Doctor’s Painful Gout Gone in Weeks! | Dr. Richard Schmidt | Exam Room Podcast

for the first time ever here on the exam room podcast brought to you by the Physicians committee we have a reproductive endocrinologist Dr Rick Schmidt is with us man thanks for taking the time yeah I'm glad to be here you have an incredible story but before we get into that I need to know what a reproductive endrocrinologist actually does that's fair um so you can get all caught up in all the hormones and everything but the bottom line is we just make babies yeah we just make babies yeah why not just go with the simple title like Dr baby maker or something like that yeah you know that works I think it just needs a little bit more Academia behind it so put the degree to use right yes oh man uh but we are here as we record this at the International Conference on nutrition and medicine and everyone who comes through these doors doc has an incredible story you certainly know except C to that about a decade ago if somebody told you you would be at a plant forward nutrition conference what would you have said no way absolutely no way you know I'm a foodie I just need all my protein sources and I just love to cook and it just wouldn't have been in my kind of thought process that I'd ever give up meat but 10 years ago twist of fate even though you're a doctor have a firm understanding about what it takes to have a healthy body you yourself started to have a number of health challenges I did I did um of course I thought that eating clean whether that be fruits and vegetables of course clean Meats if there is such a thing um clean chicken clean fish that would keep me healthy we don't learn a lot in med school we don't get that nutrition education and so what little bit we got maybe 15 minutes and four years of med school I try to take that and just kind of learn on the fly as I was practicing medicine and slowly started to educate myself and realized that maybe my dietary patterns were part of my health issues my biggest one was familial gout my dad had had it and I don't even think he knew he had it when he was alive and I realized I'm having this terrible pain in my big toe and it's recurring and I couldn't believe that I was in my 40s and I had really bad gout and so of course one to the doctor and I was put on medications and so the medications that I had were pretty benign but they still had side effects and I just kept going up on the dose of the medication because I was continuing to have these attacks and when these attacks were real they were about every 3 to four weeks I would have two to three days where I just was in so much pain I could barely put my shoe on and I'm trying to run a full medical practice and be productive and I have a Vineyard as well be productive in my Vineyard and I just couldn't do it and I said I have to make a change and so I was reading things about the anti-inflammatory diet and how important it is to have a really good number of fruits and vegetables in your diet every day and I just started to make the change and I actually not started I went cold turkey cuz I just said I have to get rid of all inflammatory products it was that bad huh it was that bad wow and so I made the change about seven years ago this month and within 3 weeks I had not had an attack and I said okay knock on wood let's see what's going on by 6 weeks not an attack and I knew something was different in my body um Not only was that going away my asthma that I had had for years was improving and I was using my inhaler much less and I'm like okay there's something going on here and by 8 weeks I said I think I'm going to start decreasing my Gap medications and I started to go down on that and now now 7 years later haven't had a gout attack and I'm just blown away by the power of nutrition so let's let's talk about what your diet was though I mean you mentioned you thought you were eating these clean healthy Meats but can you walk us through what the daily menu would have looked like when that first gout attack happened absolutely so I did have a garden I always had a vegetable garden so I did have nice you know fruits and vegetables in the house but I was of the minds said that I needed all this protein so in the morning okay let's get a bagel let's put some locks on it let's get nice clean locks and let's have you know some eggs with that too I had chickens so I what could be better than having my own fresh eggs and so I'd have some sort of egg sandwich for breakfast and then it comes to lunch Ah that's going to get a nice clean chicken salad plenty of chicken a little bit of salad but have a nice chicken salad and then move into dinner where I always would Source my meal with the protein first protein being animal protein and that was the center of the plate and then I would decorate it with some vegetables and you know a salad and but clean in my mind clean and so whether that be grass-fed beef whether that was you know cagefree chickens or you know free range chickens I just thought I was doing the right thing yeah I hear you you talk about that and I think the average person would look at that and say wow you know he eats pretty healthy that's not the standard American diet that we talk about that's so Rife with fast food pizza Burgers maybe Taco Bell like all of that stuff you weren't eating any of that and still you had this issue minimal processed food I really I mean I love my chips and salsa but other than that it was really minimal processed food I thought it was an extremely Clean Diet mhm so did you know then right away when your toe started to ache that that that was probably what was occurring or did you think like maybe I had like somehow jammed it up were you an athlete total denial yes I was running I was you know extremely active and I'm like okay this is really weird I'm getting this consistent pain shifting toes sometimes it would be the right big toe sometimes the left big toe and then one episode I actually was visiting my nephew in Japan and I literally got this knee pain and I was in a wheelchair coming home from Japan because we had a ton of seafood and meats over there when I didn't correlate and I couldn't even walk I was at LAX and I was in a wheelchair getting off the plane I'm like okay my life is really messed up I got to do something here and I'm like I got to get an MRI figure out what I did to my knee I must have you know torn a anterior posterior cruciate I don't I was just like all just bat Bamboozled by this and so lo and behold I started to put it together and I'm like wait a minute I just this resolved in 3 days on its own four days on its own just by you know kind of going away and hydrating I'm like this is gout wow this is gout wow I mean to be in your 40s at this point young healthy doctor I mean especially being a doctor I mean I would imagine like there's like almost a little bit of embarrassment there confusion like how are you feeling be honest with me well you know in medicine it's one thing to diagnose patients it's totally different thing to diagnose yourself I mean you don't get those diseases that you read about you don't well you do and that's what I had to realize is that okay I have been doctoring myself and trying to figure out how this perfect you know healthy lifestyle could lead me to anything like that and I was just in denial I just said no no no it couldn't be me it couldn't be me and it was me is that a common thing for doctors to kind of feel like you're you're bulletproof in some regard of course of course once you know about the diseases that gives you a passard not to get the disease well it doesn't work that way all right so yeah unfortunately right um so now you've got Gout and uh what is the typical course of treatment for somebody when they're diagnosed like let's take the nutrition intervention off the table for a second if a patient goes into the office what's the doctor typically going to prescribe okay so one of the main medications that's been used for you know decades is alope purinol a low purinol so lower your purinol because it's purines that are the product that of the the actual gout Crystal formation and so they just want to lower your purines and so they start they do tell you about diet they want you to lower your purine intake which is meats and beer I wasn't a beer Big Beer Drinker but they do say alcohol just cuz that can dehydrate you and problems to get worse but yeah they they want to get you started on medication and they want to keep going on the medication and they give you a backup medication called culture scene which basically helps you in the immediate attack and it goes to your kind of gout crystals and it starts to break him down but if you take too much you get massive diarrhea so I mean it's just no fun you can't win man no no no no you can't win and what's long-term prognosis typically for somebody with GT so with repetive attacks The Joint gets distorted um there's something called a gouty toofus which is just like a kind of almost like a tumor that starts to grow in the area that you're getting and it's just loaded with these urate crystals and just this kind of disease State and the joint starts to deform completely um it's it's really really disturbing that doesn't sound like a lot of fun no no no no is there a risk for amputation or anything like that if things get can surgically try to make it look better but you're going to have a joint that doesn't work well so and if it's in your foot that's G to that's going to affect your whole life so when you start to do this research and you're putting the nutrition puzzle together that comes with this are you reading books are you looking at documentaries going to PubMed and just pulling up cop amounts of studies you know I know how to read a study let me just figure this out and so you know I'd go and I'd read the studies and I'm like okay well and there was mixed studies you know that that many years ago it's just it wasn't consistent that you know you going on up and it's still not now if you do a a real good search of gout and you know the dietary recommendations it doesn't recommend Whole Food plant-based there's an occasional article about it and it's just it's a crime that it's not brought up and so I was doing my deep Dives and I started to come up with yeah okay inflammatory foods I need to stay away from it's a pretty common condition though right gal very common more common in men than women but I mean it's extremely common and going up wide so I I wonder why there is not more attention to that we hear about with you know the heart healthy diets we hear about diets for cancer but if gout is so common and it's driven primarily by diet in a lot of cases why wouldn't there be more attention put on that it's a very good question yeah I think I well you don't have the answer for that today I I I want to be the advocate I want to be the the poster child for this I really do but it it's puzzling to me though because even when and this is not a knock necessarily on you know the big cancer uh groups or or the heart groups but even when you look at those diets there's still a lot of things on there that if you look at other studies they're like well you really shouldn't be eating process meate here you really shouldn't be eating a whole lot of dairy here you know as a matter of fact we know that that increases the risk of these particular conditions and so like talking about gout healthy diets I would think that unfortunately we could get into a situation also where these types of foods that would cause the inflammation and trigger a flare up might also land on the list that's got to be a little bit of a concern as well absolutely absolutely you just realize you know as you go through this whole kind of Adventure I'd say of becoming a doctor and then taking care of patients that the body wants to be healing itself and if we don't give it the tools to heal itself then all this disease is going to come up because all disease is really based on inflammation yeah and if we can remove that inflammation out of the body we can heal every aspect of disease almost every aspect of disease so let's let's talk about this timetable here when you you come back from Japan that really bad bad episode that you had you're in the wheelchair you said what did it take you 3 Days To recover from that or how long were you really hobbled there I I was I mean like I said I couldn't even walk at LAX and 3 days later I was walking normally and I'm like okay this is not an orthopedic problem right this is something that happened and went away what could have done this and then I just started to put it together between my toe typically it's the toe joint the first you know meditar soul and that's what you get in a gout attack but it can go to other joints right that was the first time I had another joint involved and when I started putting it all together I just said okay yeah and then I remember I remember my dad had his tennis shoe with it cut out over his big toe um so he could put his shoes on I'm like holy cow my dad had gout I didn't put it together and he had long been gone um from colon cancer another inflammatory meat cause disease um and yeah I just put it all together and I said holy cow this this is gout yeah so how big was your dietary change I mean you mentioned that there were a lot of indulgences on that trip but like did you come home that day and you were like I'm going to eat an entirely plant-based diet or did you just kind of go back to what it was you have been eating back home and just by making that level of change you saw these this big Improvement so I mean it was kind of this learning curve I did the Deep dive I started learning about you know the inflammatory foods and I started to shift but I was still getting attacks and they were I could space them out I could be proactive and drink you know five six seven liters of water a day to try to minimize you know keep myself hydrated but I just knew I couldn't go on like that and so that's when I decided to go cold turkey so I mean what how what kind of toll did this take on your personal life at that point I mean work was I mean and you know I was at the point where I was you know my kids were getting older but I was still doing a lot of coaching you know they played soccer and other sports and I was very involved in you know their activities and I had to limit myself I had to call in help on some of these coaching events because I mean I couldn't walk I couldn't walk so yeah so it was it was super frustrating and I I knew it wasn't the life that I wanted to live I would imagine again especially you know young healthy dad doctor dad you shouldn't be the one that's in the wheelchair or hobbling around man no no no that was that was a shocker what did what did your kids say like to see you like that was that scary for them uh no they looked at him and they're like is that something we're going to get and you know a kid you know I care about you but I care about myself too yeah um and so they were you know is that is is that definitely something I'm going to have and I'm like no no no no it's you know we're going to we're going to figure this out right on so but yeah they were super concerned right on how surprised were you though as you started to do this research at just how strong the connection between gout and diet actually was again since the literature does not have a lot of data on this I I was pretty shocked that nobody had really taken this on as an area of research and I I still feel that I would like to get involved in something like that and do a really good random control trial and just figure this out and things answered once and for all right right but I guess in in particular with your case I mean what you saw versus I guess anecdotally what's your experiencing at that point you're like holy moly yeah yeah yeah yeah yeah I was yeah I was blown away yeah I bet I bet but it wasn't just gout that you saw improvements with as well no know of course asthma can be have a huge inflammatory component um it always was worse for me in the spring with pollen and everything but I still had my inhaler at all times and I wasn't using it and that was actually late spring that I I came back and I realized as I started to make changes I was getting slight Improvement of course when I made the full change I I mean I haven't used my inhaler in almost 5 years now you know so my asthma dramatically improved because of my diet do you still carry it with you just as a little safety net or I it's all expired I don't even have yeah I mean I'm like I have it there but I never use it so who needs that stuff no I mean that's got to be a pretty freeing feeling right oh it's amazing it's amazing just the exercise tolerance just went through the roof I could you know exercise so much better I felt so much stronger I me you look fit as a fiddle today how often are you running um so I will do some sort of aerobic activity you know five six times a week yeah so yeah look at those guns right there you downplay it dude but yeah you're jacked come on now don't no don't even lie to us or he is jacked silly guy tell me no downplay it no no no but even like you love to grow things right we were joking before the interview whether it's growing babies or growing grapes like you love just growing things and if you're growing grapes you're going to be spending a lot of time Outdoors walking around in The Vineyards I mean just to be able to have that freedom to go out there and walk and see everything and just not be in this crippling pain that too has to be a pretty amazing feeling it it is amazing because I remember it's a hillside Vineyard and I remember getting attack and I said okay let me just put on my my boots and they'll be acting like a cast and I'll be able to hobble up and down I mean this is steep Hillside I'll be able to hobble up and down the hill and you know do what I need to do prune or whatever needs to be done at that time it was so painful yeah it was so painful and I'm like I'm not going to be able to do this this is my dream to be able to have a a Vineyard as I retire from medicine and I'm like I'm not going to be able to do this if this keeps up robed you of the joy of it right yeah man absolutely but let me ask you because I I'm sure that a lot of people are kind of wondering this now as they watch and they listen alcohol and the connection with gout is there like could alcohol potentially be a trigger what do we know there so I mean as much as I'd like to sugarcoat it cuz I'm a wine maker alcohol is bad I mean alcohol causes cancer alcohol generally is bad for us now are there some studies that would show that you get a benefit from like red wine and stuff like that yeah there's some evidence that you can get some benefits from that I'm not going to go heavy into that but alcohol itself dehydrates you and as soon as you get dehydrated any condition that has inflammation without that water in your system is going to become worse whether it's asthma whether it's gout heart disease I mean you need to be well hydrated and the actual alcohol dehydrating you is what is going to cause the problem you know how do you balance beer is worse beer is worse okay because it has Pines and so that is the culprit um but they even said that oh yeah red wine is bad and several studies actually even showed that red wine could decrease gout attacks so I'm I did this really deep diet I have no doubt being a doctor and a wine maker you were the guy to ask yeah so um but yeah so as long as you're hydrating well and everything you know a small amount of good red wine right is is is okay I got you I got you so and uh the name of your Vineyard is Moose Mountain Vineyards moose Mountain Vineyard out in California after my rescue dog oh oh yeah moose is not the Big Moose it's it's my 105 lb rescue dog well that's still a healthy size dog Doc it's it's yeah it's a moose it's a moose that's a mini moose mini man yeah that's that's great how long have you had this the vineyard uh the vineyard now I planted the first Vines almost 15 years ago nice so yeah you loving it oh so much yeah I love like I said I love growing things and when you can turn Those Grapes into a product like a really nice glass of red wine might specializ in Bordeaux style wines and it's just so delicious yeah you get the twinkle in your eye when you talk about that amazing yeah man that's that's kind of your happy place but how Moose still around oh yeah yeah he's doing all right he's he's a little older but um he's on a whole food plant-based diet too and he's doing well you know good for moose good for boo what does your diet look like today you went from having those clean Meats but what's the ultra clean plant-based diet looking like today okay so a lot of stuff comes out of the garden give it up almost all my vegetables so um and I rotate a garden I actually have an aquaponic so I can have Garden year round even though it's California I mean you can have you know a garden year round in California but I'll shift it from my cruciferous vegetables in the winter and then I move into you know kind of my peas and beans and stuff in the spring and you know you want to have variety so I have an always a killer pepper and tomato garden and you know making my own hot sauces and everything like that so it's just I just love pulling stuff out of the garden I have uh a citrus Orchard I have an avocado Orchard I you know you know I just want to grow my own food and I don't want to put any pesticides on my food so this is completely organic farming and it's just amazing so besides that I'm I'm the bean guy I have the bean I would say yeah between lentils and beans I probably have somewhere between six and eight servings a day I just that that brings me to a whole other issue that I had because I got diagnosed with crohn's disease and that's where I started my ven on on legum yeah yeah and your Crohn's today I'm I'm sure doing a lot better too nonexistent they did the Scopes and they can't find any evidence of Crohns wow yeah they said that you need to go on biologics Remicade and you need to be on this and I had that diet switch and the doc is like no this wasn't because of your diet you didn't you just you got lucky and I'm like no it wasn't luck this was a dietary change that got rid of my Crohn's disease so you had gout asthma and Crohn's man you had the trifecta bro kind of well and not a good Tri oh but wait there's more there's more and this is genetic I found out I had celiacs too get out of town yeah so so I'm obviously I'm one of those real gluten-free people I need to be gluten-free right right um so yeah so I had I had things that could really really make my life miserable and my life is far from miserable we're of these things were all of these things happening at the same time the gout the asthma the croh like it was like they overlapped they overlapped yeah wow was kind of crazy bro I know it's like is this what getting close to 50 looks like that is rough man wow yeah it was crazy but look at you today feeling good and yeah okay did you do a deep dive into like Crohn's literature as well no of course oh I figured you would have I figured I have it all chronic I have every little aspect of what I need to know about Asma Crohn gout but I've done it with other diseases to because I'm a fertility dog so I'm counseling my patients about the benefit of a whole food plantbased diet to reduce inflammation and metriosis is a huge problem for women infertility and getting on a whole food plant-based diet absolutely reduces their chance of that inflammatory component causing infertility so you you do talk to your patients about that every single patient are they surprised when that comes up in conversation a little bit they're like what I 10 to 12 servings of fruits and vegetable a day and I'm like that's the minimum that's the minimum and if you don't get for women 25 grams of fiber for men 37 grams I said you're not doing your your gametes well gametes sperm and eggs you're not doing your sperm and eggs well if you don't get on this diet so I tell him that first visit I've I've interviewed people on this this show this very show Katherine Lawrence Ireland pops into mind where she was uh just famously addicted to craft macaroni and cheese in the blue boxes and I mean her friends even when she I think maybe it was when she uh uh transitioned out of the army just gave her so many boxes of it and she would just eat it day after day after day and her endometriosis got so bad that they were going in they were going to perform surgery but then coincidentally 6 weeks Pryer she begins eating a plant-based diet and when she goes for the operation that morning the doctor opens her up and says it's a miracle it's cured all that was left was scarring but like the hysterctomy was never performed and she went on to have happy healthy children unbelievable you know there's a lot unfortunately that the drug companies don't want to hear and they would much rather have their be these needs for these medications and these treatments and if I have a patient that can get pregnant through dietary changes that's my biggest win I'm not concerned about them not being my patient I'm concerned about them being a parent yeah and if they can make it in a natural way to Parenthood I am hats off to them I'm there to help them if they can't but I just want them to consider diet as a really strong intervention that's got to be a really cool feeling to help a woman or a family conceive when they've been trying and trying and trying right I mean like it's it's amazing I mean I've had some of my patients bring back their college graduates to to meet me again whoa and that's really where I'm like am I really That Old double sword you're funny man I've been doing this that long but you know I I had one that came back and she just graduated from Cambridge and she was a patient from overseas and just to meet this girl's just beautiful brilliant woman and I'm like wow I was holding that little embryo in my hands when I did that transfer I just it just blows me away that's so cool the whole process that's so cool that's so cool you talk to all your patients about nutrition or do they have to be open to it yeah no no no they're going to hear it whether they want to hear it or not um I just gauge how forceful I want to be I don't want to turn them off with the conversation I want to open the door and then if I can open it more depending on their reception than I do yeah I think this is a great place to wrap up the conversation whether it's in this instance or so many others it's always how can I talk to my friends and my family about this how do I talk to the people who I care about in terms of their own nutrition and what it is that they should be eating it is a delicate conversation and I maintain that somebody has to be ready and willing to hear the information how do you gauge it is it just a vibe that they give off or what's your barometer you know it is and I just I try to Target what I feel is important to them maybe it's their health maybe I mean longevity being around like a patient that really is wanting to be a mother I I focus on that but I also say you know with your hemoglobin A1c being elevated I'm I want you to be a mother but I want you to be a grandmother and what sometimes when they hear that the light bulb goes off and so I just try to get the angle that I feel will be best for them to be receptive and I'm not going to push it down their throat but I'm going to be their biggest supporter if they decide to head down that path and guide them along the way all right my final question to you is along those same lines you know how would Dr Schmidt today talked to Dr Schmidt 10 plus years ago how would you begin that conversation oh boy yeah and would he have been receptive at at at any point I mean I you know I think my love of my kids and the field that I'm in I think I would have angled it about hey you know your your dad died in a young age do you want that for your grandkids do you want that for your family you may want to consider some of your dietary practices if you want to be around for those incredible grandkids and maybe great grands and so I think I would have done the family angle CU it's so Central to who I am all right man well that was a great way to to leave it man congratulations on your transformation looking at you today you would never know that there was struggle one you look great you sound great kind Chuck man yeah I really enjoyed you know sharing my story with you it's it's been truly my pleasure and thanks also for everything that you've done uh with us here at the Physicians committee man you you are yeah they are dear to my heart as you are to ours my friend thank you very much awesome if your health IQ was a couple of points higher than it was a few minutes ago go ahead and like this video or subscribe to the YouTube channel and to take it even higher head over to Apple podcast or wherever you get your favorite shows look for the exam room by The Physicians committee hit the Subscribe button there as well and help to make your world a healthier place

Channel: Physicians Committee

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Length: 30min 45sec (1845 seconds)

Published: Mon Mar 18 2024