Dr. Robert Watkins IV on Support and Communication

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ContributorDr. Robert G. Watkins IV, MD, Orthopedic SurgeonRead Full Bio

Biography

Robert Watkins IV, M.D., is co-director of Marina Spine Center and Chairman of the Surgery Department at Marina Del Rey Hospital. Dr. Watkins is a board-certified orthopedic spine surgeon, specializing in minimally invasive spine surgery, computer-assisted surgery, spinal-deformity treatment, and disc replacement. Dr. Watkins earned his medical degree at the University of Southern California’s Keck School of Medicine and completed his residency in orthopedic surgery at the L.A. County/USC General Hospital. He then worked as a traveling fellow in Europe, specializing in artificial-disc replacement and scoliosis surgery. Over the past decade, he has lectured on spine issues to doctors, patient groups, athletic trainers, and physical therapists; led research teams that have published studies; and taught surgeons on specialized techniques. He is the spine consultant to many Los Angeles sports teams, and has treated professional, college, and high school athletes from all over the country.

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ContributorDr. Robert G. Watkins IV, MD, Orthopedic SurgeonRead Full Bio

Biography

Robert Watkins IV, M.D., is co-director of Marina Spine Center and Chairman of the Surgery Department at Marina Del Rey Hospital. Dr. Watkins is a board-certified orthopedic spine surgeon, specializing in minimally invasive spine surgery, computer-assisted surgery, spinal-deformity treatment, and disc replacement. Dr. Watkins earned his medical degree at the University of Southern California’s Keck School of Medicine and completed his residency in orthopedic surgery at the L.A. County/USC General Hospital. He then worked as a traveling fellow in Europe, specializing in artificial-disc replacement and scoliosis surgery. Over the past decade, he has lectured on spine issues to doctors, patient groups, athletic trainers, and physical therapists; led research teams that have published studies; and taught surgeons on specialized techniques. He is the spine consultant to many Los Angeles sports teams, and has treated professional, college, and high school athletes from all over the country.

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The mental aspect to pain is one of the most challenging and interesting aspects of my job. I see people all the time that have an anatomic source of pain but then also the mental and emotional component of pain is just as overwhelming. And it's a chicken or the egg, they both effect each other. You have pain, you get tense, you get mad at your spouse, they get mad, it makes the pain worse and it goes back and forth and it's a very difficult thing to deal with. Some people have more mental and emotional pain that they store in their spine and working out where does each person lay on this schedule is something I work with patients to understand. Especially before we do surgery. I've had some patients I've-we've talked about that with, they've done some work on it and come back to me and said I was able to let go a lot of the pain I had cause a lot of it was mental and emotional. And thank you for not operating on me.

So, we may be able to address the physical pain by doing physical therapy, getting the muscle strong, doing surgery to address the physical component, but the mental and emotional part is just as important. Patients wanna know that one, they're not alone. That they're not making up this pain, that they're not just being a wimp and they need to just get over it and live their life. I see so many people every day suffering with back pain and it effecting their life in every way.

Pain is one of the most-least understood functions of the human body. We can't measure pain and we don't always know why it occurs and what the provocation is, and just as mysterious as sex. How sex works and how the blood flow happens, and is it mental or physical or a combination of both is just as mysterious. And then when pain and sex go together, it's a very difficult problem that we deal with, that patients deal with, that there is no easy answer to. Cause if you're in pain, it'll affect your ability to have sex. The biologic function, much less the mental component and then you're in a relationship with somebody else, you're in pain all day long and you feel bad about it. They feel bad about it, they wanna help you, or they think you're being a wimp and you think your being a wimp. All the layers of complexity that go along with being in pain and having somebody help-have to take care of you. You don't want 'em to help take care of you anymore, and then putting sex into that relationship is so complicated that it adversely affects both relationships. And so the most important component is patients being able to talk to their doctor about it and it being accepted and it's not your fault. This is happening to most everybody who has back pain. And to be able to deal with it openly, and to acknowledge what things cause pain and what don’t.

When a patient comes to see me in the office, I really encourage them to bring a list of questions they have, bring a significant other, a caregiver with them, somebody else who can hear what I had to say and help interpret what it was after the fact. I know when patients first meet with a doctor, we overwhelm them with a lot of information, especially with spines. There’s a lot going on, there's a lot to know, a lot of facts. And we try and keep it simple and explanatory, but it's just a lot to comprehend. And, so having another set of eyes and ears there with you that can hear it and take it down, take notes. I give my email to every patient I see who then email me with follow up questions cause I know once I leave the room they think of five other questions that just finally popped into their head. Caregivers are vitally important, especially after the surgery.

And going home and being at home by yourself, no matter what surgery you undergo, is very difficult, especially a spine surgery. So having somebody there who can just help with very basic things, food and cleaning and helping with your pain medications is really important. We don't let anybody go home until they can get up and move and get to the bathroom on their own, but having somebody there to help support you at least for the first couple weeks is extremely important.

One of the greatest things I learned from taking care of professional athletes, one of the keys to taking care of them is treating each person as a person, and don't get too caught up in the hoopla and everything else, but this is a patient of yours and do what's best for them.

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