Dr. Peter Attia

So today, for a general abdominal case or a general orthopedic case, are you brought in preoperatively?

So today, for a general abdominal case or a general orthopedic case, are you brought in preoperatively?

If someone's listening to us and they're going to have elective surgery at some point, I want to plant a seed in their head for someone who's going to have the knee replacement, the hip replacement, the cholecystectomy, the API, whatever. Should they be requesting this of their surgeon? Should they say, hey, I want to be diligent about my recovery. I want to minimize my use of narcotics.

If someone's listening to us and they're going to have elective surgery at some point, I want to plant a seed in their head for someone who's going to have the knee replacement, the hip replacement, the cholecystectomy, the API, whatever. Should they be requesting this of their surgeon? Should they say, hey, I want to be diligent about my recovery. I want to minimize my use of narcotics.

Do you mind calling in a pain consult so that I can just have a team of docs who are exclusively thinking about my pain? Because let's be honest, the surgeon, I got enough to worry about. I got to make sure you didn't leak, that that anastomosis is fine, that you're not getting a wound infection.

Do you mind calling in a pain consult so that I can just have a team of docs who are exclusively thinking about my pain? Because let's be honest, the surgeon, I got enough to worry about. I got to make sure you didn't leak, that that anastomosis is fine, that you're not getting a wound infection.

Your pain is literally like third or fourth on the list of my concerns for you to have the best outcome.

Your pain is literally like third or fourth on the list of my concerns for you to have the best outcome.

How ubiquitous is the patient-controlled analgesic device, the PCA that we use?

How ubiquitous is the patient-controlled analgesic device, the PCA that we use?

Okay. So people are still typically getting fentanyl through a PCA in the immediate post-operative phase?

Okay. So people are still typically getting fentanyl through a PCA in the immediate post-operative phase?

And the goal is we want to get you off an opioid, even oral, before you go home. Is that generally the stated objective of the medical system now is whatever opioids you're going to need, let's try to deliver that to you in the hospital?

And the goal is we want to get you off an opioid, even oral, before you go home. Is that generally the stated objective of the medical system now is whatever opioids you're going to need, let's try to deliver that to you in the hospital?

So how are you thinking about that? How are you thinking about extracting the value of the opioid and minimizing the risk of long-term dependence?

So how are you thinking about that? How are you thinking about extracting the value of the opioid and minimizing the risk of long-term dependence?

So if you have someone who just suffers from, not that anhedonia is anything but unpleasant, but if they're only experiencing anhedonia but no self-loathing, you would say, well, the risk isn't as high.

So if you have someone who just suffers from, not that anhedonia is anything but unpleasant, but if they're only experiencing anhedonia but no self-loathing, you would say, well, the risk isn't as high.

Yeah, especially with that randomization, because what you really would like to be able to see is you take a whole bunch of people in, you get their incoming metrics of anhedonia, dysthymia, self-loathing, you categorize all the arms and tentacles of depression, and then you randomize within each of those to with and without opioid strategies.

Yeah, especially with that randomization, because what you really would like to be able to see is you take a whole bunch of people in, you get their incoming metrics of anhedonia, dysthymia, self-loathing, you categorize all the arms and tentacles of depression, and then you randomize within each of those to with and without opioid strategies.