1 00:00:00,000 --> 00:00:03,280 Most people don't like it to spend time in a hospital, 2 00:00:03,300 --> 00:00:07,260 of course you will say, but perhaps you don't study medicine like me and you don't have a doctor 3 00:00:07,260 --> 00:00:11,200 retired as an uncle. He knows everyone and decided to help me choose the 4 00:00:11,200 --> 00:00:14,880 specialization. It's not a pill morphine. And how he doesn't let it pass by 5 00:00:14,880 --> 00:00:18,120 all the tests of the biggest show medical television in the history of 6 00:00:18,120 --> 00:00:21,160 and advanced search, even if the My uncle's hospital practice is 7 00:00:21,160 --> 00:00:22,320 decidedly experimental. 8 00:00:23,340 --> 00:00:26,140 Robert is charming, come down again more. 9 00:00:26,560 --> 00:00:29,160 It's really too late to sign up for jurisprudence? 10 00:00:39,530 --> 00:00:43,490 I'm an anesthesiologist and I also have a specialization in pain therapy. 11 00:00:43,790 --> 00:00:48,250 Pain. An unbearable pain. From fall to the ground. 12 00:00:48,630 --> 00:00:52,410 Let's identify the nerves responsible for the pain. Now we will block the nerve 13 00:00:52,410 --> 00:00:56,650 sciatic. We have a bag like that of Mary Poppins full of anesthetics. 14 00:01:00,750 --> 00:01:05,069 Today we talk about those who pass the respirator and eliminates pain. 15 00:01:05,069 --> 00:01:06,070 anesthesiology. 16 00:01:06,730 --> 00:01:11,390 As anesthesiologists, we we supervise the control of certain 17 00:01:11,390 --> 00:01:14,910 such as threshold of consciousness, pain, relaxation. 18 00:01:15,170 --> 00:01:19,650 Everyone thinks anesthesiologists are the doctors who put you to sleep. End 19 00:01:19,650 --> 00:01:25,110 of history. Today we will try to debunk it this myth. Okay, it will definitely be 20 00:01:25,110 --> 00:01:29,610 like this. But let's start with the talent number one, to send us into the world of 21 00:01:29,610 --> 00:01:34,040 dreams. I counted backwards from 10 and the last number I remember is 22 00:01:34,040 --> 00:01:34,499 on the 7th. 23 00:01:34,500 --> 00:01:39,180 Before I fall asleep under the knife I have felt like I was... like I was 24 00:01:39,180 --> 00:01:40,560 glued to something. 25 00:01:40,900 --> 00:01:43,860 I didn't feel anything during mine operation. 26 00:01:44,120 --> 00:01:48,500 I saw everything double, full of auras. It is It was the best hangover of mine 27 00:01:48,700 --> 00:01:52,040 If I have to compare the profession of 'anesthetist to any other 28 00:01:52,040 --> 00:01:54,980 profection, the first response to which I think it's the pilot. 29 00:01:58,710 --> 00:02:04,210 Pilots and anesthesiologists both have a very methodical way of working. There 30 00:02:04,210 --> 00:02:08,410 we are at the helm of the ship. We have the patient's life in our hands. 31 00:02:08,410 --> 00:02:13,050 We support its vital functions while he is under narcosis. It needs to be checked 32 00:02:13,050 --> 00:02:15,750 every step if you want safety procedure. 33 00:02:22,440 --> 00:02:26,660 One of the methods to eliminate pain is the administration of drugs such as 34 00:02:26,660 --> 00:02:29,760 morphine and... You studied Robert, well done. 35 00:02:31,840 --> 00:02:38,560 Good heavens, there's not a moment to go lose. Morphine is a lot 36 00:02:38,560 --> 00:02:42,140 dangerous for the nervous system central. 37 00:02:42,500 --> 00:02:43,820 Ah, there you go. 38 00:02:52,510 --> 00:02:54,490 It's not a morphine pill. 39 00:02:54,850 --> 00:02:56,250 It's sugar, Robert. 40 00:02:57,950 --> 00:02:59,510 Yes, I know, uncle. 41 00:02:59,890 --> 00:03:02,670 Although morphine wouldn't hurt this moment. 42 00:03:03,130 --> 00:03:07,710 Witty, really witty. My uncle me he had shattered his spine. 43 00:03:07,770 --> 00:03:11,410 A terrible pain. It was one day perfect. Who lives as a child of 44 00:03:11,710 --> 00:03:14,690 We put the patient in a state of late-induced coma. 45 00:03:15,430 --> 00:03:20,070 They don't use whiskey or punches in the tits, but a sedative. The doctor tells us about it 46 00:03:20,070 --> 00:03:22,220 Popovec. It's called Propofol. 47 00:03:22,740 --> 00:03:27,120 We call it amnesia milk. It is a drug that is injected into the patient 48 00:03:27,120 --> 00:03:31,100 intravenously, which will allow him to fall asleep very quickly. L 49 00:03:31,100 --> 00:03:35,500 anesthesia doesn't kill the pain, puts the brain to sleep. In the case of 50 00:03:35,500 --> 00:03:39,540 stops neuronal activity and puts you to sleep conscience. And that's why not 51 00:03:39,540 --> 00:03:42,420 we have memories of an intervention carried out under general anesthesia. 52 00:03:42,680 --> 00:03:44,260 Think about when you will go on vacation. 53 00:03:45,240 --> 00:03:47,580 I think he's going on vacation this moment. 54 00:03:48,170 --> 00:03:52,570 When the brain sleeps, the muscles they think for themselves, so it is 55 00:03:52,570 --> 00:03:56,790 paralyze them. The last thing you can wish you is that your arms and legs 56 00:03:56,790 --> 00:04:00,670 do a dance the moment the scalpel arrives. An injection of 57 00:04:00,670 --> 00:04:05,130 rocuronium will block muscle spasms and involuntary contractions, 58 00:04:05,130 --> 00:04:09,530 paralyzing all muscles, none excluding, even those of the eyelids. 59 00:04:09,530 --> 00:04:12,890 of the anesthesiologist's duties is protect the patient's eyes from 60 00:04:12,890 --> 00:04:13,890 corneal abrasions. 61 00:04:14,380 --> 00:04:18,240 When we put them to sleep, we also put our muscles to sleep of the eyelids no longer respond. 62 00:04:18,440 --> 00:04:22,460 Even the lungs cannot work and the respirator comes into operation. 63 00:04:22,820 --> 00:04:27,080 First I give it a little squeeze to the ambu ball and see if the chest yes 64 00:04:27,080 --> 00:04:28,740 rise as in natural breathing. 65 00:04:29,160 --> 00:04:34,180 The level of responsibility given to him anesthetists must assume it is high. 66 00:04:34,180 --> 00:04:38,280 we keep the patient in good health conditions for the entire duration of the 67 00:04:38,760 --> 00:04:43,300 When the clinical condition is stabilized they must continue to do so 68 00:04:43,820 --> 00:04:47,980 One of the questions we get asked the most it is often what gives you the certainty that I 69 00:04:47,980 --> 00:04:51,880 completely asleep? They don't want to waking up in the middle of an operation. 70 00:04:52,420 --> 00:04:56,360 Inconvenience that you wouldn't like nobody. So doctors use this 71 00:04:56,500 --> 00:05:00,500 It keeps the supply of the products constant drugs and transforms the anesthetic 72 00:05:00,500 --> 00:05:05,020 gas. If I have the slightest suspicion that the induced narkosis is, as we say, 73 00:05:05,020 --> 00:05:08,760 light type, i.e. not strong enough to remove from the patient's mind 74 00:05:08,760 --> 00:05:11,480 the memory of the intervention, then I increase the dose. 75 00:05:12,740 --> 00:05:17,810 Air. laughing gas, nitrous oxide, and here the oxygen. These ingredients 76 00:05:17,810 --> 00:05:22,330 they mix in a constant flow. Not there's nothing to laugh about. Nitrous oxide 77 00:05:22,330 --> 00:05:23,169 he's serious. 78 00:05:23,170 --> 00:05:27,870 Dentists have been using it since the 19th century and is still used to calm the 79 00:05:27,870 --> 00:05:32,510 pain. But outside of a context strictly medical, like concerts or 80 00:05:32,510 --> 00:05:34,750 of the band the Grateful Dead, is illegal. 81 00:05:34,970 --> 00:05:36,750 Nitrous oxide? No thank you. 82 00:05:37,870 --> 00:05:40,670 Nowadays patients are crazy about the desflurane. 83 00:05:41,280 --> 00:05:45,580 It is one of the new generation gases. It is eliminated from the body a lot 84 00:05:45,580 --> 00:05:49,440 quickly. So, if the patient must wake up immediately at the end of 85 00:05:49,440 --> 00:05:51,600 intervention, it could be the drug right. 86 00:05:52,000 --> 00:05:54,360 Once upon a time the methods were less elegant. 87 00:05:54,680 --> 00:05:58,980 In the Middle Ages they wore a helmet skin on the patient's head and then the 88 00:05:58,980 --> 00:06:02,380 doctor violently hit the unfortunate with a wooden hammer. 89 00:06:02,780 --> 00:06:04,420 The scientific term? 90 00:06:04,960 --> 00:06:06,220 Concussive anesthesia. 91 00:06:07,180 --> 00:06:10,880 When the surgeon has finished his work, it's up to the anesthesiologist to do it 92 00:06:10,880 --> 00:06:11,880 from the coma. 93 00:06:13,260 --> 00:06:15,540 Start by stopping the supply of drugs. 94 00:06:15,860 --> 00:06:20,320 The anesthetic cocktail is eliminated from the body in a natural way, for 95 00:06:20,320 --> 00:06:25,080 diffusion. The elimination for diffusion follows the laws of physics, 96 00:06:25,080 --> 00:06:29,340 gases pass from a high state pressure, the lungs, to a low one 97 00:06:29,420 --> 00:06:30,420 the external environment. 98 00:06:31,040 --> 00:06:33,260 Then we detach the respirator tube. 99 00:06:33,580 --> 00:06:35,860 It matters how you respond to them stimuli. 100 00:06:36,200 --> 00:06:37,560 As always, or almost. 101 00:06:38,000 --> 00:06:39,040 Five minutes. 102 00:06:40,260 --> 00:06:41,520 And let's see how it goes. 103 00:06:43,280 --> 00:06:47,160 When patients wake up, the first faces they see are those of those who have them 104 00:06:47,160 --> 00:06:48,160 kept alive. 105 00:06:48,500 --> 00:06:49,500 Welcome back among us. 106 00:06:50,020 --> 00:06:54,560 The surgery is over. The brain has resumed full operation. It's the 107 00:06:54,560 --> 00:06:56,820 post pain control time -operational. 108 00:06:57,200 --> 00:06:59,760 We gave her some paracetamol. All bene? 109 00:07:00,060 --> 00:07:01,840 Everything went great. Oh, thanks. 110 00:07:02,500 --> 00:07:03,920 We'll talk more about drugs. 111 00:07:04,300 --> 00:07:08,020 Some are inhaled, some are they inject into the spine. 112 00:07:11,260 --> 00:07:17,680 To save me from a dose of water and mint, my uncle had massacred me there 113 00:07:17,680 --> 00:07:21,620 back. A terrible pain. Well, me I was in the right department. 114 00:07:22,420 --> 00:07:26,680 Maybe you thought it only happened in movies horror, but there are circumstances in 115 00:07:26,680 --> 00:07:28,380 for whom narcosis is not possible. 116 00:07:28,780 --> 00:07:32,840 And this is where local anesthesia comes in. L local anesthesia that is done for 117 00:07:32,840 --> 00:07:38,240 injection consists of putting you to sleep a specific part of our body. The 118 00:07:38,240 --> 00:07:44,400 lower part of the body, or a arm, one leg, just the face, just 119 00:07:44,400 --> 00:07:45,400 head. 120 00:07:45,640 --> 00:07:50,200 Until not long ago, the surgeries were while awake. 121 00:07:50,200 --> 00:07:53,880 they tied it to a table and stuffed it with whisky. The skill of a doctor 122 00:07:53,880 --> 00:07:55,120 it depended on his speed. 123 00:07:55,690 --> 00:08:00,550 Lucky patients fainted after 5 minutes. Those with extreme luck 124 00:08:00,550 --> 00:08:02,010 they woke up after the operation. 125 00:08:02,370 --> 00:08:05,990 When the operation takes place under the line of life, anesthesia comes 126 00:08:05,990 --> 00:08:10,030 injected directly into the spaces intervertebral. It's called an epidural. 127 00:08:10,270 --> 00:08:14,590 One of the easiest drugs to induce by spinal route it is ropivocaine. 128 00:08:15,470 --> 00:08:19,150 What I needed after my uncle he had saved me from an overdose of 129 00:08:19,150 --> 00:08:20,150 water and mint. 130 00:08:20,270 --> 00:08:24,310 It takes skill and experience to do an injection of ropivocaine. 131 00:08:24,860 --> 00:08:28,780 To reach the area where the spinal fluid, I need to locate al 132 00:08:28,780 --> 00:08:32,140 feel a small indentation between the vertebrae. That's the point. 133 00:08:32,520 --> 00:08:36,720 When I thread the needle, I can feel the passage into the muscle tissue and the 134 00:08:36,720 --> 00:08:38,880 voltage when crossing i ligaments. 135 00:08:40,600 --> 00:08:44,880 What you see are drops of fluid cerebro-spinal. We inject the 136 00:08:44,880 --> 00:08:46,840 drug into the cerebrospinal fluid. 137 00:08:48,880 --> 00:08:53,160 The spinal cord is a kind of central control panel for 138 00:08:53,160 --> 00:08:54,280 nerve endings. 139 00:08:54,640 --> 00:08:58,520 Wherever it originates, pain travels through the medulla and reaches the 140 00:08:58,520 --> 00:09:02,220 head. If this step comes interrupted, the bell of pain does not 141 00:09:02,220 --> 00:09:05,820 resonates inside the brain. It's there so-called pain at the door theory, 142 00:09:06,040 --> 00:09:09,420 according to which each nerve is connected to the marrow through a door. 143 00:09:09,720 --> 00:09:11,100 If it is open, the signal passes. 144 00:09:11,340 --> 00:09:13,100 If it's closed, you won't hear anything. 145 00:09:13,710 --> 00:09:18,110 The door can be closed with i drugs. There are some in 146 00:09:18,110 --> 00:09:21,530 opiates that act on the spinal cord e they close the door. 147 00:09:21,750 --> 00:09:23,910 Serotonin can also close the door. 148 00:09:24,130 --> 00:09:28,590 Today various pharmacological therapies are created taking into account the 149 00:09:28,590 --> 00:09:29,850 of the pain at the door. 150 00:09:30,130 --> 00:09:33,170 Which knee should we operate on? On the right one. 151 00:09:33,510 --> 00:09:37,790 The right knee, perfect. L anesthesiology also deals with 152 00:09:37,790 --> 00:09:42,030 pain. Before surgery yes install a catheter. Using the technique 153 00:09:42,030 --> 00:09:46,050 ultrasound localizes the nerve from neutralize. The painkiller travels 154 00:09:46,050 --> 00:09:49,530 through the catheter, blocks the nerve signal and stops the pain 155 00:09:49,530 --> 00:09:50,530 origin. 156 00:09:51,090 --> 00:09:53,330 Those are veins, this is the artery. 157 00:09:53,910 --> 00:09:57,770 We know that the femoral nerve does located behind the artery. 158 00:09:58,290 --> 00:10:00,990 This is the area where we are going to block the nerve. 159 00:10:01,330 --> 00:10:04,950 Blocking the femoral nerve means no more knee pain. 160 00:10:06,600 --> 00:10:10,820 Once the nerve has been localized block, doctors stimulate him to 161 00:10:10,820 --> 00:10:12,080 certain that it is the right one. 162 00:10:12,400 --> 00:10:14,820 It's a bit like testing the threads of a puppet. 163 00:10:17,460 --> 00:10:21,980 The catheter remains in the body ensuring a constant flow of painkillers for 164 00:10:21,980 --> 00:10:22,980 two more days. 165 00:10:23,160 --> 00:10:27,160 Since the anesthesia is local, during the operation only falls asleep there 166 00:10:27,160 --> 00:10:28,160 leg. 167 00:10:32,000 --> 00:10:35,840 I was getting worse and worse. My uncle was looking for a doctor who could help me. 168 00:10:36,670 --> 00:10:39,270 Excuse me, are you an anesthesiologist? 169 00:10:39,470 --> 00:10:42,090 I specialize in local anesthesia. So work here. 170 00:10:42,510 --> 00:10:44,770 I'm visiting, working in Mississippi. 171 00:10:45,110 --> 00:10:47,590 But he didn't say who he deals with local anesthesia? 172 00:10:47,810 --> 00:10:48,810 And that's how it is. 173 00:10:48,910 --> 00:10:52,150 That's it, I understand. And you, doctor, if Am I not being indiscreet? 174 00:10:52,350 --> 00:10:54,150 I specialize in local anesthesia. 175 00:10:54,370 --> 00:10:55,370 So work here. 176 00:10:55,450 --> 00:10:56,450 No, in Winnipeg. 177 00:10:56,690 --> 00:10:57,830 Oh, sure. 178 00:10:58,410 --> 00:11:00,070 Well, thank you, thank you. 179 00:11:01,960 --> 00:11:06,280 Robert, this is a ghost department. Let's try somewhere else. Yes, uncle. 180 00:11:07,040 --> 00:11:08,580 How I would like a walker. 181 00:11:10,080 --> 00:11:11,160 Look at this man. 182 00:11:11,560 --> 00:11:15,660 Absolutely calm while i surgeons replace him with a 183 00:11:15,660 --> 00:11:20,160 spinal anesthesia and nerve block specific interrupt the connection 184 00:11:20,160 --> 00:11:22,540 between the leg and the brain. And he what you say? 185 00:11:23,180 --> 00:11:27,900 I don't feel any kind of pain. I have the feeling that they are moving me there 186 00:11:27,900 --> 00:11:30,240 leg, but it's kind of... 187 00:11:30,810 --> 00:11:32,770 I can't describe it. Do you feel any discomfort? 188 00:11:32,990 --> 00:11:36,490 No. But I would like to see what you are telling me doing. 189 00:11:39,650 --> 00:11:43,410 When we meet again maybe he will have found it someone who makes you feel that way 190 00:11:43,410 --> 00:11:44,410 I'm calm too. 191 00:11:44,690 --> 00:11:49,750 From cannabis to dispensers painkillers under the skin we will talk about 192 00:11:49,830 --> 00:11:51,710 drugs and more drugs. 193 00:11:56,570 --> 00:11:58,470 Fine thanks. Thank you. 194 00:11:58,830 --> 00:12:02,690 You will tell me that in a hospital like this someone to free me from the pain 195 00:12:02,690 --> 00:12:07,890 for sure. I was getting worse and worse. Alla at the end we find Dr. Popovic and the 196 00:12:07,890 --> 00:12:12,990 pain clinic. In this clinic i patients are usually referred to us by 197 00:12:12,990 --> 00:12:17,850 other doctors or in any case are patients with chronic pain. We're talking about chronic 198 00:12:17,850 --> 00:12:22,110 if this goes beyond the duration of one lesion when there is a lesion or 199 00:12:22,110 --> 00:12:24,850 situations where the disorder is represented by the pain itself. 200 00:12:25,550 --> 00:12:30,430 Anesthesiologists and psychologists work here side by side. Patients learn to 201 00:12:30,430 --> 00:12:34,730 living with pain and a check it. The approach is there 202 00:12:34,730 --> 00:12:36,790 but applications vary constantly. 203 00:12:37,090 --> 00:12:41,190 This patient has multiple sclerosis. Sclerosis causes him pain 204 00:12:41,190 --> 00:12:45,550 defined as neuropathic because it comes from nerves that don't work properly e 205 00:12:45,550 --> 00:12:46,890 they send pain signals. 206 00:12:47,670 --> 00:12:48,950 We administer idocaine. 207 00:12:49,560 --> 00:12:53,640 And within an hour the lidocaine acts, rebalancing the functioning 208 00:12:53,640 --> 00:12:55,600 nervous for a certain period of time. 209 00:12:55,920 --> 00:13:00,620 Lidocaine acts like a giant shears on the communication system of 210 00:13:00,620 --> 00:13:04,520 'organism. Pain arises when receptors are stimulated 211 00:13:04,520 --> 00:13:05,620 nerve endings. 212 00:13:06,220 --> 00:13:10,100 The signal travels to the brain, where it is translated into pain. 213 00:13:10,400 --> 00:13:13,600 It all depends on the exchange of ions sodium - potassium. 214 00:13:14,080 --> 00:13:18,820 Lidocaine blocks the release of sodium and inhibits the electrical signal 215 00:13:18,820 --> 00:13:23,480 can no longer transfer from neuron to neuron. No sodium, nothing 216 00:13:23,480 --> 00:13:27,800 no pain signals in the brain. Not forever, but for three weeks yes. 217 00:13:28,180 --> 00:13:29,500 I see her in a good mood. 218 00:13:29,760 --> 00:13:30,760 That thing works. 219 00:13:31,000 --> 00:13:36,680 Unfortunately it's not forever, but meanwhile... Lidocaine is an analgesic 220 00:13:36,680 --> 00:13:40,980 synthesis, derived from cocaine, l 'main alkaloid extracted from 221 00:13:40,980 --> 00:13:43,300 of coke. It grows in the Andes mountain range. 222 00:13:43,740 --> 00:13:47,980 Local populations have been living there for 5,000 years they chew the coca leaf as a remedy 223 00:13:47,980 --> 00:13:52,380 against toothache, headache altitude and even hunger. It was also 224 00:13:52,380 --> 00:13:56,200 of the ingredients of Coca -Cola, but l the only drug left in Coca -Cola 225 00:13:56,200 --> 00:14:00,040 modern is caffeine. The coke came removed in 1906. 226 00:14:00,460 --> 00:14:04,800 Sometimes the pain is kind of ghost, comes back to strike when the 227 00:14:04,800 --> 00:14:05,800 been removed some time ago. 228 00:14:06,480 --> 00:14:10,960 Constant pain in the lower back. Like a knife blow, like that. 229 00:14:11,820 --> 00:14:17,600 And it doesn't go away, the pain is always there, c 'it always is. It pulls me like this, here and there 230 00:14:17,600 --> 00:14:18,600 here. 231 00:14:18,720 --> 00:14:22,820 Try to imagine a fire. Hear the alarm ring loudly. 232 00:14:23,600 --> 00:14:26,560 The firefighters arrive and put it out 'fire. 233 00:14:26,880 --> 00:14:30,100 There is no longer fire, but the alarm it still rings. 234 00:14:32,160 --> 00:14:33,800 This is chronic pain. 235 00:14:34,700 --> 00:14:37,440 Wrong impulses and actions to the brain. 236 00:14:37,760 --> 00:14:40,560 Constant pain, if neglected, it gets worse. 237 00:14:40,840 --> 00:14:44,900 The nerve fibers that transmit the impulses always perform their best 238 00:14:44,900 --> 00:14:47,820 work, like the muscles you train they become stronger. 239 00:14:48,120 --> 00:14:52,340 The longer you live with it, the more intense will become. These are the times you would like 240 00:14:52,340 --> 00:14:54,360 that the organism was not like that efficient. 241 00:14:55,320 --> 00:14:57,240 Suffering is the wrong thing for everyone. 242 00:14:57,460 --> 00:15:01,460 If you are experiencing pain or suffering, adrenaline levels 243 00:15:01,460 --> 00:15:05,300 very high and when the adrenaline comes produced at these levels is bad for the 244 00:15:05,300 --> 00:15:08,160 heart, it's bad from the pressure, it's bad for stress levels. 245 00:15:08,700 --> 00:15:14,060 At the moment my therapy is based on daily injections of copaxone. I'll take it 246 00:15:14,060 --> 00:15:19,100 Neurontin, morphine, intramusculars of lidocaine for back pain. E 247 00:15:19,100 --> 00:15:24,120 also Tegretol. I tried any what he found in circulation, for example 248 00:15:24,120 --> 00:15:25,180 example marijuana. 249 00:15:29,160 --> 00:15:33,460 The so-called joint is still illegal, but doctors soon might 250 00:15:33,460 --> 00:15:37,340 prescribe it. One is being tested mouth spray that releases the principles 251 00:15:37,340 --> 00:15:38,340 marijuana treatments. 252 00:15:38,560 --> 00:15:41,620 You won't feel done, but neither will you they will arrest. 253 00:15:42,100 --> 00:15:46,140 It is illegal and its use is severely punished in most of the world. 254 00:15:46,360 --> 00:15:50,500 But marijuana has proven it can soothe the pain of cancer, of 255 00:15:50,500 --> 00:15:51,560 multiplex and arthritis. 256 00:15:51,980 --> 00:15:56,480 For now doctors are focused on traditional drugs, but with new ones 257 00:15:56,480 --> 00:15:57,480 of administration. 258 00:15:58,120 --> 00:16:03,140 If you suffer from chronic pain 24 hours a day 24, until recently there was only the 259 00:16:03,140 --> 00:16:04,140 hospital admission. 260 00:16:05,000 --> 00:16:07,020 Now there is the transdermal patch. 261 00:16:07,980 --> 00:16:12,640 It is a thin membrane that allows the medicine to spread through the 262 00:16:12,640 --> 00:16:17,720 skin. And be absorbed into the blood. Carried by the blood it goes to calm the 263 00:16:17,720 --> 00:16:19,920 pain. And this is the state of the art. 264 00:16:20,120 --> 00:16:23,560 Nothing to smoke, swallow, inject or spread. 265 00:16:23,760 --> 00:16:26,420 Doctors implant a dispenser underneath skin. 266 00:16:26,780 --> 00:16:31,460 It looks like a bell. And it's big about the size of a hockey puck. 267 00:16:31,760 --> 00:16:34,640 It should be placed between two vertebrae at one point very precise. 268 00:16:35,310 --> 00:16:38,750 It seems to me that it is at the height of L3 o L4. 269 00:16:39,030 --> 00:16:43,630 A small intervention that eliminates a lot pain. The neurosurgeon intervenes 270 00:16:43,630 --> 00:16:47,950 intrathecal pump. The drug arrives in spinal canal through a catheter e 271 00:16:47,950 --> 00:16:51,950 it never touches the lungs or the flow sanguine. Thanks to this system, yes 272 00:16:51,950 --> 00:16:54,350 they can relieve many types of pain throughout the body. 273 00:16:54,710 --> 00:16:59,830 We program the type of drug and how fast we want it to flow. 274 00:16:59,830 --> 00:17:02,070 first time they installed it on me I... 275 00:17:02,890 --> 00:17:07,910 All I did was touch him, for three weeks I said to myself now it's coming off 276 00:17:07,910 --> 00:17:12,109 instead it is part of me. And with these instead you work on the surface, it's a 277 00:17:12,109 --> 00:17:13,890 neurostimulator called TENS. 278 00:17:14,190 --> 00:17:20,069 TENS, written in all capital letters T -E -N -S, means Trans Electrical 279 00:17:20,069 --> 00:17:21,069 Neurostimulation. 280 00:17:23,630 --> 00:17:27,829 The TENS unit uses its own electrical signal to disperse the 281 00:17:27,829 --> 00:17:32,230 signals sent to my brain. Al where I was I would have said 282 00:17:32,230 --> 00:17:33,230 anything. 283 00:17:33,330 --> 00:17:36,730 Do not increase the voltage or you will receive a painful discharge. Yes. 284 00:17:38,670 --> 00:17:39,830 Good, good, good. 285 00:17:40,350 --> 00:17:43,590 Eh, uncle, they put plasters on me for a TENS. 286 00:17:43,830 --> 00:17:46,310 It should take away the pain I feel to the back. 287 00:17:46,770 --> 00:17:49,070 The treatment lasts 30 minutes. 288 00:17:49,430 --> 00:17:50,430 Let's watch TV. 289 00:18:06,280 --> 00:18:07,340 But what's wrong with you? 290 00:18:08,300 --> 00:18:11,820 Calm down now, look what's on TV even worse. You are not obligated to 291 00:18:11,820 --> 00:18:14,280 watch television if you don't feel like it do it. 292 00:18:21,100 --> 00:18:25,280 Most TENS units are external, but the smaller ones yes 293 00:18:25,280 --> 00:18:26,420 they implant under the skin. 294 00:18:26,800 --> 00:18:30,780 Doctors program them so check the intensity of the pulses. 295 00:18:31,240 --> 00:18:35,400 It's like setting with an automatic timer the lights in your house, just that 296 00:18:35,400 --> 00:18:38,220 these impulses do not keep thieves away, but the pain. 297 00:18:38,820 --> 00:18:43,160 So, I start from this breadth of signal and increase it slightly. Not 298 00:18:43,160 --> 00:18:47,240 cause her a shock, because if I increase quickly she could have one 299 00:18:48,440 --> 00:18:53,300 The function of TENS is to interrupt the pain signal e 300 00:18:53,300 --> 00:18:57,840 spinal cord to close the door, guaranteeing the patient 50% less 301 00:18:57,840 --> 00:19:02,890 suffering. Soon, techniques pain control alternatives, 302 00:19:02,890 --> 00:19:04,510 and the use of biofeedback. 303 00:19:06,290 --> 00:19:11,230 The TENS unit had caused a shock both to the pain and to me, because it always is 304 00:19:11,230 --> 00:19:13,090 my uncle who operates the remote control. 305 00:19:13,530 --> 00:19:16,910 Do not increase the voltage, you will receive a painful discharge. 306 00:19:18,170 --> 00:19:23,450 Traditional methods had not worked very well for me, like that 307 00:19:23,450 --> 00:19:26,210 leave the electricity alone and try psychotherapy. 308 00:19:26,720 --> 00:19:32,260 Everything about pain emotional, anxiety, depression, it goes 309 00:19:32,260 --> 00:19:38,500 addressed and well looked after. And if not adequately addressed, then l 310 00:19:38,500 --> 00:19:45,500 intervention to block the way effective the pain weakens. Le 311 00:19:45,500 --> 00:19:49,080 can have a devastating impact on functioning of the drugs they block 312 00:19:49,080 --> 00:19:50,120 the pain signal. 313 00:19:51,080 --> 00:19:56,380 The brain chemistry that supports the anxiety or depression is responsible 314 00:19:56,380 --> 00:20:00,840 fact that every method of relief from pain implemented by us risks coming 315 00:20:00,840 --> 00:20:05,220 weakened precisely by the physiology of brain. In the pain clinic it is 316 00:20:05,220 --> 00:20:06,880 Psychotherapy is also available. 317 00:20:07,280 --> 00:20:12,360 We see patients with chronic pain that other doctors have attempted 318 00:20:12,360 --> 00:20:13,460 needlessly to cure. 319 00:20:13,840 --> 00:20:17,100 We are, as they say, we are... 320 00:20:17,440 --> 00:20:22,780 The last resort, the last frontier. The psychologist, the interviews, they have me 321 00:20:22,780 --> 00:20:28,400 kept alive, really. The psychologists are very operators 322 00:20:28,400 --> 00:20:32,600 these types of treatment, because they are the only ones capable of evaluating how much 323 00:20:32,600 --> 00:20:36,460 the psychological component is great patient pain. 324 00:20:37,290 --> 00:20:42,210 It's like a constant burning sensation. AND a sort of electric current that 325 00:20:42,210 --> 00:20:46,070 runs through the side. It was as if I had taken a metal brush and 326 00:20:46,070 --> 00:20:50,590 I would have thrown it in my face. In how long do male newborns 327 00:20:50,590 --> 00:20:52,210 pain differently from females? 328 00:20:52,430 --> 00:20:57,310 Six months? Six weeks? Let's make it six hours. Researchers want to find out 329 00:20:57,310 --> 00:21:01,410 because women are more sensitive to pain. One day perhaps there will be 330 00:21:01,410 --> 00:21:05,650 of pain related to sex. There are really many techniques to relieve the 331 00:21:05,650 --> 00:21:06,650 suffering. 332 00:21:07,180 --> 00:21:12,100 Psychologists can give lessons in biofeedback, so you give signals that yes 333 00:21:12,100 --> 00:21:16,540 raise and lower can be acquired the ability to relax muscles and 334 00:21:16,540 --> 00:21:22,080 control the pain. When the patient relaxes muscles signals 335 00:21:22,080 --> 00:21:26,480 visuals lower, this is the feedback and the patient learns in a way 336 00:21:26,480 --> 00:21:29,940 what needs to be done for this purpose to relax. 337 00:21:30,480 --> 00:21:32,820 Hypnosis is yet another method. 338 00:21:33,180 --> 00:21:39,350 That's the real goal of hypnosis to shut out any kind of 339 00:21:39,350 --> 00:21:44,250 external stimulus. One of the messages to which I keep more, which I want to send to everyone 340 00:21:44,250 --> 00:21:47,050 patients, is that they don't have to suffer. 341 00:21:47,430 --> 00:21:48,790 Suffering hurts everyone. 342 00:21:49,130 --> 00:21:53,530 Do what is necessary to check the pain. Follow a good program. If 343 00:21:53,530 --> 00:21:56,210 you need needles to cure yourself, become friends of needles. 344 00:22:00,310 --> 00:22:05,170 The back pain was killing me. The Dr. Popovec suggested hypnosis. 345 00:22:05,420 --> 00:22:09,960 I would have accepted anything And uncle he wanted to learn the technique to help me 346 00:22:09,960 --> 00:22:16,880 best Direct practice is best teacher Repeat what I say to Robert 347 00:22:16,880 --> 00:22:23,780 Good Ready? Ready 348 00:22:23,780 --> 00:22:30,160 Start feeling very relaxed. Start to feel very relaxed 349 00:22:30,160 --> 00:22:36,970 Now let's continue Now let's continue You feels terrible pain. You 350 00:22:36,970 --> 00:22:40,890 you feel terrible pain. That the passes from side to side. 351 00:22:41,310 --> 00:22:43,250 It pierces you through and through. 352 00:22:43,690 --> 00:22:48,610 You can't even breathe. Not you can't even breathe. 353 00:22:51,630 --> 00:22:52,990 How do you feel? 354 00:22:53,450 --> 00:22:56,730 Sorry to disappoint you, uncle, but I feel worse than before.