We discuss how:
– Frank had lots of pain – back, knees, shoulder and so on – to the point that it took him 20 minutes to get out of bed
– He went to the hospital and had a very high level of inflammation
– After his rheumatologist told him there was nothing to do, he started searching the internet and found the Paddison Program
– He started the Program 5 months ago and results came in very fast
– He was on diclofenac and prednisone (and later sulfasalazine), which made analyzing the results very difficult, so he began taking less drugs
– Then his rheumatologist told him to stop drugs completely because they were damaging red and white blood cells
– After 3 weeks he went back to the rheumatologist, and she told him the RA diagnosis must be wrong!
– She couldn’t believe the change in diet and lifestyle could have such a tremendous impact on RA
– Now Frank is drug free and feeling great again
Clint: Today I’ve got a guest from the Netherlands a beautiful country that I’ve been to a couple of times, I really enjoyed exploring that lovely place many years ago. Looking forward to getting back there again one day and doing some talks, we’ve got lots of fabulous success stories coming out of the Netherlands and we’re about to hear from another today.
Clint: His name is Frank, and we connected over email after he emailed me, after doing the program for five months. And I actually want to read out his email before we hear from Frank because it was really fun one to read he wrote, “Your program is TOO GOOD!!!. In June I was diagnosed with rheumatoid, I bought it program and did everything I could to fight my rheumatoid arthritis, exercise, Bikram Yoga, massage painful fingers, took all the food to the extreme etc. The results from my blood tests became excellent. This week I met my new rheumatologist, and she said my former rheumatologist who I’ve only seen twice must have made a mistake and I do not have rheumatoid arthritis. When I said it was because of my diet she said that diet has no effect on rheumatoid arthritis. I am convinced my pain and problems will come back if I became the old Frank again where I used eat lots of meat, and drink lots of coffee, drink a lot of beer, eat a lot of fat instead of salads and fruits and so forth. I think she’s never seen something like this before, and of course she can’t believe it”.
Clint: Well Frank what an e-mail to write thank you very much for sending me that.
Frank: Yes you’re welcome.
Clint: How does it feel to be able to have that kind of outcome after doing all of those, as you put it, extreme things for the last 5 months?
Frank: Now I feel normal again. When I was diagnosed then, I didn’t feel very well and now I feel normal again.
Clint: It’s quite incredible isn’t it?
Frank: It was good. It’s incredible, when you (inaudible). It’s incredible that you can heal again even if the doctors say it’s impossible. It’s great.
Clint: Yes, It is, it is. Now tell us how bad were you when you first were diagnosed? Give us an idea of what kind of symptoms you had.
Frank: I’ll tell my story because in the first time I didn’t expect to have something like that. I was having troubles with my back pain, in lower back, and also pain in my knee, and also pain in my arm. But 4 weeks ago I had an operation on my shoulder, so that’s normal that pain in my shoulder. It was normal, there’s a pain in my lower back. Because I am working heavy work so it was possible because of that, from the work. And I was also having pain on my knees, in one knee in my right knee. And it was all a couple days in the morning when I wake, it took me about 20 minutes to get out of my bed or to put out your alarm. And I was in a lot of pain in my shoulder, my knee, and my back. And couple of days and it was too much so I went to the doctor, and he said what do you ask and I said to my shoulder, my back, and my knee. He said let me look at your knee, and in 2 minutes he said yes with miniskirts abrasion several years ago and because that is more than 10 years ago. So yeah come back in for another guy (inaudible). I went home and I thought to myself this incredible take me more than 20 minutes to get out of my bed. And then a lot of pain but at the end of the day I was normal again because the whole day at work. In the beginning was very tough to working but I was moving the whole day and at the end of the day I was normal. And I went to bed and I wake up in the was stiff and a lot of pain. So I thought I can’t go on like this because I have my own job, and I have to work. So I called someone else to look at my knee and I went to a couple of times and he said to me I can’t help it because it’s not normal. And then there was 1 day my left arm was (inaudible) fixed, I couldn’t move it the whole night.
Frank: Then I went to the doctor again. And he said Oh you have to go straight to the hospital, and I go to medicines probably for the inflammations, I guess. I went to the hospital, and they took my blood, I went home and the day after that I was called again and they said you have to come again to the hospital because you have a lot of inflammation in my body. It was really high, it was immense high, it’s (inaudible). So you have to come again and we can take some blood and we (inaudible) we can investigate the blood. And then I heard there was something not normal in my body, and a couple of years later (inaudible). And that’s when I asked my doctor, my rheumatologist, how come did I get it? And my rheumatologist said there is no reason, and I said what can I do to heal it? You can’t heal it, you’ll have it your whole life. And sometimes you feel more than less and more than less. It’s not curable. I said, I don’t accept this. And that’s when I started to search the internet to look what I could do about it. I found a couple of things, and also your program. So that’s a little bit of my story.
Clint: Do you remember how high?
Frank: My inflammation was, I have also standing here and it was little (inaudible). The (inaudible) was 36.
Clint: The CRP or the ESR?
Frank: I think it’s, I don’t know (inaudible) information. Normally it can be between 0 and 15, and for me it was 36.
Clint: Okay. Have you had it measured recently?
Frank: Yes the last months it’s 2, Only 2.
Clint: Awesome! Okay fantastic.
Frank: Yes the first time it was 36, and then I started to change my diet. And then it became 28. And then it became 2, and I’m still only at 2.
Clint: That’s fantastic. I’ll love it 2,2,2,2, what you want to hear isn’t it?
Clint: Can you tell me when you got our program, and you looked at it, and saw what was recommended. What were your first initial thoughts?
Frank: When I got your program first I started reading, and what was so important for me was, (inaudible) I could reach what it was. What went on in your body, and I could leave it, I think Jesus Christ someone who is explaining it. And I could believe it’s what you said because I know food is very good for your body, and food can use yourself I’ve read books about it in the past. So it was very trustworthy for me, and that’s why I thought it might help. And I was convinced it could help me.
Clint: How quickly did you see results once you began?
Frank: Yeah it’s very hard to see results because I had a lot of pain before I went to the hospital and offered it. I also got medicines, I got diclofenac, and also I got another one, and then I got sulfasazine. So it’s very difficult to say because of the food or because of the medicines I got.
Frank: I got prednisone, it was the other one.
Frank: (inaudible), and your food, and your medicines, you don’t know what’s working.
Frank: (inaudible) it’s difficult to explain.
Clint: Yes absolutely.
Frank: And that was also the reason I where I hate medicines. And I also read in your program that medicines are not very good for your body. And my goal was to get off the medicines as soon as possible, that was my main goal. And I had to take medicines from the rheumatologist. And when I (inaudible) myself and I want to take left medicine but she said no which not possible, and I spoke to another doctor and I said can I heal with food and he also said no that’s not possible. Jesus Christ, I’m convinced it is possible. So I did everything I to take these medicines but I also wanted to discuss everything with my doctor. But after a couple of months my inflammation was I think it was only about 2, and I said to them I wanted to take less medicines. And my (inaudible) said no it’s not possible, I said how long do I have to take medicines? And he said, We are yet to go on but I said how long? if I my blood is Okay so how long do I have to take it? how long does my (inaudible) have to be okay? And then she said, at least you have to take it one year. I said no, I can I can live with it. I said I take less medicines, I take my blood, I take all the measures, I check it out, and I will take less medicines if possible but I do myself. And 2 weeks later she called me and then she said you’re still on the medicines or did you quit with the medicines? And then I said to her I want to try things out so I took less medicine but not quit at all. And then she said to me now we have to (inaudible) with all the medicines. Because my blood cells were damaged by the by the (inaudible) by the medicines.
Clint: Okay so let me just, I’ve got this note from you here in one of your e-mails say you said that the rheumatologist called, and said get off the medicines completely because the red and white blood cells were too low in your blood tests and that that was caused by the sulfasalazine. Is that correct?
Frank: Probably she said, yes that’s true. But I know this because now it’s okay, everything is okay now.
Clint: How long ago was that?
Frank: I think it’s about, I had to quit with the medicines 30th October. Then I quit medicines, and 1 week after that I looked at blood and still the measures were still too low. And then I think 2 or 3 weeks later it was okay.
Clint: Were you still on the nonsteroidal anti-inflammatory drug as well as the prednisone at that time?
Frank: No I started with diclofenac then prednisone, and I had to quit prednisone and then I started to start with sulfasalazine. And the 30th of October I had to quit with the medicines because of my blood cells. And the 20th November I had to see my rheumatologist again, and then she said to me I think we have the wrong diagnosis.
Clint: That’s fantastic. But really those timings are pretty amazing. So that sulfasalazine now is cleared from your system and if you’re feeling great, waking up every morning, and not taking 20 minutes to be able to turn off your alarm. I mean that’s a tremendous, tremendous outcome.
Frank: Yes it’s amazing, I guess. The doctors can’t believe it.
Clint: No. Absolutely. They don’t see this kind of stuff all the time, that’s for sure. Although there is in the Netherlands. There is a fabulous rheumatologist that is often discussed inside our Paddison Program support by our other friends from the Netherlands.
Frank: What’s his name?
Clint: I couldn’t recall it off the top my head, but I can post his name I think that’s appropriate on to our transcription of this recording which will be on www.paddisonprogram.com. If we search for the name Frank in the search bar on the website, then this podcast will come up even if you’re listening to it sometime in the future. So I will post his name up there in case other people are looking to change their rheumatologist, and work with someone who is well aware of our program. Certainly, people are very very happy with him inside our support group. Now in terms of you embraced all aspects of our program, you took a took on board the exercise, you took on board that diet, you took on board things the way that I recommend right? How much do you think that the bikram yoga played a role for you?
Frank: I don’t know because for me it was not as great as for you because at that time I had less pain when I started bikram yoga.
Frank: Most of the pain I had before I took medicines, and before I started the program. And the bikram yoga guy I took the lessons but I already had less pain than in the beginning.
Clint: If there’s anyone.
Frank: But it’s a great way to experience because you feel that it’s very good for your body.
Clint: Yeah no doubt. Well if we look at the timeline, and if there’s anyone who’s got this kind of little bit of skepticism in their mind that maybe the drugs played a big role here and certainly they were present. But the ones that you took in order were the diclofenac or nonsteroidal an inflammatory drug. I have never taken that one and then moved on to the prednisone, both of those 2 drugs actually cause more leaky gut, they caused more problems with the digestive system. So if the drugs were doing all the hard work then that would have made coming off them even more catastrophic or more problematic. Because they would have done more harm to your gut whilst you’re on it, that would have presented itself after coming off it. So obviously there were more factors at play than just pain suppression here. The sulfasalazine looks like it has played a role in parallel as well but now that you’re off that drug, and cleared of its period of lag then you actually are now in a situation where you have kind of no meds. Exactly in terms of the way you were in terms of no meds before you undertook all of these procedures. And here you are a completely different man to what you were before. So. It really is a transformation of massive proportions that has been underpinned by natural interventions which have been very powerful. So you’re a great case study Frank.
Clint: Now what I’m worried about from your earlier email is your thoughts about going back on to other foods and stuff. Are you really sort of eager to go and eat things that aren’t going to support you in terms of your health?
Frank: No but, what you could read is I like beer and spending time with my friends drinking beer, and I know my diet will always be different then before I got this. But I think I want to try beer again and then look at the results to body. I like meat very much I took lot of meat, took a lot fish, a lot of (inaudible) also a lot of food and vegetables but it was cooked (inaudible). But I know I will change my diet, I know in the future I’ll always take a lot of vegetables and fruit because I know that’s very good for my body. But I guess until now my diet is totally different than seven months ago. I lost 12. Kilograms of my body I wasn’t fit it all but now I was 80 kilos and now I am 70 kilos or something like that. I’m a little bit skinny now. I think I will drink a couple of beers with my buddies only not as much as what I used to drink. Much my just my diet will never be the same as 7 months ago.
Clint: I think once we see the power of the intervention, then it’s almost like when you see something that you can never unseen something right? You can never unexperienced what it’s like to get pain relief these methods. And therefore you just can’t ignore the possibilities of sticking with this in the future if pain comes back, because the pain can come back and that’s the problem. So whilst a beer or two you might be fine. You know I think that what I’m reassured about is that you’re not about to go and start having not just the beers but the pub food, and the lifestyle of sitting around then and not doing a whole bunch and maybe getting symptoms back because we certainly don’t want that.
Frank: No of course not.
What parts of the program did you find that were most beneficial if you’re able to pinpoint 1 or 2 things, and maybe help other people to focus on those areas. To give you some ideas in the past, people have mentioned things like the green drinks or they’ve mentioned the most important thing was when they started to get inflammation to go back to the baseline foods for a few days, and then get back to where they were up to. Other people have said, it’s about stopping food by 7 o’clock at night so that you’re not having to digest food late at night when you have a weak digestive system. Were there things, were there some specifics that you felt were most beneficial for you?
Frank: (inaudible) I said a couple of minutes ago. For me it was very important to read a background. The information you gave with the leaky gut and all that kind of stuff. Because when I went to the hospital, they said you have it and you have whole of your life. And I thought it can be possible this and with program the first thing when I read it, I had hope that there was something to do about it. And I think that that’s very important. If you believe in something is good then you know you want to try it and you do your best you do it most. And I think a lot of people don’t believe it because they go to the rheumatologist and he or she says, there is nothing you can do about it and they accept it. And I know there are some other people in my neighborhood and they know I’ve also Roma. And they are following me, they are asking questions what do you do. And sometimes they say oh it’s not good for you because they see that your body changes, and a lot thinner, I have a lot of more muscle than I have now. I’m thinner and they say it’s not good for you. I said I feel terrific, I have no pain, I have no medicines but people don’t believe it and they want to see it with me and then they start believing it. And now they ask me what do you do? And what did you do? And I can give them information. So I think it’s very important for people to have faith that it’s possible to cure yourself with of food. And I took to the extreme because I took a lot of food, I eat a whole day green food specially spinach because I so on the list it’s very good for you so I take a lot of spinach. And it’s now part of my life.
Clint: Did you do the spinach a lot in green smoothies or did you just eat them?
Frank: Yes, both. Both because I knew it’s very good. And in every morning I take a shake with fruit and vegetables and a lot of spinach and also I bake. In the afternoon I take a salad, and there’s also spinach in it. And in the night I take lots a day raw food but also a little, a little bit cooked. And so much I can eat the whole day but my body can have it because I’m losing weight.
Clint: So, what I say to that is it’s easier to put weight back on than what it is to get rid of inflammation. So getting rid of inflammation, if we quote the doctor is impossible to be done with foods, exercise naturally right? And yet you’ve just done what they consider is impossible. But if you ask a lot of people including doctors, can you put on weight. Everyone looks at you, like what kind of stupid question is that? Of course he can put on weight. The question becomes a challenge when it is, can you reduce inflammation at the same time as gaining weight? And that is a very very hard thing to do. I believe that we can maintain our weight whilst lowering inflammation. It’s tricky and it’s slow because we’re always making mistake one way or the other. We’re always getting more inflammation reduction but we’re losing a bit of weight. Or we’re retching might be gaining a little bit of weight but with that comes an increase or a bump in pain.
Clint: So you know normally if people are accelerating their inflammation reduction, there’s going to be some weight loss with that. Because the foods that are so anti-inflammatory by nature don’t have as much calorie density as the ones that we’re used eating. And like you say eating a lot of food all the time just to keep your energy intake up, but at the same time you’re also with each bite of spinach you’re also causing inflammation reduction. So yeah, so there’s a time and a place for putting the weight back on. I was like yourself, I went through a big weight loss period and then it stabilized and plateaued. It doesn’t go down forever, it gets to a point where it matches your calorie intake, the amount of leafy greens that you eat, and the amount of exercise to a lesser extent. Because exercise actually doesn’t burn as much calories as what most people think. You’ll observe that if you watch people on the treadmill at the gym. They’re all trying to lose weight by working out at the gym and then all they need to do is just shift to a low-fat plant based diet. I mean it’s trivial to lose weight when you actually do the correct things.
Clint: And so where I’m leading with this long kind of long piece of chat, is when you start eating foods that are more dense in calories and when you start doing some exercises for your lower legs likes some lunges or some deadlifts or some squats now that your knees feeling better and you do them in a nice controlled manner. And if you’re not sure about how to do that then reach out to Carl reader who was on a previous podcast, he’s our recommended exercise physiologist for the program now he’s helping a lot of people inside Paddison Program Support. Very affordable. very accessible great guy works with all sorts of physical limitations to build muscle and strength. And so, with some lower leg exercises where most of our muscle mass is, we can gain some improved muscle mass. Just at home on the floor or in the bedroom. And when we add some more calorie dense foods not even extreme calorie dense foods like nuts, and so on. But just mid range things, Maybe even some chickpeas or something like that some lentils, beans. Then we’re able to see the weight stop falling quickly. And normally most people can slowly add some weight back on whilst holding their inflammation low. So that’s the next step for you Frank is, putting a bit of weight back on. If you’re 80 before 70 now with the right strategy you’ll find that nice balance between keeping inflammation where it’s at. And adding a few more foods, and doing some exercises, and getting it probably back up into like 72’s and t73’s in a month or 2? And then you sort of don’t sort of obsess about it so much once it’s not quite as at the bottom.
Frank: No, I’m not obsessed about it at all. I’m not obsessed about it but it changes from your body, and for me, I want to gain weight again and I know it’s is possible. But I also have an operation on my shoulder so I can’t exercise now, but if I’m gonna exercise, you’re gonna eat more, and it takes more than a notch, and then it is not a problem.
Clint: Yeah, and work on the lower body muscles first as I mentioned, because you can often put on some weight there more quickly than what you can on the upper body especially since you’ve got that shoulder rehabilitation at the moment.
Frank: (inaudible) biking.
Clint: Okay. Excellent. Yeah, you can increase the resistance on the bike so that you spend a little bit less time on the bike and make it more challenging and the body will need to grow muscle to accommodate for the more resistance. So. Yeah, that’s another good option. Now you had a couple of questions for me on email, and I thought we might address those before we wrap up. Now your questions that you wrote were, why do rheumatologist deny that food can heal you? And then you also had another one. Do you think that there’s some kind of relationship between the sort of way that they are paid, and the medicines that they provide? So would you like me to go ahead and offer my thoughts on those two questions?
Frank: Yes but because I think they were earning money because they are so easy to give you medicines, and they don’t wanna listen to things that they’re not allowed to make money. So, I like your opinion about it.
Clint: Yeah. And it is only an opinion and in this particular case with regards to getting commissions for medicines, probably a naive opinion of mine here in Australia I’m not aware of it. Because I’ve fortunately not been to too many doctors other than the one rheumatologist that I went to over and over and over and over again. He’s the most loveliest man on the planet, and I can’t even dream that any of that is going on I’d be shocked and as I’m aware it’s just not something that happens in this country. But again and that sounds very naive and I probably am but I have only the most glowing and wonderful things to say about the doctors that I’ve worked with in this country and certainly the rheumatologist that I saw was very very very open to me requiring the only amount of medication that was necessary to match my symptoms. And when we got into a situation where my symptoms were very low consistently. Then he was more than happy to accommodate my requests to lower the medications so as to only have enough to suppress the symptoms adequately. And not have so much sort of almost excess medication in my system over and above what was required. So, I never suspected any anything other than just like ideal operation and ideal practice from him. I don’t know what it’s like around the rest of the world and I wouldn’t want to speculate, I just don’t have any experience.
Clint: But certainly with the other question which is why do rheumatologist deny that food can heal you? The reason that I believe this is the case is multi-factors here. But 1 of the main things is that they are educated through scientific, published, papers. So medical journal publications where studies show this and studies show that. Now because there is no money to be made in showing that spinach is good for you. Those studies don’t exist and so if your education is founded upon a certain factor, and within that factor, there’s no data. Then they simply can’t recommend or encourage you to go with something of which there is no data. So that’s part of it. Now there’s another part of it which is that they’ve seen failure, after failure, after failure, of patients coming into their office saying, hey I’ve just gone gluten-free and look I’ve eliminated a bit of my symptoms. And the next patient comes in and says, hey you know I’ve tried this ketogenic diet and I’m feeling a bit better. And then the next one comes in and says, hey you know what nightshade vegetables, I gave them up now I’m feeling better. And then they see those three patients again in 3 months, 6 months, and a year. And those patients are all just as bad as what they were before. And so what the doctor does is develops this feeling that all of these dietary changes, they are all a waste of time. And they see it so frequently that they end up just shrugging rolling their eyes and in some cases, I’ve heard lots of different scenarios. I’ve had clients tell me that their rheumatologists have thrown their pen across the room, have told them well if you’re not going to take my drugs then I don’t want to work with you, you’re not my patient anymore. And these kinds of things are spawned from lots of other patients who’ve had failures with halfhearted or inappropriate attempts to change their diet.
Clint: And then there’s another factor on this, which is even if you do everything correctly not everyone has your results either Frank. We’ve got people and I’m happy to talk about this who follow the Paddison Program only that dietary component. And then not make enough progress to affect their blood tests. And that’s because, first of all, they could be under medicated, so the inflammation could be way out of control. So if we’re trying to put out this extreme chemical fire that’s going on with only a couple of fire hydrants, then the inflammation is going to continue to get on top of us. So there are also cases where it’s not enough just to do the diet either which is why this program encompasses diet, exercise, stress reduction, supplementation, and medication management. So we need to have low levels of inflammation.
Frank: Maybe I know something else because I think it’s also there are results of breathing, healing by oxygen. Have you heard about it?
Clint: Like Wimhoff Method?
Frank: Yes, something like that.
Clint: Yeah absolutely.
Frank: And I also read. I don’t know if you heard about it, (inaudible) vision therapy. Several people were having results with that.
Clint: Maybe it’s your Dutch accent or maybe it’s I haven’t heard it before, but I’m not sure if I caught that one or I understood what that one was. Maybe if you could just say it one more time.
Frank: Oh it’s outer (inaudible) therapy.
Clint: Outer veking? Okay. All right. I still don’t know much more from.
Frank: If you want to search on the internet, it’s Dr. Cringed.
Clint: Okay. All right. I’ll get you to send that through the spelling and so forth in case people want to check it out again. Go to our transcription of this podcast on our website, search for Frank in the search bar at the top of the blog page which is forward slash blog. And you’ll be able to find this and find that link. So you know with all of those variables at play including someone’s age, including how compliant they were to follow these dietary changes, including what their drug history was how much prednisone, painkillers, how much antibiotics they’ve taken in the past which is affecting how much they absorb the foods. I mean there are so many variables at play. You don’t have 2 people who are actually the same following any kind of diet. And so rheumatologist ultimately get this wild variation in outcomes from massive variations in people’s approach with dietary changes. Ultimately they just say, look you know there’s no evidence, and just you know eat a healthy diet. Because it’s just they don’t want to waste also time talking about it when they also aren’t experts on that topic. And so what we can do is we can just go into our rheumatologist meetings knowing that we know a lot about this topic, and we can ask them questions about the things that they know things about which is matching pills to problems. So. that’s my rant on that.
Frank: Yes I think you’re right because every person is different, and I know what I don’t a lot of people I know we all saw rumor say I will (inaudible). So I think it can be a problem because people can change their diet but also don’t exercise or do a lot of things.
Frank: I only hope that people can have hope, can have faith. There is something to do about it and what to do with it’s their problem but I tell people and they have no hope at all and they have hope because they see me.
Clint: That’s right. That’s right. Well well done. You know and you doing this not just for yourself but now you’re finding that other people are inspired, and you’re giving people some hope absolutely. Hope is just having a game plan to get from A to B, so you’ve just provided them with a place to get that game plan that you can talk to them directly about how to how to go about it. So thank you. You know I just want to reiterate that your achievements are remarkable and impressive, and exciting, and you know well done.
Frank: Thank you very much.
Clint: All right so before we wrap up was there anything else you wanted to cover? Anything else you wanted to mention relevant to the topic?
Frank: Yeah I think it’s what you’re doing for me it’s truly great because people say to me what you’re doing is very good. I said what I do is maybe a little bit good but the person who did it before me will find everything out. Your spent much much much more time on the searching all the items, and I only have to do it. So for me, it’s much easier than it was for you. So thank you for that.
Clint: No. Thank you, Frank. You know it’s so nice to hear your comments on that, and I’m glad that some of my struggles were of benefit. It was motivating for me at the time when I was going through it to think that someday these things that I’m learning, and these lessons, and these discoveries are going to be helpful not just for me but for other people. So in a way this is sort of something that I imagine in the future and, and it just feels really really good to know that you’ve benefited and now you’re also helping others and certainly from doing this podcast with me you’ll be able to help a lot more people who listen to your story and feel inspired. So thank you so much, I know we weren’t able to do this via video because we had some internet connections but I hope that everyone has enjoyed listening to our conversation. And thank you so much, Frank, I’ll be in touch, and hope to hear from him down the track.
Note: Netherland Rheumatologist: Dr van Schaardenburg, in Reade in Amsterdam