Taking Charge of Your Chronic Pain with Dr. Peter Abaci

Welcome to True Grit and Grace, a podcast designed to empower you to claim your resilience and thrive through life's challenges. I am Amberly Lago, a mindset coach, fitness expert, and best selling author. Each week I'll dive deep with the world's brightest leaders and elite performers to share tangible tools and practical advice to inspire you to keep your eyes on the prize and forge ahead. So get ready to conquer your fears, heal any trauma, lead with your heart, and elevate your life with grit and grace. Hi and welcome back to True Grit and Grace. I'm Amberly Lago and I'm really excited about our guest today. He's been a dear friend of mine for a long time and he is one of the world's leading experts on pain. He's the author of Take Charge of youf Chronic Pain and Conquer your Chronic Pain. I have both of his books and they're amazing. He is also a regular contributor to WebMD and we'll talk about that too, the Huffington Post. And honestly, I've never met a doctor quite like him. I've met a lot of doctors and I've never met one like him. He's the medical director and co founder of the Bay Area Pain and Wellness center. And through his personal and holistic approach to treating pain, he has truly helped restore the lives of thousands of people that are struggling with chronic pain. He has a beautiful heart and I am so excited to share him and his story, how he got to be the top leading doctor and how he got into being a pain doctor. Dr. Peter Abachi, welcome to the show.

Thank you, Amberly.

Oh, you are amazing and I am so grateful you are here. I know how busy you are. You guys were sitting here. He just finished a long day and he is in his office and made time to talk to us. So thank you.

Thank you for having me. It's an honor and a pleasure.

Well, we met. Has it been about two years?

When did your book first come out?

It's been, oh, gosh, about a year and a half.

So I think it was after your book came out.

Okay.

We sort of connected on LinkedIn or something like that. I saw what you were writing about and I was like, this is great. I would love to have this person talk to my patients. It would be so inspiring and motivating. And you said, yeah, I'll do that. And I was like, wow.

I was like, great lady. And I can tell you what I was thinking, wow, this doctor wants me to come speak at his clinic. I'm so Excited. And then we had this fires, the Woolsey fires that were just crazy. And I had a friend staying with me. You'd asked me to come speak at your clinic. I had a friend staying with me. Her house burned down. And I thought, well, surely our house will be fine. So I got on the plane, flew to the Bay Area, and then our house was being evacuated, So I was freaking out a bit and trying to pull it together to come to your clinic. And I get to your clinic, and y', all, it is a beautiful clinic.

And I remember saying, don't come fires. Don't worry about it. And you were like, no problem. I got this. I can handle everything. I was like, oh, my gosh, I can't wait to meet this person.

I think you were surprised I showed up.

I was.

But I got to your clinic, and, well, first of all, I walked in and I was greeted, and everybody was so friendly. And I said I didn't really have all the details. Everything was a bit chaotic at the house with all the fires and everything. And I asked her, I said, well, how long would you like me to speak today? And she said, oh, just two hours. And I went to the bathroom and had a moment of freak out, like, oh, my God, two hours. Two hours. Holy moly. Okay, I made it this far. I can pull this off. But then you guys started showing me around your clinic, and I was amazed because I've been to a lot of physical therapy places, and I've been to a lot of pain doctors and pain clinics, and there's one thing that they usually have in common, and that is, like, a feeling of just sadness and hopelessness and despair. And I can tell you, when I walked into your place, it was the total opposite of that. Everyone was slow smiling. People were having fun. All your patients were so excited to be there, and all came up and hugged me. Your staff was wonderful. And then they started showing me everything you did. And I was so glad that I made it out of the fire and into your clinic. So it's truly. When I say if you're like a doctor, like no other, I mean that from the bottom of my heart, you're an angel. I would love to share with everybody how you got into doing what you do, like just the type of doctor you are. What inspired you to become a pain specialist?

Well, you know, it's funny. When I went to medical school, I didn't really know what I wanted to do, and I had a really good friend in my class who wanted to go into anesthesia and his mother, she was kind of the director of the anesthesia department at usc, where I was going to med school. And he kept trying to talk me into going into anesthesia for a couple years. And then after a while, I kind of decided that looked like it might be pretty fun. You know, I was, like, looking at the whole.

That might be kind of fun.

Might be kind of fun. I was looking at the whole world of chronic disease, and I was going, I don't want to do that. You know, all this chronic disease stuff. I go, I don't want to do that. And lo and behold, now here I am, you know, really doing nothing but chronic disease management. So I went a full circle, but I got involved in the anesthesia side of it, really, because the guy that I used to live with and play basketball with and go to football games with talked me into it. But it was a great experience on the anesthesia side. But at that time in the 90s, pain management was like a new specialty. And it was sort of this exciting new world of treating people's pain and making people's pain go away and doing all this cool stuff and learning how to do these new procedures or prescribe these new medications.

And now, what year was that?

So this was. I finished my residency in 1995.

Okay, so had they come out with things like. Were they doing stuff like spinal blocks and stuff like that back then?

They were, but there weren't a lot of people doing that yet. It was still a small and growing field, and at that time, there were very few actual fellowship trained pain management doctors. So here I am, starting this new field, and I think it looks really cool. And I go, well, I want to do that, because I thought I was going to be this magic man who would just make everybody's pain go away. So I applied for some fellowships and was lucky to get into the one at ucsf, which was really great. It was a great experience. But I started learning that managing pain was not this magic thing where you do a shot or you prescribe a pill, and then everything is all better. And that is really a much more complicated process. In my fellowship, I started to learn more about the whole biopsychosocial model or the comprehensive approach to healing. And then that took me in a whole different direction from where I ended up to where I thought I was going. But that's where the real world is.

Yeah. And, you know, I think that so many people want to take that pill that's going to make everything go away or do that one treatment that's going to make everything go away. And it doesn't always work that way. In fact, a lot of times with dealing with pain, one pill or one treatment doesn't fit all. And something that I love that you do is you take the person as an individual, their lifestyle, what they do, and you don't just put a band aid on it, like you really treat the whole person. And one of the things that I really loved the most about your clinic was the art therapy that you do, because that brought me to tears. There is a mask in there, so. Well, first of all, can you tell us a little bit about the art therapy that you do? And then I'll tell you what brought me to tears. Okay, then I'll tell you what made me cry.

Well, you know, when I sort of started my private practice experience, art therapy was something I had never really heard of. And I needed to get some units, some education units, and I went to a cancer seminar, basically, and. And it was at City of Hope in Los Angeles. And I was interested in learning about some of the cancer pain management treatment, the palliative care stuff, and I was doing a lot of that at the time. Early on in my career, I went to this really cool art therapy talk and learning about what they were doing with grieving and kids and how they were helping kids work through some really deep emotional stuff. And I was like, wow, you know, this really got my attention. It may be because I always, you know, loved art, and I was into art when I was growing up as a kid, but it really got my attention. And so then a few years later, when I was growing the practice we were building, and we started to put together this big, comprehensive program, we were looking at how to staff it and how to set it up and what kind of structure. One of the first people we hired to help us do this was an art therapist. And we wanted art therapy to be a part of that. And we learned when we started that around 2001, that nobody had really used art therapy for chronic pain. And we were like, man, we got to do this. It became such an important, integral part of what we have done over the years. It's been amazing and to see people evolve and heal over many years through their art, because we have some patients who continue to do art projects with us over a period of many, many years, and we see how their lives change for the better. And it's so powerful, it's so amazing. And I know now it's become a little bit more well known. And we know the military is Using it with PTSD and trauma, and we know other people are using it for other things, and it's got a world of potential. And.

Well, I love the therapy side of it because for me, living with a lot of pain every day, not so much that I do this anymore, but I sure put a mask on a lot of days, you know, and I pretend like everything's okay, but I'm really hurting. But before I really dealt with the emotional aspect of chronic pain, I really numbed it out, and I kept everything inside, and I tried to pretend like everything was okay on the outside. And on the inside, I really felt like dying. And I loved that you had these masks in your art therapy. And there was one mask, and on the outside, it was this beautiful mask, and it was bright and colorful, but on the inside of the mask, it was dark and broken and stitched up and scarred. And the contrast between the two, I think for people that have a hard time expressing themselves what it feels like, it resonated with me because that's exactly how I felt when I saw that one mask. And you talk about just being able to take that mask off and just be you. And so I think whether people who are listening or dealing with chronic pain or they're just dealing with something that's hard in their life, something that's kind of. They need to look at and accept, I think that art would be such a great way, such a therapeutic way to heal that trauma, because we all go through trauma, and a lot of us are taught not to talk about it, just to suck it up and stuff it down. So I love that this is such an expressive way to really get those emotions out.

And I know that you have a PhD and suck it up.

I do, I do.

Yeah.

That'll get you so far it works. Until it doesn't.

You know, funny thing about the mass. I mean, there's so many stories we can tell you about so many different masses. They're amazing every week. You know, a couple years ago, I did the LA Times Festival of Books, and I had a little booth for my second book, and we had a little setup, and I happened to bring some of the masks with me as part of the setup, just because they are pretty powerful and they are eye catching. So a lot of people, you know, looked at them and we talked about the outside of the mask is how people see you on the outside, and the inside is how you see yourself and how, like you said, there's such deep contrast between the two. But at one point at the festival I think it was like the second day, you know, it's hot outside, it's winding down, and these two little kids come running over. They were maybe like five and six years old, brother, sister. They just jumped all over me. I think the mask caught their eye. But what they wanted to talk to me about was their grandfather, who had a lot of neck pain. And it was so interesting how much of their grandfather's pain and his experience of pain, how much of that they felt and how much they want. They were grabbing their mother's shirt, you know, saying, can we get this for Grandpa? And, you know.

Really?

Yeah. Like I always say, when one person at home is in pain, everybody suffers.

Well, that's the thing. The pain doesn't just stop with a person. It affects your whole entire family. It affect. You know, I know from experience, it affects your marriage, your relationship with your children, how much. I had somebody reach out to me the other day, and they said, you know, I'm so disappointed because I get so tired of being left behind all the time because they've got severe back pain. I come from a place of, you know, instead of thinking of being left behind, I focus on. I always turn to gratitude, and that's my medicine. I think about, well, I could be stuck in a hospital bed. I could be stuck at the hospital. I'm out of the hospital. I can walk. I can go with them a little ways.

You know, I'll tell you a story about gratitude and why it's amazing how you found that to be a healing tool so quickly in your book, in your journey from your injury. They did a study on gratitude a couple years ago, and I heard them present the research at a conference. They had different people record on a card, like, for a month what they were grateful for each day. They would think of, like, one thing, and they would put it in a box, and they would keep track of it. And they found that for the people who did this, who had chronic pain, they weren't able to write anything down that they were really grateful for. It was so hard for them to do that that it almost wasn't. You know, the chronic pain patients in this study really weren't recording anything, really. It just goes to show you how hard and how we lose track of the most important core things to what's really most important to us. And our core being just gets stripped and robbed so easily and how important it is to get that back and how. Gratitude is a huge healing tool.

It is, and it's grounding, and it puts you in the present moment. Because I think it's easy to get caught up when you're dealing with any kind of trauma or pain to think of. You know, get anxious about, well, how bad is it going to get? Or get sad about the things that you used to do and compare your life to your old life or just focus on what you can't have. But for me, I knew right away, even stuck in the hospital bed, that gratitude instantly made me feel better and put me in the present moment and got me focused on the things that I could do and I did have. So I think sometimes we just need to shift our thinking a little bit to think of even the smallest of things to be grateful for. And that may be, for me, some days that my pain is a 7 instead of a 10. Or it may be some days that my pains Yesterday was a 7. And even if it's a 10, I know that tomorrow it may be a 7 again. So it's all how we kind of look at it. But that's interesting about that study that shows just how pain can really consume you.

It could take away the most important things, gratitude, love. I mean, that's the most core fundamental quality of life is love. And love is a two way thing. It's being loved, which we all need, and it's being able to love other people. To have a truly fulfilling life, you have to have both of those elements and nothing can take that away better than a chronic pain problem or some sort of pain issue.

How do you get that back? How do you get love back into your life when you're dealing with so much?

Yeah, well, that's a great question. I think gratitude is part of it. You know, getting back the attitude of gratitude. I think reconnecting socially is an important part of that. And when people are in pain, they often don't want to leave the house. Maybe they stop going to work. You know, if you have a job, think about how many people you talk to during the day. If you stop working, all those connections get lost. And then if you withdraw away from your spouse or your children or other family members, you know, a lot of patients I see, they just want to go hide in their room. They just don't want to deal with, you know, interacting socially. So starting to come out of that a little bit is.

Well, I can tell you that's really hard. Yeah, because I was that person that was in a dark room and didn't want to come out. I didn't want to talk to anybody. I had lost my career. I was barely Speaking to my family, my world got really small. And for anybody listening, if you are in that position, and I just want to say, it's hard, but it is possible. I mean, I could not imagine nine years ago that I would be excited about doing a podcast with you, especially a pain doctor. I would never imagine that.

Why would I ever want to talk to a pain doctor?

And I mean, be able to laugh, you know, And I think that it is gratitude and love, you know, and humor, definitely. Humor has really been some medicine for

me, because that's another one for sure for humor.

And thank God my husband is funny. Most of the time, you know, he has me laughing and, you know, sometimes it's some serious situations, like I've been going into surgery, and he'll ask the doctor, you know, for an ankle surgery, can she die from this? And the doctor will look at him like, oh, well. He goes, well, I just upped her life insurance. So, you know, I.

Just checking. I'll tell you, the humor part is super important for everybody. I mean, just as it's important for the patient, I think for the doctor or the person who's trying to be the healer, you know, that's a heavy job, you know, when you do that all day, every day. And in order for me to be a better doctor and to be more compassionate and more empathetic, I do need to have a little humor. You know, there has to be some lightness to balance the heaviness that goes on, you know, when you're with the patient or in between, you know, just throughout the day. We have to balance the heavy with the light, I think, to really progress with what we're dealing with. And so I need to laugh just as much as you do.

I bet you do. Because I can only imagine that people come to you and they complain all day. They're just like, this is terrible. I hate this pain. Make it go away. Fix it. Because I only say that. And I have never heard a patient say that to you, but I have. I'm going to admit it. I V's drop. When I've been at my doctor here in town, I go to a pain specialist, and I'm always asking him about, you know, what do you think about this drg? What do you think about, you know, doing this ketamine? I always ask him questions, whatever kind of medicine it is, and I can hear, like, some. Well, I don't even have to, like, secretly eavesdrop. There are patients that are just really, really upset and scream at my doctor's office. And so do you ever get people that, like, really take it out on you?

Oh, yeah.

You do?

I do, yes. Believe it or not, it happens. I mean, most people don't do that. Most people are, I think, appreciative and exhibit some gratitude. It really only takes a couple of people during the day to really come after you. You carry that for the rest of the day. And, you know, you have to realize that you can't take it personal with whatever's going on, that this person is struggling. And, you know, I don't know. I'm not in their shoes. I'm trying to get there. I'm trying to know what it's like to be in their shoes as much as I can. And so, you know, I can't take it out on them when they're taking it out on me, because that's not going to do anybody any good.

Well, I think that's a good lesson for anything in life. You know, there's a book called the Four Agreements, and one of the things in the book, it says, don't take things personally. And I try to remember that when someone is upset and they're yelling and I'm like, why are they yelling at me? That most of the time it has everything to do with them and not you. But if we could all be a little bit kinder, it sure would make the world an easier place to live in.

You know, one of my sort of gotta haves or golden rules with working with patients. And what I want to help patients with is what I call validating.

Oh, oh, oh, oh.

I think that, you know, validation is really critical when you have a chronic disease, when you got a medical problem. And so I always like to let my patients know that I appreciate what they're going through and that they have a really bad pain problem and that they're maybe having a really bad day. And I think it's really important to recognize that when you're talking with anybody who is struggling with whatever it might be, whether it's depression or anxiety or chronic pain or diabetes or whatever it is, I think everybody needs some sort of connection through some sort of validation that you get it as best you can. I try to make a point of that. And I think that diffuses a situation when somebody's getting really upset or angry about their health.

And I think I've heard. I can't remember who said it, but I think it was Brene Brown who said the opposite of isolation is connection. And so, you know, I think it's so important when People are struggling to, even if they can reach out and make a connection with one person makes all the difference. And for me, that has made a huge difference, whether eating healthy or exercising. Just reaching out to somebody, having somebody that I'm accountable to, that knows what I'm going through, gives me a little bit more motivation to keep moving forward and do that. So that really helps me. Now, we talked about people being upset. I understand that you recently did an article for WebMD that got a lot of attention, and I've been dying to talk to you about that because I think people kind of misunderstood. This is just my opinion, misunderstood, what you were trying to say, and correct me if I'm wrong, but you are really doing your best to try to get people where they aren't on disability so they can live a life that is restored and fulfilled and not that people that are on disability can't do that. Look, I've been on disability. I call myself a dignified disabled person. But in the article, what exactly did you write that people were upset by? Did it go viral? Is it all over the Internet?

I guess maybe a little bit. So before I directly answer that, I would say that when we have our FRP program that we do, I do some of the talks, some of the group talks, and in one of them, I start the talk by asking the patients, why do we have this program? You know, why are you here? Why are we here? What is the purpose of this program? And people usually give good answers, like to help me learn how to manage my pain better, to help me function better, which is all very true. But I tell them that the real underlying basic answer, the question of why we have this program is so that you can have a good life. That's the goal. Whatever we do, whatever is going on, whatever you get out of this to help you have a good life, that's why I'm here, That's why you're here, that's why we come to work. That's why you come to this program, is to get what you need to get out of it. So when I write articles or when I give talks or when I do things with my patients, one on one in the back of my head, I'm just trying to help this person have a really good life. And there's no reason why everybody can't get that, no matter how challenging the health is. But to go back to your question, one of the things that I said in the article, I was trying to give some good tips or advice on how to work through being Less impaired or less disabled or less limited by having pain. And one of the things I cautioned against was not to try to use more medication as a way of getting more things done. Because, you know, that can really set you up for a slippery slope of more problems. And that research doesn't show that that's really a good way of being more functional, you know, anyway. But it really can set you up for more problem.

Can I say how happy I am to hear you say that? Because so many doctors just want to prescribe medicine, prescribe medicine. Just. I can't tell you how many doctors just want to give me more pills, and I don't want that. I want to have a better solution with less medication so I can have a better life. So I just had to jump in and say, I loved. We think so much alike, and I think that's one of the reasons we became friends. Fast friends.

Fast friends. But I think people took it the wrong way, and I think they took it as well. I don't really understand what they're going through. And maybe they thought I was being condescending about it. And maybe the problem was, you know, these articles are often short and I don't really get to explain everything, my points, in a lot of detail. I kind of wish I would have worded it or explained it a little bit better because a lot of people took it like, I'm just trying to take their meds away or I'm trying to deny them pain management and sort of discounting the pain and suffering that they may be feeling, which was not what I was trying to do at all. I was just trying to kind of point them in a direction where they will succeed long term. But it did upset a lot of people.

Yeah, I'm sure. Like, I can see the point where if people read it and it's a short article and they don't know you. They don't know how, you know, they haven't walked into your clinic. They don't see how you treat your patients. They don't see how your whole staff treats their patients and that you truly do want them to have a better life. So I could see where, you know. But I also can see, look, I've had people that are upset with me that have the same nerve disease as me, and they get upset and say, well, obviously you don't have it because there's no way you would be able to work out if you had CRPs or. And, you know, I just had to let it go and focus.

How do you deal with that, though, because, you know, you are able to do activities and sports and workout in a way that I think anybody who had any pain problems, CRPs or otherwise, would aspire to, you know, you would think, man, I want to be able to do what she can do. And yet some people get turned away by that. How do you turn that around with them? Because they're missing an opportunity to learn some great stuff.

Well, I make plenty of mistakes, first of all, and I get myself in trouble a lot because I do often push too hard. I think that growing up an athlete and a dancer helped me to a certain extent because I do constantly, you know, with perseverance, it's constantly pushing the envelope to see just how far I can go and push it to where I know a lot of people that live with pain, they live in fear, which I understand, but they live in fear because you don't want to hurt so much and then not be able to do anything. Well, I'm more of, I guess, always been an adrenaline junkie. And I want to see just how far I can push it. Just. I mean, I can't tell you how many times I tried to run with the same result. I even bought these shoes called kanga boots that had arches on them just to try to run. And the same result. I would have a flare up so bad and I'd be down for two weeks. So I think it's taken years and years for me to know what I can and can't do. Like, look, I have a bag right over here in my office of jeans that I have to donate because I can no longer wear skinny jeans. Not because I've gained weight. I've actually lost weight because I haven't been able to lift as heavy. But my crps in my ankle is such that even the compression on my leg flares me up. So what I do is to the people who reach out to me on Instagram or Facebook or email is, first of all, I understand your pain. And we all have good days and bad days, and we all feel our pain differently. I choose not to post pictures of myself on social media when I'm laid up on the couch. And I'm feeling bad because I don't think that's very motivating for me or anyone else. Now, I'll sure tell you, I just did a post a couple of days ago about healing and the importance of. Really. You know, I talk about PACER and use. Actually, your clinic was the first time I ever talked about the PACER method.

Really?

Yes. That was the first time I was like, I think I'm going to talk about this because it's something that I do. And I had never shared it with anyone. And so I thought, well, I'd shared it with maybe a couple of friends. So I thought, well, I'll share what works for me with your patients and maybe it'll help them. But there was something I was leaving off and that was the rest. And lately it scared me. A couple of weeks ago, I started having pain in my arm. And it's a weird, burning, crazy pain that doesn't feel like I have a pulled muscle or anything. And it really. I don't even want to say it, but it almost feels like the CRPs has split, spread. I broke the arm that I'm feeling these symptoms in a while back and they were amazed that it didn't spread to that limb. But I think that over the years I have learned to wear what pants. Don't flare me up. I have two pair of boots and if I'm having a really bad flare up, then I wear my most comfortable barn boots to the gym to work out. And I do what I can, I'll do my upper body. So I always believe in mantras and I always say to myself, you know, you got this. And I also always say, start where you are, use what you have and do what you can. Because I would much rather be, you know, even if I'm in pain, I know if I go to the gym and I do some upper body, I'm mentally going to feel better. Then physically I'll feel better. So it's kind of like a vicious circle.

And I think when you share things like that, you know, people are stuck, we all get stuck. We want to help people get unstuck. And sometimes the first process or step to that is just looking at the situation a little differently and getting people to do that. And they don't see what is possible. You stay stuck. You know, sometimes you got to see what somebody else is doing. I think one of the things that we've learned with our FRP program is because we do them in small groups, the one of the most powerful healing things that we do is the social interaction between the patients. When one person with CRPs or back injury starts the program and they're with somebody else who's been there for three or four weeks and they see how well they're doing, that really has a big impact. You know, that really motivates them. It helps them see what they can do, what's possible and it's very powerful. And sometimes it means more than anything I could say, you know, to them, it really does mean a lot. And so when you do that, you know, even though some people maybe don't get it or don't take to it right away, my guess is it's still really impactful to a lot of other people.

Well, for the most part, like, it was National Women's Health and Fitness Day a couple of months ago, and I thought, well, you know what? I'm going to do a 30 day challenge where we're just going to do 30 minutes of moving for 30 days. And I posted it. I had, out of all I've got, you know, over 50,000 followers on my Instagram, and guess who took part in the challenge the most? I mean, all different. You know, there were several people that were taking part in the challenge and they were posting in their story every day either a picture of them at the gym or a little short video of them. Some people were posting it on their wall of their Instagram. CRPS warriors, chronic pain warriors, were the ones that were the most active in the challenge. And so it really inspired me, I think that when we can come together and lift each other up and support each other and, you know, there was a day during the challenge when I was struggling, but I saw the other people in the challenge working out and I was like, okay, this is a challenge. I gave them my word. This is 30 days. And so I did it. And so I think that for the most part, I've had people that. It's been so rewarding because people who had stopped moving and they're getting out of their wheelchair and going to the gym, and that's amazing. You know, it's baby steps and sometimes it's seven steps forward and 10 steps back, but, you know, you just babysit.

I was talking to the board a couple years ago from the RSDSA, which is one of the big CRPs, advocacy groups out there, and we're all kind of talking about figuring out, how do you measure success? You know, because pain is such a hard to measure thing, and we don't have, you know, like a real good way of doing that. It's subjective. But how do we know when we're doing a good job? How do we measure that? And we were kind of just throwing ideas around, but I kind of feel like maybe the best measure of success really is the movement. And if you're getting somebody who's able to do more and move more, then, you know, you're impacting their life in a really important way. Because when you can move more, you're more independent, you're socializing more, you're taking care of yourself, you're shopping for your groceries, you're cooking your meals, you know, if you're more active, it's more healthy to be active for your heart. There's so many positive things you get from becoming more active when you can. And so I kind of felt like, you know, maybe that's like your best measuring tool, you know, even though it's not directly measuring pain or pain relief, but it's a great outcome measure when you're trying to figure out, hey, are we doing a good job for our patients? Are we doing right by them or not? How do we figure that out?

You know, I've been a fitness trainer for 22 years, and one of the tools that we use for measuring a client's success is working out. We do push ups, and one of it, we do push ups, sit ups and planks. And so one of my clients that I've trained for 20 years, and I got out her chart from 20 years, I said, you know, when we started, you could only do two push ups. And look at you now. And so it's a great way of measuring also whether if we. You don't have pain, if something's going on with your health. Like I had a client who perfectly healthy guy that I had been working with, and he was not himself. I said, something's going on with you. You need to go to your doctor the second week that you're really out of breath. This isn't like you go to your doctor right away. He went to the doctor, he had three blockages in his. They took him into the hospital right away. So I think whether, you know, you have chronic pain or you're just a healthy person, it's a good way to measure your health and see what's going on with your blood pressure, your lungs, your body. And so I think I like that success way to measure. I did have a couple of questions for you because I had some people, I shouted out in my story that we were going to be doing an interview, and I had a couple of people that wrote in and DMED and asked a couple of questions. One of the questions was actually about exercise. They asked, how do you exercise when you're in pain? What do you suggest to your clients when they ask you or tell you they can't exercise?

I think that's a great question. And I think everybody in pain can relate to, you know, everybody Tells me I need to exercise. They tell me it's good for me, but it hurts. And how do I do this? And I think so many people struggle getting over that hump. And there are some little tricks and tools that we use with our patients that I think really does help. I think one is the sort of rule of, whatever you do today, if you can't do it tomorrow because you're in so much pain the next day, then you know you did too much today. And so if you do a routine or an exercise or an activity, and tomorrow you feel like you could do it again, then, you know, that's a gauge of you're probably pacing yourself at the right level. Another tool we use is to kind of break the activity up throughout the day as opposed to doing it all at once. So, for example, if you want to walk five miles and go for a nice hike or a nice walk, but you know, if you do that, you're going to get really flared up. Maybe you walk for a mile in the morning and maybe another mile later in the day, you break it up, the activity throughout the day, as opposed to doing it all at once. I think another thing that we found is no matter what the pain problem is, whether it's a horrible burning nerve pain problem like crps or something else, everybody develops some sort of compensatory muscle tightness, muscle issues in their body, you know, as a way of compensating for whatever pain they're feeling. So, you know, like a classic example is tight muscles in the neck from a whiplash injury or, you know, the whole body seems to respond when a person is hurting. And so recognizing that we got all these little muscle knots and imbalances and compensations going on and addressing that and working on that is a way of making the. Helping the body movement easier and more freely. So that might involve, you know, a little massage work or a little deep tissue work, or using a foam roller in the right place. It might involve learning how to breathe, how to reduce the stress, you know, how to breathe the right way when you're stretching or exercising. Getting those muscle groups to relax can then ultimately help you move with less pain. So there's a lot of little tricks that we work with our patients.

Yeah, I love that. I have a couple of tricks, too. There's one that comes to mind that's pretty funny. I had a client one time. This is a long time ago. This is like, way before I ever had chronic pain. I was training a client. I said, okay, we're going to Start with a squat. And I demonstrated the squat. She said, oh, well, I can't do that. I can't squat. And I said, well, did you go to the bathroom this morning?

That's what I was thinking. I was thinking the same thing.

She goes, well, yeah. I said, well, then you can squat. And so she did the squat. Then I had another teenager that I was working with and she just didn't like to move at all. Not that she was in pain, it just pained her to have to move at all. And so I ended up just getting her to dance. You know, I think music is such a good.

We use that a lot. Dancing is great.

Dancing and music. Because when I get up in the morning, I look. I don't know what a 90 year old or 100-year-old cowboy looks like when he walks in the morning, but I imagine that's what it looks like when I walk in the morning. I'm serious. It's pretty crickety. The minute I have some music that I listen to in the morning and it really kind of puts a little skip in my step and it takes my mind away from the pain and how I'm walking and kind of gets me in the groove of just moving along. And I just listen to that for about 10 minutes and then I know that you have Also, I don't want to forget this because I had mentioned that I like to listen to meditations and you are on an app, the Breathe app. Right. I downloaded that app just to get to listen to you.

Well, first of all, we don't know how many people have fallen asleep just listening to my podcast over the last hour. Right. So let's assume half the people are already. So for the other half of the people who are. No, I'm just kidding. I have a 10 part series for pain management on breathe.com. it's called Everyday Pain Relief. And there's 10 different sessions and some of them are meditations that we use with our own patients in the clinic. It's a great way to kind of get the body ready for either the day in the morning or at the end of the day. And then I have a few that are a little bit more targeted in specific areas like back pain and nutrition and, you know, a couple of things, you know, like that I think the patients I know who use it that I see seem to find it helpful to have a little.

Oh, well, I downloaded it. It's really good.

Oh, thanks.

You're amazing. Well, what is the best way people could get in touch with you? Because I could talk to you all night and I'm sure we're going to have a ton of questions rolling in and just about this podcast. So send any questions you have and what is the best way for people to reach you or even to come visit you at your clinic.

Certainly you can send me messages on my website, which is Peter Abachi P E T E R A b a c I.com and you can also message me on Facebook, Twitter, Instagram, LinkedIn, whatever works.

Thank you so much for taking the time out of your busy day to share your wisdom. I love talking to you and I love what you're doing. You are really changing lives. I know you've changed mine. So thank you so much for being here.

Thank you, Amberly. It's awesome.

Thank you. Thanks so much for joining us this week on True Britain Grace Podcast. If you like it, please rate it or share it with your friends. That would help too. If you're not yet on the newsletter list, come over to amberlylago.com and jump on it. While you're there, you can grab a free downloadable gratitude journal. And you might just want to check out my book or even check out my monthly motivational membership. Thanks again for tuning in and we'll see you next week.