Dr. Joe Tatta: Thank you for joining me for another episode of the Healing Pain Summit. I am your host, Dr. Joe Tatta. Today on the summit I have Dr. Terry Wahls. She’s a clinical professor of medicine at the University of Iowa and the director of the therapeutic lifestyle clinic at the VA in Iowa City where she treats patients with chronic disease using diet and lifestyle. In addition, she’s a patient with secondary progressive multiple sclerosis that at once I can bind it to a wheelchair for four years. She restored her own house using a combination of diet and lifestyle program designed specifically for a brain. She’s the author of the bestselling book, the walls protocol, and your radical new way to treat all chronic autoimmune conditions using paleo principles. Dr. Terry Wahls. Welcome back to the Healing Pain Summit. It’s great to have you back for the second year in a row.
Dr. Wahls: Great. I’m so glad to be here, Joe.
Dr. Joe Tatta: So I think we should start. We’re going to talk about TBI and we’re going to talk about brain injury. Um, but I think we should start out just everyone knows you obviously as someone who has been able to, you know, both cure and manage their multiple sclerosis naturally using paleo principles. But tell us how you got involved with, um, traumatic brain injury and PTSD. Yeah.
Dr. Wahls: You know, yeah, I guess so. In 2007, my chief of staff, uh, detailed, I made that as assigned me to the traumatic brain injury clinic. So I started that in January of 2008 and I was there about five years taking care of, uh, that sort of coming in head blast exposure, uh, tragic brain injury, a lot of PTSD, uh, in, at that time the, uh, thinking was to just treat the psychiatric disorders and watch and wait. I came forward to know, wait a minute, there’s a lot we can do, uh, using diet and lifestyle to help them rebuild their brains. Uh, and so I brought that clinic along in terms of thinking about things from a diet, lifestyle, functional medicine, integrated medicine, uh, perspective, and our vets. Rowan did very, very well, uh, with that comprehensive approach.
Dr. Joe Tatta: Great. And would you say that it’s so important, you know, to make sure our events get the right care they need both when they come back and actually throughout their life cause some of these things can, you know, follow them for many years or months. Um, maybe we could start out by just maybe talking about the difference between a concussion and a traumatic brain injury or talk about that spec. Sure.
Dr. Wahls: So, um, a concussion really is sort of the lay term when you’ve hit your head, uh, you may have felt that day seen stars a bent, a little woozy, lightheaded or you might’ve even, uh, passed out where and you have, don’t have any, uh, memory. The medical term for that would be traumatic brain injury, which could be mild, where you just felt dazed to Beth to quite severe where you’re in a coma, in a coma, maybe even on a ventilator and getting a lot of support, uh, and perhaps being a comatose for many days, weeks or months. Um, and it’s really quite common. I believe we have about 1.7 million, uh, concussions, try to brain injuries in a year. Now, the vast majority of those are people who’ve seen in the emergency room, uh, and sent home. But, uh, about 15 to 25% of those 1.7 million are going to have residual symptoms that last for a long time, uh, perhaps the rest of their lives. So it’s truly, that is a huge, huge public health issue from my perspective.
Dr. Joe Tatta: Yeah, definitely. And what’s the mechanism of most TBIs that they receive in the United States?
Dr. Wahls: So, uh, your head slams into something or something slams into your head and your skull stops. Your brain would just feel like a bowl of jello will slam forward and hit the skull and then it will reverberate back and hit the opposite skull. So this sort of call it coop and our counter coup injury. Um, and if that happens, the wiring between brain cells gets stretched and damaged and that wiring is called axle, uh, damage. Uh, once that injury occurs, the cells, the brain turn on a lot of inflammation to repair the damage. But if we don’t stop that inflammation, it will, instead of repairing the damage will cause more. And more and more damage. And so people sometimes see themselves having a little bit of symptoms that gets steadily worse. Stilly we’re still at, we’re still at worse over time. Um, you know, and that’s where I think diet and the lifestyle can have a huge, huge impact on stopping the damage and promoting healing.
Dr. Joe Tatta: So if someone’s concerned that they may have sustained a bad concussion, or obviously what are some of the symptoms they might see or should be aware of within the first, you know, 24 hour time period.
Dr. Wahls: So, um, let’s sort of walk it through very acutely. So the first time it can happen, uh, you may be, um, either completely knocked out. So, uh, you’re, you’re unconscious. You wake up and there was a gap in your memory. So that’s for the tape recorder has stopped playing. Uh, that’s one symptom. Uh, the other symptom might be, I didn’t really get knocked out, but I saw stars. I may have felt up very days. Balance problems, have problems with my hearing or my vision. Uh, that would be quite common. A severe headache, uh, very common balance problems. Uh, very common. Uh, and that’s in the first few hours. Now as we move a little further along, then I could have problems with nausea. I could have problems with vomiting, I can have problems where if I’m thinking, so I’m using my head, I’m thinking about something that is stressful and that causes more headache. Light and sound might cause more headache. Uh, a, uh, trying to talk, read, um, manage a meeting, manage a complicated social interaction that may cause more headache, uh, and well, that lasts a couple hours, a couple of days or a couple of weeks or it could last several months depending on, um, whether or not I eat a diet and living a very Pru inflammation generating I at the lifestyle. No.
Dr. Joe Tatta: So I’ve worked in TBI and the first year of, I was a physical therapist. I work in a TBI unit that was probably over 26 years ago. A lot has changed.
Dr. Wahls: Yeah.
Dr. Joe Tatta: Maybe we can articulate the, the conventional medicine approach to a TBI versus some of the functional or integrative holistic approaches that you’re using today.
Dr. Wahls: So what, what we’re taught is that the brain will gradually repair itself. We just have to, uh, give reasonable nutrition, enough calories, some protein, and then psychiatric drugs keep the person from being overly aggressive because there’s so much more irritable to treat the psychiatric stuff and then just wait and see what happens. That’s the conventional approach that, but there’s nothing we can do to speed recovery. It’s just going to come at whatever pace is going to come at a in to treat the psychiatric problems. That’s a very, very individual approach. Now, if you’re in the hospital in a coma, we know that nutrition is really, really important and we’ll put you on to Phoenix. Um, and then more recently for the folks in the hospital, there’s more awareness that we have to be at 10 to, uh, the vitamin lipids. Uh, yeah, often give, uh, uh, feed into, uh, feedings.
Dr. Wahls: So a person doesn’t lose weight, uh, become a Macio. Uh, more recently there’s been a lot of, uh, some interest in, uh, Dr. Lewis, his approach for a very aggressive replacement of Omega three fats and correcting the Omega three Omega six fatty acid ratio, uh, in the bloodstream in the red blood cell membrane. Uh, that’s, uh, some very interesting stuff. And then, um, I been the one who’s been writing in the outpatient setting that intensive nutrition to see to it that the person’s brain is very well nourished with the proper vitamins, minerals, phytonutrients, get rid of sugar, the white flour, and have a low grain out, relatively modestly non-starchy, a lot of non starchy vegetables. So the green sulfur color poach, uh, and healthy fats that we do some, uh, strategies to encourage nerve growth factors. Uh, a ketogenic diet, uh, acutely could be very, very helpful. Uh, and when the person, uh, if they’re able to, uh, begin a exercise and movement program, yoga, Tai Chi, uh, joggling a ballroom dancing, uh, uh, those kinds of things can be very, very helpful.
Dr. Joe Tatta: And I, you know, people are starting to talk about different hormones to use it during certain periods. Things like pregnant alone. Um, do you have any opinion or can you talk about any of the research around that?
Dr. Wahls: Well, a progesterone appears to be a very helpful, uh, pregnenolone progesterone. Uh, we also have a great deal of appreciation that the sex stories, uh, you can’t have somebody be hypogonadal. Um, because we need to start a strong, we need estrogen independent. You know, which sex you are of course, um, that very trophic, uh, to brain cells. Um, and you don’t want to be in a high cortisol state. Now, many, many, many veterans, it probably most civilians when we get a traumatic brain injury, the event that we got, the traumatic brain injury is likely to also be associated with a trauma and there may will be some, some PTSD related to that traumatic event. Uh, and more, most of us have a very high stress environment. We don’t have nearly enough relaxation phase. And so, uh, helping them, uh, relearn some, uh, mindfulness meditative practices, um, heart math, uh, heart rate variability can also be very, very helpful.
Dr. Joe Tatta: So in these patients, are you doing adrenal testing, looking at their HPA axis or the HPT axis and trying to,
Dr. Wahls: uh, am I doing that testing? I assume that they’re all, uh, excessively, um, uh, or I have too much cortisol. We all need to have a lot of work on meditation, mindfulness, gratitude, Epsom salts, bass gardening, hunting, fishing, any one of those activities that they enjoy and would resonate with who they are.
Dr. Joe Tatta: And does your clinic do anything different for the PTSD patients versus the TBI patients?
Dr. Wahls: No, actually I don’t, um, when people come in, I’ll, I’ll, I would tell them that. And Julie, given the fact that these, these were all veterans, look, you probably have a fair amount of work, trauma and PTSD just from going through the war. Then you have your blast. I don’t have any way of teasing out what percent of your problems are due to PTSD and what percentage due to TBI. But from my perspective, the good news is I treat them the same way in terms of nutrition, meditative practice, um, activities that stimulate nerve growth factor to help you rebuild your connections. And that seems to work really very, very well. Uh, for the bets.
Dr. Joe Tatta: I know some of your wall’s protocol patients, you’ve worked in group settings with them. How do you integrate that into the same concept of the TBI patients?
Dr. Wahls: Yeah. You know, I think a group setting is just so powerful. And the reason I really like groups is most of us, we have to learn health promoting behaviors. We’re so addicted to disease promoting behaviors. And when we change our personal habits, uh, in my experience we do much better when we do that with a peer support group that we can talk to about our successes or challenges and get helps for peers that people may enjoy my stories, but it’s easier to hear what their, their peers and partners are doing and find that inspiring. It gives them a lot of hope that, Oh, they can make the street too.
Dr. Joe Tatta: So is what you’re doing in the experimental phase right now where you just kind of incorporating this into the entire,
Dr. Wahls: there are a couple of things. So I have experiments that are going on and I’m just getting ready to launch a new trials in my ms research. But I also have a therapy Clive stock, like, well, we just implement all of these concepts, uh, in a series of group classes. And I have TBI folks and PTSD folks and people with, uh, neuropathic pain in people with, um, a variety of other mental health and medical problems. So the group’s very heterogeneous, but they’re all working on their health behaviors and doing very well with each other.
Dr. Joe Tatta: And do you have any idea of like the recovery rates that people are experiencing as far as, you know, the rapidity of it or,
Dr. Wahls: yeah, I also want to, so opinions about that. So, uh, the first things that improve our reuse paying, uh, improved energy, improved mental clarity. And people are usually, uh, when they’re coming back and, uh, two months reporting that they can, they can feel, uh, the improvements. Now they are normal, yet they’re not perfect. But for most of these, uh, that’s, they’ve been experiencing steady decline going on for a long time. So this is the first time they’re feeling like their energy is improving, their moods are stabilizing and their pain is diminished. Uh, so they’re very hopeful, very excited. Uh, it’s pretty common that within six months there’s a marked reduction in their pain medication needs. Often they’re off their pain meds entirely. Uh, their, uh, quality of life is much better and they’re often, uh, now to bring their, uh, mood medications or psych meds.
Dr. Joe Tatta: Excellent. That’s a great message because a lot of people in pain are obviously had been on an opiod or currently on an opioid or an antidepressants. So you’re seeing that they’re able to slowly wean themselves off of those. Yeah,
Dr. Wahls: yeah. In the VA has, after having perhaps pushed the opioids, I think too aggressively in our desire to relieve pain, then we realized that we, we’re creating a different problem. So an hour take great people off their opioids. And of course there’s still, I mean pain. And so, uh, the painful night is probably my biggest referral source. So I have all these folks with perfect levels of pain coming into my clinic and, uh, because we are so successful at getting people into a much lower levels of pain, often completely pain free off of all of their pain meds. So the referrals, you know, just keep rolling in. It’s very exciting.
Dr. Joe Tatta: Yeah, it’s, it’s, it’s incredible stuff that you’re doing. You know, I think I should maybe switch gears just a tiny bit cause you’re on the front lines and they should really ask me a question that is a wondering is, are we really doing enough for our vets in the United States? Um, you know, we have a VA system obviously, but we have, you know, a war going on and people are coming home with TBI and PTSD and, you know, what else can we be doing?
Dr. Wahls: Well, um, we need to clone these to this more of me to go around to all of the house. Yeah. It’s really pretty interesting. Joe is, uh, eight years ago when I first started doing this, people thought sort of, ah, that’s very eccentric. Now all this food and diet lifestyle stuff, uh, in our local success, uh, it has not gotten enough attention. I’ve had many VA’s come to spend a day with me and watch what’s going on. Uh, last month we had a team from Washington D C come spend a day with us, very pleased. Uh, and now I’m, uh, uh, giving you a report, uh, to my hospital director to the, a central office, uh, about, uh, the, our experience for the first three years, uh, changes in clinical outcomes and the change in cost of care. Because when you make people well, that is how you reduce a cost of care is you have to actually improve their health and vitality, then they don’t need as much. Um, and we’ll be making, we’re making the business case to expand, uh, my clinics locally and I’ve talking with the VA nationally about, uh, what strategies I might be able to advocate for training others into that end. You know, uh, I’ve started creating a training program for other clinicians. We had our first, uh, class this last August. We’ll have another one, uh, uh, next August. Um, and I think that’s what I have to do is keep training more clinicians to think about health and disease. Uh, the way, um, that I now think about it.
Dr. Joe Tatta: And what kind of clinicians is your program appropriate for? I know you have a live training that you did this.
Dr. Wahls: That’s right. Well, so we have a live training, uh, in, so I go in looking for licensed health professionals. Uh, I think physical therapists, occupational therapists, physicians, licensed acupuncturist dieticians, uh, other, uh, nutrition professionals that have nutrition certificate, uh, chiropractors. Um, and I’ve invited people who are, I’d also say health coach, just this, hopefully n*****s are so critical, you know, if people tell me that they are a licensed health professional or a health professional certificate, they can reach out to my team and tell me, uh, more about what they do so we can sort out if, if that would be a good fit or not.
Dr. Joe Tatta: And isn’t, have a week long training. How many days is the training?
Dr. Wahls: It’s, it’s four days. Uh, so there’s three days that we do with the public. So they, uh, watch how I teach the public all of these concepts. Um, and then we have a day where, uh, we’re talking about cases, reviewing cases, uh, and then talking about more advanced treatment protocols and we, uh, do some East STEM. Uh, and then we do cases together as part of an oral exam and we discuss the cases and I have everyone explained to me, uh, what they see us as salient points and what are the high Libre actions that we can take for that, uh, in that circumstance. So
Dr. Joe Tatta: yeah, I’d say it sounds interesting. So your training is not just for multiple sclerosis. Everyone knows you is writing the best known, you know, the bestseller…
Dr. Wahls: This really is for how we treat complex chronic disease, how we treat complex neurologic problems, medical problems, mental health problems, chronic pain. Uh, and because of, uh, my experience in the TBI clinic and now, uh, uh, yeah, as, as one of the managers for the pain service, I have, uh, lots more experience now, uh, with our most difficult pain patients because those are the people that are coming to me. They getting off narcs their soul in pain and misery, and we’re doing a great job of helping them get their lives back on track.
Dr. Joe Tatta: So what would be your advice, someone who’s been struggling with chronic pain for a while, but you know, they’re listening to obviously your interview to listening to other other experts on the summit and talking about lifestyle interventions. Where should someone really start? Because there’s so many things talking about acupuncture, nutrition, moving, physical therapy, pain, psychology. What do you think is the most essential places?
Dr. Wahls: Start first, you know, um, I have had more and more insight that his life’s purpose in resilience factors. So I spent in my, it’s my, that’s who really taught this. We talked about the Victor Frankel’s work man’s search for me, that between every event in my life, uh, in my response to it as a space and in that space, I have choice. And that choice defines my character and who I am and all the possibilities. So try new people that we choose our path forward. We have a hero’s journey, whether we imagine that in the Luke Skywalker kicking on the evil empire, or in the Martin Luther King using nonviolence to take on the establishment or in the mother Theresa a religious domain. But we have some spiritual journey or Warrior’s journey on how we’re going to reclaim our life from this big struggle. And so having that metaphor to help you, guide you, and then we talk about we have the puzzle life for this stuff we can enjoy.
Dr. Wahls: So even when I was struggling with horrific neuropathic pain, uh, and I knew I was going to become bedridden, demented, I still enjoy helping my daughter memorize the lines who are applying, even though I was pretty close to Benjamin at that time, that was something I could still choose to enjoy or I could choose to be pissy about it. So I chose to, uh, treasure that moment. So that’s the puzzle life. Uh, and then the good life was, uh, enjoying the things that I could still do and enjoy, which was, um, I could enjoy making a big meal for my family. Uh, and so those were those things he could enjoy. And then there’s the meaningful life when you can, uh, take some unique skill that you have and you’re giving back to society and helping people figure out. So, and so my journey, um, when I started lecturing the medical students about being diagnosed with that mass and coming to terms with having a progressive illness, uh, I was giving back to the medic, to the medical community by teaching any of the students.
Dr. Wahls: And I think that was the beginning of, uh, my recovery was learning, uh, about how to claim that meaningful life. So I spent some time talking about that, these, the resilience factors that gave you the strength, the courage, the heart to do the work. Uh, learning how to eat food. Did you knew that you could pull up the taste for learning how to do some, uh, relaxation practice and alert and being willing to do some type of movement. But if we don’t help people with some of that resilience factor stuff that they can’t take on doing the work. So I, I my my bets, uh, to my surprise, they’re the ones who taught me that the classes they most enjoy are the ones who I talk about. What is your life’s purpose? What is your hero’s journey? Uh, that, uh, our, our bets, uh, uh, hands-down the favorite classes that we run.
Dr. Joe Tatta: So I’m just thinking, I guess it’s a debt. Their purpose has obviously been to defend the country or to dedicate themselves to the country, to their team, to their unit.
Dr. Wahls: That was their first purpose. It made them come back a solution because that purpose no longer resonates for them. And they have to find a new meaning, a new purpose. And sometimes there’s the Luke Skywalker vision of their hero’s journey. They’re often have a different kind of heroes journey that they know enriched, but, but they, they still, uh, the turtle concepts still deeply resonates.
Dr. Joe Tatta: And do you have family in your programs? I mean, obviously that the supporter,
Dr. Wahls: the spouse or, or same for another, um, uh, some other adults companion to come to class. That’s very helpful from our perspective. And we talk about this a lot. The individual who does this alone struggles. The person who does this as a family unit is more successful.
Dr. Joe Tatta: Excellent. So it’s always a pleasure to talk to you, Dr. Wallace. You have so many good things going on. I think the training is so important. I especially think if you can, you know, train clinicians and some of the protocols that you have not spread the message of healing for everyone.
Dr. Wahls: Yes, yes. We want everyone to come. Uh, I think, uh, the more we have talked through all this, the easier it is to create the epidemic of health.
Dr. Joe Tatta: So how can our listeners and viewers here learn more about you?
Dr. Wahls: So please come to my website, Terry walls.com T E R R Y walls a H L s.com. Uh, if you’re like you for some of our programming and support, go to the shop page. We have a whole bunch of support things. We’ll soon have information about our 2017, uh, seminar. Um, we’ll also have you sign up for our newsletter by giving us your email and we’ll be able to tell you whatever’s coming up in the near future. We’ll have our research updates up there as well. I’m on Facebook at turmoils MD and I’m on Twitter at Cherwell’s.
Dr. Joe Tatta: Great. So I want to thank Dr. Terry Walls for being on the healing pain summit two years in a row. It’s been a pleasure talking about TBI, PTSD. Make sure you share this interviews. You can share it on Facebook or on Twitter and make sure you check out her email@example.com. I want to thank her again and we’ll see you on the next interview on the Healing Pain Summit.