We discuss how:
– At the age of 30 Carolyn started having symptoms – swollen knees, fatigue and a lot of pain overall
– It took six years for her to be diagnosed with Psoriatic Arthritis
– After being diagnosed, she started going through different medications – sulfasalazine, Prednisone, Plaquenil
– She went on Methotrexate for a brief period of time, but it made her extremely sick
– Two years ago she started with Enbrel, which gave her the least side effects
– But after about one year the symptoms started to come out again
– Carolyn then found the Paddison Program and after 2 days the swelling was gone
– She’s now on the Program and her condition is improving everyday
– She is now a member of Paddison Program Support to get assistance with her next health objectives
Clint: Well every day I talk to people about rheumatoid arthritis, inflammatory conditions, psoriatic arthritis as we’re going to be talking about today. And all these conditions can be influenced dramatically through our lifestyle choices. And today’s guest Carolyn is from New Zealand, and she has kindly jumped on a recording with me to go over her story. That is from what she has shared with me so far, but there’s so much that I don’t know so I’m excited to hear all the details about where she’s at with her progress on the Paddison Program, and also what she has left to do, and what she plans to work on from this point forward. So Carolyn thanks so much for coming on this episode.
Carolyn: Thank you very much.
Clint: Give us a quick snapshot, a sentence or two as to how you feel now compared to where you were a couple months ago.
Carolyn: Okay. I was having a lot of pain, extremely swollen knee, and hobbling to walk, fatigued, about to email my rheumatologist and say we need to up my medication (inaudible). And I thought I’ll try it, I’m 165 days later I have no pain, no change in medication, very exciting.
Clint: That’s very exciting. Okay well fantastic. Well your diagnosis is Psoriatic Arthritis, the greater percentage of inflammatory arthritis is rheumatoid, so I know there’s some subtleties with Psoriatic Arthritis. How do you describe the differences when people ask you the differences?
Carolyn: For me Psoriatic Arthritis affects one side of my body, so like I’ll have 1 knee swollen or 1 foot or 1 toe. And probably fixed bigger joints more than my little joints although I have (inaudible) fingers and toes. I would say I don’t have the rheumatoid factor when they do the blood test basically, but I would say there are a lot of similarities (inaudible).
Clint: Yeah and reacts very similarly as well to the interventions the same approach that you know that’s been put together for rheumatoid. We’ve had so many people with Psoriatic Arthritis follow the Paddison Program and get the almost exact kind of response. And so I don’t see them all as different underlying causes, I see the underline cause as the same for all of these conditions just with different external expressions of unhappiness for the body. Yes the symmetric nature of the inflammation is sometimes not there as we see with rheumatoid, the rheumatoid factor as you say. And despite its name quite often no psoriasis symptoms. Did you experience any?
Carolyn: No psoriasis whatsoever. I was surprised when that’s when I end up being although my father did have psoriasis like as a teenager but none of the rest of my family have it. And so yeah when I had my initial test my ANA was high, my CRP was high, my ESR but nothing else kind of over time they’ve worked out it’s what it is. It has also started arthritis, or my type makes bone as well so my joints in up to (inaudible) through extra bone in them as well. It makes it.
Clint: Extra calcification?
Carolyn: That’s what it is yeah.
Clint: Yeah right. Okay. How did you get diagnosed?
Carolyn: When I was diagnosed, I was 36, but I was 30 when I started having symptoms after my second child. I had my knees swell, and I got back to work and she is 3 months old, and I turned oh my knee. And so from there the swelling was huge. And at that point, after a couple of months I couldn’t walk, my knees up so I just literally like your picture and (inaudible) actually. I couldn’t bend, I couldn’t straighten it, couldn’t walk, had a baby, and couldn’t do anything hardly with my child. And so when I did an MRI they found that there was damage to the cartilage, Just assumed it was a random sort of incident. And slowly over a year and a half my knee went back to normal, but when it went back to normal my other knee swelled, it swelled up all the same. And so that time after about a month they gave and I took some nonsteroidal, because I was breastfeeding the first time I wasn’t going to take anything and it kind of slowly eased off. And yeah so over a period time up to 6 years I had random swellings of knees that completely immobilized me like on the couch. Strain, pain, I’m just about so sick. Anyway after year 6 I went to the doctor because I had a swollen knee, it just wouldn’t (inaudible) and my foot started swelling as well i(inaudible) do some autoimmune screening which I had asked for initially. But they only tested after lupus Antibodies, they didn’t do a full screen for some reason. So when I returned that’s when I ended up under rheumatology and started my journey on taking medication.
Clint: Did I hear that correctly you say after year 6?
Carolyn: 6 years.
Clint: You did 6 years of alternate in massive inflammation in the knees, and then slowly progressing into I think you said your wrists before you went and sort of got some serious medical care.
Carolyn: I had all along been attending doctors, I had seen many GP’s, none of what you probably even really know the condition or they may have done blood test that I’d asked earlier. And also I’ve been seeing physiotherapists, who said It just doesn’t behave, this is not normal to have this massive swelling. We’re talking huge like a soccer ball on your knee, not just oh you knee is a bit sore and a bit swollen, it’s extremely (inaudible). It’s 6 years it took and I tried like the first time I had no medication mix time nonsteroidal. There are times I had (inaudible) which actually ended up burning my stomach and only ended up in hospital really unwell with ulcerated stomach.
Clint: Well let our audience make their own interpretation about the marketing vs the practice use of that one. Now, in this time when you were having the alternating knee swelling, and progression to the wrists, and you were seeing physiotherapists, and probably looking at some other alternative therapies. Surely you must have thought this seems auto immune related and it just seems like a long time.
Carolyn: Yeah. Also I am a nurse by trade so I have seen people with rheumatoid arthritis. But when you don’t have the rheumatoid factor your doesn’t fit the standard picture like you could each time it could slip and pointed to something that happened that I thought hurt that knee. But you know where it got to the foot, as I actually you know this is just (inaudible). I don’t randomly twist that knee because both my knees each time I had MRI and there was damage cartilage but not knowing it was because of the arthritis and the inflammation you know. I saw orthopedic surgeons, I saw 2 of them (inaudible) your knees very swollen, (inaudible) surgery fix it but no one at any point recognized it as psoriatic arthritis. It was the family like chrons, I didn’t have chrons it didn’t have it don’t have a lot of the other things that doctors probably commonly linked to autoimmune arthritis.
Clint: Right. Okay well you got there in the end, and you saw a rheumatologist, and they gave you the diagnosis. Talk us through then, now. I also, want to just to clarify how long ago that was. You gave us a piece of the puzzle.
Carolyn: 11 years now.
Clint: 11 years right.
Carolyn: I was 30 years old and 41 now, so that’s 11 years since I first had symptoms it took 6 years to be diagnosed and then I’ve been through lots of medications.
Clint: Talk us through that. Talk us through your experience with the meds, I’m very interested to hear.
Carolyn: Okay so I started off on sulfasalazine, which worked. It was nearly two years and I said look, we need to be sure you don’t have something called reactive arthritis which can sometimes go away like it happens after an illness or we need to be sure you need these medications because they have strong side effects. So I was having all my blood tests continuously to check my liver and what not. Yeah so when I reduced it stopped working, and it took 2 1/2 years to get anything to work after that. So from the sulfasalazine I just went from swollen joint, pain, to fatigue, take 2 1/2 years and that was where I had Prednisone, I had Leflunomide which made my hair fall out massive pimples. (inaudible)
Clint: Oh hang on it’s either Plaquenil or, yeah I know I shouldn’t be adlibbing those commercial names but yeah while you know while you talk I’ll confirm.
Carolyn: I think it’s arava, I think I did see it on the (inaudible). Prednisone, I had prepared but that doesn’t work for my arthritis for some reason, I can take that much it doesn’t change the joints. Even steroid Injection joints I’ve had lots of those as well. And I took Methotrexate which I only had for a few weeks, it made me just so sick I just vomited and vomited despite the folic.
Clint: Wow. Yeah.
Carolyn: And so once I had to go through the process of going through all those medications even though they didn’t work I did take a certain period of time or you know until I could founded with the Enbrel which I started must be nearly 2 years now.
Wow. Okay. Yeah. And we just dropped out for a moment there so I just want to back up and just to confirm first of all that yes the Leflunomide is Arava, and that you said that in the New Zealand Medical system because it’s similar to the Australian medical system. That it’s a government sort of driven, That the government don’t want to just frivolously pay for these extraordinarily expensive biologic drugs and so you have to qualify to get them covered by the government by failing other treatments first correct?
Carolyn: Yeah. That’s exactly right. For a certain period, I had to take Prednisone for three months even though it didn’t help my joints. Maybe put on weight like I had no stomach. It was all along yeah just Prednisone doesn’t work for me I already knew that I had to do this three-month period. And also because my CRP elevates, but it doesn’t elevate hugely like some people do like for me 30 is high and so I would be above a certain CRP for a certain (inaudible).
Clint: That’s crazy because everyone’s different. It’s not like.
Carolyn: I just feel like I’m dying, my fatigue is huge, my whole body is inflamed, I can’t eat. You know when it’s that time and I’m really unwell even though someone else might not be.
Clint: Wow. So you almost have to sort of manipulate the system by allowing your body to deteriorate poorly for the days prior to the blood tests, so that when you get the blood test you then qualify by the system to get the markers in your blood to get on the drug.
Carolyn: Yeah I guess, because my CRP wasn’t at the right levels I ended up just having to go through all the medications and see how my body regular stay worked which they didn’t work until I (inaudible) Enbrel.
Clint: Okay. Well it’s quite fascinating, and similar to here as I said similar to the Australian system whilst there are so many benefits to the government health system. There are obviously some challenges associated with it as well like we’ve just been discussing. Whereas say in the United States, you get on your very extraordinarily expensive health care program for example for our family of five in Florida, if we go through Florida Blue which is the standard health care provider. After all the others shut down because it wasn’t profitable enough to their competitors are close because it wasn’t profitable enough to serve the public, who are like we’re self-employed. We’re looking at between $1600 and $1800 per month. Okay. That’s for a family of five which is just absolutely blows my mind coming from Australia where, yes we’ve got these little hoops we have to jump through for the government to say okay I’ll fund your $50000 drug a year. But you know now and one of the and I’m getting off on a tangent, but you know you talk health care and it just fires off all of these emotions in me. Because they have this non-preexisting condition rule, so that they assume that if you’re joining you’re a worst case scenario. My family and all of us have got this disaster that’s going to be presenting the moment we sign up so they’ve covered themselves for that by charging extraordinary amounts for self-employed. Anyway look there’s more to it than that but that’s just our unique circumstance with that. So back on track with your story, you’ve hit the enbrel. Tell us about your experience with Enbrel.
Carolyn: Enbrel has had the least side effects that I know of, like physically I haven’t noticed side effects like I did on all the other ones. With the sulfasalazine I had so bad I’ll come out from work and go to bed. Now I didn’t realize until I stopped it. That it was a side effect It makes sense I don’t get them anymore. So the Enbrel probably about a year of it was really good, and in each year kind of went up for some reason I went is when I’m my worst (inaudible). And so, I was having little niggles and then when I found your program I’m trying to remember how long it was. That’s when I was having like nearly 2 months my knee was just swelling up and up down slightly it wasn’t working like it did and I was thinking Ah. I have to get in touch with my rheumatologist like literally I took photos of my knee, I was about email, I have a really awesome rheumatologist. And say look this isn’t what am I going to do? Because I know she’s told me in the past it’s kind of one more option after this which is an IV version which I’d rather not go near you know. Yeah so that’s when I found your program, and started then you know literally within 2 days I had an extreme change, no swelling was in day 2.
Clint: Wow. Okay fantastic. So just for us to set the picture correctly and accurately you’d been on Enbrel for a long period of time multiple years.
Carolyn: I’m trying to remember it. I think it would be 2 years since I started it.
Clint: Okay. And this is really valuable for people who are considering a biologic drug. You said that you got the least amount of side effects from Enbrel but your symptoms started to almost break through the drug after a period.
Carolyn: Probably after about a year on it not quite they started. They were definitely not as extreme but enough that I was limping, my muscles were going out of my thigh because my knee was getting too swollen. So, yeah each week I’d get to the point where I know, I kind of felt like it was wearing off you know. But then I found your program it was like it just takes one whole month and I was like I really need to, this is not okay.
Clint: Okay, just whilst we’re on the educational path for biologic drugs, you were taking the injection weekly correct?
Clint: And might still be we’ll hear about that in a second. And what were you finding like a lot of my clients who were work with that by the time day 6 comes around you kind of really wanna do the injection because you already feel like the weekly injection is starting to wane. So you go through this almost like a wave thing where, was that your experience also?
Carolyn: Yup, absolutely.
Clint: Okay great. Thank you. Because we never really on other episodes, I’ve never really gone into that level of detail with these injectables. Okay fabulous. And but what you’re finding is that then it was not really having that effect, those waves of relief were not there, your symptoms were returning. And so the drug that had provided you with almost like the way the doctors describe these biologic drugs as they’re like this incredible solution for this disease. But what I see and the feedback that I get, is that these biologic drugs just like the rest of them. Offer a period of time where we get great relief if we’re lucky. But then like all of them, there’s a time limit before when they actually provide pain relief, and when it actually starts to wane.
Carolyn: Yeah. I never thought of that for other people but it’s differently been my experience with all of them and once something doesn’t work like an nonsteroidal work the first time neither work since. You know sulfasalazine, as soon as it stops working, it doesn’t work again. So I was kind of afraid it would be the word that oh no my Enbrel stopping working what’s next, what are my options.
Clint: A make a comment around the sulfasalazine not working and then finding it hard to get on another drug, I see this all the time too. This is why when someone is on a pharmaceutical treatment plan that is working, I don’t want them to touch it at all. It it’s like a delicate stack of Lego, you don’t go near it because it’s so easy to knock that arrangement over and have consequences that take months, years to rectify just like your Sulfasalazine experience. And so you know someone for example might be on methotrexate and Plaquenil, Let’s just hypothetically put those two together. And then what can happen is that liver enzymes go up on the methotrexate, and so then the rheumatologist will instantly take them off the methotrexate because liver enzymes elevated can be dangerous. So liver toxicity come immediately off the methotrexate. Then they’re just on the plaquenil and then symptoms start to return slowly after a few months whilst they watch the liver enzymes drop back down. And then reinstating the methotrexate again might not have the same level of effect as if it had just been run continually. So what was the solution? Well there are ways with folic acid, to add folic acid before and after bridge the methotrexate to try and reduce the liver toxicity which is what my doctor did and thankfully was able to bring my liver enzymes down by doing that. You have to do what the doctor says which is obviously, protect from the impact of this scenario. Now in doing so we’ve disrupted the delicate legō balance and it just becomes very difficult thereafter to try and re-establish that balance. And so, once we’re in a good position, and if we’re on drugs that don’t hurt the gut, we wanna be so so careful with reducing and tapering our medications just taking one brick at a time off that Lego stack so we don’t knock it over because it’s also delicate. So I just wanted add that little story metaphor or whatever, and then we can now proceed to talk about post PP after you began the program. You’ve had great experience in the first couple of days. Talk us through the whole process here.
Carolyn: And the 1st 2 days, I absolutely hated because I hate celery and so drinking celery and cucumber was so painful. One day I knocked my glass over and I didn’t think it was a bad thing. I really did struggle but anyway so by this night on the 2nd day literally that leg that knee that had been swollen for how long the swelling was gone. It’s amazing Just in 2 days. Yesterday I hate Buckwheat and Quinoa for about 12 days, I didn’t love it either, but I stuck with it. I made everyone who came here to try it, so they could enjoy my aim or something.
Clint: Yeah share the misery.
Carolyn: Yeah I certainly did and so from there I just started eating, and along the way I found a few things that okay for them but just my body and not okay with Potatoes and tomatoes as much as I’d love to eat them. I can guarantee I’ll just get ache in my joint, it doesn’t swell but there’s a definite ache that turns up. I can easily and happily eat how I’m eating now 165 days and it just become my way of eating. And everyone around me that works with, knows me now is me just become used to what I’m doing and see. Probably because they see much healthier and better I’m feeling.
Clint: Yeah that’s awesome. So how far through the reintroduction process have you been able to get?
Carolyn: I’ve pretty much everything on your list that you have printed except for those I can’t eat. I don’t go near (inaudible) so I haven’t tried any of the (inaudible). In my previous trials of trying to get rid of this or helped myself I’ve had to abstain like 6 months eating totally raw, I spent six months doing autoimmune paleo diet, I spent thousands on everything natural potion, lotion some thing under the sun none of which actually helped like this as.
Clint: Yes that was also my experience as well. I had sufficient pain relief from raw vegan, to justify me being on it for eight months. But the weight loss associated with that was so extreme that my self-confidence became very very a problem and lost a lot of muscle mass which took a long time to put back on. And whilst most people who are approaching this program from a Western diet will also lose weight on this, because it’s less calorie dense. That does stabilize and also there’s no issue with muscle development protein intake and so forth.
Carolyn: Yeah that’s how I felt, and just probably not enough carbs. I find if have some rice or something, I just feel really even all the time not I’m not like high energy low energy I’m just I’m me all the time. Not like when you eat like standard American diet you seem to go flare after you eat things or even when I was raw it was just, was difficult to sustain my energy. And same with the autoimmune paleo, it was offered me quite flat on that.
Clint: Yes well if you’re eating a lot of fat on that just any animal product is inherently high in fat.
Carolyn: I also struggled because I’ve been vegetarian for years so I really (inaudible)
Clint: Yes, it is a struggle. This is obviously sensational. So how you mentioned a number 100 something days how many months are we talking? Are we talk about 5 months or something since you started?
Carolyn: Just over I think.
Clint: Okay. Physically how do you appear? You’ve sent through some pictures, I hope you’ll allow me to share those on our transcription page. I mean you looked like you’re an athlete now.
Carolyn: (inaudible) I feel like one, and I work out with a lady over here in New Zealand who does an online thing called (inaudible). So I follow her and it’s all to do with physical body movement you know like using her own body. And so to get sweat everyday type stuff. It’s what I use because I can’t get to bikram yoga, my knees are so hurt that I can’t run or anything like that because there still damaged the years of inflammation. So yeah and I’ve been able to do it in the past because I had tried price starting your program I had to message lady (inaudible) say look I can’t do this money is so swollen. And so it’s been so called about exercising, keep doing it. Basically I just feel so much better it’s unbelievable.
Clint: Where have you developed most of your strength in working with her?
Carolyn: My thighs especially, you know I couldn’t do squats or anything like that in the beginning because my muscles over the years so many times have been you know gone away, because my knee swell literally your muscles just disappeared they’re Just floppy thing. So being able to do her exercises, and support my knees, so my knee pains usually reduced.
Clint: I’m fascinated by this because I would say one in three people watching this probably got knee pain and find it hard to exercise. If we could just explore this a bit further I might want to recommend her to everybody. And so the exercises that she recommends enable you to build your quads and your glute muscles without loading the knee.
Carolyn: Yeah you can, I mean she has low impact type stuff which I started with, and now I do (inaudible) which is just what everyone does. And that all, like you follow her on line but it’s all targeted at your level at your know it’s. Yeah it’s really good. I really find, I found it excellent.
Clint: Yeah okay great. Could you just repeat back her name again?
Carolyn: Kate Ivy.
Clint: Kate Ivy, New Zealand based?
Carolyn: Kate Ivy Health and Fitness I think. She is on New Zealand. She’s got a degree in what she does but she works from home. Now she has children and yeah really.
Clint: What a great contribution to the world. There we go. She’s had children she’s found it hard to professionally balance that but thought look I’m at home. I’m going to be able to provide a service for people. Okay that sounds great. I’m gonna look around.
Carolyn: Some you do online, some you can have a personal one on one contact with her which is really motivating and I find her really excellent.
Clint: Okay. Oh great tip, because strength is just so important. You know if we think about rheumatoid, prosriatic, if we think about these conditions, and we put ourselves in the mindset of having them and experiencing that. The word that frequently is not present is strength. But if we have enhanced strength it seems to displace all the other stuff that we have in our minds when we think of those conditions, because they almost can’t exist at the same time. You can’t be really strong, and have inflammatory arthritis, they almost don’t exist. And so by building strength we drive out the pain and inflammation, because strong connective tissue to the joints, strong muscles that support either side of the joints, just make the joints work better. Work in a natural way, and provide this self-confidence, and provide an ability to do more exercise which is then creates a positive snowball effect of health. So I love this word strength, and I think that it needs to be a word that we use often and we say I’m getting stronger, I feel strong. And these sort of this word usage is powerful so, well done. You look strong in the picture.
Carolyn: With Kate you can set goals and bits and pieces and so, It was what I always want was strength. People want to lose weight and look amazing, I just want to be strong. I ride horses competitively which many of time I’ve not been able to because of my arthritis, and now I just want to look strong and ride well. And that’s what I can do because I’m stronger.
Clint: Yeah, okay fantastic. So what about, have you got some a couple of tips or learning experiences that you’d like to share for other people who are doing the programme.
Carolyn: I would say, what are some things I think of, always have something prepared because quite often I would be hungry and I just couldn’t be bothered so I would just like not making anything but then you would lose the energy. Preparing even if it’s your Buckwheat you don’t like, just have it ready. You’ll learn to like it.
Clint: Something I was about to ask you. Do you find it better when you eat frequently small amounts or do you find that eating only when you’re hungry and eating a lot works better?
Carolyn: Yeah I only eat when I’m hungry, and sometimes it’s a lot and sometimes it’s not much. For me, I don’t get up and have breakfast as you should have breakfast. Some days I get up and I’m hungry, some days I find I’m not hungry at lunch time (inaudible). Yeah, so I find that and I do a lot when I’m hungry and when I’m not I just eat yeah.
Clint: Okay so you’re totally guided by your hunger. If you’re hungry you think look my digestive system is ready to crush whatever I put in it. And then I eat, and it works well. I must say my experience over the years has been very similar, and only during times when I’m wanting to actively try and gain weight and putting food into me more than what I really feel the need for. Which by the way is really common for people, they often think look I’m full but if I eat a different flavor like a dessert or some other chocolate or something. My taste buds will totally shift and it’ll be like a shock and it’ll be easy to eat something else. But I mean when you’re eating sort of a consistent meal and you get to a point where you feel full, it’s kind of natural you know. Anyway, so I always found that eating when hungry provided almost no consequences even if the foods were a little bit more challenging than what I felt that I maybe should be eating. It was kind of, if I’m hungry the fires burning and will burn whatever I throw at it. But if I’m not hungry I got to be careful what I eat because the digestion at that point is a bit weak.
Carolyn: Yeah interestingly I weighed myself every day, I think I said that in the book I just wrote down every day which didn’t make the numbers. But sometimes I could eat like a horse for two days because I just was really hungry my weight would go down. Other days I hardly much for a couple days and it would go up so it’s just, I know for some reason that tell your body sometimes it needs fuel and sometimes it doesn’t.
Clint: Yeah okay I think that’s great. I think we’ve got the main bulk of what we wanted to cover already done. Now you’re still got your Enbrel dose at play. You and I have chatted you’re going to be part of Paddison Program Support from this point onwards, and I’m going to be able to work with you over the next year. And I can assist you with the process of ever so delicately addressing the medication dosages with your rheumatologist who you’ve said is fantastic. And obviously everything will be run past her and with her and so forth. It’s an interesting one coming off biologic drugs, honestly the way it happens mostly as rheumatologist having to take you off from side effects. That’s the number one far and away most frequent way that I see people coming off biologic drugs, it’s because doctor has to take you off because you’ve got pneumonia, or you’ve got tuberculosis or some I mean stuff happens right. And so the way off it naturally is actually so uncommon because rheumatologists have never seen it, they don’t ever see or feel comfortable with people trying to come off these biologic drugs. Because they honestly don’t know the connection between what causes this disease, and what causes the symptoms. And so, if they don’t understand how to address the cause then they think the cause can never be fixed. They also feel that the disease is impossible to treat without medications, and they have a love affair for biologic drugs and so why with all of that mixture of things, why would you even touch something that’s working for you.
Clint: Having said all that, there’s sort of two lines of approach here coming off these biologic drugs. One is to reduce dosage which isn’t so common because normally there’s a fixed dose, and the other is to address the intervals between the injections which is the way that many of my clients are addressing this. Which is instead of it being every seven days, they stretch it to eight days for a couple of weeks, and then to nine days and so on. So you and I can have these kind of discussions, and you can discuss them with a rheumatologist and see what the rheumatologist feels comfortable with. But if there’s one thing that’s for sure, there’s no rush. We talked about this stack of Lego and how it’s so delicate, we don’t want to make a sulfasalazine mistake here again that’s the last thing we want. So what we want to achieve is a very very cautious, and controlled, and calculated, systematic slow approach here. That could take a couple of years, could take a year or two right where you’re constantly watching how your body responds to these slightly extended distances between injections as well as your expansion of your foods. Your attention to exercise and making sure that’s maintained. And as you mention the weather you know we don’t want to feel great in summer on a lowered like injections further apart, and then realize oh no winter’s come and now the injections apart aren’t really holding this the way that we want. So you can see how this is all a very very long term thing. And what we ought to feel very good about is that you’re on one medication of which has no direct negative impact on your gut, and you’re doing what I consider to be the ultimate approach to healing your gut and establishing a great gut health at the same time. And your exercise is fantastic and you’re optimistic and positive and now you’re about to have the right support around you. So you’re in great shape right. So it’s exciting.
Carolyn: Certainly is. It gives you hope anyway because sometimes you don’t have much hope and you have this thing.
Clint: Oh most definitely. Everyone who has this condition at times has had terrible hope outlook and just thinks this is it even worth it you know everyone I am sure. Miserable right let’s face it, it’s so miserable. But we can do or we can use that frustration and anger and misery which are strong emotions and contain all the energy around them. Into positive action and just say okay this sucks or what am I going to do about it because better to take action than to sort of than to let it affect you. Yeah.
Carolyn: That’s what’s made doing this for me easy like eating like this has not been an issue because of all those years. And just like the biggest thing for me as well as pain is fatigue, like I could just come home from work and just go to bed. And to have energy, that is the biggest thing I’ve loved about my life to just do a day and come home and do a whole another day and not exhausted is amazing.
Clint: Yeah that’s fantastic. Yeah great. All right well thank you so much for sharing your story with us today, and we look forward to maybe hearing from you again in another year or two and updating us again. But you know congratulations you’ve achieved a tremendous amount by putting in a tremendous amount of effort. You’ve done a lot of work to get here where you are in the last five months. So well done.
Carolyn: Thank you.
Clint: All right. Bye for now.