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Donate at plannedparenthood.org/slash defend. Hi, I'm Kristen Bell. And if you know my husband Axe, then you also know he loves shopping for a car. Selling a car? Not so much.
We're really doing this, huh? Thankfully, Carvana makes it easy. Answer a few questions, put in your van or license, and done. We sold ours in minutes this morning, and they'll come pick it up and pay us this afternoon. Bye bye, Truckee.
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Is there some secret to help relieve chronic pain? Neurosurgeon, medical reporter, and author Dr. Sanjay Gupta thinks he knows the answer to that question. Eu C Payne. every day in your office.
How does that typically Go. You often see people who have gone from having a perfectly wonderful day. to suddenly having the worst day of their life.
Some sort of trauma, some sort of new illness, whatever it might be. And the first thing that sort of flags this for them is pain. And it's oftentimes a bewildering experience for them. It's mysterious for them. But then I think as a physician, it's mysterious for us as well, as we're sort of trying to figure out what I call the most mysterious of all human sensations.
So it is it is, I think, 70 to 80 percent of our practice, but in some ways we're dealing with it all the time. L is a neurosurgeon. You're not the first guy they see.
Someone with the mystery of pain probably has been Looking for, right? A lot of times they see their primary care doctors, they see neurologists, they might even see a pain doctor. But at some point, I think. When they don't have good answers anymore and they think, could an operation potentially help alleviate this pain, then they come to us. And it's tough because in many ways they see us as the physicians of last resort.
And most of the time, those patients don't require an operation. And I think the question for a long time in medicine is What's next? what happens to those patients. And frankly, Jane, for 25 years, It was throwing opioid medications at them. It was sometimes doing operations that were unnecessary.
Well the person who you tell I can't help you. must be profoundly disappointed. Where do they go with the pain? I think it's starting to change. I think for a lot of people, they went home and took really powerful, sedating opioid pain medications.
There was a time in this country where even though we're just 4% of the world's population, we were taking over 90%. Of some of these opioid pain medications. Physicians thought that's what patients wanted. And now we know not only do opioids probably not work long term, for some people, maybe. But for the majority, it doesn't.
it can actually exacerbate the pain. uh opening uh the book and closing it at the end. uh someone with uh chronic pain. uh probably won't find Oh, here's the cure for my migraines, finally. It doesn't have to hurt.
How does it it doesn't have to hurt because It doesn't have to hurt, first of all, because I think we have Taken sort of a sledgehammer to how we treat most pains. High-powered medications and high-powered operations. That's been sort of our general approach. What you come to realize is that for a lot of people, the likelihood of them having pain in the first place could have been predicted many years, probably if not even longer, in advance. things that have happened to them during their childhood.
depression, anxiety, how they eat, how they move. We think about preventing heart disease and preventing diabetes. Preventing pain. People thought that wasn't possible, but we know it is. But then I think most importantly, Look, everyone's going to have pain in their life at some point.
Acute pain. I think the real question at that point becomes How do you make this less likely to turn into something that's chronic? How do you make this less likely to be something that persists? For a person listening at home who says, I've had these migraine headaches for three decades. stop the jackhammer in my head or wherever their pain is.
you know, this news is not going to help them. Feel better next week. I talk about a patient who was in exactly that situation who for 20 years had migraine headaches and it affected her whole life. What was interesting about her is that she did have these components of depression and anxiety. She also was found to have.
A very old injury from high school. where she had fallen. and had a little fracture. It wasn't something that needed an operation. She kind of forgot about it as life went on.
But then, 20 years later, a doctor who was sort of a Sherlock Holmes kind of guy. Basically it says, hey, tell me about that neck a little bit more. And what if we did neck physical therapy? Could that potentially help your headaches? targeting the neck to help your head.
And in her case, it worked. The woman with uh uh migraines Is the happy ending that she doesn't have them anymore? She's doing a lot better. She gets migraines occasionally now. She's able to work, she's able to spend time with her kids, do all the things that she wanted to do for 20 years but had a really hard time doing.
She said to me, just. Imagine the different kind of person I would have been. had I addressed this 20 years earlier. the different wife I would have been, the different mother I would have been, the different colleague I would have been. It occurs to me that torment is a facet of of pain.
That you can't address as a doctor. Yes. But if you can find a way to relieve the torment. That's exactly right. You know, John Cabot-Zinn, he basically says, suffering.
equals pain times resistance. Suffering is in in a way what we're really talking about here. Pain is a component of suffering. The more you resist it. the greater the suffering.
which is counterintuitive, I think, for a lot of people. Acute pain makes sense. You touch a hot pan. Don't do that again. Why does the pain persist for some people?
Is there a lesson that we continue to learn? I'm not sure. But the point is that that chronic pain I think can be very much addressed. A story that I I presumed incorrectly had inspired. the writing of the book.
Um you were at work on Pain. The book. when On vacation, you got that phone call. Yeah, I had my phone, you know, I felt it felt it buzz. Yeah, you're a you're a doctor, so somebody I guess has gotta reach you.
Um And in this case Who was it? It's my mom. My mom was calling me and she knew I was on vacation, which right away. That kind of got my attention. I was concerned even before she said a word because she just never calls and she never complains.
So as soon as I saw her number pop up on the screen, I knew something was up. And what'd you say? She said, I broke my back. There was no pleasantries exchanged. There's no, hey, how you doing?
I broke my back. And you know, you hear that, and just repeating it now still makes my stomach drop a little bit. That's a bad injury, mom. Mom's in her 80s. She broke her back.
And everything sort of went in a little bit into slow motion for me at that point. I mean, I'm a neurosurgeon. This is what I do for a living. And yet you know, when you hear it to your own mom. like this changes everything.
I knew that it was a bad injury and I also knew that she was probably in a lot of pain. And I needed to get there as quickly as possible, which I did. Describe a lot of pain. My mom doesn't complain about anything. She's the kind of person who she did not have epidurals during childbirth.
and is surprised that anyone else would be surprised by that. That is my mom. When I saw her first in Florida in her condo, She was lying back and her whole body was tense. She she just couldn't move. and every little movement she just started to grimace.
Did you see me grimace? I know. I still, like, I'm sitting in a chair just like this with her, and I see her grimace. And of course, I made the mistake. of saying, hey, so how bad is the pain?
And that's when my mom said something that I think I'll never forget. which is she said if This continues I don't want to live anymore. I don't want to live anymore if I have to live with this level of pain. Coming from my mom, obviously, it's really painful to hear. But also this was someone who never complained about anything.
So you knew, you had a sense of just how significant an impact this was on her. We'll have more from our Sunday morning extended interview. after this break. Mint is still $15 a month for premium wireless. And if you haven't made the switch yet, here are 15 reasons why you should.
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So you can lose more sweat and raise your game. Gatorade. Is it in you? To describe pain is sometimes there aren't descriptions that fit. There is a word that if I say will send shudders up and down the spine of anyone listening.
You were impaled. Yep, they said impaled. Do tell. I I was having a lovely day. The sun was shining, the birds were singing, and I was running.
Thinking that I was invincible, I was a Should. and there was this fence. that had these sharp spikes across the top. And instead of going around it, I thought I could sort of vault myself. over it.
I'm sorry to It's ridiculous to reflect on in some ways. I mean, I don't know what I was thinking. But I didn't make it. and this spike from the fence went right through the back of my skin on the side. and came right out the front.
So I was essentially pinned and impaled. on top of this fence. But eventually my mom shows up. She knew what to do. Yeah, and the interesting thing about moms too is that I was going through this process where in some ways I was as embarrassed as I was in pain.
I was embarrassed that it happened to it, so I was kind of like, you know, just... trying to hold it together. And then I saw my mom in Niagara Falls. I just started crying. And she came over and just sort of put her hand down and I hoisted myself off and got off the spike and And then we went to the emergency room.
Did you know the word impale? No. I didn't even know the word impaled. I don't remember how I described it to people in the first few years. I just stuck on this fence.
I got stuck on the fence. But I'll tell you the most interesting thing happened. First of all, I think a lot of people would have a perception of what that feels like. It feels like a hot poker going in through your back and coming out your front. But that's not exactly what it felt like.
it felt more like I'd been sort of slapped. more of a dull thing. And then, as I was lying there or pinned there on top of that fence for a bit, the pain started to come in waves.
So it was there. felt like someone was sort of slapping my back and then it would go away. that it might come back. But then after a while, it just didn't hurt that much anymore. And there was a couple of times when I I had to reach back around and say it's still there, right?
And what I now know took years to sort of understand this is that my body's endogenous opioid system. We have our own opioid system. It reacted. And it reacted. in a big, big way.
These are the endorphins. These are the endorphins. These are endorphins, and by the way, endorphins, endo, which means comes from your body, and fin. Morphine.
So it's like your body's own natural morphine. You haven't really thought about it for years, and I'm thinking about other people who have. not had a day in years where they didn't have discomfort ranging to indescribable. Pain. Ed, for instance.
Tell us about Ed's pain. He uses so many interesting adjectives to describe his pain. One of the things that he said to me that really stuck with me for some reason was he said it was like fishing wire. around the toes and someone was just continuously tightening that thin little fishing wire around the toes. I don't know why that really stuck with me.
It would come out of nowhere for him. He would scream. In the middle of the night. to the point where it would frighten the people that were with him in the house. And it would come for seemingly no reason.
There was no injury to his legs. There was nothing to point to and says, this is why it's hurting.
So it was just a sort of unrelenting pain. It wasn't there all the time, but when it would come, it would stay for a while. And he really could do nothing else. But he would point to his feet. That's right.
He would point to his feet, But if you were to look at his feet, his feet looked fine. Where was it? The what was the source of the pain? The brain. It's hard to conceptualize.
I realize this. But Ed is sort of this daredevil guy. He's had a lot of injuries over his life. He had had a knee operation. And it was after that knee operation that for some reason his brain had taken the experience of his knee surgery, Memorize it.
and got it a little bit wrong.
So instead of saying, hey, your knee hurts, it just went into this hyper Drive The best metaphor? would be something known as phantom pain. That's when someone loses a limb. And then they still hurt. even though that limb doesn't even exist anymore.
How can that happen? The brain. the brain is creating that pain. why that's happening exactly. We're not sure.
Now, unfortunately, you are a Brain surgeon. Unfortunately, you would not be able to see This problem. by looking at the brain. I think Ed was was at his wit's end. He had gone through a gauntlet of various different types of therapies.
I can't remember how many operations he had to try to do. I read that it was 34. 34 operations. lots of different pain medications, and he wasn't getting relief. And someone had talked to him about a trial involving brain surgery.
When he first heard that, he said, that's not for me. I'm not- you're not going to open my brain to try and treat my foot pain. But when the pain just continued He eventually called those doctors back and he said, I'm ready. I'm ready to have brain surgery for this. This is a guy who's willing to try anything if he has had Um almost three dozen.
Procedures. you know, to finally end up with the brain isn't too surprising.
So what's the happy ending? The story of what happened to Ed is kind of a remarkable story, and I think it's going to change pain medicine overall. what these doctors were able to do, and this is brand new science. They were essentially able to put these probes all over the brain. And just leave these probes in, sort of to listen to Ed's brain.
And after weeks they were able to draw this link between Ed's pain and these changes in the brain. And what they found with Ed was not only could they start to predict that Ed was going to have pain. they could quantify how bad that pain was likely to be. and they could even interrupt the pain. by giving a little stimulation.
So even before the pain would get to conscious awareness. the stimulator would go off. And it would start to interrupt the pain, interrupt that pain cycle. How has it changed his life? It completely changed his life.
He's off the medications. He was on tons of very sedating medications, which is, again, the first thing that often happens to these patients. Can't quite treat the physical pain, so let's just sedate the brain instead.
So, you know, Ed got his life back. Even though there's still pain? He'll still have these moments of pain. I spent time with Ed just sort of going on hikes and listening to him sing. There'll be moments where he'll stay, ah, a little bit there.
But what is interesting is that Even before someone consciously becomes aware of pain, there's already changes that are happening in the brain. The brain is already starting to fire energy in different ways before you really feel the pain. And with that stimulator, that can pick up those energy changes and interrupt the pain.
So sometimes it may break through. But for a lot of adds pain episodes. they never rise to the level where it actually bothers him. A remarkable fact about the brain Which I think is a Quote from the book. It doesn't feel pain.
I know. It's kind of amazing. That thing. That three and a half pounds of tissue, which controls everything about. make your fingertips hurt with paper.
Gives you your personality. Makes you remember things, makes you fall in love. It's every joy you've had, every disappointment, it's all there in the brain. But when it comes to pain, It doesn't experience it. And no one asked me how to design the human body, but we put it in a skull and we really encased it with this.
tough lining. Maybe it didn't need to feel pain. It didn't need to have those warning systems. To go back to the title of the book, If you buy the book, it doesn't have to hurt, doesn't mean. Buy the book.
Headaches gone. Buy the book. Yeah. flaming toe thing is gonna go away. What you seem to be saying is we need a new way of thinking about Pain, ah that is.
uh sort of western and sort of eastern. If I had to add More words to the title of a book. I would say it doesn't have to hurt. As long. or as bad.
That's really, I think, what we're getting at. 50 million people in this country, Jane, have chronic pain. 20% of the population. It is a faster growing condition than heart disease, diabetes, and cancer.
So we're in pain. more than ever before, and it's lasting longer than it ever has. That's what I'm talking about, I think, with this book. This is a problem. And there's all sorts of reasons for this.
We're aging, we're heavier, we're more sedentary, we're more lonely, we're more isolated. We're more inflamed. All these things contribute to that. People are going to have pain in their lives. but it doesn't have to hurt so badly.
and it doesn't have to last so long. That's what I think I really took away from from writing the book. I'm Jane Pauley. Thank you for listening. And for more of our extended interviews, follow and listen to Sunday morning on the free Odyssey app.
or wherever you get your podcasts. Mama, Papa, my cupo crece a rimo alarme, and the rope that I understand very pequeña very promptly. But not that suffering for the mode with the barges of the classes of Amazon. Amazon, we don't son real. Starting a business can seem like a daunting task, unless you have a partner like Shopify.
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Yeah.
