Transcription of Multiple Sclerosis: Understanding & Hope, #100
Speaker 1: You are listening to the Dr. Lisa Radio Hour and Podcast. Recorded at the studios of Maine magazine at 75 Market Street Portland, Maine. Download past shows and become a podcast subscriber of Dr. Lisa Belisle on iTunes. See the Dr. Lisa website or Facebook page for details.
Speaker 1: The Dr. Lisa Radio Hour and Podcast is made possible with the support of the following generous sponsors. Maine magazine, Marci Booth of Booth Maine, Apothecary by Design, Premier Sports Health, a division of Black Bear Medical, Dr. John Herzog of Orthopedic Specialists, Mike LePage and Beth Franklin of Re/Max Heritage, Ted Carter Inspired Landscapes, and Tom Shepard of Shepard Financial.
Lisa: This is Dr. Lisa Belisle and you’re listening to the Dr. Lisa Radio Hour And Podcast show number 100, Multiple Sclerosis, Understanding and Hope, airing for the first time on Sunday, August 11th, 2013. Today’s guests include Paul Leddy, captain of the Crazy Horse in the MS Harborfest and also of Leddy Houser Associates; Dr. Alexandra Degenehardt, Multiple Sclerosis Specialist and Neurologist with Pen Bay Medical Center; and Dr. Sunny Raleigh of True North Health Center in Falmouth.
Doctors know a lot about many things and about some things we know little. It is our great frustration. I became a doctor because I wanted to help people. I thought that my education would enable me to do so which has largely been the case. I believe that what I have learned has, for the most part, contributed positively to the lives of my patients. I am still learning every day. My education will never be complete. I hope that someday my education will include a greater understanding of diseases such as multiple sclerosis. Like many conditions of the brain, nerves and spinal cord, multiple sclerosis continues to be a puzzle we have yet to solve.
We have many talented health care providers and researchers working on this puzzle, but it remains what is called a disease of exclusion that is we make a diagnosis of MS when we are unable to diagnose anything else if the symptoms could possibly reflect. We have few perfect answers when it comes to MS and we decidedly do not have a cure. Thus, we must remain hopeful even in the face of uncertainty. Our hope is strengthened by individuals like Paul Leddy who races in the MS Harborfest each year in honor of his friends with MS. Our hope is strengthened by neurologist, Dr. Alexandra Degenhardt who cares for MS patients out of her Pen Bay office in Maine’s Midcoast, and Dr. Sunny Raleigh of True North Health Center in Falmouth.
We doctors do not know everything that is clear but we haven’t given up on attempting to learn about multiple sclerosis and diseases like it. We hope that you will learn something about MS and hope on today’s show. Thank you for joining us today.
Lisa I’m a person who loves the ocean and loves boats. I don’t have one so I always rely upon other people’s generous boat lending. Last year, Paul Leddy invited me and Kevin Thomas the publisher of Maine magazine to be on his boat during the MS Harborfest. I was unable to go so I’ve regretted that every day since. This year I believe that Paul you’re doing it again and I believe Sean Thomas is going to be on the boat taking photographs if I understand correctly.
Paul: I just met Sean actually so I didn’t know that.
Lisa: I think that’s the arrangement and I’m so jealous because-
Paul: You’re always invited. You have a standing invitation, you and Kevin, both.
Lisa: Thank you. Thank you for doing the MS Regatta because we’ve been doing this about 10 years.
Paul: About 10 years, I think I missed a year or two in there.
Lisa: This is something that raises money obviously for multiple sclerosis and it brings together a lot of your different interests I think.
Paul: Community, sailing, and there’s all kinds of fund raisers that people get involved in because they like running or they like biking or this type of things. Sailing is my thing and actually skiing too so I’ll also get involved in the Tri for Cure in the winter time with skiing. If it’s something that’s somebody an individual is interested in that would fit right into raising funds for it, it makes it more of a purposeful challenge than just going out and having a race.
Lisa: As far as multiple sclerosis, you actually have people in your life that you know who suffer from this disease, it’s a devastating disease for which we have no cure, tell me how this has impacted you.
Paul: I have three people in my life, two closer than one. One is a very, very good friend of mine’s mother. This was the first person that I ever knew personally that who was diagnosed with MS. As you know, it has something to do with neurological parts of our body, but it really debilitates somebody in their motor skills some things like that but their mind state is pretty sharp. To see this beautiful woman now in needing of cane and assistance now and then she still, by my standard, is very young and vibrant but not so young and vibrant because of this disease.
Then in the past 10 or 15 years, a good friend of mine that I went to high school with also wass diagnosed with it. He works every day. He is my corp dork so to speak, it’s who I go to … he recommends some good wines for different foods although he thinks there’s no reason to pair wine with food you could just have wine. This is something that you can just see these people, and my other friend too, they lose a lot of weight, they lose a lot of motor skills. They’re not as active as they can be and it makes you really think about our own lives and how you really are lucky.
I feel lucky to get up in the morning and walk in the beach every morning. At my age, I might be feeling little creakier in there, but I feel a lot stronger than a lot of people my age that can’t feel strong.
Lisa: It does seem as though you live life pretty fully. I’m friends with you on Facebook. I see the pictures of you and your wife Jen and you’re out, you’re on boats, you’re skiing, you’re here, you’re there. I know you work very hard but you also really seem to embrace all that is good about life.
Paul: As Jen says, if I could only live in your head when she knows that I accentuate all of those things in our lives when we’re together or we’re talking to friends and I’ll tell them about sailing and this and that. She’s keenly aware of the other side which is probably the 90 percentile side of our life which is just the hard work that we end up doing, but yeah you’ve got to stop. Every single morning I’m on the beach if you see the posts on Facebook. Sometimes it’s just a picture of the sun rising and good morning to all my Facebook friends. We do, we get on the boat as often as we can.
In the winter time we’re at Sugarloaf skiing every weekend if we can and then we take breaks to go down. We’ve got houses in Florida that we’ll go visit as often as we possibly can, not as often as genuine like but again that work thing is in the way.
Lisa: You also tried to, it seems, incorporate bringing happiness to other people into your work. You are a builder, a master craftsman. You do a lot of work with aesthetics. There’s that happiness. You have also Willard Scoops in South Portland, which I don’t know if I mentioned this to you but I was there the other day and while I was there, there were two women. One, I think was from New York she said, “I’m here from out of town and your ice cream store is one of the first places I am going to.”
Paul: That’s right. Oh my god, we do get that a lot though. We get people that come out of town and either they’ve been to us once before or they heard of us and they stop. It’s just ice cream but it’s good. We make it ourselves and-
Lisa: Oh no, it’s not just ice cream, I can tell you this.
Paul: Come on.
Lisa: I mean the salt caramel nut on that and I don’t eat a lot of things, but even John who our audio guru over here it’s not just ice cream. If you’re going to have ice cream, which I don’t very often, you need to go to Willard Scoops.
Paul: That’s awesome. It’s awesome to hear and I have to give most of that credit … I get a lot of the credit to Jen. When we decided to get into it, we weren’t going to do it unless it was different in quality and it reflects everything else that we try to do in our life. If I’m going to build a house, I don’t want to just build a house like… I don’t even know how to vinyl side like I don’t know how to put that on house. I don’t want to and I never want to learn so we took the same philosophy of quality and natural and everything towards ice cream.
It pays off to an extent. It’s probably more tedious. It’s more money for ingredients so your profit margin is less, but yeah, we get a lot of satisfaction when you get a line out the door and everybody is happy and everybody when they’re getting an ice cream is complimentary. They come back from out of town like you’ve suggests and can’t wait. We’ve got a Facebook page so we get people from all over the country really commenting on the Facebook page so that is pretty cool.
Lisa: Ice cream might suggest you’re an individual who likes sweet things and likes dessert, but you’re actually a very well-balanced individual. You and I were talking and you eat a lot of organic foods. You said maybe 70% organic. You are very much into fruits and vegetables and cooking in a healthy way. You’ve gone gluten-free. You’re being very mindful of your health.
Paul: Yeah, you get to a point if you weren’t… Again, if you look at people that have debilitating diseases or just don’t take care of themselves that in its own way is debilitating as you could imagine. Again, I’m very lucky to have a wife who is very conscious about what we eat. I’m not a tough sell though. I used to certainly love to eat bagels and sweets, cookies in the afternoon and stuff like that. Again, the last probably five or six years in my life with more healthy products out there if you look around and see gluten-free bakeries that are now available.
Organic food is now available in, for crying out loud, Hannaford and Shaw’s. You don’t have to go too far out of your way. We would eat 100% organic if you could but you can’t. I mean that’s a really tall order. Then gluten-free, as I explained to you that came about really from Frank Tarantino who suggested if I want to ski for the rest of my life and not have ice packs and Advil or cortisone shots that I probably should look at gluten building up in my joints. He suggested I try it for 60 days and that was about five or six years ago and it was hard to do at first. I first tried gluten rice, “What’s gluten?” Then what he told me about gluten was I’m like, “How the heck do you do that, I mean gluten is in everything?”
It turns out it’s easier than you think than when you get into that routine and now that there’s more gluten-free alternatives out there, it’s actually piece of cake but once you started going down that road like I recently cut out most of the time, cut out sugar and dark chocolate does not count by the way in the sugar thing, so every once in a while I will eat some of our ice cream but it’s not something that I go for a little bit. Once you cut that out, you’re craving stops. You don’t have that so if you can get over that hump like the gluten hump for me and everything else, if you’re willing to try it and you get over that hump, then you actually don’t feel good when you go the other way again when you go back there.
If I went to Q Street and had breakfast instead of eating granola and fruit or something in the morning, I actually don’t feel good. Before I never knew that, I just meet the crew down the local greasy spoon and have bacon and eggs in the morning and I just don’t do that anymore.
Lisa: Paul, I am looking forward to someday spending time with you and Jen on your boat, the Crazy Horse. I thank you for putting Crazy Horse into the MS Harborfest again this year for the 10th year I guess minus one and thank you for all that you do to bring joy and good tasting ice cream and beautiful homes and design into the community.
Paul: You’re welcome Lisa. Thank you and again you and Kevin know you always have an invitation, anybody here Steve and those guys I’d love to take you guys out. I thank you guys actually for giving me your banner to fly on the boat in the parade and sponsoring Crazy Horse. I’ve always gotten a sponsor, but it’s nice to have a sponsor that I have a real connection to. Thank you for that.
Lisa: Anybody is looking for the Crazy Horse out on the bay. It will be under the Maine magazine.
Paul: Yup, on one side it says Maine home and design and the other side it says Maine mag and it will be a lot of fun actually. You told me Sean’s onboard. I think he’ll have a lot of fun. Crazy crew he’s going to have to watch himself but we’ve got a good crew.
Lisa: Thanks Paul. I appreciate your coming in.
Paul: You’re welcome. Thanks for having me.
Lisa: We’ll return to our program in a moment. On the Dr. Lisa Radio Hour and Podcast, we’ve long understood the important link between health and wealth. Here to speak more on the subject is Tom Shepard of Shepard Financial.
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Lisa: As a physician, I’ve spent many years caring for patients who have various acute and chronic diseases and some of the diseases that I find most challenging and difficult to deal with are those that are neurologic in origin that is the diseases of the brain and the nerves and the spinal cord. I’m privileged today to have with me an individual who is spending her life now dealing with these diseases. This is Dr. Alexandra Degenhardt who is a Multiple Sclerosis Specialist and Neurologist at Pen Bay Medical Center. Thank you so much for coming in and talking to us today.
Alexandra: Thanks for inviting me.
Lisa: Neurology is a pretty highly specialized field and it’s something that not all medical students know that they want to go into when they are first going through their process of deciding. What was it about neurology that interested you at first?
Alexandra: I think a lot of people of our generation are drawn to the brain because there have been a lot of discoveries and there are so much to discover so I think it’s an area that does interest a lot of people. Then I just ended up in it because I still found that the most interesting as I went through, but there are so many interesting areas of medicine so it’s the one that captivated me the most.
Lisa: When you’re dealing with patients who have neurologic issues, did you find it challenging at first because it’s not as if they are … if somebody comes in with a broken leg, it’s a broken leg. If somebody comes in with a cough, you can say it’s bronchitis. Neurologic issues are not always straightforward and they’re not always things that can be diagnosed by MRI or a CAT scan or any testing that we have available. How did you deal with that sort of challenge?
Alexandra: I think it’s actually really fun because the … I always viewed it as a primary care physician has to integrate so many different aspects of medicine and they really get a hand-on approach with patients and that’s hard these days. In neurology it’s similar. There are a lot of complex pathways to think about and then you only figure it out by putting your hands on the patient and examining them in detail and that’s much better than an MRI for most things so that I thought was especially fun.
Lisa: That’s an interesting commentary because you’re right, many specialties these days they don’t even feel like you need to put your hands on. It’s an afterthought that’s like, “Well, I’ll touch the patient just so that I can say I touched the patient,” but I know that if you’re testing cranial nerve function or you’re testing reflexes or you’re testing touch sensation, you actually have to put your hands on that patient in front of you and that’s the intimacy with the patient that I think many people feels lacking these days between physician and patient.
Alexandra: Yeah, and I think the reverse is tricking for a lot of physicians. They might miss that as well because you do gain a better understanding of people and their bodies I think when you’ve got your hands on them, so I think it’s nice and then it’s fun too because if you can figure things out that a machine can’t figure out and that’s fun.
Lisa: Yeah, it’s almost like detective work and can be very satisfying detective work.
Alexandra: Yup.
Lisa: Multiple sclerosis, talk to me about that. I know that in our state and in the northern latitudes we actually have an increased incidence of multiple sclerosis. Did that play into your decision to come practice in our state?
Alexandra: Partly especially because I super specialized in … after neurology I spent a lot of time in it so it was nice to be able to find a beautiful place to live that was so interesting and be able to continue my practice so that did play a role so I feel lucky that I was able to carry on working here in that area.
Lisa: For people who are listening who aren’t familiar with multiple sclerosis, tell us what that is. What it means how it’s diagnosed, how people might … what symptoms they might have.
Alexandra: The funny thing about it is it can affect any part of the nervous system in terms of the brain and the spinal cord not the nerves outside of the spine. That really can encompass any sensation, any movement, any experience that a person has. It’s very hard to limit the definition in terms of what someone experiences which also creates a lot of confusion and anxiety because there are a lot of people who do read things about it and then think that they have multiple sclerosis and probably there’ve been many medically trained people as well who think that they have it.
The key thing is that it’s recurrent inflammatory episodes predominantly that does affect these regions of the brain and spinal cord. It doesn’t have to affect all of the regions it just has to affect more than one region and be recurring and that recurring pattern can vary from one every 30 years to every couple weeks so the point there is that it just has to be recurring and so there’s a large variability in what people experience which makes it very frustrating for the person experiencing it, but that’s how it’s defined. Then by exclusion other diseases are ruled out and that’s a combination of a good general exam, a good medical history, and MRI these days.
Often a number of puncture not always, sometimes the MRI is enough and then usually some blood tests as well. When things are ruled out and there’s no other possibility then the diagnosis is given as multiple sclerosis.
Lisa: The types of symptoms that people might have include what?
Alexandra: If we start from the top of our bodies, really there can be headaches for some people but that’s not a predominant symptom. There can be visual changes, blurry vision, pain behind the eyes, double vision. There can be changes in color detection so colors may appear different in one eye compared to the other eye especially reds tend to be affected early on. There can be numbness in the face, pain in the face. There can be slurred speech, trouble moving this face. There can be trouble swallowing.
There can be trouble moving one arm, both arms, one leg, both legs, one arm and one leg on one side. There can be pain so skin sensitivity pain in many areas of the body. There can be bladder dysfunction. There can be memory dysfunction, cognitive dysfunction. It really encompasses so many different symptoms.
Lisa: That sounds like it could be a really frustrating problem for patients and their families to deal with especially if it’s changeable overtime.
Alexandra: It’s incredibly frustrating and that’s one of the hardest things about multiple sclerosis because it pretty much remains frustrating. In the beginning, there’s always this uncertainty. A lot of times if someone has it, a lot of people experience going to multiple physicians before they get diagnosed or even multiple neurologists. Then sometimes it’s a waiting game. Sometimes one episode occurs and that does occur in an isolated phenomenon. Then that’s not called multiple sclerosis but then a lot of people go on to have future episodes if they have this relapsing-remitting type and then they’re given the diagnosis of multiple sclerosis.
Then they play a waiting game so there’s a lot of adjustment. There are very excellent treatments available but it is a difficult waiting game for many people and an adjustment period as well as things that they adjust to overtime different experiences, different medications, and then how people around them adjust because a lot of people see these individuals as looking normal but they are actually not only suffering, but they are going through a lot of turmoil and experiences that are very difficult to go through.
Lisa: For that reason, is it important for patients to have someone like you or another specialist to create a long term relationship with?
Alexandra: That would be the perfect scenario, so luckily most of the time we can develop a long term relationship. For some people, they actually do have to travel quite far in order to see their specialists. Then their primary care physician that they have a long term relationship may take over a lot of that role if they have to travel quite far. Then there are a lot of people who can have a neurologist overtime but as I’m sure you and everyone else knows there is an unfortunate turnover in the medical profession in terms of a lot of people moving, patients move, physicians move and that happens more and more these days so that makes it difficult.
Lisa: We on the Dr. Lisa Radio Hour and Podcast hope that our listeners enjoy their own work lives to the same extent we do and fully embrace every day. As a physician and small business owner, I rely on Marci Booth from Booth Maine to help me with my own business and to help me live my own life fully. Here are a few thoughts from Marci.
Marci: Do you ever feel that your personal or professional life is tale or business endeavors just haven’t seen the growth that you’re expecting, maybe it’s time to step out of your comfort zone. So many times we retreat to this comfortable place within ourselves because it’s easy, because it’s comfortable, but what if you took the harder path and started to push your own boundaries? Maybe that means really listening instead of controlling a conversation or maybe it’s making some cold calls in your business or if you’re shy, possibly networking at social events, or maybe it’s finally understanding your personal or business finances, asking someone for help, possibly asking your spouse or business partner.
Think about the worst thing that could happen if you step out. Accept it as possible but realize it’s not that bad. Now, imagine the possibilities of stepping out of what’s easy, how exciting it could be. Today, step out of your comfort zone. You’ll be so glad you did. I’m Marci Booth, let’s talk about the changes you need, boothmaine.com.
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Lisa: It sounds like from what you’re telling me that this field continues to evolve and what we know about multiple sclerosis like what we know about say the neurologic problems associated with Lyme disease or other diseases, we need to have more information on them. We need to keep researching this. We need to be spending money and energy and really understanding all of this.
Alexandra: Definitely and I think in terms of state in Maine, both those issues both Lyme disease and multiple sclerosis, although they’re not linked, it would be great. People tend to move around less here than in many other states. This is too big problem in the state here and it would be great to spend more time researching in here.
Lisa: In some ways, this could provide an interesting and hopeful population of research subjects.
Alexandra: Yup, and hopefully be able to quite quickly get some answers that would help a lot of people.
Lisa: Dr. Degenhardt, you work with people whose lives are impacted by a variety of problems neurologic in really significant ways and over the long term. You’re a young physician and you’re living your own life. What lessons have you learned from your patients?
Alexandra: They’re quite amazing and I think anyone who is in the field who they’re exposed to a lot of people finds meeting so many different people amazing so that it has that aspect to it, but also you’re seeing them when they really put through so many trials and difficult times and you really see the raw nature of human behavior which isn’t always nice. Then again it’s comforting when you see them feel better and get control their lives and enjoy their lives and also you see how well some people deal with these difficult times that probably I don’t think I’d do ask good of a job, but there are many people who do amazing jobs of that.
There are many people who I admire that they’re able to go through this and really they appreciate the simple things in life, which I think is probably a common theme in any area. If we look at it in detail, they enjoy their friends and family. They enjoy the life that they have and they make the best of it and they really enjoy life, so they concentrate more on the good things that they have and I think that’s an amazing talent to be able to have it. I don’t think I have it but I think it’s amazing.
Lisa: Do you enjoy having these long-term relationships with patients? I know you’ve been at Pen Bay for about two years, but do you enjoy being able to see people overtime and become a part of their lives?
Alexandra: Yeah that’s wonderful to be able to see people overtime and it does lend itself to better medical care too because then you know when there’s a change in their exam and you know how they’re going to deal with things and you know what medicines they tend to react poorly to and how they tolerate all these changes and so you can do a much better job.
Lisa: Dr. Degenhardt, how do people find out about the work you’re doing as a Multiple Sclerosis Specialist and Neurologist with Pen Bay Medical Center?
Alexandra: There are a number of different ways and there are a few other people in this state as well who are concentrating on this area. In Portland, there’s a very good MS center here and they have a website to find out more information about them and I can easily be found on the web as well. Our office can be called and the office staff is very friendly and helpful. There is another MS specialist in Waterville and there’s one in Belfast and then there’s a new MS center in Bangor that’s just being developed and they have a website as well. There are a small number if you compare them to other states, but they’re nicely spread out and there are many more now than there were a few years ago so I think that that’s great for the state.
The National MS Society is also getting more and more involved in Maine and that’s wonderful and so they often make their base in Massachusetts but they make a lot of trips up to the region and they try and improve and coordinate some resources. They also are a resource four persons with multiple sclerosis who are trying to find people for example a physical therapist, or a psychologist, or an ophthalmologist, or a neurologist in Maine who has this area of specialty. They’re able to hook people up as well.
Lisa: We’ve been speaking with Dr. Alexandra Degenhardt a Multiple Sclerosis Specialist and Neurologist at Pen Bay Medical Center. As a primary care doctor myself I’m very appreciative of people who are in your field helping me care for the patients in the state of Maine and the work that you’re doing on MS and really thank you for coming down and speaking with us today.
Alexandra: Great, thanks very much.
Lisa: The goal of The Dr. Lisa Radio Hour is to help make connections between the health of the individual and the health of the community. The goal of Ted Carter Inspired Landscapes is to deepen our appreciation for the natural world. Here to speak with us today is Ted Carter.
Ted: This past weekend I went to a party that one of my clients was throwing for their 25th wedding anniversary and they were both turning 50. He met me at the door and gave me a great big bear hug and she was so welcoming. The Frank family was beautiful and I thought, “Wow, what an amazing thing to be invited to this and it’s such on a personal level,” but that’s what happens when you design for people you really go into their lives and try to understand who they are and build something that really speaks to who they’re about.
I was talking to another man at that party and he was saying, “Well, you’ve really done a lot of work on this area and you’ve changed the way this whole place looks.” He said, “For the better.” I thought, “Well, that’s good he said that.” He said, “We really appreciate what you do down here.” I said, “Well, that’s nice.” I try not to really take it in and let the ego take over because it’s really important that we keep that in check and inbounds, but realize that this energy flows through us and out of us, and we don’t own it and we pass on just like our bodies pass on. We just move with the flow and staying on the flow, it’s very important.
When I look at a willow tree or I look at a birch and I see how they’re all weighted down with snow in the winter time and they’re bendable and they’re shapeable and malleable that’s what I think of when I say we’ve got to bend and move and stay in the flow and not get too rigid and not get too tight about things. I’m Ted Carter. If you’d like to contact me, I can be reached at tedcarterdesign.com.
Speaker 1: We’ll return to our program after acknowledging the following generous sponsors. Dr. John Herzog of Orthopedics Specialists in Falmouth, Maine. At Orthopedic Specialists, ultrasound technology is taken to the highest degree with state-of-the-art ultrasound equipment, small areas of tendonitis, muscle and ligament tears, instability and arthritic conditions can be easily found during examination. For more information, visit orthocareme.com or call (207) 781-9077.
Lisa: At The Dr. Lisa Radio Hour and Podcast, we believe we are helping to build a better world with the help of many. We’d like to bring to you people who are examples of those building a better world in the areas of wellness, health, and fitness. To talk to you today about one of this fitness is Jim Greatorex the President of Premier Sports Health a division of Black Bear Medical. Here’s Jim.
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Lisa: It can be challenging to be a physician in today’s health care setting because we really want to help our patients and we know that patients are coming to us with increasingly complex medical issues but also social and emotional issues. It’s always wonderful to spend time with other physicians who take a broader view of medicine as I think most of us are attempting to these days but some of them like Dr. Sunny Raleigh who is at the True North Health Center in Falmouth really are dedicating their lives to looking at health and wellness in a bigger way.
As we’re talking about diseases such as MS that we don’t really have good answers for, it’s important to be talking to people like Dr. Sunny because may be she can think about ways that she can support patients that are outside of the medical mainstream. Thanks for coming in.
Sunny: Thank you for having me.
Lisa: Dr. Sunny, I am impressed that you are raising three little boys, canning fresh tomatoes and sweet potatoes and sweet pickle relish from the family garden, going to the Saco river. I know you have a background playing at Division One Soccer. You’ve been all over the country. I think actually all over the world. Your husband is working on his PhD dissertation on Going Back to the Land. You just have this broadly varied background and yet here you are in Maine and you are working at True North and you’re bringing in your specialties of family medicine, neuromuscular medicine, and I believe functional medicine as well to help treat patients.
You’re honing down on what it is that you really want to be doing professionally. How did you get to this place?
Sunny: I was born in Northern Illinois and raised on land there with a family that was involved in a tile and slate roofing business. When I spent quite a few summers repacking hundreds of year old slate and tile and getting my hands dirty and finding all kinds of creatures buried in there, I knew that that would not be my future. It was in high school when I was doing a biology class that I had the thought I will be a doctor someday. Through my journeys, through high school into college and then even beyond, I did not really know where and what I would do specifically but I knew that I would somehow be in a healing profession.
It was when I had a life-altering appendectomy when I was living out in Sun Valley, Idaho that really prompted me into action and then that just catapulted me into the many states that I’ve lived in for furthering my education. Through it, my boyfriend became my husband who is now the father of our three boys and we were guided by what we believed in and where we wanted to settle, establish some roots and then begin a family.
When we were living in Tampa, where he was studying for his PhD, we discovered Maine. Neither of us had ever been here and as soon as we visited, it was established that this is where we’re going to make it happen. I did my residency through the University of New England in both family practice and neuromusculoskeletal medicine which was the crux of I think how I became of all encompassing physician that I have tried to become because in osteopathy, it’s the A.T. Still, our founder, his addage was “Anyone can find disease.” It’s the goal to find health in the system.
By doing that, I feel that that’s what offers a different approach specifically in osteopathic medicine and then in my practice trying to really support and nurture that hope for finding health in the system. In doing so, I was in another model of medicine that was not satisfying. I felt there was an unresolved within me. When the Medical Director of True North, Bethany Hays, approached me about really changing my practice, I was both intrigued, worried, and very hopeful. This is a rare opportunity.
When I made the leap this past January to full time at True North, I no longer had the sleepless insomniac nights of that performance anxiety that I have when I only have that 15-minute appointment and what did I miss? Was there something I could have done more thoroughly and there always was. Now, when I have this opportunity to truly listen to their story and then capture the highlights and put it on a timeline and make connections. It’s a simple practice of timeline on a piece of paper, but when 1989 what was it that happened? That was the last time you felt well and then it was like, “Oh, foreign travel, three months prior.” “Okay, well then let’s dive into that a little deeper.” Those different connections that turned on the light bulb for them to see that there could be this connection.
Whereas before while those stool studies were always negative, it’s not that or that test is fine, it’s not your thyroid or it’s not Lyme disease or you’re not anemic. Your hemoglobin and hematocrit is fine. When you delve in a little deeper, you can elicit more pieces for the puzzle and that’s what the time that I now have allows me to do. I try to compliment their specialists as a family doctor and/or a consultant and say, “Okay, I know that your specialist is excellent at managing this disease. I would like to support your entire system to optimize your functioning whole body to then support this disease process.”
By looking for the health in the system and making suggestions for lifestyle modifications and making sure that their iron stores are truly at their optimal level and taking the time to discuss their last 24 hours of nutrition and really how do your bowel movements affect your life. All of those seemingly littler components have such a foundation that my goal is then to broaden their eyes to see how that choice is then going to affect whether or not they’re going to need that intensive steroid treatment from their specialists.
Can we prevent that? Maybe your last treatment was 10 years ago with high dose intravenous steroids. How can we make that 10 years further down the road if ever again? By supporting those patients that have such a potentially debilitating disease and to see how it affects their psyche and that they can fall into a categorization and they become labeled and then they could potentially begin to live that label that’s where I try to find their barriers to overcome that and then slowly break those down. I always give the analogy of peeling back the layers of an onion and with each visit let’s remove a layer and really analyze what now lies beneath it and where are we going to go next?
I try to lay out a plan so options. Here’s the spectrum, this and versus this end. Where can I meet you? Is it in the middle? Are you ready to go for the gusto? Are you a little timid still land really need the guidance of someone else and need a little more feeling me out, making sure of what I’m talking about which I can support in that wellness wealth.
Lisa: Describe to me how something like functional medicine or neuromusculoskeletal medicine can be helpful in dealing with more really any chronic problem such as MS or maybe Lyme disease or any other of these issues that we have are challenged by medicine?
Sunny: The practice of functional medicine is to go upstream, find the underlying depletions, errors complicating factors, make them as little as possible. Try to minimize any of those upstream issues to prevent the downfall of the diagnosis. Then by optimizing the nutritional status of the individual for one example, treating underlying chronic bacterial infections or yeast overgrowth or analyzing medication and/or supplement interactions that are causing X, Y, and Z by truly looking at the foundation of the problem and then knocking out each leg of a stool of that to then break it down and then by bringing that awareness to the patient that we have to think back higher upstream as to where we can have control over this really awful disease process when it’s gotten to this big of a problem because it can seem very overwhelming.
By going to smaller, individual supportive cases that gives them some ownership of I can not only just manage this but perhaps overcome this to a greater degree. I think with the approach of functional medicine that can give patients at least hope that something they could do will really help their situation.
As far as osteopathic manipulation, I find that by having that hands-on connection with patient brings the report to another level and not only does the patient usually look very forward to just the manipulation appointment, as a family doctor I cannot check in with this, that or the other thing before they lay on the table, but I try to reserve that time for, “Okay, as we’re here together my hands on your body let’s see where we can improve on a muscular level. Are there restrictions in myofascial and in muscles to get your hip more flexible? On a deeper level at a visceral level, am I going to help with your intermittent constipation and let’s see if we can tone down some of the nervous system that’s preventing nice regular bowel movements.”
Then I feel like on the deepest level that I attempt to attain with each patient is that connection to the spirit, whatever drives the patient towards health where they’re drawing their energy and if I can meet them there and rest and settle and allow that embryo within the human to breathe that is a very powerful connection for the patient that allows extra, I considered extra healing to come in. The body has an inherent ability to heal. It’s marvelous, marvelous miracle. I am there to just give a little pat along the bomb to say, “Okay, don’t forget about this area and let’s really expand over here,” and so allowing that expansion to happen within the entire body and then beyond is my connection that I ultimately aspire to attain.
Lisa: Dr. Sunny, how do people find out about your services and also the services at True North?
Sunny: The best referral source that I have had is through word of mouth and most physicians feel that that is always speaks for itself. The wonderful social media has been great for True North of late. Our Facebook page has wonderful links for everyone and multiple hot topics that we’re discussing and our website at truenorthhealthcenter.org has pages on all of the providers, our services, the different ways to access our care and desecrate thorough foundation of our philosophies.
Lisa: What do you and your children and your husband look forward to doing this fall?
Sunny: Apple picking and lots of preparing the beds for rest for the garden and planting our covered crops. Our boys hopefully will get on the soccer teams for the fall and I’ll get back into my indoor soccer. Christopher is a professor so he’ll start classes again. I got two boys in school so it will be great fun car pooling and getting into the school scene again.
Lisa: You are a busy woman so we are very privileged to have spent time with you today. We’ve been speaking with Dr. Sunny Raleigh of the True North Health Center in Falmouth. Thanks for coming in and thanks for offering this broad-based care to patients.
Sunny: Dr. Lisa it’s been my pleasure, thank you for having me.
Lisa: You’ve been listening to The Dr. Lisa Radio Hour and Podcast, show number 100 Multiple Sclerosis Understanding and Hope. Our guests have included Paul Leddy, Dr. Alexandra Degenhardt, and Dr. Sunny Raleigh.
For more information on our guests and extended interviews, visit doctorlisa.org. We hope that you will join us at two events coming up next weekend. These are the MS Harborfest which is taking place on August 17th, 2013 in Portland and the Tri for Preservation which is taking place August 18th, 2013 in Cape Elizabeth.
For more information on the MS Harborfest Regatta, go to nationalmssociety.org. For more information on the Tri for Preservation, go to capelandtrust.org. The Tri for Preservation triathlon benefits the Cape Elizabeth land trust.
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