Embracing Uncertainty: A Discussion on Arthritis Life Extravaganza
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Kara Wada, MD: โ
Welcome back to the podcast everyone. I am so excited to welcome back Cheryl Crow.
If you are a longtime listener, Cheryl was one of our first guests when we launched the podcast originally as Success with Sjogren's, and we've had a couple reinventions over time as these discussions have evolved and grown and changed.
It was time to have Cheryl back because we're doing this series, allergy Immunology 101, and we're talking about, those conversations that we have in the exam room with our physicians and some of the questions and problems and things that come and Cheryl is a wealth of information.
I'm gonna let you introduce yourself Cheryl to so to all of our especially our new listeners who maybe aren't familiar with who you are, what you do, and the awesome human you are.
Get to know Cheryl
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Cheryl Crow: Oh, thank you so much. It's an honor to be back.
So I am an occupational therapist and I've been living with rheumatoid arthritis for almost 20 years, and I'm 41, so it's basically I'm hitting the halfway point, right? Living half my life without rheumatoid arthritis and the other half with it.
I became an occupational therapist because I was really intrigued by the field. If you don't know, I always like to take a minute to define it cuz it's, geez.
Yeah, it is really as if, I like to say it's if a psychologist and a physical therapist had a baby, it would be an occupational therapist.
But if I had to rename it, I would say we're really life skills therapists. Like the most important question to me, if I'm talking to somebody who's, let's say newly diagnosed with an autoimmune disease, is walk me through a day in your life and know and tell me what's going well and where are you encountering problems?
No problem is too big or too small, right? It could be everything from I have a hard time putting my hair and a ponytail cuz of hand stiffness. That's like a minute problem, but there's so many possible ways we could help solve that or work around that.
Then there's the bigger kind of problems like I don't have enough support. I have a small child. So we look at the contextual environmental factors and also the minutia.
So I really enjoy that cuz I like switching my mindset from like the tiny to the big. So if I would just say if nothing else, if you're struggling with daily activities, a lot of people don't know that there's this entire field where literally you can practice things like I have someone in my room to thrive support group who I encouraged her to see if a occupational therapist could help her.
She's an artist, and the occupational therapist literally helped her modify each one of implements, like her paintbrushes, everything, modified them so that they worked with her hand paint, you could work on turning pages of a book to read to your child. There's these daily life activities that they seem so simple, but they're actually complex.
Long story short, that's my background.
But then I developed a business called Arthritis Life. I'm laughing at myself because it's I never thought I would do that. But it's very similar to Kara in terms of seeing a lot of problems with the traditional healthcare system and wanting to find innovative ways to provide really heartfelt and, education and support to patient this population that just does not get a lot of support.
I do a support program and course called Rheum to Thrive, and I have the Arthritis Life podcast and I do lots of social media videos and education. I'm all about patient education and empowerment.
Match Made in Heaven to be talking to Dr. Wada today. .
Kara Wada, MD: Oh gosh. And I think we have similar taste in music too when it comes to Taylor Swift and, some of these other, just like upbeat fun.
Cheryl Crow: Girl power. Like Britney. My first concert was Britney Spears and TLC. I saw TLC yeah.
Kara Wada, MD: Oh my gosh.
Cheryl Crow: TLC and Boys to Men.
Kara Wada, MD: So fun. I'm just like, imagining what that would've been like. It was amazing. I wanted so badly to see New Kids on the Block. Oh man. There was no way that was happening though with my parents.
Cheryl Crow: I'm sorry. Oh no, I know. I got lucky. I saw Britney Spears when I was in college, so I think actually Boys to Men and TLC was before that actually in high school anyway.
Getting Diagnosed with Arthritis
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Kara Wada, MD: When you talk with folks in the RA community, we're actually having a sunny day here in Columbus, so I'm having to block out some of the sun here periodically. But this is rare. Usually from October to April, it's the season of gray.
But when you're talking with folks who are newly diagnosed or thinking back to when you were newly diagnosed, a lot of what you bring to the table are those things that are missing from the exam room that 20 minute quick visit you have with the rheumatologist who says," okay, it looks like you have RA. Let's start you on methotrexate, or this, that, or the other thing, and I'll see you back in three to six months."
Cheryl Crow: Yeah, and I think I always acknowledge in my personal journey, I was in the first six years one of those success stories where I went on methotrexate and then they very quickly added Enbrel just cuz of how aggressive my presentation was at the time it.
I didn't have to do any insurance. This was 2003, so it was a different era. I went immediately into like complete medicated remission. I felt amazing. I was playing soccer and swing dancing, and honestly I didn't have to modify my daily activities. That's like category A, some people get that experience, but very many people are in that gray zone of methotrexate or their medications, partially work for their disease activity, and symptom control, but don't work a hundred percent.
They have issues just again functioning in daily life, understanding how to cope with the uncertainties about how this disease is gonna affect them in the future.
Being diagnosed as a 21 year old, I always wanted to be a mom. My career path, I wanted to either be like a teacher or I worked in a non-profit and literally traveled the world.
It was like an international education nonprofit. Even though my disease was well controlled, I didn't have a lot of questions about my daily activities like physically cause I was doing well with that. But I also knew that I was on immunosuppressants, knew I'm on methotrexate and I still had a lot of questions about my future.
Am I gonna be able to have children? All that.
I think there's such a need for additional education and support and that's why I formed my program as well as the upcoming Arthritis Life Hack Extravaganza, which you are one of the esteemed speakers at. But that's also a chance to come together and figure out from, again, the minute stance of like little joint protection strategies and quote unquote, traditional life hacks, but also the bigger lifestyle factors that can help you mentioned, inflammation, you'll help control inflammation and support your wellbeing long into the future.
All the basics, exercise, nutrition, and the one I'm most excited about personally is like coping tools, stress management, because I've also struggled a lot with anxiety and anxiety specifically about my health and so yeah learning the tools for that.
I know you're getting, you're like, God is smiling upon you right now. Cause you're right.
Kara Wada, MD: I have my journal up here like trying to. I might actually have to invest in a little bit of a shade or something for this room.
Cheryl Crow: That's what I have to do too with my angle of my window .
Understanding the Healthcare System
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Kara Wada, MD: Oh wow. The YouTubers are just gonna get, a little extra sunshine.
Yeah. I think the other part of too of what I hear, frustration now you mentioned kind of things being in a different place back in 2003 when you were diagnosed, but the healthcare system has evolved.
I would have to say, in some ways for the better, right? We have like one of the bright sides of the pandemic is increased access to virtual care, but also
There are a whole lot of other barriers in silos that come into play too.
Cheryl Crow: Yeah, I think really, and as an occupational therapist, and it's like the amount of time that providers have, whether it's a doctor or nurse, for a collaboration is so much less. Everyone's time is strapped.
The payers like insurance companies are trying to squeeze every penny out of people.
It was interesting, I was just reading an article in the Rheumatologist magazine, which I get as a, as an allied health provider, as part of their association.
It was this, rheumatologist who was retiring and, so he's been in the field 50 years and was talking about the times when in the beginning of his career when he'd go into his office and call the primary care doctor and have a 30 minute conversation about a patient.
That's what people who go into healthcare, they want to be able to do. You want to be deep, but you don't have the systemic support to do that, like in the healthcare systems anymore.
Yeah, I think that I'm excited about, all the different. I don't know if it's entrepreneurs or the right way to put it, a lot of people are trying to say, look, we understand the healthcare system is this giant beast, and maybe we can't fix the system right now, but what can we do to creatively address the needs that patients have, whether it's through an app, coaching program, life coaching, health coaching, like online support group like I have. Sorry, I just went into a hundred directions, but..
Getting the Most Out of Your Health Appointments
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Kara Wada, MD: No, that's, and that's what I'm so excited to talk about.
I essentially, I didn't tell you this, but I essentially reworked my TED talk a little bit, the shenanigans and drama with that will share another day, but into this presentation that is going to be at the event, how to you get the most out of your visit with your doctor .
Knowing that time and bandwidth is limited, how can you make the most of it? How can you go in. Knowing your story. Being prepared and taking back a sense of control and ownership. Knowing that the power balance between patient physician has not traditionally been in the favor of the patient and especially marginalized patients, right?
Cheryl Crow: Yeah. I love that 30,000 foot view. It's hard. You do feel this, I feel this kind of stress around appointments sometimes cause I'm like, "okay, this is so crucial for me." It's like a first day on steroids, sometimes literally depending on your disease.
I like, for example, I love my rheumatologist and since she's known me, she was like my second rheumatologist cause I was in New York initially, but she's been with me for 18 years.
Yeah it's so rare. The first thing she always asks, "oh, do you have any pictures of Charlie?" My son and that's rare nowadays, and that is still important to me psychologically to connect to her as a human being at the beginning.
But then we're like, okay, let's maximize our time. Let's dig in. What are the three bullet points you brought in, and and it's hard because I think a lot of times I know, I think, I know both of you and I maybe have struggled with this kind of idea of sometimes patients who don't understand the systemic pressures on providers are like, we need to advocate for like exactly what we want.
Which it's like I want to be optimistic to say yes. Like I also want a pony but I'm not going to get everything I want. So it's like advocacy doesn't have to mean like..
Kara Wada, MD: Adversarial.
Cheryl Crow: Exactly. Like they're not out to get you on off. Sometimes there are bad providers. I won't, I'm not gonna deny that.
Kara Wada, MD: Oh, absolutely.
Cheryl Crow: When it comes to rheumatology, I don't know about allergist and immunologists, but there's a severe shortage of rheumatologists.
You don't have a complete, you don't have an endless amount of providers to choose from. So sometimes it's better to work on repairing that relationship to get the most your visits versus switching to a new.
That's why, that's a whole other point. But yeah, I'm really excited for your talk because I really think in the event we're having these little mini presentations followed by Q&As and they're about these practical things, like no one teaches you how to be a patient, how to.
Kara Wada, MD: No.
Cheryl Crow: How do I prepare for an appointment? I didn't know.
Kara Wada, MD: They don't teach that at medical school either, by the way.
Cheryl Crow: Oh, boy, that's, yeah. That's sad. I didn't know appointments had end times. I'm not kidding you. When I first started, I'm like, there wasn't a big deal about your start time. Your appointment starts at 11. Okay I don't know. No one told me if it's 20 minutes or 30 minutes or 40 minutes or two minutes. So I'm sitting here blah, blah, blah, and the patient doctor's okay, we gotta wrap up. Wait a minute. If I had known when the end time was, I might've been more strategic.
Kara Wada, MD: Yeah. And it's interesting that's one of the things, so I'm trying to tackle this issue from both sides of the coin.
So I gave a talk to a group of physicians not that long ago, and I was like, one of the things I learned from the medical students I work with, is they are now being taught when they go in, especially students, to see patients like, "Hey, we have 15 minutes together. I wanna make the most out of this time. What is your most pressing issue or question for today?"
They set the stage right? So that people have that expectation. I think so much of some of that adversarialness in part comes out of a mismatch in kind of those expectations and understanding of the bandwidth.
So if I can be upfront with people about when to expect a response about their lab results or will that need a visit or can that be handled through the portal, so that there's some of that.
One other, one other little soapboxy thing is the latest statistics show that 62% of physicians have at least one symptom of burnout.
My guess is for other healthcare professionals, nurses, in particular, they're at the bedside more than the physician many times. So it wouldn't surprise me if those numbers were the same or higher.
We're seeing a lot of folks leave clinical medicine across the board. I think there does need to be some recognition that in a realignment that physicians are human. We have human problems and we behave like humans at times too.
Although we swear an oath to do no harm. Hurt people, sometimes hurt people.
I think if we all come at things with a little more of compassion giving folks grace, that can kind of, and that needs to be within balance because your health is important. You need to advocate for yourself, but to have some nuance with that.
Managing your expectations for your health visit
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Cheryl Crow: Absolutely. And you mentioned the word expectations in that.
Managing your expectations for a visit. I think that one of the most difficult but important jobs I've learned as a patient is to understand what is realistic for me.
Like what's realistic for my disease trajectory. What's realistic for how much my lifestyle factors and my stress management endeavors are going to move the needle versus my medication on my overall care.
I think that's the a hundred thousand dollars question. That a lot of newly diagnosed patients in particular, but even long term like me, face is what is what I should expect?
I love this quote from a long time ago someone said to me, " Happiness is reality minus expectations." right? .
So if your expectations are super high reality doesn't match that you're gonna have a deficit of happiness.
Embracing Uncertainty
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Cheryl Crow: But the problem is when you get diagnosed with a disease that's intrinsically a disease that's characterized by fluctuations, exacerbations and remissions, you don't know whether your first six years is gonna be like mine, or you go into complete remission.
And you only have to think about a couple things like insurance and medication, and maybe planning for your future.
Or you don't know whether you're gonna be somebody who after nine months has already blown through three biologics and is still progressing.
What I've worked on a lot in therapy, and this is gonna sound like , a long-winded way to get to this point, but is acceptance.
That the uncertainty is not a solvable problem.
Uncertainty about how my disease is gonna progress. How is this gonna affect me in the future?
I have an eight year old, is it gonna be different when he's 10 or 12. I have all these anxieties about the future as my therapist pointed out.
If I approach those with the expectation that, okay, I'll just solve these problem. I'll just find the solution, right? I'll find the diet, I'll find the exercise, I'll find the support program, and then I will have an expectation that I will quote unquote get my disease under control and arthritis will no longer be a problem for me. That is very unrealistic for most people.
I think it's a more healthy approach to say, "Okay, all I know for sure from a mindfulness standpoint is that this present moment is what I have. The future could be a thousand billion different things, right?"
I can get hit by a car tomorrow and all these worries I have about my rheumatoid arthritis are gonna be secondary to a car accident acute recovery.
I joke that my tagline for Arthritis life is come for the life hack, stay for the social support or emotional support, because I think that's the hardest part. You can peel down the layers of, "Do this life hack. Do this. I figured out my dietary triggers. Okay, I have an exercise plan."
These things help. But at the end of the day, that uncertainty is gonna be there. You're gonna reach a ceiling. Or do you agree? I'm open for debating.
Kara Wada, MD: Absolutely. It's instinctual. We think back to like when we were first human beings back around the cave campfire.
Uncertainty were those things that killed us. Was the lion going to come attack our tribe that night?
It was that tribe of people that group of a couple dozen people living together in a space that kept you safe, that kept you fed, it was that love and connection that ancestrally really made a huge difference.
There was just an article this week in New England Journal talking about the impact of social isolation and loneliness. How it has impacts across our body, but importantly on our immune system health too.
Cheryl Crow: Yeah. I think it was Glennon Doyle Melton who said this, " It's not hard cuz you're doing it wrong. It's hard cuz it's hard."
That's why I think the social support, whether it's on social media or through connections you make on Instagram or TikTok, or whether it's through like more formal programs, it's so crucial.
When I meet people, the biggest sigh of relief that they have is, "oh, Cheryl struggles with uncertainty too, even though she has like a master's in occupational therapy."
And like arthritis literally is my life. I have an art company to call her arthritis. Like I read articles about it. I do a podcast about it.
I still have to confront uncertainty and lack of clarity.
I remember I really work through this with my therapist who takes an approach called acceptance and commitment therapy, which anyone can learn about by the way and anyone can do. It's not like a proprietary thing. You know how certain techniques like you should only, a psychologist, have them do it with you.
But and it's really about saying because would tell him like, I was so stressed about doing some of the work I'm doing cuz I wanna just give the patient, other people like the answers. I wanna help them and I need to help them by giving them the answers and helping them to control their disease.
And he's, "Cheryl, what if there aren't answers?"
I'm like, how can you do this job? Like how are you not depressed? At first it's that's why I call it the acceptance paradox, cuz it's accepting that certain things are outta your control, accepting that uncertainty will be there.
Seems so depressing at first. But the paradox is, for me, it set me free. It alleviated the burden of trying to solve problems that are at some point unsolvable.
This problem of how my disease is gonna progress. I can look at studies, I can know that 90% of people who've had rheumatoid arthritis for 19 years who've been on four different biologics, like I have plus methotrexate, 90% of them, they do great within 10 years or something. If I looked at that, I still wouldn't know, am I gonna be in the 90% or the 10%?
Providers are taught, this is like an intrinsic problem that leads to the gaslighting everything too, they're taught to treat the mean like the average, the average doesn't mean anything to you if you don't present in the average way as anyone with a rare condition can tell you.
Kara Wada, MD: Yeah. I don't read the textbook.
Cheryl Crow: Yeah. I didn't read the textbook when I had rheumatoid Arthritis. That was like definitely eventually presented as bilateral, but initially was only on my right side. Things like that.
So I think and accepting that it's not a matter of going to every different provider until you find the certainty.
It's accepting that the uncertainty is not just the nature of chronic illness, it's the nature of everything in life.
Every parent knows this, you can put your baby to sleep one night, do everything right, put the baby on their back, put 'em in a safe sleeping area, they could still die of SIDS.
That's such a scary thought that so many of us are like, I don't even wanna cope with that thought. I just need to comfort myself by reminding myself of what's in my control, which short term that is an okay strategy sometimes if it works for you, keep comforting yourself.
Yeah. But You're gonna reach a point where your brain is smart enough to know that there is no guarantee. Being able to confront that and accept it is really fascinating to me. It's been a really fascinatingly, strangely comforting thing cuz it still seems like it wouldn't be comforting.
Even as I'm talking about now, I'm like, that sounds depressing, but it's not. I don't know. I don't understand it. It's fascinating.
Kara Wada, MD: I will say one adjacent thing that has helped me so much too. Knowing and learning that our brain has a negative bias to it. So it goes back to that survival mechanism again.
Like you were always trying to prepare for the worst because it could be a famine or a flood or whatever. But now that ends up becoming counterproductive. So just reminding yourself, "Oh, that brain is just being a brain.
Cheryl Crow: Thanks Brain for protecting me.
Kara Wada, MD: Thanks for protecting me.
But we got this, it'll be what it'll be and that's fine.
We're recording this the morning after my TED Talk disaster, so this is all just very front of mind.
It's okay not to know all the answers
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Cheryl Crow: Totally. I think again, there's so much noise in the autoimmune space, right?
Things like, "oh, all you have to do is heal your gut. All you have to do is resolve your unresolved childhood trauma."
I see these claims every day and I'm like, ultimately, first of all, those things can be very helpful. I'm not saying like none of the techniques that people talk about are effective, but if you approach this as if all you need to do is just find quote unquote the solution, you're gonna be, you're ultimately going, unless you're lucky cuz some people are lucky and they do it.
They resolve a childhood trauma and then their autoimmune disease goes away. Or they go on a certain diet and their symptoms resolved and that's the rest of their life. You may be in that category, may have won the lot,
Kara Wada, MD: Awesome! We'll celebrate with you.
Cheryl Crow: Exactly. We have to learn. I think people get confused and cuz they'll see, " Wait a minute, I have this diagnosis. This other person I found online has this diagnosis. I did what they did. Why didn't it work for me?"
It's cuz it's cause you're two different people. I think again parenting is a great analogy, right?
Cuz when first you have a baby, you're like, "oh, how do I get them to sleep?"
Okay. Talk to 16 different people. They all have different techniques. It legitimately worked for that. But when it comes for healthcare, people seem to really want that.
Like you said, we're biased towards being afraid of things that are threatening to us and trying to solve problems.
As my therapist said, you're really good at solving problems, but not all problems are solvable. That's the problem. So if you spend all your time trying to solve an unsolvable problem you're wasting time that you could be using on things that you actually can solve.
So like in your case, there's some things about this TED Talk that are outta your control and how much does it benefit you to accept that versus, and I think it's totally valid to vent.
Kara Wada, MD: Yes. Feel the feelings you want. You bet. I sulked last night I took a bubble, not a bubble bath and smuggled my kids and watched my first graders presentation that had great audio.
Cheryl Crow: Oh gosh.
Kara Wada, MD: And we laughed about it. Yeah.
Cheryl Crow: It is what it is sometimes, honestly.
I remember even just a couple weeks ago I was saying, someone in the Rheum to Thrive support group I'm running asked a question, I was like, honestly, I'm still confused about that in my own life.
I can tell you again, I can always tell you the data says this, exercise, I think was the one thing we were talking about because I have a good routine and I have an idea of what my limit is, but sometimes I go well under my limit in terms of exercise that might induce fatigue for me.
Sometimes if I push my heart rate up too much or go for too long, I will experience fatigue other time. Most of the time I don't, but when I don't experience fatigue normally because I know what my limit is. There's some days where I do my normal 25 minutes at a heart rate under 120, and then it's I feel really bad afterwards.
Sometimes it's just the randomness, and I was afraid to admit that, right? Cause I'm like," Oh I'm supposed to be the one that has, and I think doctors get this too, you have this idea I'm supposed to have all the answers.
But then the person in the group is," Oh, I'm actually relieved that you don't, that you still struggle with this. It makes me feel like since I'm only one year into this and I'm struggling with it and you're struggling with it 19 years, it makes me actually feel better to know that this is just something I'm gonna have to deal with versus, oh, I missed the manual. Like everyone else has it all figured out and I don't."
I think we all have that almost like imposter syndrome. Like autoimmune imposter syndrome. Totally. Whenever I see people who are like, I'm doing yoga and like everything's wonderful. I'm always like, oh man, maybe I should be doing yoga. We all have that, right?
Kara Wada, MD: Yes. We need to chat because that needs, maybe we need to have that BS a session at the Autoimmune Warrior Conference this spring.
Cheryl Crow: Oh yeah. That would be amazing. I didn't even relate it to imposter syndrome until literally right now, but it totally is.
Kara Wada, MD: We could get a few of us together and just talk about that, we're still all figuring it out.
Cheryl Crow: Yeah. And that's okay. I just breathed a sigh relief thinking about that.
The Arthitis Life Hack Extravaganza
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Kara Wada, MD: Yeah. So let's talk a little bit more about how people can get signed up for your event and connect with you, because this event is like I've seen the lineup. It's incredible.
Cheryl Crow: I'm really excited. It's called the Arthritis Life Hack Extravaganza at this point. It is an annual event that's happening in February each year.
So it's actually coming up February 4th and 5th. But it is going to be a live online event, but if you can't make it live, it's free to attend live, but there also is like a recordings only ticket if you can't attend live, that's $10 USD.
I always give discounts if people ask, you can just email me at [email protected]. I have discount codes I can give you, and then there's a VIP ticket that includes the recordings plus digital goodie bag full of like over a hundred dollars potential worth of discounts on arthritis products and services like including coaching and My Rheum to Thrive program and tons of other discounts.
The program is, we have 18 speakers. I'm saying weed's, like literally me. I'm learning how to delegate though. I'm learning how to get help . I have one administrative person who's helping me part-time. But anyway, half the speakers also have an autoimmune disease, like you and also over half of them work in healthcare.
There's everyone from a few doctors to patient advocates as well, and occupational therapists. We're covering topics, life hacks 101, fatigue, strategies, building your flareup toolkit, how to explore nutrition without becoming stressed and confused.
Kara Wada, MD: Oh my gosh, that's huge.
Cheryl Crow: Yeah, and I'm talking about acceptance that we have a couple special topics like prep tips for pregnancy and parenting with arthritis and tips for grieving the old you after your diagnosis.
The reason I use the word extravaganza in there is that often, like healthcare information is presented in my opinion, in a dry and boring way.
I also think like part of like my mission to live life with the fullest, with my condition is that, to me that's my personality is I wanna have fun, I wanna celebrate.
These life hacks and adaptations, whether it's like a compression glove or like an adaptive tool. I don't wanna feel depressed about it, and or ashamed about it.
We're gonna address that cuz people's barriers to using things that would help improve their quality of life, like an external aid, be a physical manifestation of their invisible condition, like a walker or a wrist brace. Sometimes people don't wear them cuz they don't wanna look different or be judged and people will judge you, but you deserve to do the things that make your life bet easier.
So if they can wanna sign up, you can go to bit.ly/arthritislife 23 and that's just all lowercase or just on Eventbrite look up arthritis life hack extravaganza.
You can follow me on Instagram Arthritis_Life_Cheryl, or again, email me. I can send you more information about My Rheum to Thrive program too.
There's an online course and then there's a 12-week support group that I run. It's sequential. It's like a cohort based. You stay with the same group. I run that a few times a year. So I think that's covers, oh, my website is just myarthritislife.net, so you can always find the latest there as well and the podcast is there too.
Kara Wada, MD: It's a great listen and so fun and you connect with so many amazing people within the community, which is really fun.
Cheryl Crow: I was thinking about changing like the intro to the podcast cuz it's I think it's really just a matter of a podcaster, we talk to interesting people about their arthritis life story.
So it's literally what we talk about everything, talk about whether it's Sjogren, it's really not just arthritis, it's really inflammatory, conditions and try to figure out, we share, I share, tools and tips, but also figure out like how do we do life with this thing?
How do we still have a vibrant, meaningful existence and with our condition? Cause what's the alternative, right? it's not going away unless there's a cure. So we have to learn to live with it. So yeah, there's that acceptance again.
Kara Wada, MD: We can hope that CAR T works out.
Cheryl Crow: That's Yeah. There's always a next thing. I do wanna try vagus nerve stimulation, just cuz it's interesting to know history of gastroparesis as well. So vagus nerve stimulation works for both gastroparesis and rheumatoid arthritis. I'm really intrigued by that.
Kara Wada, MD: Looking at that for Sjogren's, and dysautonomia too.
Cheryl Crow: Ooh, that's exciting. Interesting. Thank you so much.
Kara Wada, MD: Thank you, Cheryl. I appreciate it and I look forward to the event. I can't wait to tune in and and I love the Q&As. Those are always the most fun.
Cheryl Crow: Yeah. Yeah, all the presentations, like they're divided into the two sections, are a prerecorded 20 minute presentation from each speaker, which I like because that means if something happens last minute, as you're having three small kids, or someone gets sick and
Kara Wada, MD: My husband's working that weekend, so it works out for me.
Cheryl Crow: But then there's gonna be a live 20 minute Q&A that does always allow for a lot of like back and forth with the audience and this year will be enabled so everyone can see each other's chats and we can and also see each other's faces too. Last year we kept it more like a webinar style where we wanted control over it cuz we were nervous about people like unmuting themselves and stuff, but I figured out the Zoom controls.
So anyway, I'm really excited and I'm honored that about all the speakers attending. I'm excited about your Sjogren's Summit as well and the Autoimmune Warrior.
Kara Wada, MD: So we are hard at work planning.
Cheryl Crow: Yeah. It's so exciting.
Kara Wada, MD: Yeah. Yay. Thank you again, Cheryl, and see you soon.
Cheryl Crow: Thank you. Bye.
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