Ep 131 Fighting Back: Tim Kaufman's Battle against Obesity, Ehlers Danlos and Chronic Pain Part 1

Tim Kaufman, our guest on this episode, was battling with a weight of over 400 pounds and the agonizing grip of Ehlers-Danlos syndrome. He succumbed to opioid, alcohol, and food addiction to cope. Tim's story is a testament to the power of unwavering determination and lifestyle changes, as he managed to shed over 200 pounds and is now essentially pain-free. His journey offers a beacon of hope for those wrestling with similar struggles.

Growing up on a dairy farm and an avid hunter, a whole foods plant-based diet was not part of his upbringing. Like many, he was very active in his younger years. He discusses how pain medication became a double-edged sword, bringing temporary relief but also escalating his chronic pain. But this episode isn't just about the struggles but the fight. Hear how Tim, armed with a changed diet and small exercises, began to turn the tide against the disease.

In the final stretch of our conversation, we confront the unforgiving realities of living with chronic pain and fibromyalgia. Tim's experience illustrates how a whole food, plant-based diet, and lifestyle changes can significantly manage these debilitating conditions. As your hosts, we invite you to join our community and stand together in the battle against chronic pain and fibromyalgia. After all, every new journey starts with a single step.

The fibromyalgia starter pack  categorizes the episodes in a way that is more accessible for those new to fibromyalgia.

Transcript

Speaker 1: 0:48

This two-part interview series with Tim Kaufman is one that you are not going to want to miss. He has an inspiring story of battling with chronic pain, addiction, obesity, losing over 200 pounds. He went from weighing over 400 pounds, the scale in the doctor's office topped off at 400, and he didn't even know how much beyond that he had weighed. He couldn't even get out of a chair. He was in severe pain. He had gone to multiple doctors at a time when the electronic medical records weren't able to monitor patients and had developed an opioid addiction. He also had developed a food addiction, an alcohol addiction, and all of this was on top of trying to live with a more visible illness of Ehlers-Danlos syndrome and really wasn't offered any hope but implementing lifestyle medicine with using a whole food, plant-based diet and gradual, progressive exercise setting goals. He now is essentially pain-free. He has run ultramarathons and triathlons, and his story is truly inspiring. Hearing a story like this may have mixed feelings, because if you are at the same stage that Tim was, it may seem like it can never happen to you. He speaks to that and you want to listen to. He comes from a person who had been there where you are, or maybe where one of your loved ones or one of your patients are at. Remember that while I am a doctor, I am not your doctor. All of your signs and symptoms should be discussed with your own individual physician. Now on to this week's episode. Somebody walking into the clinic who was in your shoes often gets dismissed and stigmatized as a lost cause. I have three target audiences. It's one for the people who are living and struggling with chronic pain, chronic fatigue, fibromyalgia and other related invisible illnesses, also known as central sensitivity syndrome, which Ailer Stanlos does fall under. It's for their loved ones, so, hypothetically, somebody like your wife who's out there family, friends, support people in their life. And then it's also for doctors who honestly don't have a lot of training, understanding, and if you can hear stories like yours, I think it humanizes and validates what people go through and, timidly, I'm wanting to offer hope. I'm really excited to get a chance to share with you the story of someone who's gone through a lot of struggles and valleys and yet has come through that with making some major lifestyle changes. Today we have a special guest, tim Kaufman. Welcome to the podcast, tim.

Speaker 2: 4:01

Thank you, Dr Lenz, for having me. It's a real honor and pleasure to be here. Thank you for making the world a better place by doing what you do.

Speaker 1: 4:08

Yeah, awesome. So you have a condition that I haven't talked or had a specific episode on but overlaps so much with fibromyalgia and related illnesses, as I like to describe it, including chronic pain, fatigue, and it's something called alerostanolose. Can you just tell us what that is and kind of layman's term of?

Speaker 2: 4:31

Yeah. So basically it's kind of a genetic screw up where the glue with a collagen that holds all my bones and joints and everything together it becomes super stretchy like bubble gum. When I was younger it wasn't too big of a deal, we just thought it was like a good circus trick. Because I was double jointed, I could bend in ways that most people couldn't and I think because you're young and everything bounces back pretty easily, didn't affect me that much. But over time my joints were dislocating or subluxing all the time and in time you start eroding all the cartilage and things to get like little potholes in them and your knees start not tracking well. So these obviously add up to chronic pain over time. So yeah, there is actually a lot of overlapping with alerostanolose syndrome. There's a whole host of different kinds. I think I was blessed to get the hypermobile kind. Typically you go hypermobile and very stretchy skin, but it also can affect your heart and some people are very, very sick and can't get out of bed over. So I'm pretty blessed for having this. It's genetic. My sister in Connecticut also has this and she has a bunch of problems as well.

Speaker 1: 5:47

So you grew up in upstate New York on a dairy farm. My dad grew up on a dairy farm, so have that dairy farm connection. When did pain start to enter as a regular part of your life? And sometimes people look back retrospectively and say, well, I guess I always had some pain, but when do you recall that becoming a regular part of life for you?

Speaker 2: 6:09

Yeah, I think you're 100% right. Like I think, I had chronic pain. I was always getting hurt, even as a little kid, like eight, nine years old I remember. I remember this one time going through a Kmart, running through the aisle and I twisted one ankle, kind of recovered from that, hit the other ankle, folded that one in and I laid right in the middle of the floor and I'll never forget this. This lady said oh, that's a clown. Because I literally looked like a clown. So I'm sure those twisted ankles hurt, but I mean you just kind of get used to it. Until I probably got into my I'm going to say late teens, maybe early 20s, pain started affecting. I guess the pain didn't really affect my life that much until my late teens and when you were a kid.

Speaker 1: 6:55

do you ever remember having growing pains or problems getting good sleep?

Speaker 2: 7:00

at all. I know I don't remember I worked really hard and I often wonder if I wouldn't have. You know, I work in a professional setting now where I'm at a desk most of the day but I sometimes wonder if I wouldn't. I wonder which way I would have went if I didn't go right into like hard manual labor. Ironically, I think I would have been worse off because I had a chance to really develop my muscles, which has been a huge part of my journey. And I think a lot of people get diagnosed with EDS and the doctors do what they told me to do. They said go home, don't move, get on disability and just do as little as you possibly can. I think had I had done that early on, I would not have the success that I have today. That's just my opinion. I might be wrong.

Speaker 1: 7:49

So when you were younger, you were using your muscles. How active were you?

Speaker 2: 7:54

Super. Yeah, so I grew up on a dairy farm. When you say New York, everyone thinks New York City, but I have 650 acres of corn right across the street, so it's very rural here. And, yeah, I grew up on a farm. I was tough. I was a really tough kid. I played football, always on bikes, skateboards, you know, I was just like any other kid and then when did the pain become the major problem? So I think the pain maybe isn't what prompted the whole medical trip, but what happened was I was dislocating pretty severely my lower extremities. I had learned to work around it ace bandages, all that kind of stuff but my shoulders started coming out like really bad, like bad enough that not even moving it I could just like sneeze and it would come out. I mean, I had a posterior dislocation so it would always pop out my back, so literally even the reach up to get car keys off the table, it would just flip right out. I was having trouble working. I would favor the other side. So that led to a surgery which we thought I just had an injured shoulder and they were going to patch it up. And that's where the diagnosis came. They tried to tighten everything up and stitch it and they just kept stretching. So that's the real pain. Of course it was acute pain from the surgery, but that would give me lasting, chronic pain in the shoulder. And then I just started noticing go from joint to joint, smaller joints actually. First ankles were super bad, shoulders were super bad, my wrists started hurting and then my knees and hips. All would suit over probably about three years from surgery that'll happen, and what age was that about? I'm going to say 25, somewhere in there, and I do think that the pain meds had a lot to do with that, because I just got on pain meds and then I think that getting on them, that became the focus of life. I mean, as I built an addiction I don't know if I manufactured a lot of the pain I sometimes wonder if the medicine was causing more pain because, believe it or not, you know those big giant sheets you get with the side effects that everyone throws out if you really sit down and read them. Joint pain is actually in the top three of most of the medicines that I was on. So here I'm taking pain meds to get out of pain and one of the side effects is causes joint pain.

Speaker 1: 10:19

Yeah, and that's actually what we now understand. When it comes to that chronic pain, I know you've said once before that you got a bottle of opioids, a Vortab or whatever after surgery and if you're looking that far back, where the understanding of potential opioid addiction wasn't like it is now, so there was a little more freedom and now recognizing maybe you only needed eight Vortab just through the first couple of days instead of 50, 60, 80, whatever, and there was probably sympathy by your doctor, recognizing that this is something where, wow, I feel bad, almost like somebody might look at a cancer page. And I think I remember you have said on a previous interview that, well, you were told you should go on disability, which is almost like saying you know, get ready for hospice. This isn't about living a life, it's almost like just make you comfortable.

Speaker 2: 11:20

Yeah, and I think you're 100% right. The doctors really didn't know what to do, it wasn't? You know, eds was a very rare diagnosis back 30 years ago. Wow, 30 years ago. That was a long time ago, but it was more rare than it is now. I think it's highly under diagnosed. But I think you're right. Like what do you do? There's no pills that fix this. At the time, you know, lifestyle wasn't even an issue brought up with me, and so I think you're right. Like this is how we treat it. We treat it with pain meds, and this is bad. I don't want to get into all this stuff, but this is back, you know, the mid 90s, when Oxy was hitting the market hard, and so I did. I went from, you know, lord tabs and I came from a family that, like, we didn't take medicine, like that. You know, medicine was for weak people. You know that's. I grew up in a pretty stubborn German household and if you had a headache you went to school and if you were sick you kept going. So it was kind of a new thing for me, and I think the first time I took those pain meds they were quite justified, but at the same time, I think, being in chronic pain, whether I recognize it or not, it was the first time that my body was actually calmed and numb, not numb like, just kind of muffled, you know. And so, yeah, I could relax really well. And I wasn't. You know, getting these sharp nerve pains, the worst Like so with the EDS, you know, not only do your tendons and legaments stretch, but the nerves that are packed, especially like in the shoulder, the armpits and stuff. Those nerves are getting stretched all the time and you know I would think I was getting attacked by bees, I'd start swatting my back and that kind of stuff. It never took that away but it certainly, you know, made it more manageable. And so from the Lord tab. Then, you know, we went the Percocets and then the Oxy's, and you know it's the typical story that before I knew it, you know, I was so addicted to these I would have done anything for them.

Speaker 1: 13:19

In addition to the opioids, did you use other things to help cope with the distress you were going through? Yeah, I think.

Speaker 2: 13:26

I got into the cycle where, I think at first it was physical pain and you know I was just trying to escape that pain and that reality and somewhere, I don't know exactly where. But it turned from physical pain to emotional pain because I started lying to people and manipulating doctors really good at it, you know. Back then you didn't swipe a card, scripts were just papers and scripts were cheap too. So I learned that, you know, I had four different doctors I had a rheumatoid doctor, I had a general doctor, I had a doctor for everything. And I learned that I could get a script and if I timed it right, you know, I could double dip one pay cash, one pay insurance. So I was not happy with who I was becoming emotionally and that you know, emotional weight it was trying to escape that, probably more than the physical. And then, you know, my blood pressure was through the roof and then I started using alcohol, really heavy, like right out of the gate, like I'm talking like a leader of alcohol, almost a leader of alcohol, every single night just to try to sleep. Another irony about the narcotics, especially the opioids, is, yes, they make you tired and lethargic, but you can't sleep, like you get insomnia from these things and I had not slept for five days. I wanted to sleep so I bought some vodka and that kicked off, you know, a terrible alcohol addiction as well. On top of those escapes, I started using food to escape and you know, the more processed the food was, the more hyperpalatable. The more salt, oil, sugar was in it, the better it made me feel and I could get that anywhere. I didn't have to manipulate, I just had to go to a drive-through. So I think those four things became my life really. You know, everything took a backseat to food, alcohol and drugs. And I mean, I didn't plan this Like I was a good. I was like I was teaching youth group, we were teaching Sunday school. This was totally not like me. I didn't sign up for this, you know.

Speaker 1: 15:34

Yeah, and I think that story is familiar to so many people going through similar things and that's part of why we have this podcast is to understand, because sometimes, as a physician, if they're seeing somebody like you, there's a huge backstory and, granted, you may have been lying, manipulating in the beginning, but there's, if we can know the narrative of what was going on and what led up to it, and hopefully we can avoid this for the 20-year-old versions of you who are out there who are early in this, that it's tempting to fall into that trap. What happened with your weight over this from your late teens to your highest point?

Speaker 2: 16:17

Yeah, so I mean, I was never well, I shouldn't say that when I was in like kindergarten, first, second grade, they called me Slim Tim because I they couldn't get pants to fit on me. I was so, so tiny. But you know, after I started working on the farm playing football, I was never a little guy, I was a pretty big guy and you know I was, I was. I wouldn't say I was overweight, but I was a big kid in school. And then, you know, as I got married again I wouldn't say like I was, like I probably was overweight, like clinically, but I wasn't. Like people wouldn't stop and look at me. So, as the painkillers come in and as the doing less comes in, and as the food choices come in and honestly some of it was just life was busy. You know, we had two kids, we were a new couple starting out, so you ate the cheapest and the fastest food available. Most of the time it was takeout or processed food in a box. Cooking, you know cooking and food itself was took a back burner to a busy life. So probably, you know, in my early thirties I really started packing on weight. But the short of it is, by the time I was 38,. I went into the doctor and the scale pegged out at 400 and it didn't go up any higher. So you know, I always tell people, you know I was a slim 400. I would say I was a little over 400. But when we interviewed my doctor, you know, he said I was well over 400 and we never really will know how big I did get.

Speaker 1: 17:49

So what ended up happening? I know now you're doing well, but what was that transition? What happened that you change and what prompted that? And tell us about the next chapter in your life.

Speaker 2: 18:07

Yes, I think before we go there maybe we'll just swing back a little bit. It's kind of refreshing to look back and see like well, I can see stuff that might help other people. I always look at the weight, like everyone looks at me. I was over 400 pounds with EDS A person at a normal weight. With EDS they have issues, but you start packing weight on top of that. You know it's awful. It just puts so much more stress and pressure. But looking back I could see a lot of my symptoms were from this poison I was feeling my body with it was everything that I shouldn't have been doing I was doing. It's interesting. You know we'll prescribe pills and this kind of stuff, but not once did anyone ever talk to me about the food that I ate. We never talked about inflammation. I had no clue what inflammation was. But the point here is that the food choices so the alcohol a very inflammatory on its own all these drugs slow your system down. They slow everything. They even slow your breathing down. So you're not being able to. If you could get nutrition in you, everything is like it's almost like laps because you can't get blood through your body. And then on top of that, you're filling your body with inflammatory foods and your body wants to heal, but it's just got to clean out all this crap before it can start healing. I never gave it a chance, and I say that looking back, because I don't think we give food the credit that it deserves in this, and it sounds so ridiculous. I have a genetic disease that they can't fix, but it didn't have to be as hard as it was, and inflammation was the key factor. So, along with, you know, the drugs, the alcohol, the food, you know, I also had blood pressure was 255, over 115. My resting heart rate was through the roof, my cholesterol was, and all these things, I feel that they contributed to the pain, because the worse my metabolic numbers were, the worse I felt, the more lethargic I felt and the less I wanted to do. It really, just, it sucks your hope right out of you. And I know I sat there thinking these were the cars I was dealt Like. There's nothing I can do about it. So I'm just kind of waiting. I'm just waiting so I can pass out to do it again the next day. So that's the cycle I was in. It was a very dark place, you know, at the time I had two children. They lived at home, they were young, a wife that loved me, and I couldn't see that. All they could see was the mess that I was in. Oh, we could talk about attitude in a little bit. So what happened was I got to this point where I was taking so many drugs and so much alcohol, my kidneys were shutting down. I knew exactly what was happening. I couldn't stop. I just I couldn't stop myself. So I'll make this part super quick. But you know, heather's mom was like a second mom to me. We got married super young. I had just turned 20. So her mom was like a second mom to me because we were, you know, we were high school sweethearts and we couldn't get her mom to go to the doctor. She was really stubborn. She just wanted to keep working, finally convinced her. She was diagnosed with leukemia, which spun our world around. For me, selfishly speaking, the one thing that came out of that was we started going to a cancer ward, a cancer hospital. When I went into that hospital I came out with a different attitude. After I visited One particular night. She was waiting on a blood transfusion, super tired, super groggy. She opened her eyes super slow. She looked in my eyes and she was how's your knee? That crushed me. It just crushed me. It shows you what kind of person that she is. I remember walking out of there that night thinking in my whole life all I did was think about what I didn't have, what I needed to get fixed, what was wrong with me. I thought I had it the worst. You leave that hospital when you see these little kids, these little kids, these little six seven-year-old kids with bald heads. They're in the leukemia wing and their parents are crying. It's like you know what this whole EDS thing. Maybe it's not as bad as I'm making it. I remember thinking man, my knees suck, they hurt really bad, but I get to walk out of here on my own feet and I get to go home tonight and there's people that'll never leave that hospital For me. I think one of the biggest things that happened to me is a perspective change. It's real easy when you have a chronic disease to feel sorry for yourself. I'm not blasting any support groups. I went to a couple the advice of my doctor and I mean I got in there and it was just almost a comparison of who had it worse or who had more problems and there was no real solutions. I was at a point where I didn't. I don't have to prove my problems worse than yours. I want to be done with all this stuff. So, as we're dealing with Heather's mom, my father had pneumonia, or so we thought. He got some chest x-rays done and he ended up being diagnosed with stage four kidney cancer that had metastasized through his whole body, filling up his lungs. My dad was my best friend in the whole world and the doctors gave him six months to live. I think that's another thing that changed for me is realizing that we all pay lip service to, we're not promised tomorrow. I had gotten into the thing like, well, I don't know if I'm going to wake up tomorrow, I don't know if I care, but the truth is I did care and after seeing my dad with six months to live, life is precious. Whether you're hurt, whether you're injured, whether you've got to deal with pain, it's still precious and there's a lot of people that would trade with your imperfect life. So my dad didn't make it six months. He made it six weeks to the day of his diagnosis. He lost his battle with cancer. And then after that, heather's mom. She fought like a warrior. She lost her battle with cancer. Oh, our leukemia that turned into lymphoma and ultimately a brain tumor would take her life and just like that we lost our two favorite people in the world. I really think all that tragedy. I guess if there was something good that came out of it, it certainly got me thinking in a different way about life.

Speaker 1: 25:05

You know. It makes me think of something often tell patients who have struggles is that you know you may be handicapped or you're differently abled. You know, instead of saying you can't do these things, you have to do things, but they'll be different. Right, you know how to do things and that cycle you talk about. It's so easy to get into where the momentary benefit of helping the anxiety which often is that aspect, what the opioids probably do more as they affect the anxiety, you get a tolerance to that it actually over time makes the pain worse. Alcohol is extremely effective in the moment. It's extremely effective. The reason why you did all of those addictive substances was completely logical because in the moment. But nobody ever paused from the get go, because we didn't really probably understand as much that to say hey Tim, what's going on? I had a patient that had some issues. This was early in the 2000s when everybody was gung-ho about oxycontin and I got off that wagon very quickly but I never gave up compassion for suffering. And I had a patient who came in and saw me. It was another doctor's patient but you know, was filling in before we had urgent care and I could kind of read through some of the quote lies. You talk about kind of the probably a story you might have tried to tell a doctor and you think he's just going to go through the motion like hey, doc, family doc, you know I have this kind of pain and I did an exam and didn't support that. And I said to him hey, you know, joe, his name's not Joe, but I said, joe, I think you might be addicted to this pain medication. I gave him a muscle relaxer, one that's not addicting, called cyclobenzaprene, and I saw him a year later and I remember people, I remember lots of people going back many years and he came in for a cold sore, something minor, unrelated, and he said to me hey, doc, I don't know if you remember me, but a year ago I came in to see you for back pain and you called me out about having an addiction. He said I've been seeing doctors for years. You're the first doctor who ever mentioned that. I just want to let you know. Because of that I got help and I am no longer an addict. But back then there wasn't that understanding and unfortunately, what happened with a lot of people? As the medical records could find people like you, people pulled the plug very quickly and were left without any pain meds and that's unfortunately going down another road where we get into the street opioids and now the current fentanyl crisis. So that's why we have a podcast like this is to have empathy and understanding, but also helping. And now that role of food. You know back then, food as medicine. I have a license plate that says plant RXRX being a prescription. That's the prescription that I love giving. The side effects are maybe if you ate a can of beans, which I can tolerate at a meal, but if you're not used to the can of black beans, you will have a lot of gastric discomfort. But outside of that, for the most part is side effect free and only has the positive benefits. But nobody's ever done that or considered that. But before we get into the diet part, I know that you had contemplated. You know your health is getting worse. There was another medical or surgical intervention that you had looked at.

Speaker 2: 28:39

Yeah, and you know, after we buried Ma B and dad, heather was putting my socks and shoes on me because I just physically couldn't do it anymore and I don't know. You know this, one day she kind of tapped the side of my leg after she put my sock on and I'm like, oh my gosh, like I'm next and I was tired. I was just sick of being sick and tired and I don't know that I really cared myself but, like I said, I had a family that loved me and I did not want to see Heather have to grieve through another funeral. So that's when I decided to do, like, well, really smart people do they go on YouTube and find an influencer to get medical advice from? And I saw this guy. He's super inspiring. He had gastric bypass and I mean he, within a year he had lost, you know, probably 200 pounds, because he was, he was just as big as I was and he's out running marathons and I'm like, wow, this is, this is what I got to do. So I went to my doctor the same one that treated me for the EDS and I got in there. My blood pressure was 255 over 115. I was on about 20 meds and two of them were actually blood pressure medicine. I was on a calcium channel blocker in a beta blocker. My resting heart rate was 125. I was a mess and so he was going to call 911 and he sent me to the hospital. But I was good at manipulating, so we negotiated. He let me rest on the table a little bit, came back, my blood pressure went down still super high and he told me I couldn't get to surgery. There were multiple reasons but you know the big reason was my heart. The other reason was the narcotics, but he was also worried about an EDS patient. You know, every time we get surgery we get real weird scarring. Sometimes we don't heal fast. I would get these scars like fish mouth scars, because your body, it's the same collagen that makes that scar tissue. It was just like blow it out. It literally looked like gum. So he denied the surgery for me and then you know, I felt super hopeless that night. But you know I went to bed thinking about how there's mom and like one of the most raw things you know that I talk about is towards the end of her mom's life with that brain tumor. I mean, she was super sick, she was not doing well at all. And she was running into this cancer hospital like twice, three times a week for radiation and they'd have to put her head in this like net thing that they casted. And so finally the doctor looked at her and he's like, why do you keep doing this? And she said I just want to be here for my family. And I couldn't like shake those words out of my head late at night. I just I couldn't shake it and I figured if she was able to do that for her family, you know, certainly I could try to clean my life up a little bit. And so that's really where my journey began, and I did a lot of wrong things, but the one right thing I did was recognize that what I was eating was affecting me, and I never had, I never thought about that before. So you know, I did like an Akins back then. It was Akins. I guess it would be Keto now, and for me that was right on my alley because I was basically living on meat and cheese. Anyways, I did lose weight. I think I lost like probably like 50 pounds, and but I did it all wrong, you know. And so at the same time I was writing things down, which journaling was not a thing for me. I found that that helped me stay on track. And then the other thing I did. I called it exercise, but I got out this journal and I remember I still have it upstairs. I wrote this is the first day of the rest of your life. I wrote down the date, I wrote down my menu for the next day and I wrote chair times two. And about a week prior to this I had gone up out of my chair in my office and I pushed so hard down on the handles that they like split and fell on the floor. And then I had to try to get up without using my arms, which was what was the nightmare. But I was so embarrassed one of my colleagues rolled a chair down and he goes I was going to get rid of this one anyways, take this no big deal. That was the old chair, but I knew that if I could get up out of the chair once, then I could do it twice, and so that's what I did. That's all like. That was my exercise, and I hate talking about my fitness now, because you know if, if I tell people I went out for 80 mile bike ride that I can't do that? Well, no, neither could I. My big deal was getting out of a chair two times instead of one, but whether people thought I was nuts or not, I did that for a while. And then stairs were always a hard thing for me. I would walk up five stairs and actually turn around and sit to rest, and then so I just started doing really simple things, like you know. I would go up two stairs and come back down and just do extra stairs a day and a little by little, as you know, I got better at this. My activity, you know to what, what normal people would say wasn't really activity, but I was at least making an effort to move, an effort to change how I ate.

Speaker 1: 34:00

That's where we will finish this week's episode. I hope you've enjoyed it. Next week we will dive deeper into discussing the diet and continued lifestyle changes and we'll also learn that this isn't conquered chronic pain or conquered fibromyalgia or conquered ailer Stanlos. He continues to have struggles and this is an ongoing battle. When you're living with ailer Stanlos, often the joints get affected and surgery and get an honest look into what he's gone through. I wish the best for all of you that are listening. If you would like to reach out to me and let me know how this podcast has had an impact on you, please email me at Dr Michael Lenz at gmailcom, which is available in the show notes. Until next week, go team Fibro.