WEBVTT

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Welcome to the Best Ever U Show
with Elizabeth Hamilton Guarino, here to help

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you find success in all areas of
your life. The power is in your

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hands. Join our network for free
at best Ever U dot com and now

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here's Elizabeth. Hey, everybody,
thanks for listening to the Best Ever USE

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Show. Happy Labor Day weekend follow
up day. I didn't never know what

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the day after Labor Day wherever was
like, Oh man, I I gotta

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slept each to work. And I
know, I know. I saw the

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traffic leaving Maine yesterday. We were
out driving around, like, oh my

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goodness. It looked like it was
maybe two to three hours heading out of

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the state, and traffic it was
just forever ever ever. So here we

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are. It's I think this is
fall for everybody. So this is one

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of our our fall kickoff shows.
We've had a few so far, but

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don't you thank Lisa. I've at
least doctor Lisa dog it with me.

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She's my guest. She's the author
of Up the Down Escalator. It's the

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subtitle There's medicine, motherhood, and
multiple sclerosis. So in looking at you,

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Lisa, I would never think that
there would ever be any challenge that

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you ever face or have faced,
and it seems like yet you have welcome.

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Thank you so much for having me
on. Yeah, no, I

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appreciate that I do have MS.
I was diagnosed in two thousand and nine,

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and MS there's a really weird disease. So I've been fortunate to have

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a fairly slow course of the disease
and have been minimally affected. But it

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can certainly have a big impact,
and it's had a big impact in a

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lot of ways in my life,
even though physically I'm in good shapes.

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Yeah. Well, I love the
fact that you wrote a book about it

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to kind of help all those who
maybe might be newly diagnosed or you know,

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need some assistance, you know,
especially from a doctor writing from your

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perspective and point of view and experience
and everything. It's it's a really good

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book. So it's it's new,
it's not in pre order anymore. It

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got released, right, it's it's
out there live very well. Yeah,

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just almost three weeks ago. Okay, Yeah, so it's ups and down,

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Escalator Medicine, Motherhood and multiple Sclerosis
or MS as you as you said,

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then I want to just direct everybody
to your website also because sometimes people

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fiddle around whether they're listening. So
I'm just going to spell this for you.

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So our last name is pronounced dog
it I want to put a d

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in there that is not correct.
It's l I s a d oggetp dot

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com. So you can go to
her website and you know, her books

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available wherever books are sold, though, you can go to your indie bookstore

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and order it or Amazon or Barnes
and Noble, whatever you want. But

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we're going to give a give a
little bit of attention to this, to

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the book to multiple sclerosis that it's
hard to say. I'm just gonna say

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m from now on, how I
have to asked you did something happen?

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You know, I've read your book
and someone asked us like, I kind

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of don't know the answer to this
question, but did something happen to you

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one day where you woke up and
you're like, oh, something's not working

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right. Well, how did you
discover that you that you had MS?

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Yeah? Thank you? You know, I was very healthy. I was

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working as a doctor at a clinic
for people without insurance and saw a lot

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of six people every day. But
I really expected that I was going to

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stay healthy because I did all the
right things you're supposed to do, so

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I was eating healthy, exercising every
day, really trying to take care of

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myself. But nevertheless, I woke
up. It was November second, two

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thousand and nine, and I remember
the exact date because it was two days

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before my daughter was going to turn
two years old, so I had two

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little kids. And I woke up
something and something wasn't right. As you

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said, I was dizzy, and
dizzy is not really the right word to

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describe what I felt. It's just
the best stords I can think of.

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I just felt kind of off,
like a little bit of motion, thickness,

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kind of like I hadn't gotten enough
sleep even though I had, and

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I felt like maybe I was getting
the flu, and I thought that was

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probably what was happening, is I
would just be getting you know, at

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the beginning of a respiratory infection.
Kept going to work. I was able

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to keep up with my schedule.
It just felt a lot harder to do

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that, and then I started having
new symptoms. And one of the things

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about MS is it can cause a
variety of symptoms, including things like mobility

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problems, sensory changes, visual problems, and I actually did have some visual

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problems and I started seeing double not
all the time, but you know,

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my eyes just weren't working quite right. And I started having some changes to

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my sense of taste. And this
all happened over the course of a week.

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I started getting pretty nervous because I
couldn't figure out what was going on.

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MS is an autoimmune disease and it
does strike whim and more than men

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about three to one ratio, particularly
young people between ages twenty and fifty,

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although it can strike any age.
But it wasn't even on my radar.

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I'm embarrassed to say, even as
a doctor, I didn't think about it,

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and I started thinking I had a
brain humor. So I was diagnosed

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a week later. Released I didn't
have a brain tumor. But it feel

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pretty shocked to have what I call
a life sentence with MS. And what

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happens to you, I don't know
totally you know, not totally educated on

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MS. What happens to you with
MS. YEAHS is a disease. Yeah,

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it's a condition of the central nervous
system, so it affects the brain

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and the spinal cord. And it
happens when immune cells, your immune system

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starts to attack the coding or what's
called myelin around nerve cells. Myelin acts

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as kind of an insulation, and
so if you think about insulation around the

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pipe, for example, not working
right, you know that's not the installation

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of our nerve selves. When it's
gone I went to damage, our brain

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can't communicate as well with the rest
of our body, and we start to

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get some of those strange symptoms that
I mentioned. There's not a single presentation

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that's classic for MS like it can
really look like a whole bunch of different

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things. So that's part of the
reason, the big reason why people often

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aren't diagnosed right away. I was
very lucky to get diagnosed though fast,

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and I think it's because I had
good connections as a doctor. But I

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know a lot of a lot of
people wait months, three and years to

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get diagnosed. Why was it so
important for you to write a book on

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this topic? You know, I
have always loved to write. I'm an

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obsessive journal keeper. I started writing
in a journal when I was eleven,

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and I write every day. I've
missed about five or six days since then,

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so I have like literally over probably
about one hundred two hundred journals upstairs,

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and I it's always been kind of
therapeutic for me just in my life,

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but when I was diagnosed with MS, it was kind of an outlet

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for me to just process what I
was going through. And I also was

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very concerned about some of the disparities
and care that became all the more stark

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when I saw you know, I
was able to get care quickly and easily,

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and the patients that I was treating
at my clinic were not so.

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For example, I had a patient
who needed to see an ear nose and

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throat doctor and I referred her and
she waited with two years to get in

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to see e NT. The laseless
was that long, Whereas I got into

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see EANT within a day when I
needed to, and it just it was

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frustrating to me. It seems so
unfair. It is unfair, and so

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I really wanted to shed a light
on some of those disparities in care in

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addition to sharing my story. Is
it frustrating to be a doctor and then

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be diagnosed with something? I don't
know if that makes sense, but that

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to me would be like like that
would be frustrating in a way to me.

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I don't know, Yeah, No, nothing's supposed to happen to doctors,

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right, No, I know,
I mean it doesn't make sense that

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I would think that I'm immune to
all of the things I'm seeing at my

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clinic every day. But yeah,
it kind of like I have a white

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coat. My white coat protects me
from from getting sick, and so yeah,

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I don't know. We do kind
of have this feeling that we're protected

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as doctors, and yet we are
certainly as vulnerable as anybody else. And

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you know, I mentioned I take
really good care of myself, and I

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was really thought that I was following
all of the healthy habits, and yet

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there's there's still such a thing as
bad luck. And I had bad luck.

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Did you can you trace it to
anything like you did or got into

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or we're around? I mean,
is it that kind of a thing.

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Is it a virus? Is it? I mean, did it? What

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the what's the latest studies on that? Because I would be like, oh,

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I know I touched that or you
know some logic it was logic question.

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So we're totally reefs. I mean, there's a lot of reefs as

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going on to help identify what their
causes are. I spent so much time

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going, why why did I get
this? I didn't have any family history.

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I didn't have, you know,
a lot of any other real risk

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factors other than being a woman in
my thirties at the time. But I

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couldn't understand. And we still don't
really know what causes the MS. There's

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a very small genetic component. I
didn't have any family history, not that

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we know of. But there's about
a one in twenty five chance that a

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first degree relative of somebody with MS
will get it themselves. We think that

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there's that the epstein bar virus which
causes mono, might be a trigger somehow

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for emma, but of course a
lot of people get MONTO and never get

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imma, so we're not really sure, you know, what the whole connection

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is. It is hoped that we
will develop a vaccine against ebstein bar virus

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and that might help prevent emma,
but there is still so much we don't

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know. Can you pin point?
I'm and ask, and I keep going.

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Can you pinpoint a moment where you
had mono or epstein bar virus?

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Yeah? I did. I had
mono when I was in high school and

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it was pretty bad. I remember
missing school for probably about two weeks and

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I got pretty sick. A lot
of people with MONO don't get that sick,

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and I kind of have thought,
you know, maybe the fact that

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I got more ill with MONTO than
average increase my risk. But we will

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never know. I don't think we
will anyway. I had mono in high

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school too. I also had chicken
pox, which makes me feel like I'm

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vulnerable to shingles. So yeah,
you know, I'm with you. There

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were sometimes the things kind of a
doormant until they're not or something like that.

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I get it. Well, it's
a it's a really good of your

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book right in front of me,
so I was gonna I was gonna ask

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you. It's endorsed by Stacy Abrams, which is which is very cool.

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The book demands attention from those to
seek a more just and compassionate world and

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want to understand how to make it. So that's really nice of her to

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to endorse your book. There's a
lot of famous people with MS right now.

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Are we Are we doing all we
can do to raise awareness? And

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what do you? What do you
think about that? I think we're doing

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a pretty good job of raising awareness. I hope I'm contributing to that to

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some extent, and I appreciate one
of the celebrities like felm up Lair and

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Christina Applegate that have come out and
shared their condition. And I know it's

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it's hard to be vulnerable, especially
when you're already you know, have a

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lot of media attention and public attention. But I do think we need to

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do more, particularly to educate physicians
like me as a primary care doctor,

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I never thought about MS, even
though I was struggling with initial symptoms,

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and I should have had it on
my radar. And I think a lot

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of doctors don't know when to consider
MS, what the presentation can look like,

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what to do if they suspect MS. So I think we need to

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do a better job of educating primary
care providers as well as the public to

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some extent, when to think about
NS. The reason it's important is that

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we know that if people get on
treatment early, they can reduce the chance

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of progression to disability. And so
getting on medication, identifying the early and

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getting treatment is really important. Do
you I noticed with MS sometimes people say

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it flares up and then kind of
quiets down, and flares up and kind

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of quiets down. Is that managing
a side of inflammation that goes with it.

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What is that? Yeah, the
FLAMS is an inflammatory. It is

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an inflammatory condition, and there are
periods where there's greater inflammation and where it's

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sort of more active, where there's
tends to be you know, your your

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immune system is kicking in, being
overactive and attacking a new part of the

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myelin in a new part of your
brain or spinal cord. And so we

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do have what I call flares of
MS. A lot of people have what's

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called relapsing and remitting MS. In
fact, that's about eighty five percent of

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cases. That's the type of MS
that I have at least right now.

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And what that means is you have
periods of activity where you often have new

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symptoms and there's new findings on an
MRI of the brain or spinal cord,

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and that's often treated with actually very
high to steroids to reduce the inflammation because

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it is as you maintain an inflammatory
process that condition relapsing remitting MS can progress

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to progressive NS and that that has
that happened often in the past. I'm

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hoping that with some of the newer
medicines, including the one that I'm on

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we're going to see less of that
progression to the secondary progressive MS, which

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is get you don't have the remitting
you have just continued disability accumulating. So

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I okay, so I misunderstood that
a little bit. I was thinking like

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maybe it was like it flares up
and then oh, you don't feel like

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you have MS for a while,
and then it flares up and then you

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don't feel like you have MS for
a while, but you pretty much constantly

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feel like you have MS. That
correct, you know. It's so everybody

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is different, and that's part of
the reason for I called this such a

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weird disease because it's not really that
predictable and and actually a lot of people

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with MS don't feel like they have
MS all the time. I have these

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where I feel totally normal, and
then I have these where I feel pretty

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dizzy still. And some people you
know, will have one episode and never

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feel sick again with MS, never
have symptoms, So there there are.

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I would say that probably the norm
with that re lefting remitting MS is what

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you're describing, where you have a
flare and then you actually feel better and

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you don't feel like you have MS. But there often is a little bit

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of progression. You might have a
little bit of weakness. It doesn't fully

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you know, you don't fully recover
even when you get better, you're not.

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So it's just it's such a strange
disease because it can cause so many

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different things and really manifest in different
ways. Yeah, it sounds it sounds

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like it derails you similar to a
migraine. Fully not a migraine, you

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know, just derails your life a
little bit. It's a lot of it.

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Yeah, you just feel like you
bumped offline for a little bit there.

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Do you can you? Are you
still really active physically? Are you

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running? Walking? Are you?
Are you okay like that? I am.

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I'm incredibly fortunate to be to be
mobile and very active. For me,

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my favorite thing in the world is
to go hiking, to go walking,

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and I do all both of those
things whenever I can. I'm also

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a runner. I run even some
distance runs. Right now in Texas,

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you were just mentioning fall and that
gives me so much hope because in Texas,

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at least in Austin where I am, it's one hundred and two,

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two hundred and six every day.
I'm not running as Austin right now or

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as far, but it will eventually
cool down and I will get back out

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there for some runs. I also
love to bike and I swam regularly too.

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Love it. Let me ask you
this too, So I just I'm

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just gonna keep asking questions. I
like the science and the logic and the

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things like that behind things, but
I like to talk about things like this

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with people so that other people listening
don't feel alone or you know, my

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I just I hate the I hate
that feeling that somebody's out there going I

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feel so alone, and I'm newly
diagnosed with them as so I love the

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fact that this show in your book
and you could help somebody with maybe just

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a point we've raised or something we've
said or done. I don't know,

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but that just I it makes me
sad when people don't feel very good.

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So and I know what it's like
because I have. I have terrible migraines,

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terrible migraines, but not not unpredictable
ones. There. I talk about

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it in my new book coming out
next year, about being a very long

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time migraine sufferer with a menstrual cycle
and so, like clockwork every month,

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just a debilitating migraine hits and it's
like, oh, this is so frustrating

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and and oh yeah, so I
get it completely in a different way.

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Let's talk about your website. Let's
talk about just you as a person.

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You have two daughters, Ella and
Clara with cute, horrible names. How

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old are they? What's life like
with Let's just talk about this remote just

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a woman's standpoint of managing a career
as a doctor with two small kids.

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How's that? Oh, I appreciate
the question. You know, I think

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it is the hardest thing I've ever
done. Is has been to raise my

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kids, especially with a chronic condition, and I think we don't have enough

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support for families and for moms.
I felt feel even more strongly after going

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through uh, you know, raising
my kids within us. And I do

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have a very supportive husband. My
husband's a pediatrician, so it's very good

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with kids, but he works in
a hospital full time and he was not

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around a lot in the evenings and
weekends when my kids were little. And

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I was diagnosed when they were two
and four years old, so, uh,

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you know, now they are much
older, they're fifteen and eighteen.

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I have a daughter just about to
go off to college. She's on a

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quarter SYSTEMSIS starts a little later,
but we are. We're really really fortunate

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that they have done great. I
think, you know, looking back,

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I was so worried that I wasn't
able to do everything I needed to for

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my kids. I think we put
so much pressure on ourselves as moms to

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be constantly coming up with engaging and
you know, brain developed, being activities

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and just trying to we have all
the things we should be doing. We

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have to, you know, we
never feel like we're doing enough, and

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that was I think that's true regardless
for a lot of us. But when

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I was suffering from dizziness and was
irritable and just didn't feel like I could

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do a good job raising my kids, that mom guilt I think was even

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stronger. You know, my kids
now I feel like has become maybe even

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a little bit more compassionate as a
result of having a mom with n US.

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They've been great supports to me.
And yeah, I'm glad to see

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them writing. It's very gratifying.
That's awesome. Where's the one going to

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college? She's leaving Texas to go
to California. She's going to go to

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a Uthy fan of Ardres nice.
Nice. Yeah. We have Yeah,

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we have four four sons, ages
twenty two, twenty four, twenty six,

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and twenty eight. And we've had
all four of them college for a

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while off to this year. Now
two of them are in Oh my gosh.

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So yeah, it's been yeah,
getting their master's degrees and playing college

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sports and doing everything. It's it's
a it's a cool period of time.

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But I know what that's like to
have tinier children and try and manage a

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career and all that stuff. It
is tricky, isn't it. And you

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do. I always felt like I
was divided and just sharply divided into like,

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Okay, this part of me wants
to just go home and play toys

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all day, and this part of
me needs to work. And I can

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know for me personally, I couldn't
reconcile too. I pull on, just

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quit my job and stay home with
the kids for a while. And then

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when the littlest one was in first
grade, I got suited back up,

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went out started working again as a
vice president, and I was like,

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oh, this isn't what I want
to be doing. So then I started

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best ever year and it's been it's
been a good blend since you know,

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I mean, it worked from home
for a really long time. It's been

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it's been great. So but yeah, I agree. I don't know how

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you had four Oh my gosh,
I like barely man, it was two

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girls, a great Yeah. Do
you think that you could do that?

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Yeah? Yeah, there are all
two years apart, a great husband,

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a for giving body. Maybe.
I don't know. I'm still not the

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skinny. I'm like, oh,
you know, it's been twenty three years

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now since I've had a child,
and I still have weight to lose.

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It's like, oh my gosh,
we're always hard on ourselves no matter what.

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So uh yeah whatever, But anyway, tell you mom's listening out there.

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Yeah you do you. I don't
know that there's any recipe for doing

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it all. I think you just
sort of take one day at a time

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and see what that day brings,
and something, something usually comes to the

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surfaces, what's most important in that
day. That's that's kind of how I'm

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like, Okay, something something usually
you know, bubbles up there. Yeah,

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I mean it matters a little more
if right, Like I say,

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I can only do what I can
do, Like it's a truism, but

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like, yeah, like I can. There's only so much I can do

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and I'm doing my best, and
just kind of that self talk when you're

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in the midst of a chancetram or
argument as a teenager, you just perspective

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of great right perspective for sure.
So what do you hope what do you

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hope to do with your book?
What do you hope people get from your

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book? Let's talk. Just go
back to your book, because we only

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have a few more minutes here.
I said, we were going to kind

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of keep this to about thirty minutes, and you can always come back.

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I'd love to have you back.
But what do you hope people? What

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do you want to see? How
do you want to see your book thrive

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and live in the world? Well, thank you, Yeah, I really

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hope that it does help people who
are struggling with a challenge at whether it's

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the US or another chronic condition,
or even just another challenge in their lives

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too, to feel validated. Maybe
either we'll find some of my stories helpful,

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maybe they'll laugh a little bit.
I do try to insert a lot

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of humor into my book, even
though there's a lot of bad stories too.

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But I would say that you know, really there's three main points.

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I hope my book kind of gets
across let us. I want people to

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embrace and perfection. We are so
hard on ourselves as moms, as you

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know, people trying to make a
career work. And I was the one

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that was up at eleven o'clock at
night getting the perfect orange I think from

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my daughter's Halloween birthday cake, you
know, trying to mix the yellow in

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the red to get it just right. And it doesn't need to be that

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way. And I've learned it's okay
to buy the cake, so, you

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know, just so easy on yourself. And then I think the second one

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is this unexpected challenges can often just
really do railists feel so overwhelming, and

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yet even though they often feel horrible
at first, a lot of times things

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aren't as bad as we think they're
going to be, so we catastrophize,

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but in the end, sometimes you
can even have something good come out of

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it. So for me, you
know, I got this book as a

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result in my diagnosis. I would
not have written this book had it not

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00:24:36.119 --> 00:24:38.079
been for that, And it's been
really exciting to be able to connect with

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people, and it's also especially important
and helpful for me to connect with people

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with MS and have an MS community. And then I think the third point

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is this, I really want to
set a light on the health system,

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just inequities that continue to mean so
many people in the US are without healthcare,

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and I hope we can do a
better job improving access to care.

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Yeah. Yeah, And I think
the book does a good job of that.

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When I was reading it, I'm
like, oh, she's funny,

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Like this isn't funny, but it
is. There's the funny moments in it.

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And I'm like, so you have
to laugh, but it's it's yeah,

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I get it. I actually actually
kind of thought at moments share books

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kind of go hand in hand.
Like I always say, for some of

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my books, I wish they would
live in the I see you waiting areas.

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Yeah, I'm like that, Yeah, I wish somebody had my books

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to turn to because I wrote them. I wrote a large part of one

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of my books while my dad was
a stroke survivor, and I wrote a

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lot of it and while we were
sitting there in the ICU waiting area,

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And I just think, I think
this is one of those books too,

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where you're you're learning to navigate change. So it's one of those books where

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a doctor could hand it out with
a new diagnosis and say here, here's

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a resource kind of thing. But
books kind of live together like that because

356
00:26:00.599 --> 00:26:06.119
mine helps people navigate change, and
you're talking about a major change, so

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people think about that a little bit
too. If you're listening to the show,

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both the books, the Change guide
Book and Up and Down Escalator kind

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of go together. Sometimes books go
together. I always like to do that.

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I recommend two of them are carrying
me this one on this one,

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and they kind of live together.
So it's not intentional, well not intentional

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perfect I know, but it's a
good coincidence. But I mean, I

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think that you're really focused on trying
to help people live their best lives,

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but I am as well, like
it's still coming at it with a little

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00:26:36.799 --> 00:26:41.240
different perspective and angle that absolutely our
missions are similar. Yeah, I love

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it. It's been really nice getting
to know you, Lisa. Thank you

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for being here on the Best Every
Show. Is there anything else that you

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00:26:47.519 --> 00:26:52.480
want to tell our listeners about before
we go? Well, I'm just so

369
00:26:52.559 --> 00:26:57.039
grateful for the opportunity, and I
think one other point I always really want

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to share with others, especially going
through a hard time. It's just to

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make sure that you have in our
nurturing your support circle, especially if you

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you know, even if you don't
have anything going on, like it's just

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so helpful to connect. And I
really applied what you're doing, Elizabeth with

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this podcast and with your books and
other works to help people to feel a

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sensive connection. Having friends and family
or even just one person to be there

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00:27:23.119 --> 00:27:26.960
for you is so important. Thank
you. Yeah, We've worked really hard

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to build this network and it's one
of those networks where you can go in

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00:27:30.880 --> 00:27:33.680
and and say something's going on in
your life, good bet or whatever,

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and people show up for you.
It's a really cool places We've we've kind

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of grown it more on Facebook than
anywhere. The website and Facebook. Yeah,

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I love the fact that you can
go in there and people just show

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00:27:45.400 --> 00:27:48.519
up for you. So it's it's
a neat little community. But I really

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00:27:48.599 --> 00:27:52.599
appreciate all you're doing as well.
This is a really important topic. Thank

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00:27:52.599 --> 00:27:59.720
you for being vulnerable and sharing your
the highs, the lows, the positives

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00:27:59.720 --> 00:28:02.960
and negative, the funny, the
sad, every part of it is in

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00:28:03.000 --> 00:28:07.880
this book. And it's it's a
it's a really good read. And a

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00:28:07.920 --> 00:28:11.039
really good resource and reference to for
people to use. So thank you for

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00:28:11.079 --> 00:28:18.319
being here again everybody. Lisa's website
is l I s A d Oggett dot

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00:28:18.400 --> 00:28:22.680
com. Lisa, thanks for being
with us. It's really cool. Thank

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00:28:22.720 --> 00:28:26.119
you so much. It's great.
All right, all right, everybody,

391
00:28:26.119 --> 00:28:29.799
thank you for listening. And again
that's Lisa. She's a family physician,

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00:28:29.880 --> 00:28:33.359
writer and MS warrior based in Austin. Austin, Texas. You can get

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00:28:33.400 --> 00:28:38.640
her book Up the Down, Escalator
Medicine, Motherhood and Multiple Sclerosis. We

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00:28:38.680 --> 00:28:45.200
will be back on Thursday with Congressman
Congressman Adam Smith at eleven am. Thank

395
00:28:45.200 --> 00:28:48.400
you everybody for tuning in. Take
care, thank you for listening. We're

396
00:28:48.440 --> 00:28:52.839
so glad you tuned in. Be
brave, be bold, See you and

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00:28:53.000 --> 00:29:00.920
remember to visit us at best everu
dot com. It is