May 14, 2025 • 10 mins
Dr. Jim Keany, Chief Medical Officer at Dignity Health St. Mary Medical Center in Long Beach, joins The Bill Handel Show for 'Medical News'! Dr. Keany talks with Bill about good vibrations, buzzing capsule could relieve constipation, patients finding ChatBots more sympathetic than doctors, and Listeria outbreak.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
And it is time for a medical segment with doctor
Jim Keeney that we do every Wednesday. Jim, you're doing
something with your phone there. Jim is chief Medical Officer
for Dignity State Saint Mary Medical Center in Long Beach
and an er doctor, and Jim is always thanks for
joining us, of course. Okay, excellent, well said. Okay, this
(00:23):
week is kind of interesting because, as you may not know,
I mean Jim certainly does. But my teenage wife Lindsey
suffers from something called the CRPS Complex Regional Pain Syndrome
and she lives in pain twenty four to seven. And
out of that came her podcasts, the Pain Game podcast,
(00:47):
and Jim was a guest and it just dropped and
the two of you were talking about pain, and you
and I have talked about pain before, and pain is
one of those one of those things in medicine that
are very, very difficult to deal with. And you did
about as good a job as explaining what pain is
(01:07):
and isn't. So there you are in the er, someone
comes in and complains about pain. Where do you go
from there? Because it's all subjective?
Speaker 2 (01:15):
Well, okay, so talking to Lindsay's audience, people with chronic
ongoing kind of a daily problem. It's a little bit
different to the general pain. Right, So when someone comes
into the AR and pain, are you asking me in
the sense of what do I do? Or are you're
asking me specifics?
Speaker 1 (01:35):
Uh?
Speaker 2 (01:36):
No? For both?
Speaker 1 (01:37):
For both people come in I going in there and
I hurt like hell, I have a huge headache, or
I have chronic pain and it reaches level that are
high enough, which I've seen Lindsay do that she goes
to the er in the hopes that some massive drug
overdose will help her. So how do you deal with
either one?
Speaker 2 (01:56):
Yeah, pain is a serious you know, people have referred
to that is the sties vital. It's all the he's
learning that that I commit after all.
Speaker 1 (02:06):
Right, Jim Jim, Jim Jim. We're losing you. Can you
hang up and we'll once again try it? Okay, I
guess he did. I love cell phones, don't you? So? Anyway,
while we're getting him back on the phone, I'm gonna
go ahead and pitch Lindsay's podcast because she happens to
(02:26):
be married to me at talk show host. Did we
get Jim back? It's the Pain Game podcast? Wherever you
hear podcasts. Okay, fair enough, back to Jim, and we're
talking about the two different kinds of pain, chronic pain
and the pain that is there because of an injury
or because of a headache or because of some issue.
Speaker 2 (02:47):
How do you deal with it? So, pain, again is
an important sign. You know, when somebody's got a new pain,
we take that very seriously because that's your body's way
of telling you something's gone wrong. So is a significant
reason that people come to the ear, and it's a
good reason to come to the r right you you
smack yourself hard, you know, you're using pain to determine hunts.
(03:09):
It's hurt enough that I think I might have broke
some just a battery, you know. Sometimes pain in the
stomach or in the chat, and it can be because
of things like heart attack or appendicitis or you know,
things like that. So of course, when someone comes in
with pain, we assess it, We look for causes, and
then we try and do diagnostic testing to narrow down
(03:31):
whether you know, whether the pain is serious, what we
need to do about it. And in that process we
may give pain medications to address the pain. Sometimes by
giving pain medicine, you can calm the pain down enough
that it can be more localized and really pendpoint it better.
So sometimes treating the pain helps us kind of diagnose
the problem. Now with Linday, we were talking about people
(03:52):
with chronic pain, and they live with pain every day.
A lot of them have seen pain management specialists in
addition to many other special was to try and deal
with their pain. So these are people that have an
escalation process. They have medications they use at home, and
what we talked about is, look, if you get you know,
the er is the last resort in that situation because
(04:14):
we don't have much more to add, right, don't. We
are there for emergencies, and that's what we're there for.
If you come in with your pain is worstening, we're
going to look for the emergency causes for why that
pain might be worsening. But if it's your chronic pain
syndrome that is now just worse, well, then really all
we have are the are the escalation that your doctor
(04:35):
has already given you. So there's not much more we
can add in that situation. And that's kind of what
Lindsay and I discussed, all.
Speaker 1 (04:42):
Right, So based on the fact that you and I
are on the same page, when it comes to our
healthcare system in the United States. And I know your
first piece of advice as an er doctor is stay
the hell out of the er. How are we doing
in general with pain management? And have there been any
advances in the last few years.
Speaker 2 (05:04):
Sure, yeah, there's there's been some significant advances, most recently
we did on the show a few months ago. I
believe it's the there's a new medication that is a
non narcotic that treats pain. I'm sure if it's covered
by the insurance, is going to be pretty expensive. You know,
that's the way these things are when they come out.
But there there's a new medication that's non narcotic. We've
(05:27):
also had, you know, all these other processes like interventional
excuse me, interventional radiologists and pain management doctors who can
go in and pinpoint, say a nerve or something like
that and you know, kind of dead in that nerve
or numb that nerve that's causing your pain. So uh,
more focused approaches by pain management specialists have come to
(05:49):
you know, have improved, especially with imaging and improved imaging
and things like that.
Speaker 1 (05:55):
And just as an aside, and I think I've told
people this that I had. It was out two days
last week because I had foot surgery. It was a
really messy surgery with my two toes. They had to
break and put pins through them. So as we seek
about speak about pain, I am ripped out of my
mind on Norco as we speak. And the reason I
(06:16):
know that, Jim, because I really love you right now.
Speaker 2 (06:20):
I love you man, You're one of my love everybody.
That's a good point. No, you're absolutely right.
Speaker 1 (06:29):
I do love everybody right now. All right. One of
the things about pain, and you're a lot more generous
about pain than I am in terms of you know,
people are subjective. I mean you look at a broken bone, Okay,
you know that. But if I have a headache and
you asked me one to ten how much it hurts,
I'll tell you eight or ten and it's not or
my idea of ten is far different than yours. How
(06:52):
do you deal with that?
Speaker 2 (06:55):
Yeah, I mean it's very subjective. You have to kind
of do a lot of trusting that the patient is
not telling you, you know, something that's not true. And
most people don't want to wait in the emergency room
for four to six hours to just you know, lie
to you and tell you something to get a little
bit of medication. So that's going to last maybe, you know,
(07:17):
these shots last maybe an hour at the most two hours,
so it's you know, you got to take it with
a grain of salt. But at the same time, you
got to really trust that the patient's telling you the truth.
There's there's ways we can tell, right, you know, when
you're not talking with the patient and they're sitting in
the gurney, you know, just doing their normal business and
(07:37):
calling friends and doing paperwork and all that type of stuff,
and then you walk in and they're writhing in pain.
That does seem like somebody's putting on a show for you, right,
and and you notice those type of things. But short
of that, we tend to just kind of trust that
somebody that's there is there for a legitimate reason.
Speaker 1 (07:54):
All right. I want to go back to the podcast
and having listened to it that you and Lindsay did
my new teenage wife, who, by the way, we had
to wait until she graduated high school because I didn't
want to go to jail. And you've talked about something
that I thought was really interesting, and that is hope
and then human connection not necessarily any medical aspect to
(08:19):
dealing with chronic pain, but just the human connection. And
I went, wow, that doesn't sound like a doctor to me.
Do you want to expand on that for a minute.
Speaker 2 (08:28):
Yeah. I mean we had kind of a long conversation,
so it's hard to sum it up in just a
few minutes, but we were talking about different aspects of
pain and how you know, even things like yoga and
tai chi and all that have been shown to reduce pain.
And then we started talking about when you live with
pain and it's every day that changes you as a person,
(08:51):
you have something unique and different to offer other people
who are going through struggles and similar struggles. And we
kind of talked about how you know, and she's created
this podcast and other people have done other things where
you make these human connections and you're able to help
another person. It creates some sense of purpose to the pain, right,
(09:14):
that the pain you're going through results in some good
for somebody else. That definitely helps reduce the intensity of
the pain, because in that conversation we talked about how
your psychological state magnifies the pain.
Speaker 1 (09:27):
Right.
Speaker 2 (09:28):
I've taken care of soccer players playing a final soccer game.
They hit the goalpost with their foot and have an
open fracture of their toe. Play the rest of the game,
don't even notice until they take off their shoe and
look at a bloody sock. Right, because they're having fun,
it's intense, they're enjoying themselves. Then I had people in
an argument with their spouse who stub their toe on
(09:48):
the kitchen table and they come in. It's the worst
pain of their lives because they're in an argument in
a fight. And so definitely, you know, your psychological state
for people with chronic pain can definit only influence how
well you're able to deal with it.
Speaker 1 (10:03):
All right, Jim, thank you as always, great stuff. We'll
catch you next weekend or next week, all right,
And it is time for a medical segment with doctor
Jim Keeney that we do every Wednesday. Jim, you're doing
something with your phone there. Jim is chief Medical Officer
for Dignity State Saint Mary Medical Center in Long Beach
and an er doctor, and Jim is always thanks for
joining us, of course. Okay, excellent, well said. Okay, this
(00:23):
week is kind of interesting because, as you may not know,
I mean Jim certainly does. But my teenage wife Lindsey
suffers from something called the CRPS Complex Regional Pain Syndrome
and she lives in pain twenty four to seven. And
out of that came her podcasts, the Pain Game podcast,
(00:47):
and Jim was a guest and it just dropped and
the two of you were talking about pain, and you
and I have talked about pain before, and pain is
one of those one of those things in medicine that
are very, very difficult to deal with. And you did
about as good a job as explaining what pain is
(01:07):
and isn't. So there you are in the er, someone
comes in and complains about pain. Where do you go
from there? Because it's all subjective?
Speaker 2 (01:15):
Well, okay, so talking to Lindsay's audience, people with chronic
ongoing kind of a daily problem. It's a little bit
different to the general pain. Right, So when someone comes
into the AR and pain, are you asking me in
the sense of what do I do? Or are you're
asking me specifics?
Speaker 1 (01:35):
Uh?
Speaker 2 (01:36):
No? For both?
Speaker 1 (01:37):
For both people come in I going in there and
I hurt like hell, I have a huge headache, or
I have chronic pain and it reaches level that are
high enough, which I've seen Lindsay do that she goes
to the er in the hopes that some massive drug
overdose will help her. So how do you deal with
either one?
Speaker 2 (01:56):
Yeah, pain is a serious you know, people have referred
to that is the sties vital. It's all the he's
learning that that I commit after all.
Speaker 1 (02:06):
Right, Jim Jim, Jim Jim. We're losing you. Can you
hang up and we'll once again try it? Okay, I
guess he did. I love cell phones, don't you? So? Anyway,
while we're getting him back on the phone, I'm gonna
go ahead and pitch Lindsay's podcast because she happens to
(02:26):
be married to me at talk show host. Did we
get Jim back? It's the Pain Game podcast? Wherever you
hear podcasts. Okay, fair enough, back to Jim, and we're
talking about the two different kinds of pain, chronic pain
and the pain that is there because of an injury
or because of a headache or because of some issue.
Speaker 2 (02:47):
How do you deal with it? So, pain, again is
an important sign. You know, when somebody's got a new pain,
we take that very seriously because that's your body's way
of telling you something's gone wrong. So is a significant
reason that people come to the ear, and it's a
good reason to come to the r right you you
smack yourself hard, you know, you're using pain to determine hunts.
(03:09):
It's hurt enough that I think I might have broke
some just a battery, you know. Sometimes pain in the
stomach or in the chat, and it can be because
of things like heart attack or appendicitis or you know,
things like that. So of course, when someone comes in
with pain, we assess it, We look for causes, and
then we try and do diagnostic testing to narrow down
(03:31):
whether you know, whether the pain is serious, what we
need to do about it. And in that process we
may give pain medications to address the pain. Sometimes by
giving pain medicine, you can calm the pain down enough
that it can be more localized and really pendpoint it better.
So sometimes treating the pain helps us kind of diagnose
the problem. Now with Linday, we were talking about people
(03:52):
with chronic pain, and they live with pain every day.
A lot of them have seen pain management specialists in
addition to many other special was to try and deal
with their pain. So these are people that have an
escalation process. They have medications they use at home, and
what we talked about is, look, if you get you know,
the er is the last resort in that situation because
(04:14):
we don't have much more to add, right, don't. We
are there for emergencies, and that's what we're there for.
If you come in with your pain is worstening, we're
going to look for the emergency causes for why that
pain might be worsening. But if it's your chronic pain
syndrome that is now just worse, well, then really all
we have are the are the escalation that your doctor
(04:35):
has already given you. So there's not much more we
can add in that situation. And that's kind of what
Lindsay and I discussed, all.
Speaker 1 (04:42):
Right, So based on the fact that you and I
are on the same page, when it comes to our
healthcare system in the United States. And I know your
first piece of advice as an er doctor is stay
the hell out of the er. How are we doing
in general with pain management? And have there been any
advances in the last few years.
Speaker 2 (05:04):
Sure, yeah, there's there's been some significant advances, most recently
we did on the show a few months ago. I
believe it's the there's a new medication that is a
non narcotic that treats pain. I'm sure if it's covered
by the insurance, is going to be pretty expensive. You know,
that's the way these things are when they come out.
But there there's a new medication that's non narcotic. We've
(05:27):
also had, you know, all these other processes like interventional
excuse me, interventional radiologists and pain management doctors who can
go in and pinpoint, say a nerve or something like
that and you know, kind of dead in that nerve
or numb that nerve that's causing your pain. So uh,
more focused approaches by pain management specialists have come to
(05:49):
you know, have improved, especially with imaging and improved imaging
and things like that.
Speaker 1 (05:55):
And just as an aside, and I think I've told
people this that I had. It was out two days
last week because I had foot surgery. It was a
really messy surgery with my two toes. They had to
break and put pins through them. So as we seek
about speak about pain, I am ripped out of my
mind on Norco as we speak. And the reason I
(06:16):
know that, Jim, because I really love you right now.
Speaker 2 (06:20):
I love you man, You're one of my love everybody.
That's a good point. No, you're absolutely right.
Speaker 1 (06:29):
I do love everybody right now. All right. One of
the things about pain, and you're a lot more generous
about pain than I am in terms of you know,
people are subjective. I mean you look at a broken bone, Okay,
you know that. But if I have a headache and
you asked me one to ten how much it hurts,
I'll tell you eight or ten and it's not or
my idea of ten is far different than yours. How
(06:52):
do you deal with that?
Speaker 2 (06:55):
Yeah, I mean it's very subjective. You have to kind
of do a lot of trusting that the patient is
not telling you, you know, something that's not true. And
most people don't want to wait in the emergency room
for four to six hours to just you know, lie
to you and tell you something to get a little
bit of medication. So that's going to last maybe, you know,
(07:17):
these shots last maybe an hour at the most two hours,
so it's you know, you got to take it with
a grain of salt. But at the same time, you
got to really trust that the patient's telling you the truth.
There's there's ways we can tell, right, you know, when
you're not talking with the patient and they're sitting in
the gurney, you know, just doing their normal business and
(07:37):
calling friends and doing paperwork and all that type of stuff,
and then you walk in and they're writhing in pain.
That does seem like somebody's putting on a show for you, right,
and and you notice those type of things. But short
of that, we tend to just kind of trust that
somebody that's there is there for a legitimate reason.
Speaker 1 (07:54):
All right. I want to go back to the podcast
and having listened to it that you and Lindsay did
my new teenage wife, who, by the way, we had
to wait until she graduated high school because I didn't
want to go to jail. And you've talked about something
that I thought was really interesting, and that is hope
and then human connection not necessarily any medical aspect to
(08:19):
dealing with chronic pain, but just the human connection. And
I went, wow, that doesn't sound like a doctor to me.
Do you want to expand on that for a minute.
Speaker 2 (08:28):
Yeah. I mean we had kind of a long conversation,
so it's hard to sum it up in just a
few minutes, but we were talking about different aspects of
pain and how you know, even things like yoga and
tai chi and all that have been shown to reduce pain.
And then we started talking about when you live with
pain and it's every day that changes you as a person,
(08:51):
you have something unique and different to offer other people
who are going through struggles and similar struggles. And we
kind of talked about how you know, and she's created
this podcast and other people have done other things where
you make these human connections and you're able to help
another person. It creates some sense of purpose to the pain, right,
(09:14):
that the pain you're going through results in some good
for somebody else. That definitely helps reduce the intensity of
the pain, because in that conversation we talked about how
your psychological state magnifies the pain.
Speaker 1 (09:27):
Right.
Speaker 2 (09:28):
I've taken care of soccer players playing a final soccer game.
They hit the goalpost with their foot and have an
open fracture of their toe. Play the rest of the game,
don't even notice until they take off their shoe and
look at a bloody sock. Right, because they're having fun,
it's intense, they're enjoying themselves. Then I had people in
an argument with their spouse who stub their toe on
(09:48):
the kitchen table and they come in. It's the worst
pain of their lives because they're in an argument in
a fight. And so definitely, you know, your psychological state
for people with chronic pain can definit only influence how
well you're able to deal with it.
Speaker 1 (10:03):
All right, Jim, thank you as always, great stuff. We'll
catch you next weekend or next week, all right,
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