An Emerging Revolution in the Treatment of Chronic Pain

According to the Centers for Disease Control and Prevention, chronic pain—pain lasting at or beyond three months—affected over 20% of U.S. adults, or 51.6 million people, in 2021. Symptoms were severe enough to substantially restrict daily activity for 6.9% of Americans that same year. And with chronic pain comes soaring medical costs, pharmaceutical over-reliance, and addiction.

Mounting multidisciplinary research suggests that most chronic pain is not of structural origin. In other words, most chronic pain can not be directly attributed to injury or physical abnormality. Neuroplastic pain results from the brain misinterpreting signals from the body as if they were dangerous. We habituate to pain, creating behaviors that either avoid pain or alleviate symptoms.

Encouragingly, those undergoing a psychological treatment known as Pain Reprocessing Therapy (PRT) are showing vast improvements in pain management without pharmaceutical or other medical interventions. One major study found that two-thirds of chronic back pain patients were pain-free or nearly pain-free after four weeks of PRT interventions. In addition, patients showed visible changes in the prefrontal brain regions associated with pain after therapy. While psychological treatments are effective in managing chronic pain, this does not imply that the pain is imaginary.

My guest today, Miriam Gauci Bongiovanni, suffered needlessly until she discovered the concept of neuroplastic pain. Today, now pain-free, she works from her home in Malta as a Certified MindBody Practitioner and Trauma-Informed Coach. But beyond her skills as a wonderful teacher and educator on chronic pain, I found her story of embracing a nontraditional career fascinating. Today we dive in on everything from how our personalities and fears inform our pain cycles to living a good life.  

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Lean Out: The Achievement Paradox with Dawn Baker

Today on episode 57 I’m pleased to welcome Dawn Baker, a board-certified anesthesiologist, wife, mother, climber, coach, and now the author of a new book about the perils of, as she puts it, an intense need to achieve. And Dawn has walked the walk. After years of hard-driving pursuit of linear improvement in both career and climbing, she suffered crushing fatigue and malaise, and ultimately faced a major health crisis during her residency. If that wasn’t enough, she was then plagued with infertility problems. The result was expensive and demoralizing rounds of in-vitro fertilization, an approach that ultimately proved successful and led to the birth of her daughter.

The need for achievement and success is so pervasive in our culture. And this interview is not just for downtown or medical center careerists. This is as much a discussion of climbing and our hobbies, which can so often derail into something quite different from our original healthy and recreational pursuits.

Today, Dawn’s life with her husband and daughter is so different. Through evaluation of her core values, married with a strong financial position, she now works “very part time,” and has moved with her family to a homestead in the high plateaus of southern Utah. But in choosing to step away, or lean out, as Dawn says, we risk our position and standing in the social hierarchy. This is much a discussion of status as it is of lifestyle.

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Back (Pain) in the Saddle Again

I’ve been slack on writing, which is generally a reliable indicator of an overly stressed life. That busyness came to a screeching halt early last week. Five minutes before my partner—let’s call him Bob—arrived to pick me up for the new-school classic Spirit of Squamish (5.8, 8 pitches), everything changed. At the strike of 6am, just as the sun began to crest over the lush coastal mountains, I bent over to pick up a 1-pound water bottle and felt a lightning bolt of pain in my lower spine. I knew in that moment that I was hosed, but it felt too late to bail. Plus, I often find relief from (mild) back pain when climbing…or so I thought.

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How to Have Negative Health Insurance Costs

One of the chief concerns for those considering leaving a job is the prospect of health insurance costs. I’ve met many climbers who choose to not insure, and many other concerned corporate employees who are convinced that insurance in the private marketplace will cost tens of thousands of dollars per year. As of this month, I’m pleased to announce that we are officially getting paid to have health insurance.

No joke! Let’s examine the wild and crazy ride of our health insurance budgeting. Strap in.

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The Shocking Truth About Sleep

New research presents a natural solution to being smarter, stronger, slimmer, wealthier, more attractive, more likable, less anxious, depressed, and generally far healthier. Sounds dreamy, eh? Is there possibly a natural homeopathic method to improve all these arenas in life; some sort of fountain of youth? The answer is a resounding yes, and the solution is simple: We simply must improve the quantity and quality of our sleep.

But you might already know that.

So how do we actually sleep more and sleep better in a world that wants us awake?

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Is Healthcare Insurance About to Get a Lot More Expensive?!

With the passing of Supreme Court Justice Ruth Bader Ginsburg, the nation is thrust into an unexpected and incredibly time-sensitive debate on the future of the Supreme Court. The court is suddenly on a fast-track to a hard right turn, and hanging in the balance are pivotal social issues including abortion rights and healthcare programs. Relevant to us is the continued existence of the Affordable Care Act.

Other (understandably huge) social issues aside, changes in—or elimination of—the Affordable Care Act could mean colossal changes in the cost of healthcare insurance. What should we know and how can we prepare?

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How to Make Food at Home That Doesn’t Suck

Let’s get one thing clear right off the bat: I’m not against eating out. I’m 100% an advocate of experiences, and I find that food, when done well, is an art and sensation worth the expense.

That said, far too many folks almost exclusively eat out because either they think there’s no time, or they simply haven’t taken the initiative to learn how to cook. Over time, the resultant opportunity cost is hundreds of thousands of foregone dollars and the delayed effects of one-too-many chicken fingers. Today, let’s examine a handful of really simple tips to make food at home that doesn’t suck.

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Walking the Walk and Other Tales by Foot

I really like to walk. Or maybe I really loathe sitting still. Ask my wife or any of my family members. If you invite me over and expect the bulk of the experience to be shared on a couch, you will find me pacing like a deranged man on his third rail of cocaine. YEAH! LET’S DO THIS!

This = moving around your living room aimlessly and without purpose, probably chewing my fingernails.

The Fitbit craze of late has people obsessed with the seemingly arbitrary 10,000 steps. And although counting steps carries an essence of the bizarre to me, I’m glad there’s incentive to get out of the chairs and sofas and start moving. But perhaps one of the best benefits of walking has less to do with fitness and more to do with the mind. What are we missing when we’re not out on our own two feet?

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In Defense of Stew

It is late April as I write this. Spring has sprung, flowers are in full bloom, and Gary is tuning up the lawn mower. People are aerating their lawns, for some reason. Pasty white legs are in shorts and flip flops, even though it’s not quite yet that warm. Not in Colorado at least. We’re headed out of winter, and we’re starting to crave the fresh fruit and veg of summer. But folks, I’m here to stand in solidarity with a winter standard: Stew.

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