When your focus is on "the quick fix", you ..... 1) Waste time needed heal 2) Allow Damage increase 3) Waste money you don't have 4) Waste insurance resources you will need 5) Buy 6 pack nightguards 6) Cause a lot frustration If you do not have time or money to do it right 1st time, where will time & money come from when are on 2nd time .

Medications are only tool insurance companies encourage the medical field and most time only cover up the pain. They do not usually treat cause.

Integrative tools in orthopedics are targeted at the causes; therefore, reducing need for medications.

Team Responsibilities

You have been depending on medicine to fix you with drugs, pills, shots, etc for years. How is that working for you? You are now in chronic pain (restricted opening, tension headaches, neck pain) and your health habits are not so good. Can you understand the burden you carry ? We, chewing system orthopedic team, has to work hard on your chronic pain and your poor health habits ? The most important member of team is patient !

PAIN MANAGEMENT:

1. In acute pain, doctor fixes and patient accepts drugs
2. In chronic pain, you become a member of orthopedic team.

HEALING MUST DRIVE "YOUR" GOALS

A. Need to Enhance chronic pain tools:

1. Chronic pain tools depend on healing ability
2. Healing comes from good health habits
3. Not changing your health habits, "you" decide to keep your pain
4. Passionate changing health habits enhances all chronic pain tools

B. WILL you accept responsibility

1. The doctor, insurance, society, spouse cannot make you pain free
2. No matter how much team cares, they will fail if you are not passionate
3. How many times have you blamed surgeon or doctor for poor healing
4. Take responsibility health habits & get maximium benefit tools
5. Shirk responsibility and you get failure
6. Take ownership it is "your" pain

C. Who controls your health care decisions

1. Insurance companies makes decisions for profits
2. You make wise decisions for "your" health
3. Insurance controls doctors health care decisions
4. Insurance allows 10 min for 30 minute procedure
5. So, your child needs 30 mg of medicine but insurance only pays for 10 mg
6. Look to your needs, not what insurance company wants as profits

D. Be Responsible

1. Accepting responsibility for things we can control about health care
2. Search for doctor tell you truth in love about your health
3. Not doctor who tells you what you want hear or sells the latest quick fix
4. Research physical, emotional, spiritual, and intellectual needs

E. Trust in coaching

1. Improved health habits
2. Behavior management (biofeedback, counseling, psychiatry, psychology)
3. Healing based on unique mix pains & anxiety & damage & health habits
4. Embrace all tools w/ passion

For any chance of success on managing chronic pain, the patient must understand&accept their responsibilities to promote maximum healing.

If your negative emotional brain’s message is, “you can’t trust doctor”, then you will sabotage "your" healing

If your programming as child is "your inadequate", you will sabotage your healing.

Accepting responsibility for accuracy of "your" data,

1. you assist doctor in diagnosing correctly
2. you make diagnosis more correct
3. you increase treatment success
4. decrease waste time, money, energy, healing resources

How many times do you give your doctor limited details? Patient is responsible for great detail data, so that doctor can devise proper treatment plan. Cows don't give milk, and patient do not give detail. We asked patients do they have headaches? They say no. Then we ask do you have garden variety-common-tension headaches, they say all my life !!!!

Accepting responsibility means controlling the barriers, the distractions, the excuses, misconceptions; so that, you can control healing.

WARNING: Asking for help for chronic pain? I would think twice before you ask us to coach and teach you in pain management, because you one who has to work hard. Are you prepared ??

"Demanding that doctor fix you" in chronic pain is flawed from the beginning:

1. No quick fix chronic pain
2. Allows avoidance of changing bad health habits
3. Pain relief is earned not given
4. Fix is a hope not reality
5. Fix fits my wallet and time table
6. Chronic Pain management is too demanding
7. Change my health habits

Patient Responsibilities:

1.  Learning controls over “their” pain
2. Research science: pain & orthopedics
3. Progressive testing all tools for healing ability
4. Practice tools to assist healing
5. Passionate implementation tools
6. Overcome barriers to healing
7. Trust yourself and doctor
8. Praise progress in yourself & team

Chronic pain = Trauma + Health Habits + Anxiety + Pains

Health Habits

Principles Heath Habits:

1. Enhance Chronic pain tools by changing your Health Habits
2. Patient is responsible for healing ability
3. Health habits affect healing
4. Tools success depends on healing
5. No chronic pain tool overcomes deficiencies in healing
6. Healing deficiencies developed over time
7. Fertile soil for trauma or pathology to infect

Changing health habits: Exercise, Negative Thought, Nutrition, Sleep

Progressive improvement: baby steps, positive direction, momentum, passion

Enhances benefit of each chronic pain tools by improving health habits while we reduce pain causes. It is difficult change a bad habit that took years in deterioration.

Anxiety aggravates pain

1. Increases chronic pain
2. Direct: stress-anxiety-pain
3. Anxiety system wires pain system
4. Higher pain or longer pain more rewiring
5. Over time, anxiety causes additional pain

Difference acute vs chronic

1. Entire life was exposure acute pain
2. I know acute pain; therefore, my pain is acute
3. Being acute, I am seek acute pain therapies
4. Acute pain therapies could be called quick “fixes”
5. My chronic pain has not responded to acute pain therapies
6. If 1st quick fix doesn't work, try try again, waste waste again

Chronic pain: Story of Atypical Toothache

1. Last molar LR tooth pain
2. Pain does not go away w/ root canal/crown
3. Extract tooth & tooth front start hurting
4. root canal/crown 2nd tooth pain remained
5. extracted 2nd tooth
6. root canal/crown 3rd tooth
7. extracted 3rd tooth
8. After treating symptoms tooth pain, UF orofacial pain tx cause: clench/grind

Team is necessary for Chronic pain: Biofeedback, Physical therapy, Patient, Orofacial pain

Chronic pain Analogy: car out gas on side hill w/ a woman driving, to get the car to top hill and to gas station, we must recruit a team of people, big and burley men, establish momentum, and make progress to get car to top hill.

Chronic pain cannot be manage by latest fad in medicine or dentistry ? 1) in past, it was opioids 2) In todays worl, it is botox.

For patient worried about cost of chewing system orthopedics, the more passionate implementation the less cost

Chronic pain was not included in:

1. Medical & dental schools
2. Specialty schools
3. Physical therapy schools
4. Massage, OT, Nutrition, chiropractic, acupuncture, physiology, psychology,
5. Elementary, high school, college, church, graduate school
6. Insurance companies discriminate against chronic pain

Selecting Best Team

Ask the ladies of orofacial pain team or ask doctor, who does he or members of team go to for chronic pain therapy. Ask who is best physical therapist? In future, it will be therapist who does not accept insurance.

Select chronic pain team:

1. Select Physical Therapist
   1. extra training in jaw joint
   2. extra training in chronic pain
   3. team responsibilities
   4. Extra dose empathy
   5. communicates team
2. Biofeedback Specialist
   1. Extra training chronic pain
   2. Extra training counseling
   3. Team responsibilities
   4. Extra dose empathy
   5. communicates team
3. Special members team: acupuncture, chiropractic, exercise physiologist, yoga, complementary med, massage

Who Controls your health care decisions: Your wants, insurance company, spouse, children, lack trust, world brain washing, desire quick fix, negativity, not deserving programming, not adequate programming

Take back control over “your” health care decisions

1. Determine specialist by training and experience
2. Research specialty by symptoms
3. Determine acute or chronic pain
4. Research & study chronic pain
5. Prioritize your health, if low go to your insurance company choice
6. Selects best chronic pain team
7. Change "your" health habit
8. Navigate “your” barriers care

Warning: Unlike acute pain, there is no quick fix for chronic pain.

Barriers Care:

1. Low health priority
2. Brain washing world (fast-quick-cheap)
3. Insurance control healthcare
4. "Your" barrier care (time, money, health, anger, trust
5. Lack research into chronic pain & CSO
6. Goal setting-resource allocation-passion-follow thru

Goal Setting: What do you want…What is success…Spending money wisely...pain reduction

1. Treatment:
   1. control pain
   2. opening normal
   3. damage progression
2. stop damage progression?

Harvard study: the graduates in 1970’s who set goals and wrote them down were most successful:

1. 5% set goals & wrote,
2. 15 % set goals but not written down,
3. 80 % set no goals. The graduates who set goals and wrote them made more money than all the other graduates put together.

Barriers Care

Investment in GETTING BETTER:

1. Concern over cost of chronic pain care is smoke screen
2. You have money for what we want, but not what we need
3. Spending is a reflection of our focus
4. Our wants grows bigger than our budget, we find a way to get it
5. We over spend on our wants, so, we do not have money for health
6. Insurance companies discriminate against chronic pain
7. We are willing pay for quick fix that doesn't work, unwilling pay for chronic pain therapy does work
8. We should be excited about investing on getting better

Investment in SELF WORTH:

1. Have you been told: you are not good enough, you are not loved, your are not deserving, you are stupid
2. These opinions burn hole in our emotional brain
3. This programs emotional brain to avoid this damage in future
4. We search for world to confirm that opinion
5. It will oblige you, what ever you look for you will find
6. You look for what wrong in anything you will find it
7. We look at others for what’s wrong, so, we feel better about ourselves, or so we think
8. I do not care if you stand next to mud fight, you still get mud on you
9. Childhood programming is controlling your happiness and your health
10. This is emotional hyjacking, hidden triggers that cause intense reactions, not based on logic
11. Huge surge in anxiety and pai

Investment in TIME:

1. A woman w/ a 36 hour day
2. Has no time devote her health
3. Feels inadequate as woman
4. Feels overwhelm by pain

QUALITY Health Care: Direct Pay Benefits; Fee-for-Service

1. Decisions based on science
2. Personalized medicine
3. Helps controls quality care
4. Patient Control decisions
5. Direct contact w/ team
6. High touch care
7. More time doctor
8. Reject insurance manipulation
9. Achieve success