How Healers Heal: Stories of Physicians and Lifestyle Medicine
Kara Wada, MD: Welcome back, everyone, to this episode of the Becoming Immune Confident podcast. I love bringing amazing colleagues that I've connected with and Dr. Shilpi Pradhan is one of the best. She is a board certified ophthalmologist and a lifestyle medicine doctor.
She's also the author of two books: Goodbye, Dry Eye! which is near and dear to my heart as a Sjogren's patient. But she's also an editor, compiler, and co author of this amazing book, How Healers Heal. And she has her own practice seeing patients in Richmond, Virginia.
Thank you again for joining us, Dr. Shilpi. I would love to continue our conversation. For those that are just joining on this episode, Dr. Shilpi and I spoke just recently all about dry eye and her book all about dry eyes. So, If you think you have allergic eyes, dry eyes, you wear eye makeup, you need to go listen to that episode.
And we're gonna continue our conversation in talking about the role of lifestyle as medicine or as I like to talk about, using our habits for healing, which is something that we are both very passionate about. So thanks again for coming back and continuing our conversation.
Dr. Shilpi's latest book: How Healers Heal
Shilpi Pradhan, MD: Thank you so much for giving me this opportunity to share about our latest book called How Healers Heal and you were saying how we heal from within. So this is such an amazing passion project for all of us. It's actually a compilation of 33 doctors and our stories and how we found lifestyle medicine as a field, how we've used it in our practice, how we've used it in our lives.
I'll happily share my story and some of the amazing, powerful stories in this book. All of the proceeds for this book actually are going to the American College of Lifestyle Medicine for their heal scholarship to further education for doctors and health equity. So it's a fundraiser and a very personal stories from 33 of us.
Kara Wada, MD: Amazing and I'd love to hear more about your story and when you discovered lifestyle medicine, either as a field or just as a concept.
Shilpi Pradhan, MD: I'm happy to share. That's exactly what my entire chapter is about. It was about 2017, 2018. I was working as an ophthalmologist. I had two kids. I was eating crap. I would say just terrible fried food, fast food not processed food, although I still love chips. And we flew down to Florida for a long weekend at Disney.
And that night at dinner, I was having this incredible crushing chest pain and I freaked out. But then it went away for after five minutes. But then it came back that night when we were going to sleep and it was, it would just not go away. And then I thought, "If I go to sleep here, I'm not going to wake up."
Like I need to go to the ER and that's really scary when you have two young children and you're in a place you don't know. And so I got in my rental car, left the kids at the hotel with my husband and went to the ER and spent a night in the ER, stressed out, crying, in pain.
Thankfully, everything was normal as far as my testing. I still may have suffered a minor heart attack, who knows, at that time where nothing shows up on testing. But I do think my prior exercise in my 20s helps keep my heart healthier. I think the benefits of exercise, that's a kind of a side note, benefits of exercise last decades.
So I think my running days and running marathons in med school, like probably helps protect my heart. And maybe had I would have had a more serious heart event, but so I came back and I vowed, I'm going to change my diet. I cannot die. I cannot have a heart attack.
Dr. Shilpi's journey into lifestyle medicine
Shilpi Pradhan, MD: And a physician friend gifted me a book called Beat the Heart Attack Gene and it starts talking about diet and all the genes that are affected and turned on and turned off and halfway through the book, I learned about Dr. T. Colin Campbell's plant based nutrition course and I signed up and I took that course. I think let me see, it was 2019, spring of 2019 and I became vegan for the first time and gluten free.
So that was when I, after the chest pain is when I became gluten free for life. And with that vegan diet everything regulated, my body felt so much better and not just vegan. I think there's a difference between plant based and a vegan. So you can be an unhealthy vegan eating all these processed meat substitutes and Oreos.
Vegan cookies and or being a more like conscious whole food, plant based vegan. I'm not vegan right now and I'm working my way back. I'm like a 90 percent vegan right now. We can talk about that later. But I went vegan and within three months my long life standing PCOS that I'd had that had, caused me to need fertility meds for some of my pregnancies, caused a loss of one of my pregnancies, and we can talk about Gluten intolerance and how it is linked to miscarriage.
It is linked to infertility and I'm a huge proponent that if you are having symptoms of inflammation wherever is consider getting tested for gluten intolerance. sO back to that, I became vegan and then I became pregnant suddenly at age 40 and had that baby in December of 2019 and learned about lifestyle medicine.
And then I was like, you know what, "I'm just going to get certified. I need to learn more and more." And I just, I changed my family's diet, changed my diet. So I took the test in 2020 during the pandemic with an infant, but we had all this time off to study and it's given me so many benefits.
All of the people that I studied with, our little study group of eight people. We're so close. It's so hard to have adult friendships and foster these friendships. But I think the online space and studying for lifestyle medicine, Facebook, Zoom, all of these platforms where we've connected, like you and I have connected has just helped us grow in another pillar of lifestyle medicine, that social connectedness,
Kara Wada, MD: You knew where my brain was going.
Shilpi Pradhan, MD: It's amazing. So that's my story and there's more details in my chapter, there's such personal stories in here, here are the coauthors and each one has just poured their hearts out into their story and shared powerful things about how lifestyle medicine has changed them and changed their life. I would love for you to interview all of them, or as many as want to be on camera.
Kara Wada, MD: Yeah. I think what resonates so much is our shared stories of our own health crises of sorts that kind of pushed us to that. And in that reckoning of " Oh goodness", especially as young moms are and moms of young kids to be like, "Oh shoot, I got to get my act together. Because if I'm not healthy, how am I gonna best take care of my kiddos and be there for them and watch them grow up?" and it's a really scary place to find ourselves.
Shilpi Pradhan, MD: Can you share your lifestyle medicine journey?
The power of diet and its effect on health
Kara Wada, MD:
it's interesting, I think it started as a little bit of a trickle and it's it probably originally started well before I knew lifestyle medicine was something I could take a test for. I remember in the end of my medical training, I think maybe even before I became a mom, that my dentist had shared with me that I needed to quit drinking soda because I was going to end up meeting your crown before I was 30.
Yeah, so I definitely was before I didn't have kids till I was in my early 30s. So, that was that first behavior change of switching from my daily diet coke to drinking water more regularly that really I noticed a big difference in how I felt and better dental checkups and not needing fillings as often.
And in hindsight, there probably was some dry mouth playing in as I pull back the onion skin and the layers of the onion and thinking about my own illness story. Other aspects that I had noticed along the way that I would have I've talked a lot about my back stiffness that interestingly got better when I was pregnant, but it also seemed to get better when I was moving more regularly, whether it was running or doing Pilates or what have you.
But that always seemed to make things feel better. And we also had dabbled with different styles of eating. So I had a period of time after having my first child in. This would have been late 2015, early 2016, where every time I ate eggs that were not fully cooked, like baked in something, I would end up with excruciating stomach pain, essentially out of commission and other gastrointestinal symptoms for several hours, totally exhausted and then symptoms would ease up.
And at the time, I was an allergy fellow, and we were learning about this entity called FPIES, which is something that happens in children more often than what we, at the time, especially understood in adults, but it's a non IgE, so a non antibody mediated type food allergy, where every time you're exposed to this particular food in kids, it tends to be milk, soy and other in grains. So rice, oats, are some that are common, egg occasionally too. But now from what I've read in, in the intervening years, I do think that at the time I probably had this type of physiology going on. And that seemed to get better when I switched to a more vegan style of eating at the time.
It was after though I had my diagnosis with Sjogren's, I noticed significant changes in my symptoms with minimizing processed food. At the time, I experimented with a little bit more strict paleo style of eating which I worried about the sustainability from a cardiovascular standpoint with all of the red meat and saturated fats. My husband's a cardiologist, so that stressed him out considerably. And so over, then I was like, "Okay, so what is the science? What can I learn?" And that's when I learned I think probably about your class starting your training through lifestyle medicine. And then I studied that following year while I was pregnant with Oliver and sat for the exam then about two or three weeks before I delivered him.
Shilpi Pradhan, MD: Wow.
Kara Wada, MD: So I would say, for our family right now, knowing that this is a pretty busy season of life and we're doing the best that we can. We do aim for probably 80 to 90 percent of like cooking more home-based meals. Some processed food does make it into the house. I'm still working on getting my husband a little bit more on board with not buying those sorts of things. That's been a slow burn. And really when we do have meat, trying to make sure that it is less often the main star of the meal, and more often more of a condiment.
Inspiring patient success stories
Shilpi Pradhan, MD: There's no judgment from anyone, even judgment of myself. I've tried to let that go in terms of, "Oh, I'm not a hundred percent vegan."
"I'm not a hundred percent plant based", Oh, we try the best we can and I try the best I can for myself and for my family and I'm far better than I was when I had that chest pain episode and helping patients with this knowledge has been amazing as well.
I do talk about from stories in my chapter about ophthalmology and lifestyle medicine, how it's mixed. I'll share one with you. I had a patient with rheumatoid arthritis induced painful nodular scleritis, where she had just this horrible bumpy areas all over her eye. I won't talk, too squeamish, but I just started to, that was when I had first certified and I was super excited and I would talk to patients for 30 minutes about diet before I get too far.
Well, let me finish the story and then I'll come back. So she took my words to heart and actually I had no idea. She became vegan and started eating whole foods and plant based. And when I saw her again, I saw her many times over for her nodular scleritis, and she was put on prednisone and other, I think, HUMIRA injec infusions, but over three months, she lost 60 pounds.
And when I saw her at that three month mark, I was like, "What are you doing?: And she was like, "Oh, I listened to you and I'm vegan and I eat kale salads every day and I eat chickpeas. I love chickpeas and I get my fiber and my kids are eating a lot less meat". And so despite being on oral prednisone, she lost weight and controlled her rheumatoid, it controlled her scleritis and hasn't had a recurrence. And I was like, "Oh my gosh this is amazing". I've had another patient who every, in the last year and a half, wouldn't say every time, but she's had three strokes in the last year and a half, which is, and they're all, one of them affected her mobility, but the other two affected her vision. And she's got what we call a homonymous heminopia where she can't see half of her entire visual field anymore. And she can't get better. And that was one where I had to check my biases in clinic, cause she was like 85 years old. And I was like, should I bother explaining to her diet and exercise and is she going to change her ways?
She's already had three strokes. And this was with her first one. And I was like, "No, you know what? It's not my position to judge whether she can apply these principles or not. I have to share." And I shared with her wholeheartedly all the six principles, and we started talking about her strokes.
And I think this was maybe after the second stroke. I'm not sure. I don't remember exactly. But anyway, and we came down to it that her strokes were an hour after eating her breakfast. Almost all of them and her breakfast was bacon and eggs and bread and she would eat three to four slices of bacon and I was like, "Can you please just cut out bacon and replace it?" Like kale or spinach or whatever raw cooked, whatever you want. And, and I even said this to her, actually, I was like, in my mind, I went through whether I should explain this to you or not, but I'm going to let you decide whether it's something you can apply or not. But this is what I know.
We know that diet can make a huge factor and can cause strokes, can cause vision loss can cause heart attacks. And she listened and she's lost weight. She hasn't had another one since. Well she had the third one, but it was a much milder one. And it was again, after eating bacon. And after that third one, she's okay, I've given up bacon completely. And I'm like, "Thank you. And it's not for me. It's for you. Anyway, so that was, those are a couple of stories. I don't think that last one is in my chapter, but before we get too far in,
The six pillars of lifestyle medicine
Shilpi Pradhan, MD: I wanted to talk about the 6 pillars of Lifestyle Medicine just so everyone knows them because the book, the introduction does go into a little bit more detail about each pillar, but nutrition is a huge one that we all talk about.
Physical exercise, we know or physical activity is huge as well. That's one pillar that I need to improve on and get more moving, but I try to incorporate it in fun activities with my kids. The next one, social connectedness, which we mentioned through our study groups, which is so, so important.
And I think it's highlighted by our surgeon general and his report on loneliness and his book together how we really need each other to stay healthy. That's pillar number three, four would be stress management, five, sleep. So important.
The importance of sleep in overall health
Shilpi Pradhan, MD: Sleep may be the one pillar you need to address to help all the other pillars fall into place.
I know when I'm sleep deprived, I crave more processed junky food but I try not to keep it in the house to prevent myself from eating it. And then the sixth pillar is avoiding risky substances like tobacco, alcohol, and drugs.
Kara Wada, MD: I have to say for me, sleep has been one of the most critical in my pain control too. And we know that our sleep is so closely linked with our immune system health and with inflammation. And so it's not super surprising, to learn too that it is also really linked to our hunger cues and our hunger based and satiety based hormones, too.
Shilpi Pradhan, MD: One of my favorite books I want to say is called The Promise of Sleep. I wish I had mentioned that in the introduction of this book, but it's by Dr. William Dement. And I think he is the person who discovered REM sleep, but that book is amazing. I think it was published in 2000 when we were, when I was in medical school.
And it's just a phenomenal read for anyone who wants to understand sleep better and how it affects our physiology.
Kara Wada, MD: I'm gonna add that one to my list. I am voraciously trying to read. I've tried to make good use out of our community library. And there are certain popular books that when you get the book, you have to get it read in three weeks. Otherwise, you're out of luck for six months.
Or you can go buy it, which I guess is great and supports the author as well. But I will add that to my queue. Yeah.
Shilpi Pradhan, MD: Oh yeah, it's a phenomenal book. I think I read it in three days. It's such a great read. I could read it again. I hope I got the title right.
Kara Wada, MD: We can double check it and then we can, maybe we'll put like a link in the show notes. Then we'll have it both have that and then also the book that we're talking about today, which is.
Shilpi Pradhan, MD: How healers heal. I don't want to share too much about other authors journeys because I feel they're private to them, although they've been so kind and open to put their stories in this book.
Kara Wada, MD: And there's a huge breadth of specialties. We have age, different, of course we're not, we don't have people super duper young that aren't physicians yet, across age spectrum and geographic locales, and it's really awesome.
Physician Stories in How Healers Heal
Shilpi Pradhan, MD: Well, I will share some of my favorites really quickly. Dr. Hagerich is one of my favorite chapters. It's like her coming out story about her CVID, Common Variable Immune Deficiency, and she's never really talked about it in public and this is just such a powerful chapter.
Kara Wada, MD: That's near and dear to my heart because I take care of those patients every day in the clinic.
Shilpi Pradhan, MD: It's an amazing author and she just talks about her journey through it and how she found lifestyle medicine. Dr. Hardisty, I think she's like our peace guru who shares so much compassion in how she deals with patients. Dr. Garodia, who is at the VA and she is just amazing. She treats patients at the veterans with battlefield acupuncture, which I had never heard of and pressure points and ears and gets them feeling better.
And she is really into positive psychology and she's so, so humble. There, there's so many so many chap, oh my gosh I could go through all of them if you have time, there's Dr. Garg, who in her studying she runs her own lifestyle medicine clinic, but in her studying, she actually wrote a handbook for patient, for doctors to study from for the lifestyle medicine board exam.
Dr. Chu who Cherie Chu, who talks about the loss of her mother. It's just such heartfelt stories. I feel like I should go through them all, but I don't know if you want to go through them all. Dr. Schimek, Trisha, she's just a ball of sunshine and just her passion for public health that really just shines through what she's doing and in this chapter. Oh my gosh, I'm so grateful to these 33 women physicians for sharing their stories.
I hope everyone gets a copy, whether you get it from the library or Kindle Unlimited or buy Kindle or a paperback copy just to learn. And then of course, if you buy a copy, you support The scholarship for the American College of Lifestyle medicine.
Kara Wada, MD: I think this is amazing and it's given me the idea. I think this would be so inspirational for our trainees and so I have been thinking about starting essentially a little library at the office. I'm always recommending different books to our trainees that rotate through the clinic or our fellows certainly who are there all the time.
But I think that this has pushed me just that little bit further. Further that I'm gonna order some of those favorites, this included, because it really can be helpful to see and hear other stories and use that inspiration as your North Star as you're thinking about changes that you would like to see in that future version of you. I know, and it's helpful to have all sorts of different people to look up to. So for me, one of the people I look up to in the celebrity world is Venus Williams. She's like the most famous person with Sjogren's, but then certainly having kind of these other folks that are either mentors that are actively in your life. Or others that have walked or shared kind of other similar paths is really helpful.
Shilpi Pradhan, MD: I agree wholeheartedly. I think that's what makes this compilation amazing is we're just, we're so raw and real. And that physicians struggle with our health too. And we're sharing our stories. We are human and, but there are, there is a path and no one's perfect. And we're not expecting you to be perfect. And we're just sharing our struggles to help everyone else.
Kara Wada, MD: And I think there's so much healing in that and also I think it's so important as we think about the struggles our healthcare system is having, how vitally important it is that we think about the health of our healers. The health of our health care systems and teams and how you can't separate those, that those are really inextricably linked.
Shilpi Pradhan, MD: On that note, I'd love to point out Dr. Padmaja Patel. She's not one of the co-authors, but she is the president elect of the American College of Lifestyle Medicine. And she is a powerhouse in changing some of the systems and healthcare. She's many, many publications. in the last couple of years highlighting how she's changed the entire healthcare system at her prior hospital, Midland Health.
And she's now the medical director at Wellvana. But I'm so excited. Our presidents and past presidents, Dr. Kate Collins, Dr. Beth Frady, Dr. Padmaja Patel. There are just amazing women that are changing medicine, changing health systems, and hopefully getting lifestyle medicine into your primary care doctor's office.
So we all benefit from this amazing evidence based knowledge to help us get better as a community, as humanity.
Kara Wada, MD: I'm just reminded of this saying that my parents used to always say. Now, we didn't always practice it, but we said it, they said it a lot and continue to say, "An ounce of prevention is worth a pound of cure". And I think lifestyle medicine, preventative medicine, like there's no greater analogy or, it's true that it shows in the science, and generally shows in the cost savings as well, if we could just get the right folks on board.
Shilpi Pradhan, MD: I think the American College of Lifestyle Medicine is such an amazing organization because they're moving that forward so much more than you and I could do as a huge organization with the government, with Medicare, with all the places that we need to move forward. So that's why I love being a part of it and supporting it.
And I never dreamed that this is where I would be or what I would be doing when I went to medical school, but life just puts you on a path and you follow it. And I'm blessed to be part of all of that, all of this movement and women. That are my co-authors and the American College of Lifestyle medicine.
The future of lifestyle medicine
Kara Wada, MD: I can't wait to see the immense growth, like I just this field is not very old. So to think about the huge growth and and change that has been affected in such a short, relatively short period of time, I'm really excited to see what the next 10, 15 years has to bring. I'm hopeful.
Shilpi Pradhan, MD: I'm hopeful too. I think we've just crossed the, I think at the conference a few weeks ago, they said we've just crossed 10,000 board-certified physicians.
Kara Wada, MD: And I'm starting to hear and see interest in our trainees too. I've had several that came through on the interview trail this season alone applying to be Alergist-Immunologist in the future that knew about lifestyle medicine, were going to the conference. Like it just had me all excited of my two worlds coming together.
Thank you so much, Dr. Shilpi. I look forward to a time when we'll be able to see each other at one of the meetings and just continue to see how these friendships and collaborations continue to grow and evolve.
Shilpi Pradhan, MD: Thank you so much for doing what you do, sharing your message of positivity and education.
Kara Wada, MD: Thank you so much and make sure to click over to the show notes so that you can pick up your copy of Dr. Shilpi's collaborative book and her dry eye book, which we talked about on previous episode, which is chock full of great tips, tricks, education, all the good things. Thanks again for tuning in today and we'll see you next week.
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