Cathy Brodsky’s presentation notes
2) Cathy Brodsky RN introduction:
I started my healthcare career 1978 as an emergency room technician at the then recently opened trauma center of Suburban Hospital . A licensed registered nurse for over 25 years primarily in the operating room and in the interventional pain medicine capacity. I am a Certified Pain Management Nurse, a certified health and wellness coach. I act as a peer support group leader with the US pain foundation, am a member of the American Society for pain management nursing, and a member of the American pain Society. Mmost notably I am a chronic pain sufferer myself!
3) ROADMAP OF KEY IDEAS today in our discussion we will talk about understanding pain management techniques
4) WHAT IS CHRONIC PAIN? Reading from the slide adding The latest research on pain is around neuroplasty : the ability of the nervous system to change its activity in response to a stimulus…. basically reorganizing or rewiring, forming new neural connections. (CBT) cognitive
behavioral therapy and other mind body protocols including (PRT) pain reprocessing therapy
are having remarkable results.
5) chronic pain facts by the numbers 51.6 million adults 21% (2024 usate is 24%) of the
population live with chronic pain, 17.1 million American adults live with high impact chronic
pain, or pain that frequently limits life or work activities… sadly, an estimated 11 to 38% of
children under the age of 18 experience chronic pain. There are 52.4 new cases of chronic pain
per 1000 people each year, a higher rate than other common health conditions like diabetes,
depression, and high blood pressure.
Pain is the number one reason Americans access our healthcare system. chronic pain is the
leading cause of long-term disability in the United States. more than 14 million people with
high-impact chronic pain are unable to work. And people with chronic pain are 2x at risk of
suicide.
6) CHRONIC PAIN IN PERIPHERAL NEUROPATHY .
Symptoms of peripheral neuropathy depend on the peripheral nerve affected sensory nerve
damage can manifest as unusual sensations of pain from light touch, burning, numbness,
tingling, and balance problems.
60% Diabetic
23% Idiopathic (unknown)
10% Chemo related
5% other
2% HIV/AIDS
Motor Nerve damage can manifest as muscle cramping twitching reflex abnormalities.
Whereas anatomic nerve damage can manifest with excess sweating, heat intolerance, erectile
dysfunction and orthostatic hypotension (dizziness or fainting)
7) management strategies just read from the posted list. ADD FOOT CARE to list
8). MOVEMENT just read from the slide
Researcher believe exercise can help reduce neuropathic pain by potentially restoring some
nerve function, increasing blood flow, and improving muscle function.
9) TIPS FOR EFFECTIVE CARE (3 slides) including 2 with body diagram
Doctors typically have a 10 to 15 minute block for each patient visit. They try their best to
pinpoint what’s going on, but unfortunately, with such a limited time you can end up with a
surface level assessment. This could have you feeling like your concerns weren’t fully explored
or that you were not heard and you still have unanswered questions.
10) I’m going to provide several tips that I find helpful and could help you leave your
appointment feeling empowered and more informed. Your doctor will appreciate working with a
patient who is educated, has a strong sense of body awareness, and is actively partnering with
them to help find the best solutions.
TIP 1 between appointments keeps a pain journal to include things such as: date and time,
intensity (1- 10) description including stabbing, burning, throbbing, intermittent. daily activities
or changes in activities. The weather, things that help pain or things that make your pain worse.
TIP 2 remember to take a current medication list to each and every doctor’s appointment,
keeping in mind that one practice may not be aware of of adjustments made by another
healthcare team. This list can be kept updated on your phone or kept in your wallet.
TIP3 Tip number three using a detailed body pain indicator chart as an example shown on
the screen: take a colored pencil to mark the exact area where you’re feeling discomfort. Be a
specific as possible, this will help you make the most of your appointment time with your doctor
body pain indicator chart can be found online.
11) Sleep Hygiene: read from the slide
12) Stress Reduction : Meditation, even start with 5 min
Breathing exercises (Box breathing)
Progressive muscle relaxation
Visual / Guided imagery
Music,dance,or art therapy
Journaling
Adult coloring books
Support groups
Spirituality
Therapy/coaching
Pacing yourself to allow for rest and recovery
Learning to say NO!
Focusing on the things you CAN DO vs things you can’t do
Communicating clearly with friends and family about your
Needs.
Learning to let go of guilt and shame around pain and
Limitations
Spending time outside in nature or with a pet
13) Diet and Nutrition : while medications and therapies are often the focus an increasing
important factor is emerging: THE role of gut health and nutrition in pain management Research
is revealing a significant connection between your gut health and chronic pain , suggesting that
your dietary choices can greatly influence your pain experience. Your diet plays a critical role in
regulating inflammation . Foods rich in antioxidants , omega 3 fatty acids can calm inflammation
while processed foods, higher in sugar and unhealthy fats can exacerbate it.
Fruitsveggieswhole grainsand healthy fats can significantly lower inflammation.
14) Pharmacological Management: given this topic is out of my true scope of practice I will only touch on this point
Transdermal pain patches, tricyclic antidepressants, SNRI’s ( Cymbalta, Prozac), anticonvulsant
drugs (gabapentin) spinal cord stimulators and TENS unit , medical grade cannabis including
topical balms and lotions (THC/CBD)
15) Social connections : people who suffer from chronic pain often feel isolated many have
difficulties driving or even leaving the house
● find “your people” a tribe of sorts.
● support groups such as this provide connections with empathetic “ pain warriors”
● find people around a common interest like a hobby
● Many groups even hold sessions via zoom .
Staying stuck in your head is not a good place to be, it’s like getting stuck in a bad
neighborhood !!
16) Travel info:Travel Tips
Make a plan well ahead of your trip
check with your health insurance company about coverage out of your immediate
Geo location or out of the US
Understanding the culture,climate and topography of a location is important for planning
Choosing the right mode of transportation:
Plane: Faster but be prepared for delays and have a backup plan and try for direct,non stop
flights. Reserve an Extra legroom or Aisle seat, typically and hopefully you’re able to get up,
walk and stretch. Book any needed accommodations with airline at least 24 + hour ASAP after
booking is best. , Air pressure changes can affect PN !
Train: Smooth Ride, Sleeper car for long trips, easily walk about and stretch ;contact train about
accommodations early when possible
Auto: Can take frequent breaks, travel time flexibility
Ship: Amenities for relaxation and enjoyment without ever leaving the ship on bad pain flare up
days, Book handicapped Accessible cabin close to the elevators but these cabins have limited
availability so book early. The larger ships typically have health care available on the ship for
an extra fee.
Will need to check with the special needs office about ADA shore excursions typically when the
ship is able to pull into dock vs tender there is very limited availability so book early.
Rental scooters can be arranged on ship and in some cases when on shore.
Health and medications away from home.
Research laws for destination (certain meds can be illegal) even if prescribed by your physician.
Bring all your Medications in original script bottles!!
Bring a letter from your health care provider with diagnosis and meds list, allergies
Check if any of your medications need a temp control environment.
Accommodations: Keep in mind that some international destinations have a different
idea of what ADA means
If you need a handicapped accessible room call early to reserve! Then recheck !!
Check if accommodation has an elevator
Adaptors for phones, CPAP and other needed electronics
Fridge for medications if needed
Shower chair or other adaPtable devices
Diet:
Choose restaurants that offer a variety of options inc. dishes that offer low sodium and sugar
,Opting for meals rich in lean protein,whole grains,fresh fruits and vegies
Limit alcohol and stay hydrated!!
Sleep and Stress.
While travel can be fun it can be stressful
Prioritizing a good sleep schedule, this is particularly important during travel. disruptions to
Sleep patterns due to time changes, jet lag, unfamiliar environments are common.
pace yourself! Listing to music, deep breathing (box breathing), yoga and meditation
Additionally build a traveling toolbox :
Compression socks, stay hydrated, moderate temperature (portable fan), stress balls, mobility
Aids(cane,walker,walking poles,rental electric scooter)
cold packs, heat packs
topical creams ** careful with the THC/CBD creams in certain countries its illegal!
orthotic shoe inserts
sleep mask, Ear plugs
Blankie or pillow or whatever helps support you
***Be prepared to answer questions in case of emergency and need emergency care, if the
country is non English speaking have a sheet with this info translated into native language .
DON’T ASSUME THERE IS AN AVAILABLE INTERPRETER!
google translate helps but have the basics pre printed including: allergies, Medications, Primary
Diagnosis, providers names and contact information.
17) Recommended resources
ADD the Maryland Cannabis program to the bottom
18) recommended books/podcast/Apps
Chronic Pain Reset, By Dr Afton Haddett.
Healing Chronic Pain , The Way Out
By Alan Gordon,LCSW
Mayo Clinic Guide to Pain Relief
19) how to contact me :
Cathy Brodsky,RN
Certified Pain Management Nurse & Health Coach
Cathybrodskyrn@gmail.com
301-674-5556