Purpose of Life: Learn and Share

Values: Curiosity and Courage

She is a Painiac.

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A Pain centric care to Patient care

Sharna Prasad DPT

TPS (Therapeutic Pain Specialist)

MBSRTIT(Mindfulness Based Stress Reduction

teacher in training)

Sharna Prasad PT 2019 Personal use only

Disclosure

I own a Continuing Education company where we host international

speakers on Pain

I teach in this company too.

Currently have a grant from DST Delivery System Transformation IHN-CCO

to create a curriculum for the Freshman class in Corvallis on Opioid misuse,

Pain and Healthy Self care.

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Objectives

Participants to be able to

demonstrate the ability to Explain

pain using the pain triangle with the

patient story.

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Presentation Outline

My Chronic pain story and my

transformation A Patient story on how I use the pain triangle

Pain Science in Practice in our community

Patient story.

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Sharna Prasad PT 2019 Personal use only

Beginning of my journey of pain

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NYC 1988-89 Jelly filled donut

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Kids and LBP 2013-2015

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A Crazy Doctor ( Jan 2015)

“Financially Bankrupt

rather than Morally

Bankrupt”Dr Kevin Cuccaro DO

Straightshothealth.com5/29/2019

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Adriane Louw

PT PhD

Switching my perspective on Pain

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Change of Perspective on Pain

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My Belief system

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Microscopic vs Global

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3.5 yrs later- transformed

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Sharna Prasad PT 2019 Personal use only

Presentation Outline

My Chronic pain story and my transformation

My Patient story on how I use the pain

triangle Pain Science in Practice in our community

Patient story

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Sharna Prasad PT 2019 Personal use only

Bio Medical assessment

20 min interview with multiple question

Checking boxes

30 to 40 min detailed physical examination

Rushed

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Take a moment!!!

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Case Study

Patient is an elderly male “John” with a

diagnosis of Spinal Stenosis, with central

LBP which is burning, sharp, throbbing in

nature.

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What are you afraid of?

The stenosis is going to get worst.

I am going to be dependent on my wife

I am never going to go back to making my

picnic tables.

Making dumb financial decisions

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What does Spinal Stenosis mean to you?

Narrowing of the spinal canal

Nerves are getting pinched

This is hereditary, my mom had it

I am going to be paralyzed and be on a wheelchair like my mom.

Be lonely in a Nursing home

https://www.worldwideweirdnews.com/2013/05/27425.html

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https://www.worldwideweirdnews.com/2013/05/27425.html

Physical exam

A quick but thorough physical exam.

To tell them what is right with them more

than what is wrong with them.

Got him on the floor and up-”I don’t think

I could have done that”.

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Summarize my findings

You are strong

You are scared

You are OK

Your nerves are not pinched.

We can wait for the earthquake to happen

High ACES –analogy of backpack

Are you OK if I talk to you about pain what it is.

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Richard Feeney (2016) Lumbar Spinal Stenosis, Journal of Pain & Palliative Care

Pharmacotherapy, 30:2,150-152

What is pain?

Fire Pain

Kevin Cuccaro DO straightshothealth5/29/2019

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Sharna Prasad PT 2019 Personal use only

I am going to be

dependent on my

wife.

Wheelchair/NH

Picnic tables

Nerves are pinched

Fear

Frustration

Sadness

Loneliness

Social isolation

Burning, sharp, throbbing

Next visit-1 week later

Had a frown on his head

I have no pain.

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Singh et al, Healthcare providers’ perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study

Presentation Outline

My Chronic pain story and my transformation

My Patient story on how I use the pain triangle

Pain Science in Practice in our community

Patient story

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Sharna Prasad PT 2019 Personal use only

Mid Valley Pain Alliance: (our community)

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Sharna Prasad PT 2019 Personal use only

This is our elevator pitch to our community

All Pain is Pain

All Pain is protection

All Pain is real

All Pain can change

Mid Valley Pain Alliance

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Sharna Prasad PT 2019 Personal use onlyRudd, Rima E. 2015. “The evolving concept of Health literacy: New directions for health literacy studies.” Journal of Communication in Healthcare, 8 (1): 7-9.

High School Project: Prevention

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Sharna Prasad PT 2019 Personal use only

Santos 2017,

McDonnell 2018

Our Conference-Oregon Pain Summit

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Sharna Prasad PT 2019 Personal use only

Pain Science in Practice

MMAPS (Movement Mindfulness and Pain

Science-Trauma Sensitive) :PT Group Treatment

Schütze et al. Mindfulness-Based Functional Therapy: a preliminary open trial of an integrated model of care for

people with persistent low back pain. 2014

MMAPS PAIN PROGRAM

Movement, Mindfulness, and Pain Science

N=17

58% decrease in average medical cost per mth

24% decrease in ER utilization, 41% increase in mental health services utilization

76% of patients had lower medical costs and total costs in 2017 compared to 2016.

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Sharna Prasad PT 2019 Personal use only

The End

My pain journey

My pain transformation

My community transformation.

With Gratitude to Dr Cuccaro

Pain Triangle with patient story

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Food for Thought

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Acknowledgements for the pictures

Slide 3NYC https://www.google.com/search?q=NY+city+with+twin+towers&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwij5uXlxYDiAhWBup4KHfYmC4IQ_AUIDigB&biw=1242&bih=597#imgrc=sMOlkgLsPr0oAM:

Slide 3 disc :https://www.google.com/search?q=jelly+filled+donut+herniated+disc&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjE74ykx4DiAhVTrZ4KHfb5DUoQ_AUIDigB&biw=1242&bih=597&dpr=1.1#imgrc=Y3NE6Dfh_7DuyM:

Slide 4 : https://www.google.com/search?q=gif+man+crawling&rlz=1C1CHZL_enUS716US716&tbm=isch&source=iu&ictx=1&fir=JJUVIcSPpChQEM%253A%252CKTAUTExu0IygnM%252C_&vet=1&usg=AI4_-kRNBTusHnM9hk7BAg39bLACt4nuhg&sa=X&ved=2ahUKEwjHsI3kx4DiAhVGu54KHcJSAlEQ9QEwAXoECAgQBg#imgrc=JJUVIcSPpChQEM:

Slide 5: https://www.google.com/search?q=library&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjf87WlyIDiAhVRJDQIHdIyCoUQ_AUIDygC&biw=1242&bih=597

Slide 6: https://www.google.com/search?q=CSM+2016+anaheim&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjRoYHgyIDiAhWO9Z4KHfT4BfMQ_AUIDygC&biw=1242&bih=597#imgrc=7-zyd34D0lWwzM:

Slide 6: Adrianehttps://www.google.com/search?q=Adriane+Louw&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwia6Y7FyYDiAhVWrZ4KHVnlBx8Q_AUIDygC&biw=1242&bih=597#imgrc=a_eTnKE3cTcpaM:

Slide 7 :https://www.google.com/search?q=head+in+the+sand+gif&rlz=1C1CHZL_enUS716US716&tbm=isch&source=iu&ictx=1&fir=4VMisBUYUZKGaM%253A%252ClQSIugH98yjuaM%252C_&vet=1&usg=AI4_-kQyBo8KQYCDndZD2jHGWC5UXUHnSw&sa=X&ved=2ahUKEwjWuvnJy4DiAhUPsZ4KHSIbBTcQ9QEwAHoECAcQBA#imgrc=Qb-R9XRlegjfJM:&vet=1

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https://www.google.com/search?q=NY+city+with+twin+towers&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwij5uXlxYDiAhWBup4KHfYmC4IQ_AUIDigB&biw=1242&bih=597#imgrc=sMOlkgLsPr0oAM:https://www.google.com/search?q=jelly+filled+donut+herniated+disc&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjE74ykx4DiAhVTrZ4KHfb5DUoQ_AUIDigB&biw=1242&bih=597&dpr=1.1#imgrc=Y3NE6Dfh_7DuyM:https://www.google.com/search?q=gif+man+crawling&rlz=1C1CHZL_enUS716US716&tbm=isch&source=iu&ictx=1&fir=JJUVIcSPpChQEM:,KTAUTExu0IygnM,_&vet=1&usg=AI4_-kRNBTusHnM9hk7BAg39bLACt4nuhg&sa=X&ved=2ahUKEwjHsI3kx4DiAhVGu54KHcJSAlEQ9QEwAXoECAgQBg#imgrc=JJUVIcSPpChQEM:https://www.google.com/search?q=library&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjf87WlyIDiAhVRJDQIHdIyCoUQ_AUIDygC&biw=1242&bih=597https://www.google.com/search?q=CSM+2016+anaheim&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjRoYHgyIDiAhWO9Z4KHfT4BfMQ_AUIDygC&biw=1242&bih=597#imgrc=7-zyd34D0lWwzM:https://www.google.com/search?q=Adriane+Louw&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwia6Y7FyYDiAhVWrZ4KHVnlBx8Q_AUIDygC&biw=1242&bih=597#imgrc=a_eTnKE3cTcpaM:https://www.google.com/search?q=head+in+the+sand+gif&rlz=1C1CHZL_enUS716US716&tbm=isch&source=iu&ictx=1&fir=4VMisBUYUZKGaM:,lQSIugH98yjuaM,_&vet=1&usg=AI4_-kQyBo8KQYCDndZD2jHGWC5UXUHnSw&sa=X&ved=2ahUKEwjWuvnJy4DiAhUPsZ4KHSIbBTcQ9QEwAHoECAcQBA#imgrc=Qb-R9XRlegjfJM:&vet=1

Acknowledgements for the pictures

Slide 8: https://www.youtube.com/watch?v=8NUmsSRVP8s

Slide 9: https://www.google.com/search?rlz=1C1CHZL_enUS716US716&biw=1242&bih=553&tbm=isch&sa=1&ei=Ld3MXOm7LaiF0wLUyZiwBQ&q=silhouette+people&oq=silhouette+&gs_l=img.1.6.0i67l10.801.801..6148...0.0..0.230.230.2-1......1....1..gws-wiz-img.A1KWe4S5jE8#imgrc=hwC1yAMHqgKazM:

Slide 9 :https://www.google.com/search?rlz=1C1CHZL_enUS716US716&biw=1242&bih=553&tbm=isch&sa=1&ei=5d3MXKrVDMiN0wK_yb24CA&q=lumbar+vertebra+L2&oq=lumbar+vertebra+L2&gs_l=img.12..0i8i7i30j0i8i30.6906.9760..16109...0.0..0.108.670.8j1......1....1..gws-wiz-img.......0j0i7i30j0i5i30.uJsxLdjwwiY#imgrc=MCCJZw6F3IpqSM:

Slide 10: https://www.google.com/search?q=eating+hamburgers+patrick+gif&rlz=1C1CHZL_enUS716US716&tbm=isch&source=iu&ictx=1&fir=ZBQk2ZQqwucXAM%253A%252CbjJCRF66HLdveM%252C_&vet=1&usg=AI4_-kQ5BT5Pc-bOz4vSdRIb68GpuMWjxw&sa=X&ved=2ahUKEwih-qKR0YDiAhWOsp4KHRnOABcQ9QEwAHoECAcQBA#imgrc=ZBQk2ZQqwucXAM:

Slikde 12: https://www.google.com/search?rlz=1C1CHZL_enUS716US716&biw=1242&bih=597&tbm=isch&sa=1&ei=a2LPXIK7DIn_0gLS1b2gAw&q=checking+boxes&oq=checking+boxes&gs_l=img.1.0.0l3j0i8i30l2j0i24l5.54987.59359..61208...0.0..1.113.981.13j1......2....1..gws-wiz-img.....0..35i39j0i67.e9PGVMAFj5s#imgrc=17M-080QLhkLaM:

Slide 13;https://www.google.com/search?q=telling+a+secret&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiC0O7Yt4XiAhXSOn0KHeM3DvEQ_AUIDigB&biw=1242&bih=597:

Slide 20: https://www.google.com/search?q=picnic+tables&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwi7sf29i4biAhVFGDQIHb4LBjwQ_AUIDygC&biw=1242&bih=597#imgdii=bu10on_mNT1RlM:&imgrc=BQhY9JEU2-oWAM:

Slide 22: https://www.google.com/search?q=if+you+can%27t+explain+it+simply&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiJ_KuwuoXiAhXOv54KHfcsD2EQ_AUIDigB&biw=1242&bih=597

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https://www.youtube.com/watch?v=8NUmsSRVP8shttps://www.google.com/search?rlz=1C1CHZL_enUS716US716&biw=1242&bih=553&tbm=isch&sa=1&ei=Ld3MXOm7LaiF0wLUyZiwBQ&q=silhouette+people&oq=silhouette+&gs_l=img.1.6.0i67l10.801.801..6148...0.0..0.230.230.2-1......1....1..gws-wiz-img.A1KWe4S5jE8#imgrc=hwC1yAMHqgKazM:https://www.google.com/search?rlz=1C1CHZL_enUS716US716&biw=1242&bih=553&tbm=isch&sa=1&ei=5d3MXKrVDMiN0wK_yb24CA&q=lumbar+vertebra+L2&oq=lumbar+vertebra+L2&gs_l=img.12..0i8i7i30j0i8i30.6906.9760..16109...0.0..0.108.670.8j1......1....1..gws-wiz-img.......0j0i7i30j0i5i30.uJsxLdjwwiY#imgrc=MCCJZw6F3IpqSM:https://www.google.com/search?q=eating+hamburgers+patrick+gif&rlz=1C1CHZL_enUS716US716&tbm=isch&source=iu&ictx=1&fir=ZBQk2ZQqwucXAM:,bjJCRF66HLdveM,_&vet=1&usg=AI4_-kQ5BT5Pc-bOz4vSdRIb68GpuMWjxw&sa=X&ved=2ahUKEwih-qKR0YDiAhWOsp4KHRnOABcQ9QEwAHoECAcQBA#imgrc=ZBQk2ZQqwucXAM:https://www.google.com/search?rlz=1C1CHZL_enUS716US716&biw=1242&bih=597&tbm=isch&sa=1&ei=a2LPXIK7DIn_0gLS1b2gAw&q=checking+boxes&oq=checking+boxes&gs_l=img.1.0.0l3j0i8i30l2j0i24l5.54987.59359..61208...0.0..1.113.981.13j1......2....1..gws-wiz-img.....0..35i39j0i67.e9PGVMAFj5s#imgrc=17M-080QLhkLaM:https://www.google.com/search?q=telling+a+secret&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiC0O7Yt4XiAhXSOn0KHeM3DvEQ_AUIDigB&biw=1242&bih=597https://www.google.com/search?q=the+opioid+epidemic&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjtos-B0oDiAhUVHjQIHdZrDb0Q_AUIDygC&biw=1242&bih=553#imgrc=gP5bTohK0FaCrM:https://www.google.com/search?q=picnic+tables&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwi7sf29i4biAhVFGDQIHb4LBjwQ_AUIDygC&biw=1242&bih=597#imgdii=bu10on_mNT1RlM:&imgrc=BQhY9JEU2-oWAM:https://www.google.com/search?q=if+you+can't+explain+it+simply&rlz=1C1CHZL_enUS716US716&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiJ_KuwuoXiAhXOv54KHfcsD2EQ_AUIDigB&biw=1242&bih=597