not even asking for opioids: they say “I just need help. As soon as a provider finds...

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The anatomy of the visceral innervation: different organs cover the entire abdomen and pelvic region, including

  • Bladder
  • Uterus
  • Fallopian tubes
  • Ovaries
  • Lower part of the sigmoid and the rectum

Viscerosomatic conversion is a very interesting phenomenon when it comes to visceral pathways:


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Why do doctors get into legal trouble? The 4D model: dated, duped, dishonest, disabled (from decision making). It can happen in the courtroom. Experts will point that out that a doctor...

  • Didn’t stay current on licensing board guidelines
  • Was fooled and didn’t have the appropriate measures or...

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The following chronic overlapping pain conditions either solely or predominantly affect women—vulvodynia, temporomandibular disorders, myalgic encephalomyelitis/chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis/painful bladder syndrome, fibromyalgia, endometriosis, chronic...

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Documentation is a many-headed beast:

  • It started out as a way to keep track of what we’ve done, to create a record that would be a legacy to patient care
  • It has transmogrified into a tool for billing, a risk management function
  • It tries to document with other professionals who are caring for...

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In geriatric patients, chronic pain is quite common as well as challenging. Due to age and comorbidities, surgery can be tough on this patient population.

What’s New?

  • Fewer surgeries are being done on patients 65
  • We have an option to provide, as the medical field is growing, minimally...

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Interest in cannabinoids is at an all-time high. Does this interest impact the perceived opioid crisis? Do we know enough about CBD and THC to make decisions? What has Dr. Jay experienced?

We don’t know enough to be certain of anything:

  • I personally hesitate to tell patients, “Oh, you should...

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A chronic pain patient may see many doctors, from general practitioner to pain specialist. But what comes between those visits? What’s the process?


  • The patient is managed conservatively by the primary care doctor or practitioner, which may entail certain medication therapies or...

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Potential treatments

  • Increased fluid intake: sickle cell disease patients are more at risk for dehydration because they can’t concentrate their urine
  • Ibuprofen, NSAIDs
  • SSRIs, SNRIs
  • Gabapentinoids
  • Antispasmodics
  • Hot baths, heating pads, hot packs
  • Massage
  • Distraction
  • Activity when...

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Abuse deterrent formulations: different manners of preventing someone from transgressing to the inhalation or snorting of medications, or intravenous use.

  • Aversion: if someone attempts to abuse the product it would not feel good. For instance, if the product is crushed and snorted, the nose is...

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