Dear Patient

Dear Patient, Hello, This episode is aimed to help explain that there are many ways that we can help with pain that are not just increasing medications! most notably, REHAB is a huge part of recovery, and you need to be able to engage with rehabilitation to fully recover.  Beyond rehabilitation there are multiple ways to engage with and treat pain. hot and cold packs can be highly effective for some people, but even beyond this, it's important to get back to things you enjoy. be active, go for a walk, if possible, find some sunshine to brighten up your day, talk to friends and family, and eat and drink things that you can have and you enjoy. It's true that after surgery we are going to have to work with you to fully control your pain, but these actions can hopefully help you further improve your pain, and enable you to have the best outcome and experience possible. Here is wishing you a speedy path on the road to recovery! and remember, you are not alone. 

Dear Patient, Hello, This episode is aimed to help explain why we use Paracetamol and NSAIDs as a first line pain medication to establish a baseline of pain relief before moving on to stronger medications. These medications are generally very safe and well tolerated. Almost everyone should get Paracetamol (acetaminophen) as needed, and NSAID should be available unless you fall into one of the following 5 categories: 1. pregnant, 2. heart disease, 3. kidney disease, 4. prior bleeding from your stomach or intestines, and 5. if you're over the age of 65 (this last one is a much looser criteria). These medications are highly effective and if you are in pain you should inquire with your health care provider about whether you should be on these REGULARLY to get the best possible outcome! Here is wishing you a speedy path on the road to recovery! and remember, you are not alone. 

Dear Patient, This episode in the mini-series of acute surgical pain is to talk about how and why we use opioids after an operation. I hope to educate you surrounding these drugs to enable you to engage as a key part of your care team to get the best possible outcome! My goal remains to give you the education you need to help yourself and help you have a speedy ride down the road to recovery! If there are any questions remember your health care team is always there for you! And always remember, YOU ARE NOT ALONE!! Dr. John Keenan Fanning

Dear Patient, Hello, This is the introduction to a mini-series on how we manage post-surgical pain in a hospital. While this topic can get very complex, at its core its simple, our goal is to get you the best pain management strategy possible. To do this we need your help! to enable this I am providing you with an overviews of pain management. This is important, because you are a key member of your health care team! My goal is to give you the education you need to help yourself and help you down that the road to recovery! If there are any questions remember your health care team is always there for you! And remember, YOU ARE NOT ALONE, Dr. John Keenan Fanning

Dear Patient, In this episode I hope to cover a very basic approach to managing an opioid overdose. I wrote this as a bonus episode with the goal helping anyone who finds themselves in a position where they need to respond to an opioid overdose with no other resources. This is not a replacement for seeking medical help and not a replacement for first aid training. I hope you never need this but I recorded this if someone finds themselves in this position. Remember, we are stronger together, the medical community is here for you, and YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible!

Dear Patient, This episode is for all the things I wanted to talk about but that I could not fit in earlier. I touch on Methadone, on some myths surrounding buprenorphine, and additionally give you a few additional resources, and some advice on finding more information. I also take the time to thank the people who helped me make this podcast, and thank-you for listening. I truly hope this has helped you on your path to making you your best self. We are stronger together, so remember should you ever need help, there are people who are there to help you! YOU ARE NOT ALONE! Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible!

Dear Patient, In this episode I would like to talk to anyone who continues to use illegal opioids despite our recommendation not to use these drugs. I feel that providing education on how to use these drugs in the safest way possible is important and I hope this information allows you to be your safest self. Remember if you ever find yourself in a position where you would like to seek help, the medical community is here for you. We are stronger together, and YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible!

Dear Patient, In this episode I continue to talk about Buprenorphine, but rather then talk about it from the side of opioid use disorder I hope to educate you about how this medication can be used to treat chronic pain. While opioids are generally poor for chronic pain, may people find themselves taking long term opioids in attempts to treat this pain. If you are currently using and opioids and you have concerns about your use I am here to give you the knowledge to inform yourself. You are a part of your health care team, and if you are considering switching to buprenorphine as a treatment, remember, the medical community is here for you. YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible!   Here are a couple links that describe how good Buprenorphine is as a painkiller! Buprenorphine is a full opioid agonist: Citation from NIH: Raffa RB, Haidery M, Huang HM, Kalladeen K, Lockstein DE, Ono H, Shope MJ, Sowunmi OA, Tran JK, Pergolizzi JV Jr. The clinical analgesic efficacy of buprenorphine. J Clin Pharm Ther. 2014 Dec;39(6):577-83. doi: 10.1111/jcpt.12196. Epub 2014 Jul 29. PMID: 25070601. https://pubmed.ncbi.nlm.nih.gov/25070601/ Buprenorphine better then traditional full opioid: Citation from NIH: Daitch J, Frey ME, Silver D, Mitnick C, Daitch D, Pergolizzi J Jr. Conversion of chronic pain patients from full-opioid agonists to sublingual buprenorphine. Pain Physician. 2012 Jul;15(3 Suppl):ES59-66. PMID: 22786462. https://pubmed.ncbi.nlm.nih.gov/22786462/ *These are medical papers, and as such they may take some time to read through. If you are struggling to understand any of the content I would encourage you to talk with your doctor for help interpreting them. We are here to help!

Dear Patient, In this episode I am excited to talk about Buprenorphine! This is one of the treatment options available for opioid use disorder. In this episode I discuss the drawbacks of this treatment to give you the knowledge to help yourself. If you every would like to seek help, remember, the medical community is here for you. YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible!

Dear Patient, In this episode I am excited to talk about Buprenorphine! This is one of the treatment options available for opioid use disorder. In this episode I discuss the benefits of this treatment and in the next episode I discuss the drawbacks. If you every would like to seek help, remember, the medical community is here for you. YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible!

Dear Patient, In this episode I cover what Naloxone is and how it works. If you every would like to seek help, remember, the medical community is here for you. YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible! Additionally I owe thanks to Dr. Kathryn Dong who provided useful edits for this episode.

Dear Patient, In this episode I cover the Risks of opioids, specifically the risks of opioids themselves, but I would also the risks of how you use opioids. This information is not meant as a scare tactic but rather as a way for you to inform yourself and understand the risk of ongoing opioid use. If you every would like to seek help, remember, the medical community is here for you. YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible! Additionally I owe thanks to Dr. Kathryn Dong who provided useful edits for this episode. P.P.S. Here are some resources if you want more information: Opioid numbers in Canada: The continuous opioid death crisis in Canada: changing characteristics and implications for path options forward – The lancet https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(23)00011-X/fulltext. Published: February 03, 2023   DOI:https://doi.org/10.1016/j.lana.2023.100437 US Statistics of Opioid deaths in the States: EM Clerkship – “Opioid use disorder – what you do matters” https://www.emclerkship.com/opioid-use-disorder-what-you-do-matters/ Good simple infographic about Medication strength: https://www.pbm.va.gov/AcademicDetailingService/Documents/Pain_Patient_FentanylCarfentanil_IB101137.pdf Get your drugs tested: https://getyourdrugstested.com/

Dear Patient, In this episode I cover how opioids work. I focus on 3 big effects including 1) how they are pain killers, 2) how they can make you feel good, and 3) how they can make you stop breathing. This information is meant as a starting place to enable you to become your best self. Remember, YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible! Additionally I owe thanks to Dr. Kathryn Dong who provided useful edits for this episode. P.P.S. Study showing no difference in pain between opioids and non-opioid alternatives: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/fulltext Mayo Clinic on Opioid use: https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372

Dear Patient, In this episode I talk about the HUGE link between past traumas, isolation and substance use disorder. I hope this makes you recognize that if you are someone who has experienced trauma in your past it is okay to ask for help. Further I want to stress that there is help out there if you ask for it. Remember, YOU ARE NOT ALONE! Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible! Additionally I owe thanks to Dr. Kathryn Dong who provided useful edits for this episode. P.P.S. Here are some resources if you want more information. I have included some medical paper references, I have included these for completion. Number of Canadian users: Canadian Statistics website - https://www150.statcan.gc.ca/n1/pub/82-003-x/2021012/article/00002-eng.htm Number of American and Worldwide users: https://www.ncbi.nlm.nih.gov/books/NBK448203/ Citation from website: Azadfard M, Huecker MR, Leaming JM. Opioid Addiction. [Updated 2023 Apr 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448203/ The former governor declares loneliness an epidemic: https://www.forbes.com/sites/bryanrobinson/2023/05/06/us-surgeon-general-cites-loneliness-as-serious-mental-health-hazard-in-new-report/?sh=29b5225d1adc Everything you think you know about Addiction is Wrong TED talk: https://www.youtube.com/watch?v=PY9DcIMGxMs Increased opioid Use during pandemic: https://covid19-sciencetable.ca/sciencebrief/the-impact-of-the-covid-19-pandemic-on-opioid-related-harm-in-ontario/ Citation from website: Friesen EL, Kurdyak PA, Gomes T, et al. The impact of the COVID-19 pandemic on opioid-related harm in Ontario. Science Briefs of the Ontario COVID-19 Science Advisory Table. 2021;2(42). https://doi.org/10.47326/ocsat.2021.02.42.1.0 CDC website cited study saying 15x more likely to suffer with multiple ACE’s: https://www.cdc.gov/injury/priority/index.html CDC REFERENCED PAPER - Swedo, E. A., Sumner, S. A., de Fijter, S., Werhan, L., Norris, K., Beauregard, J. L., Montgomery, M. P., Rose, E. B., Hillis, S. D., & Massetti, G. M. (2020). Adolescent Opioid Misuse Attributable to Adverse Childhood Experiences. The Journal of Pediatrics, 224, 102-109.e3. https://doi.org/10.1016/j.jpeds.2020.05.001 CDC REFERENCED PAPER - Stein MD, Conti MT, Kenney S, Anderson BJ, Flori JN, Risi MM, Bailey GL. Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder. Drug Alcohol Depend. 2017 Oct 1;179:325-329. doi: 10.1016/j.drugalcdep.2017.07.007. Epub 2017 Aug 5. PMID: 28841495; PMCID: PMC5599365.

Dear Patient, This episode is an introduction to my podcast, and covers a a description of the 4 C’s of addiction. Remember, YOU ARE NOT ALONE. Dr. John Keenan Fanning P.S. I need to thank Dr. Landon Berger for his contributions to this podcast. Without his amazing guidance and suggestions this podcast would not have been possible! Additionally I owe thanks to Dr. Kathryn Dong who provided useful edits for this episode.