Welcome back to the inspired
living with autoimmunity podcast.
I'm your host, Julie Michelson.
And today we're joined by Dr.
Kara Wada, quadruple board certified
pediatric and adult allergy, immunology,
and lifestyle medicine physician
who also happens to have Sjogren's.
In today's conversation, we discuss the
differences between allergy, autoimmunity,
immune deficiency, and cancer, as well
as what might be driving the ever growing
incidence of these health challenges.
Dr.
Wada, welcome to the podcast.
Thank you so much for having me.
I'm thrilled to be able to
connect and to talk today.
I would love for you to share
with listeners and me a little
more about your personal journey.
Not just with, you know, why are
you quadruple board certified?
But your wellness journey, your
personal journey and, and what
has led you to this world that you
are now just totally rocking only,
so about four years ago is when I was
diagnosed with systemic Sjogren's.
At that point, I was two years
into my, you know, full fledged
allergy immunology practice.
I was just back from maternity leave
from having my second child and I was
at a bit of a crossroads because I At
that point in time, I was so exhausted.
I was professionally and personally
just zapped, totally burned out.
And thought that I might actually
step away from clinical medicine.
I dropped my clinics, like
the number of clinics and time
that I was in clinic by half.
And really realized that I
needed to focus on my own health.
I needed to refill my own cup.
And...
It has been a really, in many ways, a
slow but fast evolution since that time.
And I think I continue to just peel
back the layers like an onion and
realizing how, even though at the time
I was only triple board certified, I
guess, but like but at the time that
that education that I had really did
not prepare me for one living in the
role of a patient, nor did it really.
Like the education I received on
Sjogren's really did not reflect at
all the lived experience of Sjogren's,
and I think did not help me all that
much in realizing that that was what
was going on with my own health,
because in hindsight, I actually had
symptoms that, you know, was it full
blown Sjogren's or not at that time?
Who knows?
And it doesn't really matter, but I
had symptoms that I now recognize as
related in some way or prodrome back to
when I was in college in my late teens,
early twenties, and I was in well into
my mid thirties when I was diagnosed.
What I will share, you know, with, with
folks within the patient community, and
actually, I just I just wrote an article
for Kevin MD on this as well that we'll,
we'll publish tomorrow, but what we learn
about Sjogren's in medical education
is how to answer the question on your
boards correctly, which is, they're
going to describe a postmenopausal woman.
She's coming in complaining of
a gritty sensation in her eyes.
You notice on physical exam that she
has poor, poor dentition, poor teeth,
and then you have some lab data to
say that her blood work shows that
she has this antibody SSA positive.
And then you'll get, you circle the
question, you're like, oh, yes, I got it.
I don't ever have to think
about Sjogren's again.
Or if you're a pediatrician this
will come up in the SSA antibody
can cause congenital heart block.
So that will be the question that you
learn is, you know, did mom baby has
congenital heart block and then the
question may ask, you know, what was wrong
on mom's lab work, but here's the reality.
And here, you know, thinking back
to the puzzle pieces of symptoms
I've had over the years yeah.
a lot of digestive distress.
So, you know, symptoms that we describe
as irritable bowel, but really wicked
stomach aches migraine headaches,
profound fatigue, back stiffness that
I actually do recall going and kind of
seeing a primary care about at one point
during my medical training, which must
have been pretty significant because
as residents, like resident physicians,
you like never go to the doctor cause
you don't have time, like, and you're
trying to take care of yourself.
Like we're the worst patient.
So it must've been pretty bad.
I had an episode of idiopathic
anaphylaxis after having my first child.
And I also over time realized that I
couldn't wear mascara without looking
like a raccoon because I was always
touching my eyes, rubbing my eyes.
Wasn't able to tolerate wearing contacts
at a certain point because of the dry eye.
Yeah, and.
What is fascinating, especially as
I now clinically am seeing patients,
no one ever comes in with this, you
know, their, their main complaint
of like dry eyes or dry mouth.
They're complaining about their dry
cough or their body pain, their fatigue
maybe their sinus issues because
I'm an allergist by trade, right?
So they're coming to see
me for their sinus stuff.
And the other reality is that 30 to 40%
of patients have totally normal labs.
Thank you.
yeah, totally normal labs.
So, you know, they get that.
Oh, your labs are normal.
Must be in your head.
must be normal.
Yeah.
Let's try this antidepressant or maybe
you should try losing a few pounds.
So all that to say that, you know, this.
And it's been the patient community
that has welcomed me and embraced me
that I've learned so much more from
than, you know, those several hundred
thousand dollars I spent in my education.
Now granted, you know, I learned some
other things along the way too, but so.
Once I was diagnosed and, and I will
say I feel incredibly fortunate,
and this is seems odd to say,
but my labs were totally wacky.
And that like, they were
terrible at the time.
I think took my my rheumatologist
slash friend by surprise
had those not been abnormal.
I don't know.
I don't know how long it would
have taken me to be diagnosed.
There's so many parts and
pieces of your story that I'm
like, let's talk about that.
Let's talk about that.
I want to first just kind of reinforce.
Because I have this conversation
with clients a lot that because
standard Western medical training
doesn't teach about how to, you know,
they don't teach about gut health.
They don't teach about how to heal
autoimmunity, how to, you know, reduce
inflammation, all of the things.
And so I know that by the time
people find me and probably
you, they're frustrated because
Absolutely.
They had normal labs.
They were offered antidepressants.
They were searching and searching.
And so I just, I want to highlight
that part of your journey and every
other physician that has been on here
that has, you know, an autoimmune
journey or a health recovery journey is
that it's not, I said this yesterday,
you know, nobody becomes a doctor
if they don't want to help people.
Thank you.
And somebody said, well, that's not true.
I said, Oh, there's
easier ways to make money.
I promise.
You know, but, but it's this, the
education system has to change as we now
we have information and, and this is where
integrative medicine, functional medicine.
lifestyle medicine, whatever
you want to call it is, is key.
And, and I love you touched on it.
And I think this is really
important for people.
You kind of said it, but didn't say
it like, you know, it doesn't matter
if you have a diagnosis or when you
get the diagnosis, this idea of.
We ignore and normalize symptoms,
and if we don't hear the whispers,
we will get shouts, and that's what
Yes.
Yes,
and yeah, yeah, it's like, you know,
shocker, your autoimmunity, you
used to have gut issues, no way,
you know, there's a connection yeah,
yeah.
And you know, I think part of it I will
refer to myself as the ostrich with
their head in the sand for a long time.
I.
I
In part, I was totally in denial, but
also, like, I didn't have time to be sick.
Now that I say that, but then it's a
little like tongue in cheek because
there would be afternoons where I
was totally incapacitated because.
I ate something that didn't sit well,
or I had a terrible headache or.
I was just totally zapped from really
overdoing it, and so I was having,
I was forced to take rest, right?
Because of symptoms, and that's
what your body needs and is
like demanding at that point.
Yeah.
Which is so true.
I had a client last week who was very
sick, like, you know, ER had a really
high D dimer, like a scary moment in time
where, and, and two days later she was
like complaining that she was still sick.
And I'm like, are you in bed?
Well, no, I'm working and I'm
like, yeah, like , you're not
gonna get better if you don't rest.
And especially when we've got these
chronic, whether it's autoimmune or not,
just these chronic symptoms, we do tend to
just try, ignore and try to push through.
And our body will always take
us down if we're not gonna
give it the rest that it wants.
For sure.
So I, I wanna touch on, 'cause it.
There's, again, so many
questions I want to ask you.
You have this whole host of, of symptoms
that you've experienced, and this is what
you're seeing in your other patients with
Sjogren's is this, you know, because it
sounded like, I always think by the time
you get the really dry eye, There was
always this other host of, of things.
And so is that what you're seeing
is, you know, it doesn't, I almost,
I don't, I don't want to offend you.
I don't know you well enough yet, but
to me it's like, I, I, you know, it's
all, it all comes back to the same stuff
when we're talking about autoimmunity.
And so I don't care if.
You know, they show grants is one
of the things they threw, you know,
that was like my fifth diagnosis.
As you know, things just
progressed and progress.
And it's like, I don't, I don't care
what name they gave what you have, like,
let's just go after what's going on here.
You know, why?
Let's answer the question.
Why?
And then we can start
shedding some of those labels.
But it sounds like that that's accurate.
You see the same, almost the same host of,
yeah, and the data supports that too.
The other symptom that I left off
the list is Dysautonomia, or POTS,
is incredibly common in Sjogren's.
It's the number one
autoimmune cause of POTS.
And although I don't, as far as I know, I
haven't had I wear my aura ring and some
of my trackers, so I don't think POTS
is going on, but I have had significant
issues with orthostatic intolerance and
I would have to scrub out of Thank you.
Thank you.
Surgery is a medical student because in
that hot, especially it wasn't so much
an issue on the actual surgery rotation,
but on the rotation where they keep the
war, the room much warmer for the babies
that are, you know, about to be born.
I had to scrub out on multiple
occasions because I think.
In hindsight, combination of
prolonged sitting or standing.
The warm environment all those things kind
of came into play where my blood pressure
would drop and I would, to the point
where I thought I was going to pass out.
Thankfully, I didn't.
Yeah.
Thank you for so many reasons.
right, they drill into you, like
as a med student going through, you
know, the OR procedures, like you
cannot pass out in the operating
Not allowed.
You got to get out
first, drop in the hall.
Yeah, but I distinctly remember my
preceptor say, you know, asking if I
happen to be pregnant because I was having
to scrub out so often, which, of course,
now that would kind of be frowned upon,
but but it was memorable to now, you know,
Oh, yeah, that probably was all related.
Yeah, shocker, shocker.
So, so you have such a unique background
and practice and I want to dig in a little
bit to like allergy versus autoimmunity
versus immune deficiency because it's all
I'll enter.
We're all one human organism.
Yes.
all so
in addition to our microbes.
But so when we think about our
immune system, its purpose is to
help protect us, obviously, against
infection, its purpose also is to help
us heal, like from injury as well.
So if you think about a cut that you may
get, you'll get an inflammatory response
at that cut, it's going to get better.
It's ouchy.
First of all, it's painful.
It's red, swollen,
typically and it's warm.
Those are all the signs and
symptoms of acute inflammation.
And so, you know, during that response,
you're having this coordinated
effort of cells and proteins and
these things called cytokines and
chemokines, like this beautiful
orchestra of our physiology taking
hold so that it can stop the bleeding.
It can bring in the cells that are
going to help repair the tissue damage.
It's going to fend off any microbes from
the surface of our skin that maybe have
made their way in or other infection.
And it's going to allow that area to heal.
And it's this magical
thing that happens, right?
But when we think about allergy and we
think about autoimmunity and throw cancer
in there too and immune deficiency,
that system, it has gone haywire.
It's misbehaving.
And so an allergy, our immune system
has recognized something in the
outside world as the, the danger
signal, the enemy, and it mounts.
a particular flavor of an inflammatory
response against that, whether it's a
pollen or kitty cat allergen or dust
mites, or in some cases foods, as we've
seen in the last 20 or so years, this
really steep rise in true food allergy,
where if someone is exposed to this minute
amount of peanut or egg, that they have
a life threatening allergic response.
In the case of autoimmunity, When
we are incubating, when we are in
in mom's womb, our immune system is
already hard at work determining what
is Self from non self and what is safe.
And so things that are too good
of like recognized too easily.
Those types of cells are eliminated
and those that are not recognized
self are eliminated as well.
So that you end up with this
immune system that can tell.
Okay.
What what is us and what is not us and.
In autoimmunity, essentially the immune
system loses that tolerance over time,
so that then the immune system is seeing
our own bits and pieces as that enemy.
And it depends, you know, each
autoimmune condition has a little
bit different flavor of this.
It has particular targets that are
implicated, and that then explains
some of the symptoms we end up with.
In immune deficiency, We don't
have all the parts or pieces or
they aren't quite working and in
a perfectly coordinated fashion.
So we are at an increased risk
of infection, whether it be, you
know, more frequent infections,
more severe infections.
Eyeball infections that most people
wouldn't be, you know, wouldn't have
any issue with and a lot of times the
collateral damage and inflammation
that occurs is not appropriate either.
So, sometimes there's, like, too much
or there's too little and so that
then can expose the immune system to.
actually creating an autoimmune
response to because it's not
cleaning things up properly.
So the really obnoxious thing for
many of my immune, my patients with
primary immune deficiencies, especially
is that a lot of them coincide, like
co occur, occur in the same person.
as autoimmune disease.
You end up with autoimmune and
immune deficiency in the same human.
It's a real kick in the pants.
And then you, you're forced you know,
to make some really difficult decisions
as a team with your immunologist, maybe
your infectious disease doctor or the
rheumatologist in deciding how can we
try our best to like restore balance
as best we can because sometimes you
have to like Tap down the inappropriate
inflammation, try to boost things up
the best way we can and so that is.
They can be incredibly
challenging and frustrating.
And then in cancer, essentially, the
you have cells that have gone rogue.
They are reproducing at levels and
numbers that they're not supposed to.
Usually there's some kind
of glitch in the system.
And the immune system is
unable to recognize and take
those out appropriately.
And so what you're seeing with some
of the newer Immunotherapy cancer
treatments is they actually turn the
immune system back on to help then
target the cancer more appropriately.
Yeah.
And that's.
I think at least in regards to cancer
and the general population, I think
the more we have these conversations
where people can realize, like, we,
we have bad cells all the time, we all
Yeah.
Yeah.
Yeah.
And a lot of times our immune
system sees them and takes
them out and you never know.
What it's supposed to do, right?
And that's the, you know,
that approach of that.
I look forward to the day when there
is a more integrative approach across
the board with cancer so that we are
supporting the whole human while we are
helping the body go after the cancer.
Yeah.
you know, it's, it's a, it's an
interesting conversation, but I, I,
that to me, the key for People to start
to understand is, you know, we still
need to support the body to do its job.
And, and so there was a reason your
body didn't catch those cells, I guess,
is what I'm, you know, at which to me
ties into this whole conversation of
what are the things that, you know,
we can do, what is that approach,
whether we are, you know, for wellness.
Right.
Because I, and I'm guessing it sounds
like you have people that show up,
they're coming to you for allergies.
And I'm guessing often they have, like
you did, like I did have issues brewing
that they didn't realize were autoimmune.
Oh my gosh.
Yes.
I would have to say so I am currently I
see patients two and a half days per week.
So I'm not totally full
time in the clinic.
In part, that's how I keep my cup full.
It's awesome.
but I would say at least out of maybe
those 36 patients I might see in a
week that at least probably six of them
have specifically come in wondering
about food allergies, but what they're
really dealing with are gut issues.
It's not, it's not like
they need an EpiPen.
And I would say probably a good 4 to
5 of those patients are maybe the 5th,
6th, 7th, 8th opinion on their symptoms,
which to me, they describe symptoms
of too much inflammation in one way,
shape, or form and or dysautonomia,
so issues with like blood pressure,
heart rate, fatigue unfortunately, so
I'm, I'm located in Columbus, Ohio.
I work at the Columbus, Ohio.
large university there.
And we don't have anyone locally
who's taken the lead on dysautonomia,
which is really unfortunate.
So my patients to see a specialist
have to go all the way up to Toledo
and wait about two years to get care.
seems insane.
And, but
It is.
Yeah, we were in a in a metro
area of several million people.
And so
Right, you're not in the
especially, yeah, we already had a
lot of these folks pre pandemic that,
you know, weren't really getting
great care or great recognition.
I think there's a better, more
discussion about what these symptoms
represent and folks seeking care.
But we've also had a really, you
know, an increased prevalence of
these symptoms to with long COVID.
And for listeners, and I apologize
I didn't ask this sooner,
explain what dysautonomia is
for people that aren't familiar.
So dysautonomia is essentially a, an
umbrella term used to describe the
automatic nervous system going haywire.
So, and it could show up in
all sorts of different ways.
But most common, and I would say
probably affects quality of life
most significantly are issues with
blood pressure and heart rate.
So folks may have issues with Feeling
like they're going to pass out, or they
actually pass out and may have issues with
digestion, can have differences in how,
like, their pupils dilate and constrict.
issues with sweating.
I have a few patients who will wake up in
the middle of the night drenched in sweat.
Now there are some other
reasons why that can be that you
I was gonna say, you're
not, not talking about
Yep.
Not necessarily, you know, change of life.
Yep.
And not necessarily blood sugar
issues would be the other main
thing you would think about.
And.
Ruling out cancer but and they are
symptoms that have, we've known that
they exist for some time, but they
are like many autoimmune conditions,
things that affect different
organ systems and are not well
understood, not super well researched.
And so when you have a medical
system that is incredibly siloed.
Where the cardiologists are in one
space, the neurologists are in another
space, the immunologists somewhere
else, and we kind of stay within our
groups, it's challenging to have.
really good coordinated
care for these folks.
Yeah.
So, so well said and you mentioned long
COVID being one reason I feel like in
general, even like pots, pandas, these
kinds of things, you know, it's that
question of, are we just more aware?
And so now we, you know, more people, we,
more diagnoses are happening or is it.
Like real food allergies,
autoimmunity, autism, is there
just really more, you know,
Yeah.
think this increase in, I mean, I have,
I have two, I still call them kids, two
adult offspring who carry EpiPens and
have, you know, one, Didn't, well, did
when he was little, seemed to outgrow
stuff, and then randomly, again, you
know, different, different allergies.
It is
Yeah.
It's really fascinating too,
because there is this really almost
like a not quite a land line in
the sand, but so I am, I'm 39.
So I'm an elder millennial and
I don't remember a single kid
in my class having food allergy.
My sister's 36 and I think she probably
would say about the same, but you go
another like 2 or 3 years and that's when
those numbers really kind of blossom,
you know, kind of those born early 90s.
Onward, and this has been a
really interesting topic of
conversation at our national.
Allergy asthma immunology meetings
and this past spring, you know,
the real big discussion point was.
One of the ways that we have
conceptualized this increase
over the last 30 years or so is
the hygiene hypothesis, right?
The reason why we're seeing more
is because we're all cleaner.
And yeah, like, that helps
explain it to some degree, but
it wasn't the whole picture.
And so there is a
physician researcher, Dr.
Adkis.
Who is out of, I believe, Switzerland
who took kind of the center stage
and really spoke a lot about the
epithelial barrier hypothesis.
So this idea that we have interfaces on
our bodies, our skin, our respiratory
tract, our gut, that are how we
communicate with our outside world.
And.
Those barriers are
permeable or semi permeable.
We want communication from
one side to the other.
That's how we interact
with our environments.
Right.
But if you have too many chinks in
the armor, then you get into trouble.
And so what happens when you end up with.
leakiness or breaks is that you
see a change in the microbes that
are living on that surface and
you see a change in inflammation.
And a lot of times in particular, what
we talk about a lot in allergy is eczema.
It's easy to see like what's going on.
A little bit easier to study
sometimes than, than gut related
things, cause you're not having
to do endoscopies all the time.
but it is a gut related thing.
But from like a bi, yeah, but
I know, you can see it.
I
it's a little
easier.
to get to.
Yeah, easier to see and conceptualize
and but what you'll see, for instance,
Staph aureus lives on our skin.
It's kind of a natural commensal.
It's kind of like a generally a
friendly ish bug, but you see.
That's like the strains and the types of
toxins that they may change when that skin
is inflamed and essentially what happens
is you end up with a snowball effect and
so when you have breaks in the skin, the
bugs change, there's inflammation, it
makes it more leaky, so on and so forth.
And that continues.
But as you mentioned, there's crosstalk.
So you can see then changes maybe in gut
microbiome and development of eczema,
or you can see changes or exposures
through the respiratory tract that then
will increase the risk of developing
something like multiple sclerosis.
So there, there's, you know, this
growing body of evidence that problems
at these barriers and increased.
inflammation leakiness kind of
at these barriers is the issue.
So then the question is, okay,
what's making them more leaky?
And there's a whole bunch of things.
We think about how different our day
to day lives are compared to like my
great great grandma who was living on
the farm in Northern Georgia, growing
all her own vegetables, canning things.
She was out with the cow and they would,
you know, kill the chicken and my Even
my dad, when he was growing up, he'd
have to go kill the chicken and pluck
all the feathers and bring it in for
dinner, like they were, he was outside
on the farm working all summer, like
they didn't have air conditioning.
the earth.
Yeah.
It just was.
Totally different.
And here we are, you know,
in our creature comforts.
I'm in air conditioned space.
And I have my ear, but you know, I'm
sitting and in that's not to villainize
everything about our modern way of living.
It's just a lot has changed.
And we're seeing now the downstream
effects of that significant amount, you
know, change the different exposures that
we are Are exposed to rapid change in
diet increased sugar, oil, refined grains.
And on the whole, we're very sedentary.
We spend upwards 90 plus
percent of our time indoors.
And so, and then the newest and
the, and what Dr Adkis is kind of,
I think pet project is looking at
the role of dishwasher rinse aid.
In particular, those used in commercial
dishwashers but the, the, the residue left
on glasses is very damaging to the gut.
And so commercial dishwashers
came about late 1980s.
Is that then implicated in what we've
seen with increased rates of food
allergy, eosinophilic esophagitis, drug
allergy.
two kids with that when they were little.
Who knows, right?
Yeah.
And so you know, there still is a lot of
work to be done to really hone in, but
Well, and I think that's
a, a very specific product.
But I think it, it underscores the whole.
Exposure to toxins, right?
So they're studying commercial
dishwashing, but, you know,
but what are people using at
home even day in and day out?
And, and, you know, that's a whole we
could talk for another hour about that.
But I do think it's this combination and.
You can't, so you mentioned, you
know, the changes in our food system,
the dogs are piping in and, and to
me, you can't separate the changes
in the food system and toxins.
It's the same, you know, the bad
oils, the ultra processed foods,
you know, all of that is toxic.
And so you know, when I say toxins, I'm
not always talking like chemicals, right?
And forget and EMF, all, all the things,
Yeah.
And I think then it's, it's,
we all probably need to sit
down, metaphorically probably,
and, or stand up, yeah, and just
think about, you know, what,
what are our non negotiables?
What are the things
we're willing to change?
What is our comfort level with risk to?
And I think that's where
more data would be helpful.
But as I I've talked a lot with my
patients about the dishwasher stuff in
particular, I have three young kids.
I'm working.
I have a business.
I don't want to go back
to hand washing dishes.
Right.
So, you know, on the flip side, I'm
trying to look for generally more eco
friendly products that typically, you
know, in broad brush strokes, things
that are healthier for the planet tend
to be healthier for our physiology.
And, you know, similarly with the things
we put on our skin, like those are
easy, simple swaps and switches that
But I love that you brought up the also
know what your non negotiables are.
I mean, one of, one of the pieces
and we all need to be doing it for
wellness, you know, the, the smart
ones are doing it ahead of time before
they have any symptom they're ignoring.
But one of the things I do with my clients
is we're reducing that exposure, right?
As we're supporting the body's detox
pathways, we are, and it is a process.
It's a process.
There's no way you could wake up tomorrow
and say, I'm going to reduce my exposure.
And by next week, you've done it.
Like, there's so much that we come
into contact with and that's fine.
Every change is an improvement.
I had one client who, and she did, she
was a vegan when I met her and I was like,
I'm not the one to help you as a vegan.
Let's find you somebody.
Oh no.
Just tell me what to eat.
So she would eat meat.
But when we were cleaning up
products, I said, what kind of
shampoo and conditioner are you using?
And I never did find out because she
said to me, that's not negotiable.
Not negotiable.
That for her, she loved her
shampoo and conditioner.
It literally cleaned up every
other product she was using
on her body in her home ever.
And I'm like, great.
Like, it's not about, A,
we can't reach perfect.
And B, we don't need to is the, you
know, cause sometimes we get the, we
have these conversations and it can
start to sound doom and gloom and you
know, we've got all of these hits we're
taking, but we really don't have to fix
everything in order for, for the body
to be able to heal, which is, you know,
the, that's the exciting part, right?
That's why we're here.
We are resilient, amazing species
that has made it this far.
Right.
is sometimes, you know, the enemy of good.
And I will say, I was the first to fall
down that rabbit hole, not too long after,
yeah, after my diagnosis, I doubled down
I've had a Peloton bike for quite some
time, since probably like 20, 2018, 2019
early adopter.
maybe, yeah, early, maybe it was
2019, anyways, doesn't matter, but I
pre pandemic Peloton.
And I was like shooting for,
you know, PRS like, okay, like
I'm in a like workout hard.
I was drinking green smoothies
that I was adding some super
fluid, you know, stuff to and.
To make a long story short, I
ended up with an acute liver
failure from the supplement.
So that's always just my word of
caution of just, you know, don't, don't
overdo it and just be conscientious
And more of something
good isn't always better.
Yes.
And then
good for everybody either.
it, that is absolutely.
And then I took that perfectionism
and then put it totally into kind of
the elimination diet game and got.
Really restrictive, lost a bunch of
weight, which, of course, as you know, a
woman in our society was, of course, like.
You know, like, oh, you look great,
you know, all those sorts of things.
But I ended up spending so much
mental energy fixated on what I
was eating, what I wasn't eating.
That at a certain point, my
symptoms were like rearing back.
And I, and I honestly think I was
just constantly in fight or flight.
It didn't matter that I was eating like
a really anti inflammatory diet and like.
You know, working out and doing these
things like I had to kind of address all
of it and I also just had to let go of
the perfectionism like that was, I think,
And I think everybody, I'm
sure you have the same thing.
I think that the
perfectionism, if we could.
Somehow like diagnose perfectionism
first, we could prevent a lot of
this chronic illness because it
really does that stress level.
I've yet, and it may
present totally different.
Like, it's not like everybody you
meet, you're going to know right
away, but pretty much everybody that
I've worked with is a perfectionist.
And that letting go is such
an essential healing step.
Yeah.
So,
wonder if there are like, particular
personality traits that also may,
they, they absolutely provided a
survival advantage at some point,
you know, across our lifespan, right.
Bye.
Do those also, like, increase
the potential sometimes for
yeah.
And that's where we just need to learn.
wonder.
Yeah.
Oh, I, I think, I think for sure.
I, I really do.
I, it doesn't mean that if you don't
care about anything, you don't get sick.
I'm not
No, no, no, no.
Just, you know, like, we talk about
risk factors.
Like, yeah, if you, if you drink a
certain amount, you're more apt to
get breast cancer, colon cancer.
You know, like, those sorts of
things where you just kind of
take those into account, and...
Yeah.
Yeah.
So, but I, I love the, what
you're bringing to the world.
And I just think, you know, the
more anytime, especially like
somebody who thinks they're just
coming to see an allergist, right?
Like anytime somebody can walk
into a doctor's office and have
contact with somebody like you
who can help them understand.
True wellness, you know,
and the body is such a gift.
So I am so grateful that you are out
there in Ohio doing what you're doing.
Clearly you need more counterparts
Well,
in your neck of the woods.
the wonderful, wonderful thing
about my position is that I
get to work with trainees.
So nearly nearly every day
there is a medical learner
of one one shape or another.
So from undergraduates who are applying
to med school, I will on occasion have
them shadow with me all the way up through
our allergy and immunology fellows.
We have two per year and actually.
The season just opened for interviews.
So we have you know, 100 plus
applicants for, for these, you
know, two spots every year.
It's pretty incredible.
And so to be able to share my story
with them, share some tips and
tricks as to how to think about and
conceptualize these things that we have.
We may not have all the answers to.
I think as human beings, our
brains really hate uncertainty
and and that is absolutely the
case with physicians as well.
And to push them to get.
More comfortable with feeling
uncomfortable, I think is is clutch.
And to help instill and support their
curiosity, I think is really important
to and what really, really needs to take
place to ensure that all of us as health
care professionals can stay curious and
compassionate and kind of leaning in is
we need to ensure that our health care
professionals have wellness as well.
Oh,
Because if they are unable to fill their
own cup, that is when you get someone
who is burnt out, unhappy, maybe unhappy
with their situation or their job.
And I, I would almost guarantee that
you are not going to get the best
care that you could get from someone
They're going to end up sick.
Like I always,
Oh yeah, yeah,
like, why?
When you just, you look at medical
school and how it's set up, it's
like, why are we trying to kill people
who are training to help people?
And it's not just this country,
it's, it's medical school across
the board is set up that way.
It just doesn't make sense.
I was thinking about that with your a
hundred plus applicants for the two spots.
Like every one of those applicants
really needs to be filling their
cup and doing stress management.
You know, it's such a high stress.
And, and that's a great the flip
side to that, that I can say is I'm
not a physician is also, we need
to remember that our physicians are
human and they're people and, and
yeah.
You know, and we have this training of
decades of, you know, this mentality
that you and I are trying to change,
which is you show up at the doctor
because you want the doctor to fix you.
Right, like,
yes, you need a partner.
Right.
You know, we have to take responsibility
for our own wellness and we, and we
have to realize that our doctors don't
necessarily have all the answers.
But when you can find one like
Kara, like that's, it's gold.
It really is.
So,
There's this really cool paradigm
that has been written about and
talked about called wellness 2.
0 where essentially it outlines
this idea of the physician is human.
There is this equalization the
power dynamics between patient
physician will never be equal, right?
Like, there's there's no way to fully.
Equalize that just to the nature of.
These systems.
But it brings it into closer balance.
And I think the more that we can
lean into that is really important.
But the reality is we live in a very
capitalistic society and money talks.
So they're also, you know, we're going
to have to grapple with making the case.
Unfortunately, probably.
from the financial side of things in
order to really see systemic change.
And that's kind of the tough
love aspect of all of this.
yeah.
Yeah.
But the good news is that when,
when that does happen and that the
broken system finally collapses,
we already, we know, you know,
what can work and what is working.
So I love that.
So give listeners, if you will, and
it can be anything can be directly
shoguns related, not doesn't matter.
What is one step that they
can take starting today to
start to improve their health.
So I think the one thing is taking a
few minutes just to sit, give yourself
a little bit of that white space,
that quiet to just listen to that
inner voice and what he or she needs.
I think that is
Incredibly important and I think it's
really helpful to do that before a
medical visit medical appointments almost
on the whole tend to put us into fight
or flight and when we get into fight,
flight, freeze, fawn, we may not always.
We may forget, like, what our
objectives were for that visit,
so jotting down some notes can be
really helpful ahead of time to think
about, okay, what are your questions?
What are your goals?
How are your symptoms really
impacting your quality of life?
Being able to communicate how they
are showing up in, in your, in, in
showing your humanity can be really
helpful, especially to maybe tug
on that doc who is on, on the brink
of burnout, or who maybe just needs
that reminder that you are human.
And this is showing up in very human ways.
Yeah, so that's
Yeah, and I'll
throw the other piece in because
I see it a lot and it's, I don't
think people do it intentionally.
We tend to, even though we're
showing up at the doctor's office
for help, we do have this natural
tendency, most of us, to downplay.
Just what you're talking about.
We may say, you know, these are the
symptoms, but we don't share how it's
impacting our life or, and so it's like,
Oh, we said the word and then that's it.
And the doctor that's, they're
not getting like, Oh my gosh, this
is really impacting your life.
So I'll share a really quick example.
Low back stiffness was one of
the main issues that was totally
impacting my quality of life.
And so I could tell the doc.
Oh, I'm having low back stiffness.
I sit down for prolonged periods of time
and it's really hard to get moving again.
It's worse in the morning.
Yes.
All that's helpful.
But what really illustrates how
much it was impacting my life was I
was not wanting to sit on the floor
to play with my young children.
And that like was breaking my heart.
And so to share, you know, that
little extra nugget of like,
this is how problematic this is.
Like that helps light the
fire, hopefully under that.
That person's bottom to like, to
do something about it, whether
it's to refer you or get imaging or
start meds, what have you, but to
make to have some sort of action.
I love that.
I love that.
Amazing.
Before we wrap up, where
can listeners find you?
Where's the best place?
Yeah, so the best place is probably Dr.
Kara Wada dot com on there.
I have a freebie.
So the 25.
Things that we did in our family over
the last four years or so to make simple
swaps to like less toxic things that we
were talking about just simple, easy.
I'm a Midwest girl born and
bred and I love a good deal.
So things generally are, you know,
not going to cost a ton to really
help start making those changes.
And, on there.
Also, you'll find so each year
the last two years we've hosted
the virtual shogun summit.
So it is a, we have a ton
of great resources on there
and coming up this fall.
We are launching a fall event called
the demystifying inflammation summit.
So you're going to want
to get on the email list.
So you can stay in the loop.
It's going to be a free event.
Tons of experts across.
The, you know, the spectrum of
things of too much inflammation.
So allergies, autoimmunity,
asthma gut health issues.
So I'm super excited and in the
weeds of planning that right now.
I love that.
I am definitely signing up.
Love it.
Love it.
Cara.
Thank you so much.
You have given us amazing gold today.
Thank you so much.
I have loved talking and we're going
to, we're going to have to have you on
the Becoming Immune Confident podcast
so that we can hear your story too.
Yeah, I would love it.
I'd love to continue the conversation
Yes.
For everyone listening.
Remember, you can get the
transcripts and show notes by
visiting inspired living dot show.
I hope you had a great time and
enjoyed this episode as much as I did.
I'll see you next week.