Issue link: https://tmcpulse.uberflip.com/i/1048847
T M C ยป P U L S E | N O V E M B E R 2 0 1 8 31 Even in that situation, people can pretend they are calm even though they are constantly stressed. Marco identified as one of those people, but knew it was not healthy, so he worked to turn his life around. During his early years of yoga and meditation, Marco found qui- eting his mind difficult. He would think about things going on in his life, his patients, what just happened moments ago and even what might happen in the next five minutes. A self-proclaimed perfectionist, he would get upset with himself for allowing his mind to drift. It wasn't until his instructor said it was acceptable to let his mind drift and come back that he allowed himself to take those steps. "That was amazing to me," Marco said. "Probably the first time I tried yoga, I felt a sense of calm." It was that sense of calm that inspired him to recommend the same exercises to his patients who were undergoing painful surgeries and wanted to reduce their reliance on opioids. He read articles that discussed the amygdala as the center of fear and anger and how certain activities could calm those emotions and even help with pain cessation. When Marco sensed fear and anger in his patients, he suggested some of the meditation activities. Not only did patients report back that their anx- iety was released, but, like Brindell, they were able to reduce pain, and, in some cases, stop using opioids altogether. "It's not going to get rid of all of the pain, but the pain can be lowered through endorphins," he said. "I've seen patients come out of major spinal surgery without narcotics, but just taking regular pain medicine." Treating and avoiding addiction Edythe Harvey, M.D., addiction psychiatrist at The University of Texas Medical Branch at Galveston (UTMB), treats patients for chronic pain who are addicted to pain medication. More than 191 million opioid prescriptions were dispensed to American patients in 2017, accord- ing to the Centers for Disease Control and Prevention (CDC). The Center for Behavioral Health Statistics and Quality estimates that more than 2 million Americans are dependent on or abuse prescription opioids. And the CDC notes that, on average, 115 Americans die every day from an opioid overdose, which includes prescription opioids, heroin and fentanyl. Amid an opioid crisis, Harvey and her colleague, pain medicine specialist Courtney Williams, M.D., created a task force to share ideas about educating staff, identifying community resources, monitoring opioid data and examining opioid alternatives. Harvey confirmed there was a push in hospitals to make sure no one was in pain. "However, if you are addicted to opioids, what are you going to tell the nurse about your pain? That is a problem," Harvey explained. "Lots of factors go into prescribing behav- iors, which include prescribing more so the pain is taken care of." (continued) Left: Helen Brindell meditates and exercises to manage her pain.