Innovative Approaches to Chronic Pain with The Anodunos Method Team

Dr. Jessica Drummond 00:00:03 Hi and welcome to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I am so thrilled to have you here as we dive into today’s episode. As always, innovating and integrating in the world of women’s health. And just as a reminder, the content in this podcast episode is no substitute for medical advice, diagnosis, or treatment from your medical or licensed health care team. While myself and many of my guests are licensed healthcare professionals, we are not your licensed healthcare professionals, so you want to get advice on your unique circumstances. Diagnostic recommendations treatment recommendations from your home medical team. Enjoy the episode. Let’s innovate and integrate together. Hi, and welcome back to the Integrative Women’s Health Podcast. I’m your host, doctor Jessica Drummond, founder and CEO of the Integrative Women’s Health Institute. Today, I am so thrilled to introduce you to the founders and collaborators at the Anode and Moss Institute. And I’m sorry if I have a bit of a challenge in this episode pronouncing a no. Two dose, but it is a term that comes from the Greek language, and you’ll learn specifically what it means.

Dr. Jessica Drummond 00:01:38 But the goal of this organization is to help train people who want to help those with chronic pain navigate a multidisciplinary set of resources that actually will help them meet their goals, including the client themselves. And for those of us who have worked in chronic pain for decades now, the evolution of the research and the resources has been amazing in the course of my 25 year career, and I love the conversation that I had with these wonderful pioneers and innovators in the field of chronic pain, because we really talk about how challenging it can be for a person with chronic pain to walk this line between accessing the care and services that they need in a non-traumatic way that doesn’t exacerbate their situation and get the support that they need from others who are experiencing chronic pain or very well versed in chronic pain. And by entering that community, sometimes we have to be careful of that becoming someone’s entire identity, which is, you know, a draw, right? It’s a draw to be in a community that is not as ableist, that is supportive, that understands what you’re going through and keep people engaged in their lives.

Dr. Jessica Drummond 00:03:08 So they’re not stuck with just the label of their illness, of their chronic pain diagnosis and being limited in what they can do in the world. And yet when they go in the world, there is a real lack of understanding of chronic pain, chronic conditions, episodic disability, invisible illness. And it’s such a challenging line to walk for the team of professionals and for the client herself. So as you’re listening to this episode, really think about when you are working with someone with chronic pain. Are you pulling in all the resources, and how can we help our clients navigate the resources? And in a true multidisciplinary approach, we’ll talk about how sometimes the education is not truly really multi-disciplinary and also helping your clients live more, thrive more without being gaslit, being well supported and not having to go deep into identification with their diagnoses. It’s a really challenging conundrum in the world of chronic illness and particularly chronic pain. So listen for that. And as always, we’ll talk about it in more depth on the other side of this wonderful conversation.

Dr. Jessica Drummond 00:04:27 Thanks so much for joining us. I want to welcome everyone as we talk about how to take a very integrative and multidisciplinary approach to chronic pain. So welcome to Jenn and Christine and Monica, who are all a part of the Ananda method and the therapeutic Alliance. So, Jen, let me start with you. Where did this idea come from? And what is the grounding principle of the anonymous method for healing from chronic pain?

Jenn Trepck 00:05:06 Absolutely. So anonymous is Greek for without pain. Sorry. And no, no, don’t worry. All good. Everybody butchers that you are in good company. Okay. So it’s the anonymous method. And it’s really about fundamentally a truly integrative approach to care. And one of the things that we all know about anything chronic is that even the word healing is sort of loaded. Right? So we talk about it as an approach to care. The method itself is based on the Health and Human Services report that really showed that a combination of modalities implemented simultaneously or in tandem created exponential benefit for the patient.

Jenn Trepck 00:05:55 And so I want to give this to Christine, too, because Christine really brought Monica and I into the fold of this to help create an approach and a system for implementing this, because it was something that we saw a real need for in our clients, our communities, and a gap in terms of how this gets implemented. Because while many of us know our domain right as a health coach, as a massage therapist, as a physical therapist, you know, as a pain physician, we know our domain, but we don’t necessarily understand what everybody else is bringing to the table and the benefit and the complexities of how we simultaneously implement these things without it feeling super overwhelming to the client or the patient.

Dr. Jessica Drummond 00:06:49 Absolutely. So, Christine, who are the key members of the team. Is that something that’s based in a particular body of evidence? Is it something based on your experience? Is it something that was maybe recommended? And the HHS report, how did you come up with who the team should optimally be?

Christine Sotmary 00:07:09 So what it is in terms of the training is we train pain navigators to create a team.

Christine Sotmary 00:07:15 So we are the team for the training program. But John Rosa down in Maryland has 17 clinics and he’s our mentor. And instead of doing brick and mortar, we came up with a way to have this launched without having to have the actual office space. It would be that each provider would have their own business, but you’d have a pain navigator coordinating everybody. So you have the patient, you have their doctor, you have the pain navigator. And now the pain navigator goes into the community, finds acupuncturists, finds massage therapists, nutritionists, yoga teachers, trainers, physical therapists and creates a team, usually of about ten people. They all get trained by us as well. Because I work with the US Pain Foundation and I can’t tell you how many misunderstandings there are between providers and people who are living with severe pain. Some of it’s the stigma that goes along with it. Some of it’s that the providers feel like they’re overwhelmed. And so even for the providers, this is an excellent way to join together and collaborate so that maybe I, as an acupuncturist, wouldn’t have all the answers.

Christine Sotmary 00:08:32 But the person who’s the nutritionist is like, I think this is about inflammation. I think we should talk to this person about their diet, and maybe another person can talk to them about their relationships or their the movement in their lives, different things. And then when that’s all together, then it turns out the HHS report and the VA have also integrated their care so that really the people benefit way, way more than if just I was working alone or even the doctor was working alone. They’re kind of at their wits ends. About all we have is, you know, these interventions and these prescriptions that we can offer, but they don’t have the mind body all the time. And so as integrative providers, we bring that in.

Dr. Jessica Drummond 00:09:17 And so who is the pain navigator. Could it be someone with any professional background, skilled health coach eventually the client themselves. What is that role?

Monica Demitor 00:09:30 The pain navigator could be a health care professional that’s, you know, working in a another role but is now decided they would like to be a navigator or it could be somebody with chronic pain, or it could be just somebody interested in helping patients.

Monica Demitor 00:09:43 And I think the role of the navigator with the individual’s primary care physician or the doctor that’s in charge of their care, they really work together to define what are those sort of 2 or 3 top issues for 2 or 3 top professionals that an individual could utilize to start with? I think it’s really important to not say that you’re going to have Christine talked about ten people on a team, and there could be ten people involved in a group, but at any given time, you really just want to focus on 2 or 3 people. Otherwise it could be very overwhelming for a client. And so I think the important thing is, is the navigator along with the physician that’s treating the patient, really identify what are the 2 or 3 biggest issues that are going to impact this individual and then get care for them. And the navigators role is really then to go out and find if they’re not on the team, getting somebody who can address those 2 or 3 top items. And once you see the reason, you also want to limit it, not just overwhelm the patient, but you want to see what’s actually working for the patient because you may engage them with, say, diet.

Monica Demitor 00:10:52 But after a while of that process, that’s really not seeing the improvement that you want. And you may need to get somebody else involved in the process. And so I think in order to get the best treatment approach for the patient, not to overwhelm, but also to be able to refine what’s working best.

Dr. Jessica Drummond 00:11:09 Yeah, I could see a really strong aptitude for this kind of role for any of our health coach graduates, because I think it’s a really strong role in terms of communication, integration of resources, a client centered approach. And so, Jenny, we were talking a bit earlier about how the client is from the get go, just like in health coaching, a very important collaborative member of the team. So talk a little bit more about how that works.

Jenn Trepck 00:11:46 That’s part of why the certification exists because the expectation isn’t necessarily that somebody is showing up to this work. With all of these skills and all this knowledge of the pain patient. It is potentially, for some health coaches, a way to expand their practice or, you know, their scope of work and open or specialize in a niche of patients that can be complex.

Jenn Trepck 00:12:12 Right. So part of the navigator certification is to walk through understanding the pain patient and some of those specialized communication pieces. And the part that we were talking about before of is a whole module about the therapeutic alliance. And the idea of the therapeutic alliance is that the three practitioners, the patient and the navigator, are all locking arms together to work toward healing. And that looks different, by the way, for everyone. So who those practitioners are for each patient might be very different. And we recommend sort of a re-evaluation of that care team every 12 to 16 weeks, because it might be where we started with acupuncture. And now after 12 weeks, we’re ready to move into physical therapy or to go from physical therapy to personal training. Right? So there’s an evolution in that progress that everybody on the care team is involved in. So with that therapeutic alliance, it enrolls the patient in an equal capacity to the direction of the care team, as every other professional, as their medical professional, their allied health professional.

Jenn Trepck 00:13:36 Right. Everybody on the team. And part of that gives a lot of ownership and autonomy and value to the patient’s voice and the patients experience that, Especially when it comes to pain. You know, at the end of the course, we have a number of interviews and testimonials with people who have become navigators and our pain patients. So by the way, yes, part of the process might be that somebody evolves into this role and saying, look, I’ve had so much progress. I want to pay it forward to, you know. And so the pain navigator plays a critical role in the communication with the client, the communication between the other practitioners. And the objective is to lighten the load on the patient from having to do all of this coordination of care and appointments and telling their story 800 times. And, you know, for some that’s retraumatizing each time they have to share the story. So then it becomes with the therapeutic alliance, letting the patient and we know this in a coaching model to ask questions, letting the patient also guide what’s working, what’s not working.

Jenn Trepck 00:14:50 What do you think would be beneficial on the care tape? Where do you feel like you want to be making more progress than you are? Or what do you feel like is working really, really well that we want to double down on? So it allows this collaboration with all the practitioners and the patient?

Dr. Jessica Drummond 00:15:09 Yeah, I love that very organized, tight knit strategy because as you’ve been mentioning, it’s so challenging with chronic pain because often there are so many different subspecialists involved. There’s pain, mental health care, there’s physical therapy, there’s acupuncture, there’s mind body therapies, there’s movement therapies, there’s pain management from a medical standpoint. And so absolutely, that can be an overwhelming journey for clients that sometimes they don’t know where to begin. So before we get to some of the success stories of what this looks like in practice. I would love to hear some of the challenges that your clients might have when they actually get access. You know, I think one of the struggles that people with chronic conditions have the most is like just plain access to care.

Dr. Jessica Drummond 00:16:01 I haven’t been able to find someone to see me for the next five months, or the care is very disjointed. This method and this strategy pulls that all together for the client to make it less of a slog to just get access to care. Have you seen any challenges pop up when the opportunity kind of opens up for them to step into this multidisciplinary experience?

Christine Sotmary 00:16:25 Definitely the coverage to be able to get payments and coverage for these treatments. So the second half of our mission statement, in addition to training people and creating these programs, is to have in New York State anyway to have the insurance cover these practices when it comes to pain, because now there are pain codes. So if someone’s being treated for pain as a standalone, we’re talking about people who had a car accident 25 years ago and they still have back pain, people who have disease processes that cause pain. So to look at the pain, it’s not separately, but as an individual standalone component. Now we can do that because they’ve created these codes.

Christine Sotmary 00:17:12 So then the next step is to get coverage. We got so close this last spring. And so according to the politicians we’ve been working as they said that it should go a lot faster this coming session, which is in January. So, you know, would it be nice to have that kind of coverage all over the country? Massachusetts already has it. So we’re modeling what we’re proposing on what’s already existing in Massachusetts. And it was the same idea was that for pain, you would get coverage for acupuncture, massage, mostly things that are licensed right now, but some of these modalities are just certified like essential oils or hypnosis or some of the things that we would recommend, but that would be maybe step two or plan B or something to get that covered later down the road. But let’s at least get people who are licensed to do what they do to get the full coverage that in order to keep their doors open. And and as Jenn said before, this is a way for people to expand who they’re able to treat because they’re coming into a whole system that would be created in and it’s community based.

Christine Sotmary 00:18:18 That’s another important thing, because a lot of the pain management programs, you go to the hospital, and that already carries a certain connotation for the person who’s living with pain to be able to be treated in their homes or to be able to go to someone just down the block. That’s what we’re striving for in an ideal world. There’s also telemedicine, too.

Dr. Jessica Drummond 00:18:39 Yeah. That’s wonderful. I think that’s always one of our biggest challenges when we’re talking about integrating multidisciplinary care. And integrative care is getting payment for that, for the payment to not be such a large burden on the client, but also for the person who’s running these practices to have a living wage. And that can be challenging in a lot of the insurance models. So it’s great that you’re working on that. And then I think, you know, that reaching into the community because let’s say when I was early in practice, say 25 years ago, we knew from a lot of the data that these multidisciplinary pain centers were very effective. But we had two main problems.

Dr. Jessica Drummond 00:19:22 Exactly what we’re talking about here. One was essentially, everyone decided to not pay for that because it was very effective in a certain percentage of cases, which you wouldn’t know until later. And so they didn’t want to invest in anyone who might or might not actually get benefit from it. And so almost all of those centers have now shut down in a sort of single location, multidisciplinary kind of pain center. But the downside to those, which I think you’ve really done a nice job of overcoming, is that it’s a very different experience to kind of go somewhere, step out of your life, to get healing done to you, if you will, versus be still living your life and your goals, and then having the support team of things like fitness professionals, you know, massage professionals, nutrition professionals, physical therapy professionals working with you towards a goal that allows you to maintain your, you know, less active than you want to be, to being more fully active. So I think that healing within real life is so, so important to maintenance of the gains.

Dr. Jessica Drummond 00:20:37 Have you seen some examples of that?

Christine Sotmary 00:20:38 Monica is an example of that.

Jenn Trepck 00:20:40 Absolutely. I mean, Christine, you can speak to some of the people in your support groups. Yeah. Monica too, but I just want to jump in to say that I think two part of the role, the navigator, is to help the client or patient connect with the professionals who can meet them where they are. So because for a patient with high impact chronic pain, especially trying to find those practitioners and then deal with the right, it just keeps adding to the pain and the burden of making progress.

Dr. Jessica Drummond 00:21:11 Monica yeah, so tell us your story. Monica what what was so helpful for you? So, you.

Monica Demitor 00:21:16 Know, you talked about you were asking Christine about challenges. And yes, payment is a challenge, significant one for many people. But I think even a greater challenge from my perspective having been through this, and I’m a healthcare professionals, so I came into the situation with a lot of knowledge. The issue really is finding people who know in the different disciplines, whether it be physical therapy, acupuncture, massage therapy, nutrition that really have the education and knowledge to be able to treat people with chronic pain.

Monica Demitor 00:21:51 You know, I think there’s a lot of stigma out there about what chronic pain is or what pain is, and people come in with those preconceived ideas they don’t really understand, but they proceed to treat and give advice from what they believe is their expertise, when it really it isn’t appropriate. And I think that, to me is actually more detrimental to the patient who doesn’t have a knowledge in healthcare. And how to manage how to navigate through the healthcare system is healthcare professionals who are not trained in treating chronic pain, trying to treat chronic pain, and give advice around chronic pain to patients who have chronic pain. And so to me, as somebody has been through this, I think that to me is the larger challenge. Yes, payment is a big issue, but health care professionals telling you what you should and shouldn’t do, when they really don’t know and haven’t been properly trained is, to me, a bigger disservice to the chronic pain population.

Dr. Jessica Drummond 00:22:48 Yeah, because I think and you know, the literature is now very clear that going through a essentially a medical trauma exacerbates the trauma of living with chronic pain for a period of time.

Dr. Jessica Drummond 00:23:03 And, you know, continues to erode trust in healthcare professionals continues to erode, I guess, a sense of hopefulness and competency. And that can be really exhausting and fatiguing on top of the pain and even directly exacerbating the pain. So I think that’s a really important point that people who are working with acute pain, it’s not a directly translatable skill to work with people with long term chronic pain, because there are so many layers to it.

Monica Demitor 00:23:40 Oh, absolutely. I mean, the the impact that chronic pain can have on people’s mental status for people to get treatment and to for it to be successful, you really have to address the mind body connection for people who’ve been going through chronic pain for a significant part of time. And so many of the practitioners out there, I don’t think, understand that the impact, because the actual pain is traumatic when it’s such a long term for the patient. You know, having been a healthcare professional and having been engaged with alternative forms of healthcare pretty much my entire career, I have been able to navigate that.

Monica Demitor 00:24:17 But I think about people who aren’t trying to find quality practitioners, because even if somebody doesn’t have pain, there are multiple levels of expertise. Just example physical therapists, acupuncturist, they might have that title, but the level of expertise and the level of knowledge that that person brings, irrespective of whether it’s they’re knowledgeable and chronic pain varies. My experience in the healthcare profession is that there’s really only 20% of healthcare professionals that are delivering service at a level that I think is satisfactory. The rest are mediocre at best in every single profession of the healthcare industry. And I think laypeople don’t understand that and they don’t know how to navigate that. And that’s where the education of the navigators and education of the healthcare professionals, to me, is critical in this space to ensure that that a patient gets adequate care.

Dr. Jessica Drummond 00:25:17 Yeah, I think that’s very important. You know, there certainly are with any profession, levels of skill, levels of expertise, level of commitment, level of safety. And not only that, but because this is such a human profession, it’s not even just about the direct knowledge, but about whether or not that knowledge is applied in a way that’s aligned with how the client best would receive it.

Dr. Jessica Drummond 00:25:46 Right. Some people really respond to sort of a straightforward, clear, tough love kind of approach. Other people really need slower pace to support their nervous system recovery or slower ability for the client to really settle into navigating that history of trauma and the pace that she can integrate some of these therapies. So I think that’s an important piece to it’s not just about the kind of skill level in terms of knowledge and training, but how that knowledge or training is delivered, being in alignment with how any individual client might best receive it. So, Christine, now let’s talk about some of these success stories and what the chronic pain professionals and people living with pain can learn from this model to take into their own lives and practices.

Christine Sotmary 00:26:44 So what we’ve seen, like I said, Doctor John Rosa has these 17 clinics. We haven’t mentioned it yet, but we are adjacent to the opioid crisis. So he in Maryland, he actually goes to the white House and speaks to them about the opioid crisis and how to treat pain in this way, so that I think he uses acupuncture, massage, chiropractic, and cognitive behavioral therapy at each one of the 17 clinics.

Christine Sotmary 00:27:10 So that’s what we’re modeling what we’re doing on. So we envision that the navigator would actually have a job. So they would be hired by either a hospital, a medical practice, a community center, or even a corporate setting, because how many employees are out with back pain or chronic migraine. Migraines, so you would have a pain navigator on staff at the corporation so that people could go to them and get the care in the community that they need. And then the providers, at least now, would have their own practice so that everyone’s independent. But then the organization would be done through the navigator working out of either the hospital or the corporate setting. So that’s how we envision this to happen. So what we heard at the VA, I think they did a study, it’s called IPM Integrative Pain Management. They did a study and they did exactly what we’re proposing. The clients were happy, the patients were happy. They got their acupuncture and their massage. And they felt much, much better and their pain was greatly reduced.

Christine Sotmary 00:28:20 The providers, however, this was so interesting, the providers felt that they didn’t have the training they needed to either. Like, as Monica said, work with people who have this degree of pain and also how to talk to each other. Like if I don’t know what hypnosis I don’t if I don’t know what that is, if I don’t know what chiropractic is, and if I don’t know what a nutrition my nutritionist might bring to the table, it leaves me almost like speechless. Like I don’t have the words to communicate. So even if I was at a zoom call where all the other providers are on the zoom, I may not even know what to ask. So we train people in what everybody else is doing, and we give them the language, and we also give them the language of how to speak with the pain patients. So language is a big part of this because you can really make some mistakes that you think you know, oh, what’s the harm? But it’s important. It’s important because of the stigma and all the things that these people have been through.

Christine Sotmary 00:29:18 They’re easily retraumatized. So it’s like paramount. And I get from the feedback that I get as being a peer support group leader for the US Pain Foundation. I hear all the stories. It’s almost like I feel like I’m a plant, you know that I can hear, oh, this is how they were disrespected. This is how they weren’t listened to. So I came home and I would write down everything they said. And that became part of the training because these were real people in real situations.

Dr. Jessica Drummond 00:29:46 Yeah, absolutely. I think that’s a super important point, that even if you have multidisciplinary access to other colleagues that you could reach out to and connect to, sometimes you just don’t know when it would be valuable to pull somebody like that in. So I think that kind of multidisciplinary training around what other people do within their scopes of practice and their education can really layer on top of the work that, say, an individual chiropractor, an individual acupuncturist or PT is doing. So I want to talk specifically about the role of mental health in chronic pain management.

Dr. Jessica Drummond 00:30:26 There’s a lot of challenge to that because of course we don’t want our clients to be thinking the pain is all in your head, but we do all know here I think that pain is always, at least to some extent, in the brain, especially when we’re talking about chronic pain. So how does your program and your experience educate practitioners and clients on how to integrate a nervous system strategy, a mental health strategy as a part of pain management and pain recovery.

Jenn Trepck 00:31:00 In a variety of ways. Fundamentally, it even goes back to what Christine was saying about part of the provider course is an overview to some degree, of all of these other disciplines. And I will say, right, in writing this course, we did try to fine line because especially a lot of our traditional medical practitioners, it’s not about talking down to them, right. So we have to speak their language. We have to, even in the course, communicated in a way that it’s received. We do in that highlight cognitive behavioral therapy and the role of the nervous system in acupuncture, in Reiki, in a lot of these other modalities.

Jenn Trepck 00:31:51 And there’s a lot of really interesting work out there that actually shows long term on opioids can actually heighten the pain. Physiology because of what actually happens is that desensitize is. So then the same trigger creates a heightened sense of the pain, even though from the physician standpoint, it’s exactly as it was before. So part of the education is also about how are we helping evaluate and work with the client or the patient in measuring their progress in what they’re noticing. And communicating to them about the two way communication between the mind and the body. So again, we don’t want to say to them, oh, it’s all in your head, but how do we talk to them about potentially adding cognitive behavioral therapy or some nervous system work or meditation into this practice? So for example, I have a client who he even has a history of trauma around psychotherapy.

Dr. Jessica Drummond 00:33:07 Absolutely. Yeah I’m sure that’s common. Yeah.

Jenn Trepck 00:33:10 Exactly. And really his healing is stunted to the extent that we cannot address this from both sides of the equation.

Jenn Trepck 00:33:22 Right. The body and the mind. And so it’s somewhat of a longer process to continue to drop those hints. How do we have those conversations? How do we talk about the role of all of these things with the patient and their getting on board, and over time, it becomes their idea, right, to add in this piece to the care team. And so part of it is also that evolution of the care team, where we might know as practitioners that this is fundamentally what’s needed and they might not be there yet. And that’s okay too. Right? So part of the education is on all of these different elements that are going to come into play. And it’s just like we all know from practice we have the textbook side. And then there’s the implementation piece. We’re not teaching anybody their expertise. We’re teaching put the puzzle pieces together and here’s how we can do that and what that looks like in practice. And then what the benefit is of that with the pain patient.

Dr. Jessica Drummond 00:34:28 Monica being a former or maybe improved pain patient in this experience.

Dr. Jessica Drummond 00:34:35 Did you ever struggle with. And this is a common thing I see in my clients. Over the last 25 years, I’ve worked with a lot of people with chronic endometriosis related pain vulvodynia painful bladder syndrome, and I even had my own experience in the last four years with long Covid. There’s a real challenge when you kind of step into a chronic illness community in that it can be very, very supportive at first when absolutely everyone around you is completely ableist and doesn’t believe in episodic pain and all of that. But then there’s a risk of too close of an identity with either your diagnosis or your diagnostic community to sort of keeping you stuck from fully healing. How have you addressed that personally? How do you guys address that in your program?

Monica Demitor 00:35:29 I do think that is a challenge, because it could be very easy to slip into that identification as a chronic pain patient and become part of that sort of community. And my experience is, is that the health care profession facilitates that process. Every single time I have gone for care, the first thing they offer is some kind of medication, whether that be an opioid, an anti-inflammatory, a antidepressant.

Monica Demitor 00:36:03 This is their first line. And for me, I, I don’t like taking pharmaceuticals. I’m just that’s not who I am. And that’s not what I’m going to do as a first line with any kind of illness that I may have or any kind of health issue. I want to figure out what the root cause is and address the root cause, and if medication is required, or surgery or something like that. It’s not that I won’t do that. It’s just that that’s not the place I’m going to go first. And unfortunately, the health care system navigates you in that way. And so for me, I’ve found that it’s a fight to keep out of the community, to keep out of going down that road, because that’s the way you are directed. And for me, I’m lucky. I’m fairly independent and skeptical, I would say, of health care, even though I’ve worked in the health care system my entire career. I’m a health care professional, and I’ve worked in both the clinical space as well as the corporate space in health care.

Monica Demitor 00:37:04 But I have a very healthy skepticism of traditional health care. It has its place, but it also has significant flaws. I think you have to be really careful. And that’s one of the things that I think the training we’re really focused on trying to help health care providers understand this disease process, that it is something that’s multifaceted and really requires individualized approach based on how the patient presents themselves, but that some kind of mind body approach to care is required. And if it’s not, it’s easy for a patient to slip into identified as a chronic pain. I think the most important thing is keeping people engaged in their life, not seeing the disease and everything that they do in life rotating around the disease. And that’s why it’s really important to to minimize interactions like important to have the appropriate health care professionals involved, but not too many that that comes to define the individual. You want them to have a life outside and a life outside of the community. I think that’s really important. The community is there for support, but it shouldn’t be their whole life and encouraging people to keep active in other ways in their community that are unrelated to their chronic pain, I think is critical.

Monica Demitor 00:38:27 And I know for myself, that’s really been an important aspect of recovery, is keeping involved in my work, keeping involved in other groups and people outside of the chronic space that aren’t talking about chronic pain or talking about their experience with chronic pain that they’re just out doing. They’re living their lives. And I think that is so important for health, not just related to chronic pain, but just health in general.

Dr. Jessica Drummond 00:38:56 Yeah, I agree. I think that keeping people tethered to other things about their lives is very, very important. And I think on the flip side of that, helping people have the communication skills to navigate those things when you know they have things like episodic disabilities or when people in the community can also trigger that traumatic response when they’re ignored or their not believed, or they’re seen as kind of malingering or faking it. And I think we have a very complicated relationship with disability in this country. There were laws making it invisible up until the early 1970s. You know, people with disabilities were not really allowed in public in the same way that they are now.

Dr. Jessica Drummond 00:39:44 And so I think that internalized ableism is really challenging to overcome, too. So I think one of the most important roles in a multidisciplinary health care experience, working with people with chronic pain and episodic disabilities, is really giving them the language to feel comfortable in public. I think, Christine, what you said is so, so important how we speak about this kind of walking that center line between becoming completely identified with the illness or disability, keeping them kind of stuck there and having them sort of gaslit out in the world that their experience is not real. So it’s it’s a very fine line. So I think your program is so, so important because you’re right, health care professionals have an opportunity here to really help people navigate that in a very, very productive way versus a traumatic and exhausting kind of way, or over identification with their situation.

Jenn Trepck 00:40:50 Yeah. I want to just point out two things. One is that the nature of chronic pain is that it is often not visible. And so they can be out in the community.

Jenn Trepck 00:41:00 And we don’t know. There’s also a piece of that in the conversation that I think is really important, even to validate with the client or the patient as they go about their activities of daily living. Right. And then the other piece is Christine and I attended this continuing medical education course that was I can’t remember, Did they call it multidisciplinary or multimodal? Do you remember? I think it was.

Christine Sotmary 00:41:25 Disciplinary, I think disciplinary.

Jenn Trepck 00:41:27 Yeah. So they called it multidisciplinary. But the entire module, you know, ten module course, whatever it was, their definition of multidisciplinary was two pharmaceuticals. Right. So I just want to put that out there to everybody as the phrase multidisciplinary means different things in different contexts. And so first of all, Jessica, thank you for letting us, you know, expand on this and help people understand what we really want multidisciplinary to mean. And so even for our clients and patients to show up to their health care professionals, as Monica has and said, here’s what I would like to do.

Jenn Trepck 00:42:08 Right. Here’s how I would like to approach this. Can you get on board with that?

Dr. Jessica Drummond 00:42:11 Yeah, and I think you’re exactly right. Health and wellness professionals are often just completely unaware that things beyond pharmaceuticals, particularly physicians. I mean, they’re trained physicians, nurse practitioners, Pas sure are trained. That’s the tool that they’re trained with, and they’re very rarely even aware of other tools. They might be aware of physical therapy. But as you’ve mentioned, Monica, there’s a wide range in the skill set of various physical therapists. But for many physicians, for sure, that’s the extent of their training, where the burden usually lies on other allied health and wellness and mind body professionals to go back and educate the physicians and other medical professionals about what they do, because they are not educated about that in their training, of course, but apparently also not in their continuing education, by and large. So I will give a bit of a hats off to some of the chronic pelvic pain organizations and endometriosis organizations, such as the Endometriosis Summit or International Pelvic Pain Society.

Dr. Jessica Drummond 00:43:21 There are a few women’s health and pelvic pain societies that do integrate, surgeons and physicians and physical therapists and mind body medicine and mental health. But you’re absolutely right. That’s extremely rare, especially in things like chronic back pain, chronic joint pain, which are so common, chronic headaches. I do think it’s amazing how much the military and the VA has really taken a strong lead on this. I mean, they’ve been talking about using acupuncture even in surgery for more than the last decade, which is really cutting edge. So I think the work you’re doing to expand this and the fact that you’re speaking directly with state level politicians about reimbursement issues, I mean, I just applaud the work that you’re doing because this is the real definition of multidisciplinary, not just multiple kinds of pain meds. So thank you so much for being here. So where can our professionals or people who are struggling with pain find you and learn more?

Christine Sotmary 00:44:32 The anonymous method. Com so if you see on the screen, I don’t know if some people probably don’t have their podcasting in their ears.

Christine Sotmary 00:44:39 So ano de Uno’s a nose to nose method. Com and that’s where we have the trainings the courses. And they can find out more about our advocacy work as well.

Dr. Jessica Drummond 00:44:52 We’ll include these links and connections to your social media on LinkedIn in our show notes as well. Thank you so much to the three of you for being here today and sharing your stories and the advocacy work that you’re doing.

Monica Demitor 00:45:06 Thanks so much, Jessica.

Jenn Trepck 00:45:07 Thanks for having.

Christine Sotmary 00:45:08 Us. Yeah. Thanks, Jess.

Dr. Jessica Drummond 00:45:09 Thank you so much for joining me and the team at the Anonymous Method. I’m so glad that we have organizations working in such an interdisciplinary and holistic way, trying to pull in new avenues for funding, for support, not just for the clients and patients, but for the professionals that serve them. New avenues and innovative strategies for building multidisciplinary care. When multidisciplinary care in a center in one brick and mortar practice is one no longer necessary, but two is not well funded or well supported. So how can we get creative? So I know that many of our listeners are practitioners who work in the fields of chronic illness and chronic pain.

Dr. Jessica Drummond 00:45:57 Think outside the box. I hope you got inspired. I know you’re already thinking outside of the box, so I hope you were inspired with a few new ideas. If you are someone living with chronic pain or chronic illness, know that all of these tools available to you really do exist. And I know that they are difficult to find. They’re difficult to coordinate. It’s an added stressor to navigate the health care system. But reach out. Have health coaches and navigators in your community that will help you do some of this legwork and be there to support taking those baby steps over time. Deep healing, deep care, deep support, and full living is available to you. And there are people out there who are working very hard over the course of their entire careers to help make this more successful and accessible for you. So know that these resources exist. Step in and be these resources. If you have the capacity to do that. When you have the capacity to do that, and in your chronic health condition and chronic pain practice.

Dr. Jessica Drummond 00:47:13 And we’re here at the Integrative Women’s Health Institute to support you all along the way. Whether it’s in professional training or support for your own health challenges, we are here for you. The Anode and Nose Institute and Method are here for you, and the people behind that wonderful method are here for you. There are more resources than you know. I’ll see you next week. Thank you so much for joining me today for this episode of the Integrative Women’s Health Podcast. Please share this episode with a colleague and if you loved it, hit that subscribe or follow button on your favorite podcast streaming service so that we can do even more to make this podcast better for you and your clients. Let’s innovate and integrate in the world of women’s health.