November 19

Tom needs less RA drugs with the Paddison Program

We discuss how:

– After being diagnosed with RA at 21, Tom started taking many different medications
– He started with Celebrex and after 4 months he added Methotrexate, which had heavy side effects
– Enbrel was also added to the mix and initially it helped with the symptoms
– After about 8 months Enbrel started to lose its effect, and switching to Orencia didn’t help as well
– After having stopped Methotrexate Tom wasn’t able to start again with it and began taking Rituximab
– Rituximab started working and in the meantime Tom went on the Paddison Program
– His change in diet and lifestyle following the Program helped him reduce the side effects of the drug to a great extent
– At that time he was still taking Celebrex and prednisone, but thanks to his new diet he eventually stopped both
– He’s now on his journey to recovery and progressing every day

Clint: My guest today is Tom, he lives in Albany which is a few hours south of Perth on the west coast of Australia. Never been to Albany, but he tells me it’s cold today whilst we’ve got a warm day in Sydney. How are going Tom?

Tom: I’m good, yeah thanks Clint. Thanks for having me.

Clint: Yeah mate, pleasure to have you on here. We’ve got some good topics lined up that we haven’t covered on other episodes in terms of medications here, medication combo I have not covered before in another episode. And also of course your personal story which I know nothing about, you’ve emailed me and said look I don’t normally do this kind of stuff and prefer to keep to myself and quite sort of personality. But I’ve benefited from other people’s sharing on this program, and thought I’d like to share my story. That’s kind of how we connect wasn’t it?

Tom: Yes exactly (inaudible) sort of pain killer type anti anti-inflammatory. That was something that hit home for me because yeah I’d been taking those for a couple of years. I remember actually early on watching some podcast with you, and you’re talking about how damaging they can be to the gut. And thinking, oh no this is not good because I’m taking a lot of these. And I couldn’t get through a day without them. So yeah I didn’t really want to hear your message at that point it was just too much.

Clint: Well when someone saying that the strategy that you’re doing every single day is the worst one for your long term. You really do want to hit pause or stop on the video. So tell us then you were, let me just kind of give people. I like to give an overview of what we’re going to cover in an episode. So what we’re going to cover in this episode, you’re currently taking Rituximab which is a drug that’s in injectable that is taken, I thought every 12 months but you’ve told me you’re all taking it every six months so we’re going to learn more about that drug. I’ve got other clients who would take that drug, and I want to share my experience which is the feedback that I’ve gotten from them. You’re also taking the methotrexate, so we’re going to talk about your medication combination. We’re also going to cover how you’ve improved on the Paddison Program because we just spoke about before we started here how these two drugs on their own did not give you the symptomatic relief that you were after. And how it was only when you shifted and did our program that you’re able to find the right level of fluidity, and pain reduction in your joints. So we’ll get to that shortly, but let’s let’s just start to put some ideas out there. First of all you mentioned that prednisone, the painkiller approach. Were you doing that exclusively in the early stages of your rheumatoid? And take us back to that time, and when you were diagnosed. Let’s hear about how things evolved.

Tom: So, my diagnosis was very similar to your story, really very similar. And I went to the GP and he said, yeah we’ll do some blood tests. I went back a couple weeks later and said, looks like you got rheumatoid arthritis we’ll send you to a specialist. And I think he gave me Celebrex on the day. I think I started taking those, I was just waking up with morning stiffness and I was really active at the time or I had been merely active up to that time. But I wasn’t living a particularly healthy lifestyle, and I was pretty stressed out. I was only 21. And then I didn’t really connect the dots but the Celebrex probably did exacerbate the problem right straight away, because I had so much going on at the time it was a bit of a blur like now looking back it was bit of a blur at that time.

Clint: Yeah and I think you’re referencing the story I tell which is I was at around about 4 or 5 out of 10 pain level. After I came back from the doctor, and then I took Voltaren for 3 weeks at increasingly higher dose to maintain the effect that it gave me. And then I started to worry and decided to go cold turkey after 3 weeks and stop taking them, and in that three-week period or after that 3 week period my pain levels were then at 7 and 8 out of 10 and would not go down like that Intervention of painkillers for those 3 weeks had a permanent negative effect on my symptoms. And that was when I remember the day I stopped taking those feeling the first time ever, a deep sense of concern, like a very very deep sense of what my future might look like. Because I was in a very bad physical pain level, and realised that I had done something very bad over the past 3 weeks that was irreversible. So yes I understand.

Tom: Exactly, but I guess I didn’t have the clarity of mind at that point to stop taking the Celebrex. Just sort of continue down that that train for along time. I guess the Celebrex is all that I had up until I started on Methotrexate the first time and it took probably, I didn’t want to take the Methotrexate at all like everybody else. So I think was probably 4 or so months before I started taking it from the diagnosis till I got to that point I was like, this is what I have to do pretty much you know because I’m not going down to manage that time yet. So that was 25. Milligrams. I remember the first time that I took it. I’m not sure if I took a half dose but it just, I took it on a weekend on like a Friday night and not the whole weekend I spent in bed, it just knocked me out for like 2 days.

Clint: Did that keep happening or did your body start to adjust?

Tom: No my body adjusted. So I take Methotrexate now, still I take 12.5 mg a week now.

Clint: And you started on 25 Tom?

Tom: 25 yeah the maximum dose.

Clint: Yeah that’s not that common to start on maximum dose, normally I see a start on like for a strong case maybe 17.5 or 20. But starting on 25-30 your, so symptoms must have been very bad, what that look like?

Tom: Yeah, I guess I had swelling in all of my joints. When I think back on I didn’t think I was that, it was that strong at the start but when I look at the. My rheumatologist has got like sort of a graph of my CRP, it kind of looks like that(inaudible) worst at the start I think it was about 55.

Clint: Wow, funny you mention how we had similarities. Mine was 55 as well, it was 55 or 56 as well so a lot of parallels there.

Tom: (inaudible) I’ve been an Aussie bloke from the country as well (inaudible)

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Clint: Yeah absolutely. So what did the methotrexate do?

Tom: The Methotrexate it really helped with the symptoms, it took a little while but I felt quite a lot better once I was able to sort of get into the groove I’ve taken. But I didn’t like it at all like I never did, you sort of hate take every every week when it comes around. (inaudble)

Clint: Yeah, I completely understand. I used to, you sort of block out your mind don’t you? You don’t like thinking to yourself I’m on this really strong medication. You just sort of try and focus on other things that you can influence and be positive. So you’re on the methotrexate, and the maximum dose, and it’s starting to do some good things. How does one go from that position to end up on Rituximab? So bridge that gap for us.

Tom: Well I think, I started on the methotrexate in 2012 and then about a year later I still have plenty of inflammations I’m still struggling (inaudible) swelling.

Clint: Sorry to keep interrupting, but I’m trying to prompt you to send out some chunks of info here. Is your diet pretty rough?

Tom: My diet is rough.

Clint: Rough diet. What does rough look like in Tom’s world?

Tom: Bacon and eggs, iced coffee (inaudible). And I knew that I had to change it at that point too so I think I was curbing my behavior. So it’s come it’s come a long way in the last six years.

Clint: Okay. Alright well let’s let’s move through the period there where I kind of interrupted you. You’re moving from the methotrexate and then moving on from there. So I wanted to just understand that yes if you methotrexate is at maximum dose not holding your condition at bay, whereas it was at first. Then you must be doing something working to exaggerate the condition or to continue exacerbated and that’s why I asked about the diet.

Tom: And I think the Celebrex to, at that point I wasn’t taking Celebrex every day but I was taking it I think as soon as I needed it which is probably I can’t even remember it but I think that’s pretty often. So after a year the rheumatologist still wasn’t happy with the way where I was at and get me started on one of the biologics (inaudible). And he recommended doing that starting with Enbrel.

Clint: Yeah. Good.

Tom: So yeah I did started that I think I might have taken weekly injections.

Clint: Yeah. it sounds right.

Tom: Yeah and that really helped as well. After a couple of months taking that, few months I was in a really like oh it was almost like I didn’t have arthritis. I still did like I knew in myself I did and I hadn’t, I was just sort of covering up the symptoms. But I was able to (inaudible). Again that I wasn’t able to do what I’d first been diagnosed, and up until that point since I was yes I was in pretty good. And it was around that time as well that I came across your program I think I just looked up on YouTube, just methotrexate I just wanted to learn a bit more about it. And I think it was one of the early videos of you standing in front of your bookshelf you’re talking about methotrexate.

Clint: Yeah. We used to have a one-bedroom apartment in Paddington here in Sydney. And most of my healing, and also most of my challenges were in that little one-bedroom apartment that I shared with Melissa. And I tell you that was a pressure cooker of pain, and discovery, and experience, and eventually the first early stages of putting some content online and starting to share what I and Melissa had had learnt. So that’s right, that little bookshelf, that was the only thing we had in the whole house that I could sit in front of that actually looked half decent, because I mean in a one-bedroom apartment there’s not many options when you’ve got no lighting gear and no equipment or anything so.

Tom: Yeah it was great light, that’s how we went out in this conversation now.

Clint: That’s right, it’s crazy isn’t it?

Tom: It is crazy yeah.

Clint: So you found this guy on YouTube talking about methotrexate, who you then found out said that everything you’re doing is wrong. But hang on a second, because somewhere along the line you’re on prednisone and painkillers. You said so I’m kind of a little confused there.

Tom: Yes I’m getting there.

Clint: Oh sorry mate.

Tom: Yeah. So the Enbrel it stopped working like after about, I took it for maybe 8 months or something like that. And then it just slowly sort of its effects just diminished. And then down here, I live in Albany it’s 5 hours south of the major city in Western Australia which is a pretty isolated state and we don’t have a specialist rheumatologist down here. They do do Skype meetings, but they can’t get a good look at you. So I did one appointment via Skype with the rheumatologist in Perth in the city hours away, and at that point my health was diminishing but because it is sort of happening slowly I wasn’t so aware of it. I just knew I wasn’t feeling that great and then before I knew it I was (inaudible), I went back of the rheumatologist and rheumatologist that I saw in Perth. And he said Yeah well this is what happens with the biologics, a lot can happen with the biologics they just stop working sometimes, we don’t really know why which is at waht you got a lot in RA it seems like. (inaudible). He said we’re gonna start you another one which was Orencia. I said okay, you’re the expert. And I found that it also didn’t work for me. I think I injected that maybe, it was a little bit longer I think every 2 weeks something like that.

Clint: Every 2 weeks between injection?

Tom: I can’t remember.

Clint: I honestly I’m not sure.

Tom: Anyway I took that for a few months and wasn’t getting the desired result, and at that time my girlfriend’s German she is studying in Germany at the moment. So I went over there I wanted to live there with her. And so (inaudible) take some Orencia here over there with me. But what happened is because I failed the required like the minimum required inflammation. So the inflammation needs to come down to a certain level before the Australian Government agrees to pay for my medication.

Clint: So they didn’t want to continue to pay for the Orencia because it wasn’t showing that it was doing its job?

Tom: Exactly yeah.

Tom: You need to show at least 20% improvement something like that, and I was showing 15%, it was helping (inaudible). And so I sort of stretch that stay out there in Germany, I just thought I’ll just I don’t know I guess I was I was pretty naive and I just had so I pretty much wasn’t on any medication during that time it was also start taking methotrexate.

Clint: So did you take yourself off methotrexate?

Tom: No my doctor, Just before I went over to Germany. I met with the doctor and I had a few issues with the methotrexate just like I had some sores in my mouth and I think maybe through my own forgetfulness I might have forgotten a couple times I have the folic acid. And so that put me in a pretty bad state, and because I hated taking it as well anyway. And the time difference between like when you’re taking it and when you when you feel the pain is quiet, there’s a gap between when you start taking methotrexate it’s like 6 weeks.

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Clint: Yes I think if your symptoms are being suppressed by methotrexate, and we’re often not aware that the symptoms are actually being suppressed as much as what they can be and then we stop taking methotrexate. The symptoms maybe 4 to 8 weeks later can come back and often people are surprised that the symptoms were there and that the methotrexate was doing as much as what it actually was. And it’s often very disappointing because you think I thought that wasn’t doing anything but clearly I was getting some benefit from that drug.

Tom: Yeah absolutely. So that’s what I experience pretty much, I was naive to how much the methotrexate was helping me. So yes I spent about 3 months medication free while I was in Germany, my condition deteriorated until I got back. So I was hoping to live over there with my girlfriend but my condition worsened to the point where it just wasn’t possible for me to live and work there. So I came back to Australia with my towel to my legs, and I went to the rheumatologist and he said yeah okay so well we’ll get you started on the rituximab. So this was the start of 2016, a couple years ago. And he didn’t say, because I’d been struggling with the methotrexate he didn’t sort of recommend starting that again. And actually during my time in Germany I tried a couple of times to start once I realize how much the methotrexate had been helping and thought I would get started on that again. But each time I tried to start I just got completely just wasted me again, same as the first-time in. So I would take it the first week and then I came round the next week, and I thought I was nowhere here.

Clint: Yeah you just can’t face it again sort of thing.

Tom: Yeah. So I came back to Australia I got started on rituximab, and just really took it easy, mum and dad looked after me.

Clint: Like yeah let’s just talk. I mean getting started in the rituximab sounds like I got home and I went to a movie. Now just to set the scene for people who are watching or listening to this. And I just want to say Tom I appreciate you going in, I know you mentioned to me before this was this isn’t easy for you to share a story like this and to open up so appreciate it mate and you’re doing a great job. So I hope that people are you know getting some insights into the situation by listening to your story so far, and we’re about to get into the transformational stuff which we’ll get to probably just a couple of minutes. But just to set the scene on rituximab, there’s 1 client who I spoke with who took this drug and it took this client a month to recover from the side effects the way it knocked her out from taking the rituximab injections. She had them in two courses, so she had maybe a half of it in one day.

Tom: That’s what I do too yeah, then two weeks later.

Clint: Exactly, 2 weeks later she had it again. Well it floored her, after the first one she was mostly in bed for the first 2 weeks and then similarly she struggled further after the second one. And I mean it was a kind of toxicity that I had never seen before or observed from any kind of drug with any of my clients. So what was your experience? Hopefully it was not as bad as that.

Tom: The first time that I had the infusions it wasn’t too bad I didn’t think, I thought I was is similar to methotrexate that’s similar sort of feeling really drained. But I think it was really only the first week after the first infusion that it really sort of, the last few times that I’ve had it’s really hasn’t been too bad at all. I was expecting something like that. Eventually in a week’s time I got another infusion, I’m not dreading it too much.

Clint: How long do they take.?

Tom: I’m usually in there most of the day, like 5 hours.

Clint: And it’s a drip so like drip, drip, drip.

Tom: Yeah you’re in the chair and then (inaudible) to the drip.

Clint: Do you get a break to go to the bathroom and so on?

Tom: (inaudible) take the drip sort of (inaudible) give you a cup of tea and that’s the kind of thing.

Clint: Okay. And you’re able to maybe have a small snack or something as well?

Tom: Yeah.

Clint: Yeah, Okay. so I’ve got the picture now a bit more clearer. And so you’ll spend most of a day there and we also spread them out over two weeks like you’ve done in the past?

Tom: Yeah that’s , I think that’s the way it needs to happen.

Clint: The way that it’s done. Okay so you’re on every 6 months, she was on every month. And I keep referring to the same individual because not many people I know are on this particular medication. There’s one more that I know of here in Sydney actually prescribed by my old rheumatologist. So she’s seeing him and she’s taking this now. Was it pitched to you as the sort of approach that you go on when the biologics aren’t working?

Tom: Yeah it was, I think the rheumatologist said the good thing is usually when this one starts working, it usually works and continues working. I think he said something like 80% of the people that it’s worked for like they considered stay (inaudible) yeah. And I speculate that he might have put me on that as well’ because it was such a long call start with six months. Yeah just because I needed that sort of flexibility I guess because that as opposed to having a lot of the other ones a week the injections. There’s a lot of organizing that’s involved (inaudible).

Clint: You think that just from a logistics point of view.

Tom: Maybe, I’m not sure I didn’t asked him that, I suspect.

Clint: Certainly more convenient it isn’t just to spend you know 2 days, what’s 4 days a year for all your medications isn’t it. So It’s certainly convenient from that point of view. Okay. And how has that drug been?

Tom: Good, it’s helping me lot. It’s a little bit like all the other drugs (inaudible) I wouldn’t choose to take it if I didn’t need to. And in parallel with doing this diet, and lifestyle changes, yeah it’s it’s working for me at this point. And what I’m hoping to do is just to stretch it out so I’m taking it 6 months at the moment. I’m looking at next time I see how I’m going because usually I can start as the effects wear off towards the end of the cycle. I’ve been able to observe that over the last year and a half that I’ve been doing the Paddison Program. And each time it’s gotten a little better.

Clint: So what you’re saying is that, it feels like you could have went another month for example.

Tom: Yeah.

Clint: Okay cool. Okay well good. So well if you if you’re due to go next week how do you feel today?

Tom: Yeah pretty good. Yeah I could, I think I could go longer without it. But yeah I don’t think I will this time around I think. Yeah I’m living pretty full life.

Clint: Awesome. Alright well let’s talk about the effects that you experienced when you implemented the program. How long it took to feel effects? How hardcore you went on it or did you just dabble? And also what your what other people like when I refer the program, I also talking about the exercise component. Tell us the changes you made and the positive impact that they’ve had.

Tom: Yeah. So. I actually tried it twice, so the first time I tried I made 3 months. But three months in and capitulated, it was too much for me. And so because I felt like the first time I started the program was in October 2014 actually. But at that time like I resented the fact that that’s what I needed to do, so I didn’t approach it in the right frame of mind. So I actually made some pretty some errors, so I would go as it say low fat I’d go nuts. I guess my body was craving, and I thought surely it’s all natural it’s going to be.

Clint: Yeah, I’ve had the same thought a million times so took me a long time to eat nuts that were dry roasted, but I was eating when my raw food time tons of nuts to get by. But I was sprouting them as in raw and then sprouted. So look I think the body naturally craves higher fat foods as creatures that need survival instincts. We’re going to want to eat foods that give us maximum satiation for maximum amount of time, because it’s efficient right? If you eat a high fat food you don’t need to eat again for a longer period of time, and that’s efficiency and bodies always looking for ways of doing things faster and better.

Tom: Yeah. So because I did that, because I had been eating nuts and I wasn’t getting the desired results, but I think it was important for me to try that first time because I learned a few things that helped me out and I eventually came to it the second time. What was important to me I think with being successful with a program was because I knew that mind space really so I rented a little apartment. And actually I wasn’t consciously planning on starting to sort of hardcore go hardcore with the diet, just naturally happened because I was the only one there and I was in pain and it whereas I had been living in share houses and that kind of thing. Previous to that where on you living with your friends and.

Clint: Yeah that’s hard.

Tom: It’s really hard to change. Changing habits is hard at the best of times so.

Clint: It’s hard to eat quinoa when they’ve just ordered pizza.

Tom: It is yeah. I had a lot of quinoa, for about 6 months I just had quinoa on my plate.

Clint: Yeah. And how did you see your body transform in terms of the pain levels? And I know it’s hard because you’ve had a long history of changing medications and that even the medications when they’re consistent change in their effectiveness as the 6 month period moves and stuff. How were you sure that this was helping you with all of these other variables?

Tom: Okay so up until that point I hadn’t been able to get through a day, I had actually been taking those painkillers that Celebrex, the anti-inflammatory to 200 milligrams a day for a good while, like I was in trouble. I think I’m still paying for that now really in my in my journey. Once I got started on the on the rituximab, I got down to 1 Celebrex a day but I still needed it every day. And I was also taking every second day prednisone.

Clint: Wow man okay. That’s the worst worst combination of all, I mean it’s one thing to take one and it’s another to take the other. But the scientific studies show that the most amount of are lesions and problems with the digestion. So your gut health happens when you take the combination of the 2.

Tom: And I was taking those and watch YouTube and I’d see like see you say that I’d been, I’d be too far gone I think to even attempt this. But I was also in such a bad way like that I had to do something. So the first thing I dropped was the prednisone.

Clint: Good, that’s what I would have done.

Tom: So I did that as quickly as I could I’m not sure how long it took me maybe a month to get to stop it.

Clint: Did you find not just a physical sort of bounce back of symptoms but an emotional challenge that really almost tore you apart as you trying to come off it and lower the dose that the emotional side of the experience was tough to?

Tom: I guess the whole thing thing is just so emotionally draining. So I think I got to the point where it was just like it was going to be that hard no matter which direction I chose.

Clint: So true.

Tom: In the Netherlands.

Clint: Danny?

Tom: Yeah Danny. I think it is they did talk about running, no he swam a lot did a lot of swimming.

Clint: Baldhead?

Tom: Yeah. I didn’t want to say that sorry Danny if you’re watching.

Clint: He’s got a girlfriend that loves him so (inaudible). He doesn’t mind (inaudible) he is a good guy.

Tom: Yeah, doing swimming as well after. Doing breaststroke and just saying my heel was so no Mantoux to myself every stroke just saying heal.

Tom: Yeah. A Yes because he was on prednisone. I thought that talking about how hard it was to get off. I didn’t find it like, I don’t think as hard as. Yeah because I was everything else is so hard I guess that was.

Clint: Right, you just basically expected that it would be just ridiculously challenging and just went through with it.

Tom: Pretty much.

Clint: I think that that’s the hardest to get off at all when it’s your only drug, because you know it’s playing a large amount of role in terms of its pain reduction it’s at a very very extreme strong painkiller right?

Tom: So immediate is the thing, you know you take it in the morning and it feels great.

Clint: Right.

Tom: Same day.

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Clint: Yeah, so highly addictive, effective. So like one rheumatologist said in a tweet at a rheumatology conference last year, that prednisone is our best drug but it’s our worst drug. So I think that sums it up. So you’ve gotten off that just to.

Tom: And the next thing that’s Celebrex that was then next thing to go that also seems to be what you were saying. And I think that, yes I tried a few days to get through without it and I’d just like, Icould barely do it right. But yeah after a couple of months I could do it, I can get through a day and I’m not sure if I needed like a day or in two days and then. I can’t exactly remember how I did it but I just knew I was going to get oh I’m just going to stop taking it somehow.

Clint: Right so you just made the decision and you just kept at it, and you sounds like you slightly increased the distance between when you took it. And you just eventually found that you could get by without it.

Tom: And I knew it was the diet that was helping those because there was no way I could do that without it. Yes and I knew I was working at that stage and I was only probably 3 months in. And I wasn’t really deviating from. the baseline cause I didn’t want to have to do it again.

Clint: That was exactly my thoughts as well. You might as well take this slow and get it right, yeah exactly. Fantastic so it helped you get off this Celebrex which you’d been on for so long like years and years, and the prednisone which you’d been taking as well every other day. So to be able to get off those two things just by shifting your diet I mean it’s fantastic.

Tom: Yeah it is. So that’s when I knew, I was onto something because the first time I tried it because I made those mistakes with their nuts or fatty food. So I was really disillusioned and I wasn’t even sure if it would work, but I thought this time around I thought well like I really need to do something I’m going to give at least two years. I can remember coming across healing. Josephine on YouTube this year, and following her journey through that. After about two years she seems to have some. Really good results.

Clint: Oh absolutely. like I want to say that from the day I decided myself to change my diet into a raw vegan. I think you know there was 8 months there, and then I did like 12 months of basically baseline foods. And then it took me another 12 months of reintroducing foods at which point it’s around about that time I stop methotrexate and then like another year and a half of trying to get rid of the sort of shouldering pain. So we’re talking like in my case like three 3 1/4, 4 I don’t know like a long time. Right so nothing’s quick, nothing’s fast.

Tom: I had a good laugh I think it was one of the last YouTube videos you made me said it’s either a slight slow or really really slow or really really slow.

Clint: There are your options. There’s nothing else.

Tom: I’ll take the really really slow. Thank you.

Clint: Yeah let’s lock that one in. Our day to day’s influenced so much by so many things that it’s a little bit too microscopic to look at our progress. But if we can look at it how it is week to week and then use blood tests month the month then that’s more appropriate. And it’s kind of like if you pay only attention to how you feel every single day as opposed to week to week or month. It’s kind of like jumping on the scales to weigh yourself three times a day. I mean there’s stuff, that’s in the noise you know. You want to weigh yourself once a day or once a week to gauge a trend, and similarly with the inflammation once a week we should be keeping an eye on things. So yeah okay. How do we now transition to where we’re at today? Fill us in on the last portion of the story.

Tom: Yes so I think the best way I can say where I am at today probably.

Clint: Yeah wow. Absolute, extreme, maximum, yeah. Fantastic.

Tom: So I wasn’t to do that for about five years. Would have been right. And I remember seeing you like move your hands and other people on the podcasts and thinking, I don’t think, I don’t know if that’s possible for me.

Clint: Yeah. And what about the rest of your body. Were there other parts affected that also?

Tom: You know when you talk about like having the pain breathing in your throat.

Clint: In your chest.

Tom: Yeah the lymph nodes are really inflamed. (inaudible) need to sneeze. You actually didn’t realize before but you did take a deep breath before you sneeze. (inaudible) to sneeze. But the swelling would be too great like around my chest area. (inaudible) from sneezing some time.

Clint: And no problem now?

Tom: No, if I had the wrong food now, and is still very limited but I’m eating. I’m eating a lot of Pasta.

Clint: Okay awesome.

Tom: And a lot of oats.

Clint: Great!

Tom: So there are good things but there’s other things (inaudible). I still have issues, and beans things like that.

Tom: So I guess, where my concern is at is I guess moving forward because until I do sort of a reassure myself by saying that I was on those very damaging medications for a really long time. So it’s probably going to take at least that amount of time to sort of even get back to that to an even playing field. I guess that’s what I’m looking for advice around that.

Clint: Well, I think you know I feel like though those words are very familiar. That’s how I’ve described it in the past and whilst I don’t think it takes a day for every day that you’re on the drugs to kind of get back to. I mean that would be a worst-case scenario I think that if you’re on you know painkillers for five years, to take five years before you’re able to eliminate the effects of those. I know that’s not what you’re saying but to maybe eliminate symptoms that were exacerbated from those medications. I think that’s worst case scenario, if we look at someone on the podcast in the past Angelica she was taking painkillers for 18 years. And then within 3 or 4 weeks of our program was able to completely come off the painkillers.

Clint: So, I think the prednisone does far more damage than the painkillers, I think that I would even go as far to say that it’s kind of like 10 to 1. That’s how much more damaging I believe the prednisone is because they operate in different ways. The negative impact of the prednisone is that I believe no one can tell me a better answer but my theory on this is that, it depletes the mucosal lining in the colon and that’s where our healthy gut bacteria actually live. And so the prednisone is more damaging because it removes the home, it removes the housing, and the the actual physical location of where our gut bacteria need to adhere to to actually do what they need to do in our colon. Where as the painkillers just cause some more leaky gut, so they just allow some more proteins to enter the blood but they’re not deteriorating the mucosal lining. And that I believe is the key distinction which again this isn’t in the science, this is what I’m basing my theories around because of the seemingly, extremely long term implications of long term prednisone use on the symptoms. Compared to someone like Angelica 18 years of painkillers and in a month been able to get off them. Someone does 18 years of prednisone I tell you this guaranteed you’re not going to be able to get off prednisone, and take no drugs after 4 months of any any kind of dietary intervention. So that’s where I believe what’s going on.

Clint: So, if I was in your scenario in terms of looking you know you mentioned looking for advice, my thoughts and just my views and comments around this would be that. Obviously, physically your symptoms seem to be at an extraordinary low level, so you certainly don’t have a problem where you’re backed up against the wall with regards to inflammation and you really need an adjustment on medications or anything at that point. I think that your combination of meds at the moment seems like, although they’re strong. Right? Although the rituximab, methotrexate 15 milligram, it’s a powerful combination of drugs. But you’re also simultaneously applying some powerful restoration, and improvement strategies around your diet. And sounds like if you keep up your swimming and maybe even get back into a gym routine, and just basically aim for building strength, building of feeling of power wherein masculinity and muscle, think words like that. And that will be exciting you know I think, 9 out of 10 guys like the concept of trying to get stronger, gain weight, build muscle and strength, and stuff. So this is the area that I would look towards, and with that as I said it builds optimism and rightly so because a strong body is more robust body. You might find that you can eat as much corn on the cob as you like and that’s very enjoyable sweet flavor to mix up meals. You’re eating a lot of pasta that no problems with pasta whatsoever.

Clint: So it seems like you’ve got enough platform of foods from which you can have a sufficiently satisfying diet to then build upon, and fall back upon if you sometimes find that you’ve made a mistake. Like the rice is still aggravating something okay drop it, at least you’ve still got your pasta, you’ve still got your other pseudo grains, you’ve still got some other things that you can enjoy. Look at sour dough, oat sour dough without oils a bread that you might be able to enjoy. So working on expanding the diet, not being too quick to change medications I’d just keep as you are doing keep things the same for the next six months. And just look to try and become less sensitive to the foods, because it is as you see less sensitivity to the foods you’re realizing that the message that your body is giving you is that your digestive process has become more robust. With a more robust digestive system, you can infer that therefore your going to be more okay on a reduction of medication dose. And even then you want to be careful and if I was in your position, I wouldn’t want to decide and suggest something right now. But monotherapy, single drug therapy is always going to be better than a double drug therapy if you can achieve it. I know that sounds common sensical but if you can get off the methotrexate and just be on the rituximab, and then with time increase the duration between the infusions. You’re getting into a really good position where it is just the one drug there a long time apart, you’re not seeing the side effects. Meanwhile you’re always working on the gut health, building strength, basically investing. It’s investing in your health, Invest invest invest like every day you’re putting money in the bank, and you’re building a wealth of health right.

Tom: Yeah I think I was planning long term, I’m thinking I thought I’d stick with the methotrexate more than the rituximab.

Clint: I mean that certainly, as it’s certainly going with a lesser of a more dangerous drug even though methotrexate can be. But something that requires 2 incomplete days to drip into your body’s obviously comes off as more dangerous than any alternative I can think of. But you know it’s about trying to find that balance between keeping the symptoms low, and doing so by making small incremental changes to the medication strategy. Not massive interventions which can rocket and mess up everything.

Tom: I think it comes across right through your message through the podcast, that certainly comes across as an important. Because I think you’re probably a lot of people start the program and then jump (inaudible) I just realize how big a mission is going to be and overcoming the rheumatoid arthritis.

Clint: Oh yeah man it’s like one of the hardest things that one could ever attempt to do, I often draw parallels to climbing Mt. Everest. I think that it is quite literally the same challenge as summiting Mt. Everest. Think of how few people get to the summit of Mt. Everest, and it takes a team, you’ve got Sherpas, you’ve got to have all the equipment. You got to prepare for it for many years.

Tom: (inaudible) with the metaphor that you tend to use with the path through the mountain, and sometimes it’s like you need to be initiated. (inaudible) and you just hopefully it’s gonna reappear about 50 meters or so.

Clint: Yeah and you got to cut your own way for a while. I love it, I might add that to the book. I’ll reference you if I do. Well mate, we’ve put in a long one here, we’ve we’ve covered your story in its completeness or at least I think we’ve done it justice. And so we might wrap it up, and I want to thank you for sharing all that you have. I think a lot of people can relate to a lot of things we talked about. The one thing that stood out to me especially was that it’s always hard. Doesn’t it matter if you try this approach or that approach. It’s hard everywhere you look and I think that was an important message that I took out of this and learned a lot from you about you know perseverance. I learned a lot about these different medications as well. So thanks very much for sharing today and keep up all the hard work and keep using that machete when you need to get.

Tom: Back at you Clint.


celebrex, Methotrexate, prednisone, rituximab

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