Welcome to the Best Ever U Show with Elizabeth Hamilton Guarino, here to help
you find success in all areas of your life. The power is in your
hands. Join our network for free at best Ever U dot com and now
here's Elizabeth. Hey, everybody, thanks for listening to the Best Ever USE
Show. Happy Labor Day weekend follow up day. I didn't never know what
the day after Labor Day wherever was like, Oh man, I I gotta
slept each to work. And I know, I know. I saw the
traffic leaving Maine yesterday. We were out driving around, like, oh my
goodness. It looked like it was maybe two to three hours heading out of
the state, and traffic it was just forever ever ever. So here we
are. It's I think this is fall for everybody. So this is one
of our our fall kickoff shows. We've had a few so far, but
don't you thank Lisa. I've at least doctor Lisa dog it with me.
She's my guest. She's the author of Up the Down Escalator. It's the
subtitle There's medicine, motherhood, and multiple sclerosis. So in looking at you,
Lisa, I would never think that there would ever be any challenge that
you ever face or have faced, and it seems like yet you have welcome.
Thank you so much for having me on. Yeah, no, I
appreciate that I do have MS. I was diagnosed in two thousand and nine,
and MS there's a really weird disease. So I've been fortunate to have
a fairly slow course of the disease and have been minimally affected. But it
can certainly have a big impact, and it's had a big impact in a
lot of ways in my life, even though physically I'm in good shapes.
Yeah. Well, I love the fact that you wrote a book about it
to kind of help all those who maybe might be newly diagnosed or you know,
need some assistance, you know, especially from a doctor writing from your
perspective and point of view and experience and everything. It's it's a really good
book. So it's it's new, it's not in pre order anymore. It
got released, right, it's it's out there live very well. Yeah,
just almost three weeks ago. Okay, Yeah, so it's ups and down,
Escalator Medicine, Motherhood and multiple Sclerosis or MS as you as you said,
then I want to just direct everybody to your website also because sometimes people
fiddle around whether they're listening. So I'm just going to spell this for you.
So our last name is pronounced dog it I want to put a d
in there that is not correct. It's l I s a d oggetp dot
com. So you can go to her website and you know, her books
available wherever books are sold, though, you can go to your indie bookstore
and order it or Amazon or Barnes and Noble, whatever you want. But
we're going to give a give a little bit of attention to this, to
the book to multiple sclerosis that it's hard to say. I'm just gonna say
m from now on, how I have to asked you did something happen?
You know, I've read your book and someone asked us like, I kind
of don't know the answer to this question, but did something happen to you
one day where you woke up and you're like, oh, something's not working
right. Well, how did you discover that you that you had MS?
Yeah? Thank you? You know, I was very healthy. I was
working as a doctor at a clinic for people without insurance and saw a lot
of six people every day. But I really expected that I was going to
stay healthy because I did all the right things you're supposed to do, so
I was eating healthy, exercising every day, really trying to take care of
myself. But nevertheless, I woke up. It was November second, two
thousand and nine, and I remember the exact date because it was two days
before my daughter was going to turn two years old, so I had two
little kids. And I woke up something and something wasn't right. As you
said, I was dizzy, and dizzy is not really the right word to
describe what I felt. It's just the best stords I can think of.
I just felt kind of off, like a little bit of motion, thickness,
kind of like I hadn't gotten enough sleep even though I had, and
I felt like maybe I was getting the flu, and I thought that was
probably what was happening, is I would just be getting you know, at
the beginning of a respiratory infection. Kept going to work. I was able
to keep up with my schedule. It just felt a lot harder to do
that, and then I started having new symptoms. And one of the things
about MS is it can cause a variety of symptoms, including things like mobility
problems, sensory changes, visual problems, and I actually did have some visual
problems and I started seeing double not all the time, but you know,
my eyes just weren't working quite right. And I started having some changes to
my sense of taste. And this all happened over the course of a week.
I started getting pretty nervous because I couldn't figure out what was going on.
MS is an autoimmune disease and it does strike whim and more than men
about three to one ratio, particularly young people between ages twenty and fifty,
although it can strike any age. But it wasn't even on my radar.
I'm embarrassed to say, even as a doctor, I didn't think about it,
and I started thinking I had a brain humor. So I was diagnosed
a week later. Released I didn't have a brain tumor. But it feel
pretty shocked to have what I call a life sentence with MS. And what
happens to you, I don't know totally you know, not totally educated on
MS. What happens to you with MS. YEAHS is a disease. Yeah,
it's a condition of the central nervous system, so it affects the brain
and the spinal cord. And it happens when immune cells, your immune system
starts to attack the coding or what's called myelin around nerve cells. Myelin acts
as kind of an insulation, and so if you think about insulation around the
pipe, for example, not working right, you know that's not the installation
of our nerve selves. When it's gone I went to damage, our brain
can't communicate as well with the rest of our body, and we start to
get some of those strange symptoms that I mentioned. There's not a single presentation
that's classic for MS like it can really look like a whole bunch of different
things. So that's part of the reason, the big reason why people often
aren't diagnosed right away. I was very lucky to get diagnosed though fast,
and I think it's because I had good connections as a doctor. But I
know a lot of a lot of people wait months, three and years to
get diagnosed. Why was it so important for you to write a book on
this topic? You know, I have always loved to write. I'm an
obsessive journal keeper. I started writing in a journal when I was eleven,
and I write every day. I've missed about five or six days since then,
so I have like literally over probably about one hundred two hundred journals upstairs,
and I it's always been kind of therapeutic for me just in my life,
but when I was diagnosed with MS, it was kind of an outlet
for me to just process what I was going through. And I also was
very concerned about some of the disparities and care that became all the more stark
when I saw you know, I was able to get care quickly and easily,
and the patients that I was treating at my clinic were not so.
For example, I had a patient who needed to see an ear nose and
throat doctor and I referred her and she waited with two years to get in
to see e NT. The laseless was that long, Whereas I got into
see EANT within a day when I needed to, and it just it was
frustrating to me. It seems so unfair. It is unfair, and so
I really wanted to shed a light on some of those disparities in care in
addition to sharing my story. Is it frustrating to be a doctor and then
be diagnosed with something? I don't know if that makes sense, but that
to me would be like like that would be frustrating in a way to me.
I don't know, Yeah, No, nothing's supposed to happen to doctors,
right, No, I know, I mean it doesn't make sense that
I would think that I'm immune to all of the things I'm seeing at my
clinic every day. But yeah, it kind of like I have a white
coat. My white coat protects me from from getting sick, and so yeah,
I don't know. We do kind of have this feeling that we're protected
as doctors, and yet we are certainly as vulnerable as anybody else. And
you know, I mentioned I take really good care of myself, and I
was really thought that I was following all of the healthy habits, and yet
there's there's still such a thing as bad luck. And I had bad luck.
Did you can you trace it to anything like you did or got into
or we're around? I mean, is it that kind of a thing.
Is it a virus? Is it? I mean, did it? What
the what's the latest studies on that? Because I would be like, oh,
I know I touched that or you know some logic it was logic question.
So we're totally reefs. I mean, there's a lot of reefs as
going on to help identify what their causes are. I spent so much time
going, why why did I get this? I didn't have any family history.
I didn't have, you know, a lot of any other real risk
factors other than being a woman in my thirties at the time. But I
couldn't understand. And we still don't really know what causes the MS. There's
a very small genetic component. I didn't have any family history, not that
we know of. But there's about a one in twenty five chance that a
first degree relative of somebody with MS will get it themselves. We think that
there's that the epstein bar virus which causes mono, might be a trigger somehow
for emma, but of course a lot of people get MONTO and never get
imma, so we're not really sure, you know, what the whole connection
is. It is hoped that we will develop a vaccine against ebstein bar virus
and that might help prevent emma, but there is still so much we don't
know. Can you pin point? I'm and ask, and I keep going.
Can you pinpoint a moment where you had mono or epstein bar virus?
Yeah? I did. I had mono when I was in high school and
it was pretty bad. I remember missing school for probably about two weeks and
I got pretty sick. A lot of people with MONO don't get that sick,
and I kind of have thought, you know, maybe the fact that
I got more ill with MONTO than average increase my risk. But we will
never know. I don't think we will anyway. I had mono in high
school too. I also had chicken pox, which makes me feel like I'm
vulnerable to shingles. So yeah, you know, I'm with you. There
were sometimes the things kind of a doormant until they're not or something like that.
I get it. Well, it's a it's a really good of your
book right in front of me, so I was gonna I was gonna ask
you. It's endorsed by Stacy Abrams, which is which is very cool.
The book demands attention from those to seek a more just and compassionate world and
want to understand how to make it. So that's really nice of her to
to endorse your book. There's a lot of famous people with MS right now.
Are we Are we doing all we can do to raise awareness? And
what do you? What do you think about that? I think we're doing
a pretty good job of raising awareness. I hope I'm contributing to that to
some extent, and I appreciate one of the celebrities like felm up Lair and
Christina Applegate that have come out and shared their condition. And I know it's
it's hard to be vulnerable, especially when you're already you know, have a
lot of media attention and public attention. But I do think we need to
do more, particularly to educate physicians like me as a primary care doctor,
I never thought about MS, even though I was struggling with initial symptoms,
and I should have had it on my radar. And I think a lot
of doctors don't know when to consider MS, what the presentation can look like,
what to do if they suspect MS. So I think we need to
do a better job of educating primary care providers as well as the public to
some extent, when to think about NS. The reason it's important is that
we know that if people get on treatment early, they can reduce the chance
of progression to disability. And so getting on medication, identifying the early and
getting treatment is really important. Do you I noticed with MS sometimes people say
it flares up and then kind of quiets down, and flares up and kind
of quiets down. Is that managing a side of inflammation that goes with it.
What is that? Yeah, the FLAMS is an inflammatory. It is
an inflammatory condition, and there are periods where there's greater inflammation and where it's
sort of more active, where there's tends to be you know, your your
immune system is kicking in, being overactive and attacking a new part of the
myelin in a new part of your brain or spinal cord. And so we
do have what I call flares of MS. A lot of people have what's
called relapsing and remitting MS. In fact, that's about eighty five percent of
cases. That's the type of MS that I have at least right now.
And what that means is you have periods of activity where you often have new
symptoms and there's new findings on an MRI of the brain or spinal cord,
and that's often treated with actually very high to steroids to reduce the inflammation because
it is as you maintain an inflammatory process that condition relapsing remitting MS can progress
to progressive NS and that that has that happened often in the past. I'm
hoping that with some of the newer medicines, including the one that I'm on
we're going to see less of that progression to the secondary progressive MS, which
is get you don't have the remitting you have just continued disability accumulating. So
I okay, so I misunderstood that a little bit. I was thinking like
maybe it was like it flares up and then oh, you don't feel like
you have MS for a while, and then it flares up and then you
don't feel like you have MS for a while, but you pretty much constantly
feel like you have MS. That correct, you know. It's so everybody
is different, and that's part of the reason for I called this such a
weird disease because it's not really that predictable and and actually a lot of people
with MS don't feel like they have MS all the time. I have these
where I feel totally normal, and then I have these where I feel pretty
dizzy still. And some people you know, will have one episode and never
feel sick again with MS, never have symptoms, So there there are.
I would say that probably the norm with that re lefting remitting MS is what
you're describing, where you have a flare and then you actually feel better and
you don't feel like you have MS. But there often is a little bit
of progression. You might have a little bit of weakness. It doesn't fully
you know, you don't fully recover even when you get better, you're not.
So it's just it's such a strange disease because it can cause so many
different things and really manifest in different ways. Yeah, it sounds it sounds
like it derails you similar to a migraine. Fully not a migraine, you
know, just derails your life a little bit. It's a lot of it.
Yeah, you just feel like you bumped offline for a little bit there.
Do you can you? Are you still really active physically? Are you
running? Walking? Are you? Are you okay like that? I am.
I'm incredibly fortunate to be to be mobile and very active. For me,
my favorite thing in the world is to go hiking, to go walking,
and I do all both of those things whenever I can. I'm also
a runner. I run even some distance runs. Right now in Texas,
you were just mentioning fall and that gives me so much hope because in Texas,
at least in Austin where I am, it's one hundred and two,
two hundred and six every day. I'm not running as Austin right now or
as far, but it will eventually cool down and I will get back out
there for some runs. I also love to bike and I swam regularly too.
Love it. Let me ask you this too, So I just I'm
just gonna keep asking questions. I like the science and the logic and the
things like that behind things, but I like to talk about things like this
with people so that other people listening don't feel alone or you know, my
I just I hate the I hate that feeling that somebody's out there going I
feel so alone, and I'm newly diagnosed with them as so I love the
fact that this show in your book and you could help somebody with maybe just
a point we've raised or something we've said or done. I don't know,
but that just I it makes me sad when people don't feel very good.
So and I know what it's like because I have. I have terrible migraines,
terrible migraines, but not not unpredictable ones. There. I talk about
it in my new book coming out next year, about being a very long
time migraine sufferer with a menstrual cycle and so, like clockwork every month,
just a debilitating migraine hits and it's like, oh, this is so frustrating
and and oh yeah, so I get it completely in a different way.
Let's talk about your website. Let's talk about just you as a person.
You have two daughters, Ella and Clara with cute, horrible names. How
old are they? What's life like with Let's just talk about this remote just
a woman's standpoint of managing a career as a doctor with two small kids.
How's that? Oh, I appreciate the question. You know, I think
it is the hardest thing I've ever done. Is has been to raise my
kids, especially with a chronic condition, and I think we don't have enough
support for families and for moms. I felt feel even more strongly after going
through uh, you know, raising my kids within us. And I do
have a very supportive husband. My husband's a pediatrician, so it's very good
with kids, but he works in a hospital full time and he was not
around a lot in the evenings and weekends when my kids were little. And
I was diagnosed when they were two and four years old, so, uh,
you know, now they are much older, they're fifteen and eighteen.
I have a daughter just about to go off to college. She's on a
quarter SYSTEMSIS starts a little later, but we are. We're really really fortunate
that they have done great. I think, you know, looking back,
I was so worried that I wasn't able to do everything I needed to for
my kids. I think we put so much pressure on ourselves as moms to
be constantly coming up with engaging and you know, brain developed, being activities
and just trying to we have all the things we should be doing. We
have to, you know, we never feel like we're doing enough, and
that was I think that's true regardless for a lot of us. But when
I was suffering from dizziness and was irritable and just didn't feel like I could
do a good job raising my kids, that mom guilt I think was even
stronger. You know, my kids now I feel like has become maybe even
a little bit more compassionate as a result of having a mom with n US.
They've been great supports to me. And yeah, I'm glad to see
them writing. It's very gratifying. That's awesome. Where's the one going to
college? She's leaving Texas to go to California. She's going to go to
a Uthy fan of Ardres nice. Nice. Yeah. We have Yeah,
we have four four sons, ages twenty two, twenty four, twenty six,
and twenty eight. And we've had all four of them college for a
while off to this year. Now two of them are in Oh my gosh.
So yeah, it's been yeah, getting their master's degrees and playing college
sports and doing everything. It's it's a it's a cool period of time.
But I know what that's like to have tinier children and try and manage a
career and all that stuff. It is tricky, isn't it. And you
do. I always felt like I was divided and just sharply divided into like,
Okay, this part of me wants to just go home and play toys
all day, and this part of me needs to work. And I can
know for me personally, I couldn't reconcile too. I pull on, just
quit my job and stay home with the kids for a while. And then
when the littlest one was in first grade, I got suited back up,
went out started working again as a vice president, and I was like,
oh, this isn't what I want to be doing. So then I started
best ever year and it's been it's been a good blend since you know,
I mean, it worked from home for a really long time. It's been
it's been great. So but yeah, I agree. I don't know how
you had four Oh my gosh, I like barely man, it was two
girls, a great Yeah. Do you think that you could do that?
Yeah? Yeah, there are all two years apart, a great husband,
a for giving body. Maybe. I don't know. I'm still not the
skinny. I'm like, oh, you know, it's been twenty three years
now since I've had a child, and I still have weight to lose.
It's like, oh my gosh, we're always hard on ourselves no matter what.
So uh yeah whatever, But anyway, tell you mom's listening out there.
Yeah you do you. I don't know that there's any recipe for doing
it all. I think you just sort of take one day at a time
and see what that day brings, and something, something usually comes to the
surfaces, what's most important in that day. That's that's kind of how I'm
like, Okay, something something usually you know, bubbles up there. Yeah,
I mean it matters a little more if right, Like I say,
I can only do what I can do, Like it's a truism, but
like, yeah, like I can. There's only so much I can do
and I'm doing my best, and just kind of that self talk when you're
in the midst of a chancetram or argument as a teenager, you just perspective
of great right perspective for sure. So what do you hope what do you
hope to do with your book? What do you hope people get from your
book? Let's talk. Just go back to your book, because we only
have a few more minutes here. I said, we were going to kind
of keep this to about thirty minutes, and you can always come back.
I'd love to have you back. But what do you hope people? What
do you want to see? How do you want to see your book thrive
and live in the world? Well, thank you, Yeah, I really
hope that it does help people who are struggling with a challenge at whether it's
the US or another chronic condition, or even just another challenge in their lives
too, to feel validated. Maybe either we'll find some of my stories helpful,
maybe they'll laugh a little bit. I do try to insert a lot
of humor into my book, even though there's a lot of bad stories too.
But I would say that you know, really there's three main points.
I hope my book kind of gets across let us. I want people to
embrace and perfection. We are so hard on ourselves as moms, as you
know, people trying to make a career work. And I was the one
that was up at eleven o'clock at night getting the perfect orange I think from
my daughter's Halloween birthday cake, you know, trying to mix the yellow in
the red to get it just right. And it doesn't need to be that
way. And I've learned it's okay to buy the cake, so, you
know, just so easy on yourself. And then I think the second one
is this unexpected challenges can often just really do railists feel so overwhelming, and
yet even though they often feel horrible at first, a lot of times things
aren't as bad as we think they're going to be, so we catastrophize,
but in the end, sometimes you can even have something good come out of
it. So for me, you know, I got this book as a
result in my diagnosis. I would not have written this book had it not
been for that, And it's been really exciting to be able to connect with
people, and it's also especially important and helpful for me to connect with people
with MS and have an MS community. And then I think the third point
is this, I really want to set a light on the health system,
just inequities that continue to mean so many people in the US are without healthcare,
and I hope we can do a better job improving access to care.
Yeah. Yeah, And I think the book does a good job of that.
When I was reading it, I'm like, oh, she's funny,
Like this isn't funny, but it is. There's the funny moments in it.
And I'm like, so you have to laugh, but it's it's yeah,
I get it. I actually actually kind of thought at moments share books
kind of go hand in hand. Like I always say, for some of
my books, I wish they would live in the I see you waiting areas.
Yeah, I'm like that, Yeah, I wish somebody had my books
to turn to because I wrote them. I wrote a large part of one
of my books while my dad was a stroke survivor, and I wrote a
lot of it and while we were sitting there in the ICU waiting area,
And I just think, I think this is one of those books too,
where you're you're learning to navigate change. So it's one of those books where
a doctor could hand it out with a new diagnosis and say here, here's
a resource kind of thing. But books kind of live together like that because
mine helps people navigate change, and you're talking about a major change, so
people think about that a little bit too. If you're listening to the show,
both the books, the Change guide Book and Up and Down Escalator kind
of go together. Sometimes books go together. I always like to do that.
I recommend two of them are carrying me this one on this one,
and they kind of live together. So it's not intentional, well not intentional
perfect I know, but it's a good coincidence. But I mean, I
think that you're really focused on trying to help people live their best lives,
but I am as well, like it's still coming at it with a little
different perspective and angle that absolutely our missions are similar. Yeah, I love
it. It's been really nice getting to know you, Lisa. Thank you
for being here on the Best Every Show. Is there anything else that you
want to tell our listeners about before we go? Well, I'm just so
grateful for the opportunity, and I think one other point I always really want
to share with others, especially going through a hard time. It's just to
make sure that you have in our nurturing your support circle, especially if you
you know, even if you don't have anything going on, like it's just
so helpful to connect. And I really applied what you're doing, Elizabeth with
this podcast and with your books and other works to help people to feel a
sensive connection. Having friends and family or even just one person to be there
for you is so important. Thank you. Yeah, We've worked really hard
to build this network and it's one of those networks where you can go in
and and say something's going on in your life, good bet or whatever,
and people show up for you. It's a really cool places We've we've kind
of grown it more on Facebook than anywhere. The website and Facebook. Yeah,
I love the fact that you can go in there and people just show
up for you. So it's it's a neat little community. But I really
appreciate all you're doing as well. This is a really important topic. Thank
you for being vulnerable and sharing your the highs, the lows, the positives
and negative, the funny, the sad, every part of it is in
this book. And it's it's a it's a really good read. And a
really good resource and reference to for people to use. So thank you for
being here again everybody. Lisa's website is l I s A d Oggett dot
com. Lisa, thanks for being with us. It's really cool. Thank
you so much. It's great. All right, all right, everybody,
thank you for listening. And again that's Lisa. She's a family physician,
writer and MS warrior based in Austin. Austin, Texas. You can get
her book Up the Down, Escalator Medicine, Motherhood and Multiple Sclerosis. We
will be back on Thursday with Congressman Congressman Adam Smith at eleven am. Thank
you everybody for tuning in. Take care, thank you for listening. We're
so glad you tuned in. Be brave, be bold, See you and
remember to visit us at best everu dot com. It is