Conquering Fibromyalgia with Dr. Michael Lenz

In this episode of me&my health up we speak with Dr. Michael Lenz who has a strong interest in helping those with Fibromyalgia go beyond just learning to live with but to reducing and even reversing the levels of Fibromyalgia. Weaving the best of lifestyle medicine and medical management.

About Dr. Michael Lenz

Dr. Michael Lenz is a practicing physician in Delafield, Waukesha County, Wisconsin. He is Board Certified in Pediatrics and Internal Medicine which means he sees patients from newborns through adulthood. He is also a diplomat of the Board of Lifestyle Medicine and a diplomat of the Board of Clinical Lipidology. Dr. Lenz also has received a T. Colin Campbell Plant-Based Nutrition Certificate. Dr. Lenz graduated from the Medical College of Wisconsin in Milwaukee and completed his Residency at the Virginia Commonwealth University Hospitals in Richmond, Virginia. Dr. Lenz has helped hundreds of patients suffering from fibromyalgia-like pain. He is committed to educating, inspiring, and equipping patients to walk through this battle triumphantly. He is the author and host of the book and podcast, Conquering Your Fibromyalgia.

About me&my Health Up & Host

me&my Health Up seeks to enhance and enlighten the wellbeing of others. Host Anthony Hartcher is the CEO of me&my wellness which provides holistic health solutions using food is medicine, combined with a holistic, balanced, lifestyle approach. Anthony holds three bachelor's degrees in Complementary Medicine; Nutrition and Dietetic Medicine; and Chemical Engineering.

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Transcript

Dr. Michael Lenz: 0:00

The blind men and the elephant fibromyalgia patient is an elephant. But they're all looking at one aspect, that spine surgeon may be seeing them for back pain, but they also have painful periods, which you know, so you get all these compartmentalization, which is a terrible way to approach fibromyalgia. And that's ended up being the charism. Because I'm somebody who's both specialists in kids and adults with an interest in lifestyle medicine. And I'm able to bring these together. I often hear and this is just humbly saying this, but often hear patients if they're they're seeing me there, I call it bittersweet. The sweet part is they're getting better. They have these explanations. It's understanding what's going on, but also they're bitter. They're like, Doc, I, you just saw me one time and granted, it might be a very long visit, but you were able to put this together. I've been seeing doctors for years, you know, decades, you figured this out in one visit.

Anthony Hartcher: 0:48

That was Dr. Michael Lenz, and you've landed on the me and my health up podcast show, and I'm your host Anthony Hartcher. I'm a clinical nutritionist and lifestyle medicine specialist. The purpose of this podcast is to enhance and enlighten your well being and Dr. Michael Lenz is going to be doing just that for you. We're going to be discussing conquering fibromyalgia. Dr. Michael Lenz is an internist, pediatrician and lifestyle medicine physician who has a strong interest in helping those with fibromyalgia go beyond just learning to live with, but also reducing and even reversing the levels of fibromyalgia by weaving the best lifestyle medicine and medical management. He is the author and host of the book and podcast conquering your fibromyalgia. So without much further ado, I'd love to welcome you into the discussion I'm having with Dr. Michael Lenz. Welcome Dr. Lenz on the me and my health up podcast show. How are you today? Doing great. Thanks for having me. So great to have you on the show. It's really good to have physicians on the show and we share a bit of commonality and that's our surname. It's a German surname. So that's, that's good.

Dr. Michael Lenz: 2:08

Yep. Well, thanks for having me, it's a pleasure to be able to talk half way around the world.

Anthony Hartcher: 2:12

Awesome. Dr. Lenz, let's start with how you've arrived at what you're doing today.

Dr. Michael Lenz: 2:17

So as far as interest in fibromyalgia, I do pediatrics, internal medicine, lifestyle, medicine, cholesterol management, but my specific interest talking about today and fibromyalgia was started because it was a mystery kind of problem. And I know that was leaving a lot of people frustrated, I heard of the word maybe around 1988, 99, 2000 never had any training on it just on my own research, looking things up and wasn't getting a lot of, you know, there's so much you have to learn in residency, and started recognizing that there were other problems going on, like migraines, IBS, recognizing there's a familial connection to things and probably in the last 11-12 years started recognizing through more information, people like Dr. Daniel Claw, who's done a lot of research at the University of Michigan, in the United States on fibromyalgia, and recognizing how this is a central pain processing problem and started incorporating that in my patients starting to learn more, and probably in the last four or five years started seeing some other connections recognizing the role, lifestyle has. And I started with probably six, seven years ago, a two page handout, which, when you have a very complex problem that involves so many different aspects of medical and lifestyle management, it's very hard to get that out in a visit. So I did extended it to a 20 page handout that I would print out on my computer system. And then I thought that's still not enough. And then I decided to get interesting in writing a book probably three or four years ago, and then accelerated that with the publication of that about a year and a half ago. And the goal was really primarily my first thought was if I could give this to my patient, and also to their loved one to their spouse, their friend, their family, who really just doesn't understand this mysterious problem that they have. That's so frustrating. And also wanted to add a high enough level that other medical doctors can pick it up and have it not just at a sixth grade science level, but get into a pretty in depth understanding of a lot of the biochemistry and discussing the studies and how our brain works. They feel that a lot of people with fibromyalgia are extremely intelligent and they deserve more than just a superficial elementary discussion, but trying to give as much evidence and discussion for that. So that's a quick overview of kind of just also just a heart you know, one of my favorite group of people that I get a chance to take care of our people who have fibromyalgia because by the time they have seen me most of them have had years if not decades of frustrated did care often dismissed by the medical system and felt that they were just imagining their pain and that it wasn't actually real?

Anthony Hartcher: 5:08

Yet? Because the process of getting diagnosis can be lengthy? Because I guess the medical fraternity is ruling out any other I guess, conditions before it really gets to this sort of It's a bit like do you categorize it a bit like IBS? It's sort of that default when they don't, can't really classify it as some other condition or Yeah,

Dr. Michael Lenz: 5:29

so yeah, it's because because both of them are, we call them central pain, which means central nervous system processing problems within the brain, brainstem spinal cord, affecting how the brain and how you experience pain and ethika Fibromyalgia is the overview of that. And then under that a regional central pain syndromes, including things like migraines, tension headaches, painful periods, abdominal pain, cyclical vomiting, even painful intercourse for women falls under that category. And in one sense, it's not very hard, I would say, it's like making a diagnosis of a migraine headache, or an irritable bowel syndrome, I can make a very good history, if you come in and you tell me I've had, let's say, you said I, for 15 years, I've had these episodic headaches that can last from a few hours to two or three days that are severe and pounding, I get light sound sensitivity, and I need to lay in a dark room, I used to back and lay down, I can pretty much say you do not have a brain tumor, because brain tumors do not come and go and if you had one, or if you have a bleed or a stroke, and you're relatively normal in between. So in a similar way, if we know what we're looking for, and there's now accepted criteria for diagnosing this has been around for several years, now we use a history. So a careful clinical history, right? If somebody comes in and says I've had chronic diffuse, or often it starts as painful. You know, a classic story is a woman who had some stomach pain, maybe in elementary school, when she started menstruating, regularly developed painful periods much more painful than their friends almost where they have to miss school for a couple of days, it gets so bad, then they might start getting migraines, tension headaches, and then maybe there's an accident injury or something happens, where they start hurting all over their body. But even if somebody has fibromyalgia, and I have a episode on my podcast, where I talk how history is so important. But if they suddenly say now I've got bloody stools, and I've lost 15 pounds, I might have to go, Well, maybe this person has also developed colon cancer, ulcerative colitis, you can have other things going on. So you always have to be careful and listening. Just like somebody who has a panic attack could end up having pulmonary embolism or blood clots in their lungs. So you always have to be careful, but you can then take what we call the widespread pain index. So WPI for short, and the symptom severity score, in addition to a careful history, and then it's basic, common labs that aren't fancy, you know, you don't have to spend a lot of money you know, checking your thyroid, CBC, comprehensive metabolic panel, looking at liver, kidney function, glucose levels, and also usually a sedimentation rate. And then a careful exam, we usually are inspecting joints for swelling and other problems. Although in the past, they said oh, if you have rheumatoid arthritis, you can have Fibro. So now that actually is incorrect, you can have other problems, in addition to Fibro In other words, you can have rheumatoid arthritis, and you're gonna have fiber. In fact, about 40% of people who have rheumatoid arthritis also have fibromyalgia. So it's part of that. And then, so you use that and most doctors in I did a Facebook group I asked, do you guys do you even know what this is? These were people who with Fibro, and they've never heard of it. The doctors are not regularly using this because the doctors were never trained on this. When they were in training, you know that often, the saying is that every seven years half of what you learned changes. And it takes about 17 years for something that is commonly accepted in practice like this was in 2016 criteria. Most doctors have not implemented that. Because you have to be interested in this, this is kind of a problem and where you just have to either have a heart or know somebody or just have picked up a passion to want to learn. So getting back to I really like helping people with this because it's very frustrating. But when you have somebody that is the most frustrated and you can help them and reduce their symptoms and even reverse them through a comprehensive approach, that's just the best kind of joke. Nobody gets excited and say Dr. lens, I've had a urinary tract infection. For the last seven years I've been to 15 Different doctors, you're the first person to diagnose it. Nobody says that because that's common. You know, that's a common easy one, you know to fix and a medicine we kind of like easy ones. You know, people who go in the emergency medicine like saving the person who had the heart attack and rescuing people and fixing broken bones but these are somebody who wants to spend time getting to know people getting to know their backgrounds. You know, talking about lifestyle. The role of lifestyle has a strong effect. Kind of an interesting and maybe get to it later. But one of the surprising things is of many, and probably the vast majority of people who have fibromyalgia actually were extremely active when they were younger, whether or not they were actually an athlete may or may not be the case. But they might have just been at a time, if they're my age, they just played after school because it weren't the video games, and they just played with their friends and rode bikes, and whatever the kids in the neighborhood, they were just playing for hours after school, and they were getting their exercise, or they might have actually been high level athletes when they were younger. And then something happens, they blow out their ACL, they get neck pain, or they graduate from their sport, whatever level they get to whether it's high school, college, even professional, and then they start developing the symptoms later, but by the time the doctor sees them, they don't even fathom that this person who is at such a low level of activity and high level of suffering ever was very active, would be shocking. But by just bringing that up, it validates like, Hey, I know that you have a memory of what it's like to be living a different life. And I often say a few when in a time machine, I like movies with time machines, if you could go back in time and say, Hey, in 25 years, you're going to be living in a severe Fibro, they would just never believe it. And often, that's the frustrating. How did I get here? So

Anthony Hartcher: 11:23

that's unknown, right? It's essentially we don't I mean, there's probably there's some genetics that are at play here. Some other areas, I guess, other disease areas that could have been, you know, a causative factor, but it's really unknown, right?

Dr. Michael Lenz: 11:37

Well, actually, my opinion is that we understand it. But the problem is, it's multiple factors that play a role. And I just did a podcast on the author of Gone With the Wind to famous world novel, epic novel woman who wrote the book, Margaret Mitchell, born in the year 1900, had both fibromyalgia and ADHD, just understanding how we understand pain, and how we understand disease back then it was all it was just infection in the year 1922. There and surgical management's the idea that we couldn't even look into the brain. Now with our understanding of using functional MRIs that look at blood flow to the brain, we can recognize that people who have fibromyalgia experienced pain, at the same level as others, looking at the same parts of the brain are activated to the same levels, but it's for stimuli that are much that should not cause pain, you know, they do studies where they apply pressure to the thumb. And if you don't, and I don't have Fibro, we might have to have four kilograms of pressure to on our thumb to have pain where the person with Fibro reports the same level of pain but only at two kilograms. They've done that with studies where they'll have a very quiet room, and they'll gradually increase the decibels and then you say, Just tell me when it's moderately uncomfortable. The person with fibromyalgia reports that at a lower threshold, they've done this in looking at in the irritable bowel spectrum, put a balloon with a pressure sensor in there and inflate the balloon. And then tell me when it's moderately painful. People with fibromyalgia will report pain I lowered threshold years ago before we did colonoscopies routinely, I do flexible sigmoidoscopy, which are only going up half of the way and we didn't need anesthesia. Well, we said we didn't need anesthesia. We did it without any. And I remember there were patients who would just like spasm and they'd get tight and it would be painful and other people just flew right through. So what we now know is actually It's how our nervous system responds. It's that nervous system being hypersensitive. And then we know that is connected with other coexisting conditions. There are other conditions like RLS and ADHD that play a role and make us more prone. There are lower levels of likely neurotransmitters like norepinephrine and dopamine that are lower that affect it. So there's heightened pain sensitivity, and also there's often deficiency in what we call the descending pain pathway within the brain in the central nervous system that affect it. And then there's a lot of inputs I kind of the apparent comparison is like having a guitar hooked up to an amplifier. And this volume coming from the guitar represents the amount of pain somebody experiences or discomfort because it might be light sound sensitivity smells similar. If you know somebody who's at a migraine headache, if you're around them, and you're kind you can tell they you just turn off the TV, put on your headphones, turn off the lights and you guys go hey, just you guys just go outside, they're not feeling good. If they're laying on the couch and you let them rest because they're hypersensitive. You and I could sit there and be not bothered at all. When I have people come into my exam room who have fibromyalgia, I can tell just by looking at them just almost like a severe migraine where they might have sunglasses on and I have some windows with shades, one side of my room and I'll just turn off the lights. I'll say is there if I turn off the lights? You're like, No, I'm fine. I'm like, let me just turn off the lights where it's and they just I feel better. They take off the sunglasses. You can just feel the weight come off their shoulders, but it's also being empathetic to recognize that I Like having it bright, as I'm getting older, so I can see better with these nice bright lights in my exam room. But for somebody struggling with fibromyalgia, those lights would be extremely uncomfortable noise light sounds and whatsoever getting back to that amplifier concept with the guitar connected is that some people, their amplifiers set higher, it's like a pre genetic preset, well, then we look at what are factors that can turn down the volume, you know, getting the good sleep, consistent exercise, eating a healthy diet, having the stress at a good level, you can't control your genes. But if you do have a coexisting condition, like restless leg, or sleep apnea, or ADHD, recognizing that and then treating that actually can make a difference to help reduce the suffering. But all of those are working in concert. And it's a different thing when you're dealing with lifestyle that treat medical problems, right, it's not just giving insulin, or taking a thyroid pill, it's a very active engaged problem. It's, it's not a passive problem disorder, where you just the doctor does this and it works. You know, you have to be engaged, and it takes it's a different concept. So that's again, that's why I wrote the book as well to get a deeper understanding to recognize, okay, with the podcast to continue to have those conversations so that people can have some agency that sense of self control to whatever they can. And also because recognizing how educating their loved ones that know when they say the TV's too loud, and it's too bright in here, they're not making that up and support them. Yet, at the same time, it might be Hey, well, can you help support them, you know, eating a healthy, more plant based diet, keeping on a regular schedule, help encourage them, but not annoy or harass them to try to get on a regular exercise regimen. And getting that attention and being supportive, because it's very challenging, very challenging.

Anthony Hartcher: 16:52

So I have identified the gene that can give these people a genetic predisposition to the condition,

Dr. Michael Lenz: 16:59

there's not one gene, there's multiple genes that are likely involved in a lot of these that they are identifying are often like, affecting like levels of dopamine, norepinephrine, serotonin levels, and there's probably multiple areas that are affected, there isn't just one magic gene. Even in the world of high cholesterol hypercholesterolemia, we used to think oh, the concept is one genes broken now, there's probably 7080 genes that are involved in this. And there's probably slight variations that affect different levels, to different degrees. So there isn't just that one magic and we don't do any routine testing to measure any of these levels, either just done in research and very special tests that involve radioactive like or I don't know, if it's some radioactive especial isotopes that are take a lot of time and money to do these scans that show different levels of this that I love reading about the research, but it's not something you use in a practice, it's just to validate that yeah, there are these issues, they do play a role. And that's often why because genetics do play a roll. It's roughly about a 50 ish percent inheritance. I think what we know just like lifestyle issues, diabetes is often in that

genetic 50: 18:08

50 inheritance, type two diabetes. But whether that passes through is can be, you know, is the same as you probably heard genetics can load the gun, and your lifestyle pulls the trigger. So a lot of times, if you're able to say ahead of time, and I actually because I'm a pediatrician and an internist. So I see kids and adults, I have three generations of people who I take care of. And often when I see somebody who may be in their 30s, with a child, who's maybe already having some struggles, identifying, because they treat, for example, ADHD, if that's something they have recognizing, okay, that's something we got to look at if medication can be very helpful, but also recognizing that, hey, this child throughout their life, like if mom can role model this as well or dad, that exercise is what we do. And like I heard on one of your podcasts, as you've probably said many times I don't like calling exercise, I call it movement. I call it exercise, I call it having fun, you know, you can go for a walk or swim, whatever you want to call it. But hey, we are wired, I use this analogy. And I have a sense of humor. So when I use this, I'm not calling people dogs. But as you know, there's a bell curve and I don't know how many people in Australia do you think have dogs? You know, it seems like half the people.

Anthony Hartcher: 19:27

We had the dog boom during COVID Dog explosion, there was a dog shortage.

Dr. Michael Lenz: 19:33

So we have about we we are just as busy with our life and our one daughter really, really wanted a dog for you. And we just don't have the lifestyle to pull the trigger to attend to a dog and give appropriate care. But we see all different types of breeds of dogs and there's one dog that one of her friends has who has the look that if you walked the dog around the block it would be like oh my gosh, it's so far, a whole block and then others other breeds if you went for four or five mile run The morning before work, they say, okay, so who's gonna run me after work? That was a good one, I'm ready for another one, let's do another one. And they just are wired to have to run. And so just if you embrace that, and that's why that college or that former very active level, and women maybe would have been dancers, you know, you might not have been the formal athlete, but hey, you're wired, I've had a lot of patients unknowingly say to me through on that kind of little bit of that Fibromyalgia predisposition. Doc, if I don't exercise vigorously, 90 minutes a day, my mental health is in good. And they've had that self awareness. I'm bridging like, hey, that's part of that's like taking medication. And that's what your body's wired to do. Other people who aren't prone to fibromyalgia, they could go and go to a lifestyle conference for a week, and listen to, you know, the best speakers in the world eight hours a day, and then hang out and socialize. And they wouldn't feel pain where there's other people who if they don't get there, you know, at least 10,000 steps a day, they start hurting. And that's just how they're wired. So that recognition, right, that this is how you are and so if you can recognize throughout your whole life, it's going to be really important. And also recognize, yes, there's some people who can eat really bad food that's really low in fiber and high in processed carbs and fat. And so and they don't get any irritable bowel, they don't get migraines. But if you're prone to this, you don't have that. So it's just an extra you feel better. Why would you want to, and there are some people who are prone to asthma, right. And other people aren't, if you are, don't smoke cigarettes, and that other people might smoke cigarettes, and they don't have an asthma flap, you know, you never should smoke cigarettes, but it's just like, if you're prone, well, you just have to have that awareness. And often when I talk to people about this, they'll say, I wish you were my pediatrician when I was eight years old, because they started saying that they thought I was coming in with chronic abdominal pain with going to the school nurse faking it, that I was just trying to get out of class. And now when I see those kids, it's like, hey, one interesting example. Because it's on these regional pains and talking about lifestyle, I had a patient who was filling in seen for the partner I work with. And he had stomach pains, while they were triggered, because he stopped exercising, and I live in a cold part of the world. And he was playing basketball. And then after Christmas, there was a gap for two months, and he stopped exercising and it was too cold. He wasn't going outside, probably in video games, and he wasn't as active. And then he started getting these, what we call abdominal migraines, bad stomach pain, with nausea, they were episodic, and nothing else changed except he stopped exercising and kids are wired. But if he would have taken to the local YMCA and said, hey, you need this. And that's why a lot of kids in my part of the world in the summer, they don't get stomach pain and headaches. And then school starts and if they're not in a sport, or it gets cold out, and they don't, you know, compensate and go to the gym, they start getting more pain. And they also have more stress because of more schoolwork, which might squeeze out exercise. And all of these are feeding back and forth. You know, if you're trying to get a lot of exercise, but you're not sleeping well or you have a lot of work demands that you're maybe if you have untreated ADHD, you're not as efficient and getting done, then you feel guilty about getting that two hour workout in which you know, you needed before what you got when you were in college, but now it's hard. And then you're stressed and you now you're tempted to eat junk food, which temporarily makes you good, just like having a shot of liquor makes you temporarily relaxed, but isn't a long term solution. And you see how these all are interconnected. And it's like a perfect machine. And then it starts to get out of rhythm. And you can start having problems. So that's explaining how complex but to me, it's, I'm a faith person. And I look at and say, Wow, how incredibly designed we are. But you just take one thing and you shift it off. And it starts to not work efficiently. How you know, it start getting all these problems. And so, so to say, Yeah, I do think we have a really good understanding of it. But it's a different concept and understanding you know, this 100 years ago, it's just simple. Oh, you have a bacteria find the bacteria, right? Find the malaria find there's a podcast that talks about the history of medicine and I love it's by a doctor and it's pretty nerdy. And but I love going back and wondering well what it was like, Well, how did we figure out what malaria was? How did we the first people when they didn't know they you know the whole story of the four humors like melancholy and all that the bio and you know, George Washington, our president got bled to death because they thought well, he let's take off some steam. He's got too much blood, you know, but we laugh, but the poor people with fibromyalgia who are struggling, aren't getting that information because it's a lot more complex, right? It's a lot more complex than just some simple A equals B.

Anthony Hartcher: 24:39

And is that why you think it's getting missed and often late diagnosed or people carrying the condition for many years because physicians just don't have the time with the client in you know, in Australia will certainly I can't talk about the states but if physicians typically have a 15 minute consult and they hear all the symptoms, you know that they don't get a lot of time with their patient. Yeah.

Dr. Michael Lenz: 25:00

generally get. Yeah, yeah, that is a barrier. And that's actually again, part of why I wrote the book. And with that, and I actually ended up you know, often get behind, because I'll take time, you know, I get a 30 minute visit for patients love to get 45 minutes I always love if you want to see me try to say, Can I have the last patient of the day? Because then I had somebody that was new to me who came six and a half hour drive, because she went after years of seeing different doctors, she finally got diagnosed by a rheumatologist who often makes the diagnosis, and it's the second most common diagnosis in rheumatologist, but most of them do not treat it. Because it's a brain and how your writing process if they're used to real problems in their mind, that's a real inflammatory problems of lupus and rheumatoid and those kinds of things. So let's say okay, you have this now go talk to your primary, and she's like, Well, my primary didn't know what to do with me. And now you're telling me to go back to them. And they didn't know in the first place. So I don't have a lot of confidence. And then they call around other primary offices and say, Do you treat fiber or nobody treats fiber? I kind of compare it to Jesus and Pontius Pilate go to King Herod inherit doesn't know what to do when it comes back to punches pile and he's like, What am I going to do with you right with it, then you get this uncomfortable feeling. And I think I often it's like, put the head down and mumble a couple of things, and just hope you go away in order. And then often what happens is the doctor doesn't know what to do. So what it can adapt, you're doing a short visit? Well, well, we'll order another thyroid test and a CBC and another test. And then you, Doc, and I have my second episode that I have, I think on my podcast, I think it's the second one, the first ones it's called, it's not my thyroid. Because all of these patients every time they go to a doctor, they're like, well, let's check your thyroid. No, no, no, no, no, you're not getting away that easy. I've had this like this checked, exhibit check four times in here. It's not my favorite. I know it sounds like a good buy me my thyroid. I know if you look at the textbook. And actually sometimes what happens is they got shuffled in an American, I don't know how much alternative medicine out of the within the government system is then there'll be people who go well, no, it is your thyroid, but we didn't do the right tests. We got to do this really special expensive tests. And then they go on all of this. And then they end up going for years of this or in America, there's something called Lyme disease. I saw two people with Lyme disease. If you look in Wisconsin, it's known as it's there's a lot it's summer, people are going outside to people with Lyme disease two weeks ago, their classic Lyme disease actually had a third person who was in urgent care who I talked to who had it today. But then there's people who have chronic really fibromyalgia. And there are quote Lyme literate doctors who will say Oh, well, your chronic really fibromyalgia pain is actually Lyme. And we have to do a special test that your regular doctor didn't have the infectious disease doctors dismiss that. And if they go, I want to see the infectious disease doctor for my chronic Lyme, they don't even see them. They just dismiss them, which doesn't help. So then they everybody, they get shifted into this other world. And then they get taken advantage. A patient of mine had a shopping bag full of supplements. And she was having an upset stomach, taking I mean literally handfuls every morning of this, and doing all these special tests. And I'm like, you don't have this and she was getting suspicious. And the reason I met her was because I was seeing a friend of hers mom who was in for a visit and something mentioned fiber. I don't even know how come I think Oh, who is that? Oh, my friends. She's had this and she's looking for a new doctor. And she was very frustrated. And then I saw her I squeezed her my schedule. But the person who came six hours way I spent like four hours with her. Because I felt terrible. I'm like, All right, I can't normally say come back in two weeks. And so I tried to get as much information. She had read the book. And she actually said, she found me because her one back said, Well, maybe you'll find somebody on the internet, maybe we'll learn something. But good luck. And she that's how she found me. She emailed me listen to the podcast, and she read the book. And in the book, the first four chapters, she said I was crying because you talk about this and that was my life. And part of a lot of people say well, do you have Fibro, like no, I don't have fibromyalgia. I occasionally if I'm not perfectly getting good sleep up excited for staying up late for a football game or traveling and bed schedule, I might get a headache. But I don't have this. But I just care about people. So I just want people to get better and help in some way. So normally, I could say have people come back in a couple of weeks and see them back. So spend time with them. But you're right, having that limited time with patients. And part of it is I think often when they might go to the doctor and they list all the symptoms. The doctor is like oh my gosh. And they often must think well, this is the crazy patient. And she always keeps telling me it can. We'll just order some more tests just to humor you. And then the patient actually isn't wanting more tests. They just want an explanation. And sometimes when they do get more tests or maybe an alternative medicine doctor, and they got all we found it but then you have questionable motives like here, here's a special supplement. Here's a special thing to take. And then here's a special test that shows this genetic thing that you have and it's true. Really not evidence based, you know, and then then going with hope, maybe a slight short term placebo effect. And part of that is that caregiver effect of just somebody who's caring. But that's part of my hope with the podcast and with the book too, is that this you can take to the doctor, what ends up happening is a patient themselves has to be an advocate for themselves, but they have to have somebody standing in their corner, and I did a blog on my website, conquering your fibromyalgia like I'm in your corner, like, Hey, here's a doctor out there. And I know, I can't take care of in the United States to 10 plus million people who have fibromyalgia. But hey, here's somebody and hey, if there's a doctor out there, who's neutral, who just literally doesn't understand it, but he's really wanting to help, hopefully, the light will click on and go, oh, oh, that's interesting, you know, and want to take that on. And hopefully they can. But that's where like, if you get to get it in with a lifestyle approach, you know, somebody's got to work to try to teach them how to eat properly how to incorporate exercise, and work as a team, you know, and I do recognize when I talk about concrete, there are people who are in terrible circumstances, who are in very high stress situations in abusive relationships with a long history of really big struggles, who may be economically in thing in a situation where it's really hard, you know, and even with the perfect medications, they're things that are going to play an impact and, and have barriers. And this is one where it's not just a pill, it's all of these things. It's not one thing, you know, in America, we play football, you probably heard of it, or baseball, two very American sports. So for Australians, but we have to have 11 players. And maybe I don't have to explain rugby leftover fun rugby explanation, we occasionally have the championships here. And I'm like, I don't quite get it. But maybe that's the same thing. Australians think about football here. But we have like four times to get 10 yards, well, for Fibro, and then you have to get a touchdown, which is 100 yards down the field. Well, 11 players have to do everything right, just to get maybe a four yard gain, and you got to do it right. And if one person doesn't do things, right, well, you end up getting sacked, and you have to kick it to the other team. That's the same thing with Fibro, you have to do everything right every day, all day, every week. And if you get something, you know, breaks through, you know, flying to Australia, and completely getting jet lagged and eating junk food. And suddenly it sets off your fibro for a week because you're jet lagged. And you know, now in the recognize, okay, we have to try to do the best weekend. So there's so many different pieces that have to be played. But if you understand that, then you just have to recognize how all of those are important. Yeah, I

Anthony Hartcher: 33:15

was just wanting to pedal back a bit or cycle back. You mentioned this hypersensitivity. And I'm thinking there's probably mothers that are listening to the podcast thinking, Oh, my son or daughter complains about loud noise or bright lights, and they do complain of a stomach upset or stomach pain, every now and then periodically. Do you recommend the parents? Or do you advocate for DNA testing to see if that we do inquire about a history in terms of a family history to see whether there is Fibromyalgia within the family history and whether genetic testing should be done that way.

Dr. Michael Lenz: 33:55

So I don't ever recommend any genetic testing. Because there isn't any marker. There are very few diseases where we do genetic testing. One would be hemochromatosis, for example, there are gene testing that will do sometimes, cystic fibrosis where they might do some gene testing with that. But there isn't any gene testing, but it's actually just listening and taking a very good history and the recognize and usually and you know, and I have a chapter on my book on pediatrics and fibromyalgia and I say, you know, some often by the time it culminates it's into adulthood, and it's been going on for years, but there were regional pain syndromes chapter it says, you know, your fibromyalgia didn't start likely in adulthood, it might have likely started when you're younger, but, you know, I've had patients go, I thought it was normal to have severe pain with my periods. I just always have had that. And then I until I got older people go like, No, I don't get three days where I'm miserable. But one of the earlier signs, interestingly, of the fibromyalgia spectrum is colic. And I used to explain years ago how I'd say to parents, when I give talks or explain, I say, you know, colic is basically your baby's hypersensitive, and you know, you're not doing anything wrong, you know, you can try doing white noise and rocking and different things. Well, now, this shows that there's a connection between history of colic and things like migraines and restless leg syndrome. And often when I now as a pediatrician, when I have somebody who's clearly a baby's got clearly as colic often then ask the parents and like, Okay, I'm just curious which one of you guys has a history of IBS or migraines or restless leg? And the thing is, like 80% of people who have a baby who has colic has some level of restless leg and so it's interesting conversation. Now sometimes it's very mild. Maybe they were doing a healthy diet. They got mad Right, and now they don't eat junk food, and they're eating more fruits and vegetables, and they're exercising. So the IBS isn't bad. But often it's a you hear the story like, well, you know, Dad, he kind of gets a bad stomach or grandma, and then army, oh, my grandma's got Fibro. So she probably had these others earlier. So it's very interesting how you can connect the dots and share that in the in you after asking the right questions. So if you know what you're looking for, you then will ask the right questions. And so and that actually validates because then as somebody who cares for the parent, one of them might be struggling to some degree as well, what we used to call growing pains and kids, for example, there's two types. One is a growth plate stress. So it's the soccer rugby runner who's running and jumping in his high plyometric exercise. And they're pulling on the growth plate that hasn't fused yet. That's an active activity based pain, but growing pains that are at sleep and at night and I can't sleep and my legs bother me and waking up through the night is actually what now we understand is restless leg syndrome and periodic limb movement disorder, which is on that puts you at predisposition to developing fibromyalgia and hypersensitivity because if you can't get into deep sleep, then you can't get into that good restorative and your put your brain becomes more hypersensitive to start with with Sven. They're more tired during the day, which makes them harder to exercise, and you get in this vicious downward spiral. So I hope that answers the question, but it's as I go, I'm talking a lot here. But all of these are like dominoes. And they're all interconnected. You know, so that would be one of those asking more of those questions.

Anthony Hartcher: 37:20

Okay. And it's probably, again, back to that point of why it's typically missed in, you know, early consultations with physicians is because it involves it's multi factorial multi systems. And you know, if the physician sends it to a particular specialist, that specialist may miss it, because it's not coming up on the radar as a condition of that system. And so I can see how you know, it can be easily missed if you're not got a trained eye like you do for the condition.

Dr. Michael Lenz: 37:51

And to that point is that when you have a complicated problem, a pediatrician or internist family practice, type, Doctor general GP is going to refer to a specialist. The problem is the specialist only looks at one organ system, the GI doctor only is going to talk about IBS, they're not going to be talking about migraines, they're not going to be talking about the psychiatric component, maybe lifestyle commode. The neurologist might talk about migraines, but might not recognize other things. And I use the analogy of the blind men and the elephant. fibromyalgia patient is an elephant, but they're all looking at one aspect, that spine surgeon may be seeing them for back pain, but they also have painful periods they, what's the you know, so you get all these compartmentalization, which is a terrible way to approach fibromyalgia. And that's ended up being what the care is, and because I'm somebody who's both specialists in kids and adults with an interest in lifestyle medicine, and I'm able to bring these together, I often hear and this is just humbly saying this, but often hear patients if they're they're seeing me there, I call it bittersweet. The sweet part is they're getting better. They have these explanations. It's understanding what's going on. But also they're bitter. They're like, Doc, I, you just saw me one time, and granite might be a very long visit. But you were able to put this together. I've been seeing doctors for years, decades, you know, decades. And you found you figured this out in one visit? Why doesn't everybody know this. And it's like, all the stuff we talked about. And that's where, you know, it's one of these where my mom had passed away from pancreatic cancer a year ago. And she always had a big heart. And she always cared for people, she worked as a nurse. And I think part of that carries over to me is like if I can just care for the little ones, people who are struggling, the suffering the poor, the needy, and offering what I can to help them to stand up for them and care for them. I remember her giving of support for family and friends who were struggling with now what we'd probably call depression, and I talk in the book, and this is from a foreword. At the end of the foreword to the book is that Dr. Jung said at the end of the foreword, he said in the years past depression was often ignored as a real problem. Until finally the medical community acknowledged that this mood disorder is a valid problem affecting millions and needs to be treated. Now it is time for physicians to step up and realize Fibromyalgia is a similarily debilitating medical problem that strongly merits diagnosis and treatment and conquering your fibromyalgia is an important contribution to bringing both doctors and patients up to speed on this profoundly serious problem today, offering them helpful solutions to their perplexing problem. And that's kind of you know, you look and I'm a I'm a practicing physician, one of the worries is like, Okay, I'm very busy. I can't see everybody and if people hear this in No, I don't think anybody don't come from Australia to see me. It's too far. But if the United States, I can't see everybody, and there's no way I can, you know, it's impossible, and it's due the time, but I'm hoping that just like depression is commonly recognized and understood, and most people now would not dismiss it. But until, you know, probably 30 years ago, it was often dismissed as why can't you just be happy, right? Just put a smile on your face. And we laugh at that. And hopefully, it'll be a time where like, no person's got Fibro, their brain works differently. They got a different operating system and how they process things and your road. If you say that, you know, and hopefully the next generation of physicians comes through, they'll have that heart, they'll have that understanding the questions, you know, that they're not just like, how we've progressed in understanding medical problems going from the history of medicine and how we understand things.

Anthony Hartcher: 41:31

It's been a fantastic discussion, Dr. Lanza, really appreciate you coming on the show. How can the listeners best connect with you.

Dr. Michael Lenz: 41:39

So if they want to connect with me, you can email me at DrMichaelLenz@gmail.com, you can go to the podcast conquering your fibromyalgia. And you can also go to the website conquering your fibromyalgia. And I'd love to get feedback. If you've listened to the podcast, you know, you probably have a link on there. I'd love to hear your feedback on stories and just validate. And if you have any other questions that you'd want to ask me, I'd love to have that. You know, just like as you're trying to do a podcast trying to get ideas, and I want to serve people who want to learn more, what are the questions on there? Because there's so much and just in this brief conversation, there's so much more to talk about, like I mentioned off the air. When you start a podcast, you're like, I don't know, well have enough material. And now it's like, Oh, I'm getting I think enough material. So I hope when you listen, I love listening to the podcast love Listen, your podcast and learning more is hopefully you'll get a chance to hear somebody who's just caring who has a big heart, who cares about people. And while you're going for a walk, doing the laundry, cooking a meal it listen for 20 for 25 minutes and gain some wisdom and then share it with others. And actually, this is something where you could share it with your doctor and say, Hey, I've had patients might say, I'm giving this to my doctor, you know, or I'm gonna give this to my sister who lives far, but they're gonna read it and give it to their doctor. And hopefully they'll go oh, well, that's really helpful. That's really interesting, and then want to hopefully apply this to help their patients so,

Anthony Hartcher: 43:07

and listeners, I'll include Dr. Lenz, email links he shared with you in terms of his website and his podcast in the show notes. So you can go directly to the show notes. And yes, I agree with Dr. Lenz, please give us some feedback, because I'd be happy to have Dr. Lenz on the show. And I've already asked him to come back on the show to speak about other medical conditions. But we certainly would love to have him come back on his topic of passion. And he would love to know, what would you like to know more about, so please share the feedback. And we can then set up another episode on fibromyalgia with Dr. Lenz, because he's got so much heart and that's what I want to conclude on is absolutely Dr. Lenz, you are someone that gives cares, and it's got the biggest heart and I really appreciate you coming on devoting your time to really just helping people with this condition or just and also today, you've been spreading the awareness, getting it out to more people aware of it, that it actually is a condition and that it's often misdiagnosed or overlooked and that they may know someone that you've mentioned that may have or but you know pretty much all these symptomology or you know, or you know history and they may then think well maybe they've got this condition and hence they can then connect with you and you know, read your book or certainly get your support. So thank you once again. I really appreciate it. You're welcome. Love to be back and to the listeners. Thanks for tuning in to another insightful episode of me and my health that stay tuned in for more coming. So thank you and I really appreciate you listening in bye