Microboosts to Feel Better: Holistic Pain Solutions with Dr. Sharma Part 2

Dr. Mia Yang  19:38

Yeah, absolutely. So we talked about refill for food, revitalize for exercise, and recharge for sleep. Anything you wanted to add to those three R's before we move to refresh?

Dr. Saloni Sharma  19:52

I think for the refill part because that's such a big piece in nutrition. There's something called choice architecture and the way you set things up to make your choices easier to the path that you want. -to make healthier choices easier for you.One tip is to set your pantry or kitchen as if it were a grocery store, where the things that you want you or your family to eat are ,in front and center. Having the desserts in the back of the cabinet high up and out of the way, and having your healthy alternative (whether that's mix knots in the fridge, it could like good fermented yogurt in the front with some berries, as opposed to the ice cream)  having something like that more in the front of your eating spaces can make a big difference. Whatever is easy is what we tend to do, especially if we're multitasking or talking to someone on the phone, we kind of grab it right there. So having the fruits and vegetables front and center, having mixed nuts front and center (if you're allowed to partake in that without any allergies)  , having those things front and center can make a big difference in terms of what we intake.

Dr. Mia Yang  20:51

Absolutely. I know for desserts (at least at our house) that we just need to make that one hard decision not to buy it at the grocery store rather than buying it and then trying to resist it every day sitting on the kitchen table.

Dr. Saloni Sharma  21:05

For sure. Yeah, if you don't bring it to your house, that's the best.

Dr. Mia Yang  21:07

Sometimes you just wanted a treat. That's one thing that we're trying to instill in our house, that there's no forbidden foods. There's no food that is so bad that you have to hide away and feel shameful if you do eat it. However, you may with a little bit in moderation, and try to keep your overall diet as healthy as possible. I like setting up your pantry in a way that incentivizes you to pick some of the healthier choices. All right, let's transition to talk about refresh, which is another topic that, I think we are very dependent on medications in our society, stress, anxiety are so common. I’m not saying that medications are not important but can you tell us what are some strategies that you would suggest in terms of relieving our emotional stress?  

Dr. Saloni Sharma  21:59

Yeah, so the refresh section, as you alluded to, is about stress reduction. The data about mindfulness and meditation are just irrefutable at this point for reducing stress, inflammation and pain and really quality of life. If people are open to using apps, there's many free apps that people can access such as calm, headspace, and 10% happier, they all have a free version. At least the Kaiser Permanente actually has free online mindfulness and visualizations too. Like we said, we can share the website with you. These are simple tools that are really accessible. I tell people to try to stack them into your day before and after a stressful event. For some of your patients, or for a lot of people going to the doctor, it can be a stressful event. So either before or after ,in the hospital garage, doing a five minute mindfulness activity to sort of prepare yourself. Then to de-stress ,it can be helpful for physicians and really, for any person who's working outside of the home. Same thing in the parking lot of the place where you work, just doing a five minute mindfulness activity. Just park your car, and transition from your work self to your home self can be really beneficial. This is beneficial for people who work from home too. I would advise them to go for a walk outside, or sit outside in different space and do it to sort of make that delineation and do a fake commute where you walk around the block and say, Okay, I'm leaving, work me behind, and I'm going to be home me  and vice versa at the start of your day. The data is huge so if you're not a tech person. You can take a mindful walk outside and do what's called an auto walk. There was a study that came out a few years ago and showed that they took two groups of people and told them to take a walk. They told them to take selfies and they told one group to find something that brings them all, or they think is beautiful, or inspires them. Take a little selfie of yourself with that awesome thing like a beautiful flower, for example, and your walk. They found that the other group just wanted to take a walk and the people who were actually given the assignment or task, had improved mood for weeks after the study was done. Their own face and the selfie became smaller and smaller, they became more of a focus of what ™s behind them during the capture. It gives you that perspective and you don't need any technology to do that. You don't have to do the selfie part, you can just go for a walk and just find something that's inspiring on your walk. It can be the same walk you take every day around the same block and if you look, you can find something; you can find a rock, a cloud formation you didn’t notice and a leaf. There's so many things you can find like oh, that's kind of different. That's kind of neat. It pulls you out of your own head a little bit and your own stress. It makes you recognize the beautiful things around you. I think there's a lot of simple ways to be mindful that are not soaked in religion or soaked in technology.

Dr. Mia Yang  24:26

Absolutely. I know that you mentioned earlier that you also do acupuncture. I think one thing that sometimes my patients ask me (I don't know the answer to)  is how do you know who to choose in terms of finding an acupuncturist. Who is appropriate for acupuncture?

Dr. Saloni Sharma  24:45

Acupuncture can be used just for maintenance, for general kind of wellness and calming the body in the mind. The way I approached acupuncture is purely for pain just because that's my specialty. That's how I have people who are candidates for it in terms of finding a good acupuncturist. You want to make sure that they have a state license, just like how you make sure a physician has a state license. You want to make sure that you single use needles. Those are the two big requirements and really backed up with acupuncture. I refer out a lot and those are the things I tell them. You want to make sure they have a state license, and they use the single use needles. In this day and age, most practitioners should use single-use needles, but not everyone.

Dr. Mia Yang  25:21

Yeah, that's a great idea. I can't imagine sharing needles among people. I think

Dr. Saloni Sharma  25:25

They're Sterilized but you know, yeah, your comfort level with that.

Dr. Mia Yang  25:29

Right? Exactly. I know you talk about the kind of the mindset around pain as well and the relationship between pain, our mood and depression. What are some potentially helpful thoughts or reframes that you will suggest to your patient?

Dr. Saloni Sharma  25:46

Some of the reframes are having what I call a rise attitude, or a rise mindset. Which is this is not permanent, I'm not stuck here forever, so that there's room to change. I think that's a big reframe. If you get to that point where you feel like you're not doomed, you're not destined to be suffering your whole life, that's really going to open a lot of doors because if you're not at that point, then you can't make these little steps. These little changes we're talking about today. I think having gratitude has been overdone over the years lately, but finding something you're thankful for each day. (You don't have to write it down). One thing I talk about is the big three, which is the person, place and thing you're grateful for that day. You can just go over that when you're sort of not feeling great, or in a moment of stress. I think reframing your perspective as  things can get better . I suggest having a rise mentor which is a trauma camp with finding someone who inspires you. Someone who may have overcome adversity, similar or greater than yours can be helpful. It doesn't necessarily have to be a person, you know, it could be someone that you've met at work, or it could be someone in history, it could be someone on a television show, but whoever inspires you to do good and be good, that can be helpful as well. I can think about what would they do in this situation? or how would they overcome this. Some of them can be really big, famous people like Mahatma Gandhi, or Mother Teresa, or it could be something like Ted Lasso, or Leslie Knope from television and people who kind of persevere, despite challenges and sort of borrowing their attitude a little bit.

Dr. Mia Yang  27:13

Yeah, I think that the mindset is so important. If people don't necessarily think that they can have the power to change their life and do things that are proactive for their pain. Pretty much everything else is not going to happen because of the thought that I'm going to try this, and I'm going to take baby steps to see if I can feel better.  That's oftentimes a very, very important step

Dr. Saloni Sharma  27:39

For a lot of people feeling better for themselves is not motivating enough. Sometimes you have to reframe it as for someone else, so I want to be there for your so and so's graduation, or I want to be there for my spouse, I want to be there for my church group, I want to be there for my neighbor. I want to get healthier or feel better, so that I can support someone who I love and who is important to me, sometimes that's more motivating. Talking to people or even ourselves thinking about what our big goal is, or our purpose, that can really help have some perspective, so that when you hit that hurdle, and you hit that challenge, you're like, Well, I've got to figure this out, I've got to get better because I have to work on this big project. This is my big purpose in life. And if I'm sitting here incapacitated, I'm not working on that.  Having a bigger goal, and sometimes asking people what their bigger goal is, can be helpful, or what brings people joy, so we can get them back to their joyful activities can be really beneficial as well.

Dr. Mia Yang  28:29

Yeah. Then coming back to social relationships, something that we mentioned earlier on one of my common complaints that I hear from my older adults. As they get older, particularly the older you go, the fewer friends you have, because a lot of people who are important in their lives have passed away or moved away. The older adults are having difficulty meeting new friends or reestablishing important social relationships. What are your thoughts about that?

Dr. Saloni Sharma  29:02

Part of that is prehabbing a little bit. I talked with my patients who are retiring or near retiring about this, when you leave your job. If you've been working full time for 30 years, 20 years, 40 years for the bulk of your life, then you have to have a little bit of a plan and it might involve being a little more proactive in your social life. You previously were volunteering in your neighborhood library or your neighborhood religious organization that you are comfortable with or things like Lions Clubs, and reaching out and making new friends if you have to. Your previous Social Security circle is not the same as it was before. If you're tech savvy, definitely connecting with people on online groups can be helpful. I think the biggest thing is getting involved in your community one way or another, in places like libraries . They are always looking for volunteers. I have some elderly patients who have done Meals on Wheels for 20 years. She's almost 80 And she's been doing it for 20 years now. She is not capable of driving out meals but she goes to the kitchen and makes sandwiches every Friday. Then she and her friends go out for lunch, after her Meals on Wheels friends, they go out for lunch after. So it becomes kind of a win-win, you feel like you're serving a community, but then she's also getting her social interaction. I think sometimes recognizing that you still have so much to offer, and that you can make the world better (even if you're not formally working anymore in the workforce). Then to that you might have to be a little proactive about finding a community that makes sense for you in this stage of life.

Dr. Mia Yang  30:25

Yeah, absolutely. I think older adults have so much to contribute to our society. We don't talk about all of their contributions, we think that oh, because you're retired and not working anymore , it's almost like your value as a person decreases. That definitely is not the case, and shouldn't be the case for a lot of people. Thinking back to my own grandparents, they retired fairly early, but they still had a very full life and were involved with a lot of different social groups and ways to get themselves involved in the community for decades after the retirement.I'm not familiar with prehab in terms of preparing for retirement, but I think that's another great idea to kind of proactively say what other things I can get involved in in my community to meet more people and to have that additional social connection.

Dr. Saloni Sharma  31:19

I think people undervalue if you still go to an office or hybrid or work in healthcare, then you're still on site, how much social interaction happens in the workplace. When you retire how much you lose that social interaction. We talked about social connection, and relationships are so important for physical and mental well being that really preparing for that and not losing that is so important. Before you retire, you can start joining some of these community groups as well and volunteer groups to sort of have that setup. Transition is not so hard. It's so important, it can be challenging. You and I both have young children, but even spending time with other mothers or at school with their parents was a great way to start building that even now.

Dr. Mia Yang  31:58

Yeah, everything takes intentionality and planning and effort and making small steps. Making even one social outing, sometimes is better than not planning for any social interaction and just say,  Oh, well, I'm just too busy or too limited by pain or can't drive. It really, a lot of times comes back to your attitude and how much you think are within your power to change.

Dr. Saloni Sharma  32:27

For sure! Recognizing that it's important and so that's why it's so wonderful to be on this podcast. Have two physicians talking about social connection being important, and not being something that's just at the bottom of your to do list. It's one of the big five things that I advocate for to reduce stress and inflammation to help with longevity and aging. Unfortunately, it's not something that most providers have time to discuss with their patients, just the way schedules are set up between administrations ensures physicians can't discuss everything they would like. You asked me earlier, and that's part of the motivation for writing the book, too. It's all these things I want to talk about and share with patients. It's all evidence based data, but it's not something I have time to do. Giving someone a tool and saying,  Look, I believe in this. And more than I believe in this, this is what the literature shows. I don't have the ability to go through all of it with you but here's sort of something written for lay people that's evidence based, and can empower you . I think that's what inspired me to write the book as well.

Dr. Mia Yang  33:19

Yeah, that's great. For those who are listening, Dr. Sharma's book is called The Pain solution. We are going to put the link to purchase the book, the show notes as well. I really appreciate you joining me today. Dr. Sharma, are there any final words of advice or anything else you would like to share with our audience today?

Dr. Saloni Sharma  33:42

The final thought is , we all have the power to feel better, we just might need some guidance. None of us are incapable of improving our health just a little bit each day. It may not be a complete cure, but feeling a little bit better, taking back some control of our health from a healthcare system. That often doesn't give that to us as possible. I think just knowing that you have the power to feel better within your own hands.

Dr. Mia Yang  34:04

That's great. We have agency in our lives, even in cases when people don't think they have agency. There's always something within our control, whether it's the things that we put forth to help ourselves to have a healthier and more joyful life. Well thank you so much, Dr. Sharma for joining me today. If you enjoyed this podcast, please leave me a review on Apple podcasts or a platform of your choice. For those of you who don't know how to leave a review because I've finally heard from some people that's a problem. Go to the Apple podcast, the show and scroll down. There are options to put in stars and it has a little tab that says write a review and that will really help me and help other people find this podcast to listen to and thank you so much.