Sjogren's Strong

Introduction

A Talk with Dr. Wong

Dr. Wong joins us on our first interview. Dr. Wong is a Doctor of Pharmacy and shares her wisdom and experience with us in regards to Sjogren’s Syndrome.

A Talk with Dr. Wong

A Talk with Dr. Wong

Brian:    Welcome to another episode of Sjogren’s Strong.

Lupe:     This is Lupe.

Brian:    And this is Brian.

Lupe:     And today we have a special guest, Brian?

Brian:    Dr. Karine Wong, a Doctor of Pharmacy, having graduated the University of `Pacific School of Pharmacy in 1997, being one of the youngest to graduate, having skipped undergraduate studies. Dr. Wong worked as a staff pharmacist for three years and was promoted to Director of Pharmacy where she worked for a year before lateraling into a Clinical Manager’s position. She chose this route so she could focus on patient care more than hospital administration. With a true entrepreneurial spirit, she is also the CEO of My Guiltless Treats, but more on that later.

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Lupe:     And with that, I’d like to welcome Dr. Wong to the show, Dr. Wong…

Dr. Wong:           Hi. Good evening.

Lupe:     Hi.

Dr. Wong:           Thank you for having me on board.

Brian:    We appreciate you taking the time to do this with us.

Dr. Wong:           Yes. Anything to help.

Brian:    Awesome. So did, did I do you justice in that bio?

Dr. Wong:           Oh, it was perfect.

Brian:    Awesome! See, I get a gold star already. So, um, we actually met Dr. Wong at a local Farmer’s Market and she was kind enough to spend some time answering some questions that we had. And then we actually stumbled across her working her booth at the Farmer’s Market, sampled and tasted some awesome treats. But again, more on that later, we want to dive into what Sjogren’s Strong is all about. So, I guess I’ll go ahead and kick this off.

Brian:    The first question I’d like to ask you, our last episode was actually… we discuss nutrition. So with that having been said, when somebody has a chronic illness, how much can diet contribute to feeling better?

Dr. Wong:           That is a superb question and I’ll give you a few reasons why.

Dr. Wong:           One, is that diet is something we do everyday. You can’t live without food for more than three days, honestly. Before we switched to stick something in an IV, so you had to have good diet. Even when you’re in the hospital for your chronic condition, diet is the first thing that come up on board next to medicine. And of course, plan of care.

Dr. Wong:           Number two is whatever you and consume can trigger or alleviate symptoms, um, of your body. For example, if you had renal disease, a chronic condition and you took too much protein, you might make it worse. On the other hand, if you had cancer, having more protein is obviously a benefit. So what you ingest when you take will help you in the long run.

Brian:    Awesome answer to that question. We’ve been playing with diet so much and, to make, you know matters worse, you know, we’re going to throw that curve ball where she also has an iron issue. So trying to keep the iron up without as much meat… Her doctor actually told her no red meat. It’s been a struggle.

Dr. Wong:           Wow, that’s rough.

Lupe:     Yeah, told me that my body can’t process red meat. So, you know, I kinda stayed off of it for a while but after a while my body craves it. So, you know, I do have some sometimes.

Dr. Wong:           Is it the, there is too much iron your body that way?

Lupe:     Uh, no…

Brian:    Not enough.

Lupe:     Well why? Why did he take me off of it though?

Brian:    Oh.

Lupe:     Not sure. He just said my body couldn’t process it and not sure why, but yeah…

Dr. Wong:           That is odd.

Lupe:     Yeah.

Dr. Wong:           I have a patient that has, ah, Sjogren’s and they have too much iron, uh, too much iron everywhere, in the liver, so I tell her to donate blood every month, in order to release the hemoglobin out in the world. I said we could use, some blood,

Lupe:     Wow, send it over to me!

Dr. Wong:           There are treatments for… So homeostasis is when you have too much iron in the blood. Not necessarily a bad thing, but it can be a complication of Sjogren’s and so you have to cut back on red meat for those reasons and you donate blood to get rid of it.

Dr. Wong:           You really can’t take drugs to bind iron out of your body or eliminate it rectal, you know, through your elimination processes.

Lupe:     Correct.

Dr. Wong:           It’s stuck in your body. In your case, you don’t have enough of it, but I find it odd that your doctor would tell you to get off of it. I’m wondering, maybe he told you that because of the cholesterol, there’s a lot animal fat in red meat. That’s all I could think of.

Lupe:     Hmm.

Brian:    It’s interesting. Unfortunately, Dr. Ryba is no longer with us, who was a phenomenal rheumatologist.

Dr. Wong:           Oh Ok… hmmm…

Brian:    I’ve never come across a doctor that, uh, had such an awesome bedside manner and would take the time. He, he would spend a considerable amount of time or that. So…

Dr. Wong:           that’s good you had a doctor that you liked a lot.

Brian:    Yeah. Yeah.

Lupe:     So, Doctor, in all your years in health care, how many Sjogren’s patients have you come across?

Dr. Wong:           That is a great question. First of all, in a hospital setting, Sjogren’s does not come up as a diagnosis. It’s more of like a diagnosis of rule out. They come in, they have like dry eyes and all the problems your experiencing, but it’s not life threatening. So, a lot of times the team will work up that diagnosis.

Dr. Wong:           Well, they’ll notice these symptoms. And they’ll list them as a list of problems. And then they go to the primary care physician at an outpatient to find out what is going on. Why is there a triad of symptoms and what’s it caused by. And that’s kind of where Sjogren’s shows up. Because you want to find out why you have all these symptoms. Because it all could be linked to, as you know, Sjogren’s or Lupus or Rheumatoid Arthritis or some other autoimmune disease. So Sjogren’s is kind of collateral find. So in my personal experience, I found only one and you are two.

Lupe:     You know what? I personally don’t know anybody with it. Um, but I know what, that’s probably why it takes a long time to diagnose. Correct?

Dr. Wong:           Yeah it takes a long time, cause you really go look for it, you know. And lots of people when they dry eyes or they have dry mouth, they don’t go to the doctor and complain about. It’s not a thing of concern to complain about. So the most part it’s undiagnosed for those reasons. It’s that a big deal.

Dr. Wong:           Diabetes, hypertension is more of a big deal and that’s what we chase. But when your Sjogren’s, yeah, it’s undiagnosed because people don’t complain about it. That’s one, uh, number two is that you’re not alone. There’s actually a lot of people with dry eyes. A lot of people with fatigue and muscle aches, but they attributed to something else. You know, could be Fibromyalgia, could be, um, the drug I’m taking or the fact that I’m getting older. So that’s why you feel you’re alone in reality you’re not. But you just happen to be the very rare people that actually got diagnosed with it. You got the positive antibodies. You got the tighter. So that makes you special, because you know, for sure.

Brian:    It’s funny you say about the dry eyes and dry mouth. It seems that people that we’ve met online and spoke to… it’s something that they’ve been dealing with for so long, they don’t know what moist eyes feel like. It’s just this is my normal and

Dr. Wong:           Right.

Brian:    It’s kind of, I don’t know, a unique situation for me.

Dr. Wong:           Yeah, you get used to it. Everyone has their problems. You get used to it. No one… like I have asthma and I don’t think I can ever run a mile in five minutes, you know. Never will know the joy of that. But I can still walk. And I can still practice. I can still live.

Lupe:     Correct.

Brian:    So we understand. You kind of went on a personal quest looking for solutions, remedies, things to ease the pains of Sjogren’s. What cool stuff have you found?

Dr. Wong:           I found that a lot of stuff is treated. is easily readily available. That’s step one… it’s easy to treat. Unfortunately, there’s no cure for it. So, what I tell my patient is that they’re stuck with it, but there are ways to alleviate it. And not everyone has those symptoms, by the way. You know, there’s a triad of symptoms… Dry eyes, dry mouth and fatigue. But that doesn’t necessarily happen to all patients.

Dr. Wong:           So, for my patient, I don’t honestly say take eye drops because her eyes are fine. But she does have dry mouth and does have fatigue and the muscle aches. So, then I recommend treatments for those ailments. And I try to use over the counter remedies. Homeopathic modalities before I recommend drugs. Drugs is probably not a good option here because of drugs that are available through the prescriber are so, um, toxic compared to the, over the counter ones. It’s almost not even worth it. So you really gotta look at your… how bad is my muscle aches, before I take this anti-rheumatic drug, for example.

Brian:    So, are aren’t you worried about them coming and taking your doctor licensed for not wanting to prescribe drugs, doctor?

Dr. Wong:           As a pharmacist, I recommend. I mean doctor can do whatever he wants. But I have always a very strong relationship with my clinicians and I always tell my doctors, you have the option, um, when the patient’s complaint, isn’t that severe… they can live through it. I would say use topical agents, for example, versus using an oral agent. Um, I find that, I give them alternatives, like better alternatives. And then if it’s really bad that the poor patients cant walk and they have a poor quality of life, then I try to find the least toxic disease modifying agents out there.

Dr. Wong:           And those are called DEMARS, that’s what we call them. They’re called disease modifying anti-rheumatic drugs. And they as a class cause a lot of white count changes, platelets, elevations or decreases. So it messes up your immune system. That’s the best way of saying it. You get sick easier. You bruise easier. You’re a big hot mess.

Dr. Wong:           So, I don’t like to recommend those agents unless the doctor has told me, you know what… my patient is really, really bad. Muscle aches. Terrible. Can’t walk. Can’t function. Can’t work at a job. Then I had to find something that’s a little less less toxic. And of course affordable. That’s kind of like the two things like focus on for my patients

Lupe:     Story of my life. I’m on… I’m going to get off topic here a little bit. Um, I’m a Plaquenil right now and a certain doctor told me that it makes you really susceptible to infection?

Dr. Wong:           Yes. And the sun. That happens to be me, when I go out in the sun… you will burn…

Lupe:     Oh, I do! I actually blister. So…

Dr. Wong:           So you get SPF 90 and you just douse yourself in that. But Plaquenil or Hydroxychloroquine, which is what you’re taking.

Lupe:     Yes.

Dr. Wong :          It’s the original antimalarial drug, so you won’t have any malaria, Yay! But you might get the, um, low white count and so it’s a rare problem, but when it happens and you get sick, you get sick bad, you know.

Lupe:     Yeah!

Brian:    That and I think it’s the healing factor. Because we, we do a lot outdoors. We do a lot of hiking and sometimes we’re… I’m kind of adventurous. If I see a trail on a map, I’ll take it even though it’s five years old. And it’s really overgrown. So, we get scratched up a lot. And insect bites. And things like that and she has such ah, such a long recovery period from a simple scratch.

Lupe:     Yeah, it takes me a long time. So, what do you recommend to take, you know, instead of taking Plaquenil, is there anything you recommend?

Dr. Wong:           No, actually Plqquenil is probably the least toxic. So, you’re good at the beginning stages of it. The other ones that would come as plan B or plan C are much more toxic. The second one would be Menthorexate, which is a chemo drug. Given orally, like once a week… it causes the same problems but more at a higher instance.

DR. Wong:          So, if you get scratched up, what I would say that happens to you, um, one, don’t go with him.

Lupe:     Leave him at home, yeah!

Dr. Wong:           For you, if you do get scratched up – bring some Neosporin. Neosporin ointment is fantastic in terms of bacteria kill. It covers gram-positive and gram-negative bacteria, which are the most common bacteria that you’re going to get, if you to get scratched up. You’re less likely to get infected by a fungus or a virus, you know, on a branch, right. So getting an antibacterial ointment and gauze is great for when you get hurt at that time, you know.

Dr. Wong:           Of course, clean up the wound and apply the ointment and it does an immediate kill. Change at twice a day and you’re good.. at least … I mean, just keep doing that for four or five days, that should heal on its own. When you get sick like that, the way you’re describing it because it’s gotten into your bloodstream. Um, it was a deep cut or you didn’t take care of it, you know, like it spread.

Lupe:     Yeah, yeah.., could be.

Brian:    I mean, we’re pretty good about it. And I’m kind of old school. I keep Iodine in the house. That, you know, that fixes everything, to include the common cold. So my mom told me.

Dr. Wong:           Yes. Iodine is actually is a great as an antiseptic. Just, you know, we don’t, I don’t like using it is because people have Iodine allergies. That’s the only reason I don’t use Iodine personally. But It’s okay, if you guys aren’t allergic to it. Yeah.

Lupe:     I’m going to try Neosporin cause it’s easy to keep in your pack and your purse.

Brian:    She’s lying, it doesn’t sting as much.

Dr. Wong:           Yes.

Lupe:     Oh yeah, Iodine stings too.

Dr. Wong :          Iodine does sting and it looks awful, its red. Yeah, Betadine, Alcohol, they’re all fine to use. Um, actually, in our hospital, what we do , is we actually alternate sanitizers because we’re worried about resistant organism. So, you know, cause we use so much of it. We actually alternate monthly, you know, which cleanser we’re using today?

Lupe:     Yes. Okay. Being a doctor, do you have any super secret information that, you know, a regular person doesn’t have access to… that we may not be aware of?

Dr. Wong:           Well, as a pharmacist, I have really good access to clinical trials. And that’s what makes me… makes us pharmacists different from, I think, um, the doctors. Doctors prescribe, based on what they know… I recommend based on what… what trials are out there. You know, everything’s in it’s space, which means that if a trial is out there, showing it’s effective, I’m going to recommend that.

Dr. Wong:           You know, and I look at all things. I look at, you know, who sponsored the trial and you know, how did it get better. And you know, what terms a lot better, a little better, you know. And how long did it take them to get better.

Dr. Wong:           I’ll give you an example…. If you have dry eyes for example. Everyone knows if you have Sjogren’s, and you take moisturizing artificial tears for example, right? There was like $2 in the store. Or you can get Restasis which is that cyclosporine eyedrops, the one with the fancy commercials

Lupe:     Yes.

Dr. Wong:           You can do that. Unfortunately, people don’t know it cost like $500 a month, for that. And that’s kind of pricey for a lot of people who can’t afford, that medication. But what you didn’t know is that you can actually go to, like, Target or any store really and get Omega 3 fatty acid supplement. So it’s like a fish…

Dr. Wong:           I don’t know, well, most people don’t know this, but in 2013 there was a moderate size study that showed that patients with dry eyes, with Sjogren’s actually improved by just taking a low dose of the fish oil, you know? And so they were getting 100 milligrams twice a day, but it has to have EPA and DHA, which are the two long chain fatty acids. This is important because this is great for dry eyes. If you take it everyday for three months. It’s not great if you want to reduce your cardiovascular risk.

Dr. Wong:           So you know, if you’re thinking, oh, fish oil, I can take that for my dry eyes and my heart, not, it won’t work. You’re is probably go no.-no, no-no. If you had a heart condition, for example, let’s say you had a high cholesterol, your parents had a heart attack and you’re a high risk of having a heart attack yourself. You need to be on at least a thousand milligrams a day of fish oil. That’s how different it is. So, usually it’s not over the counter, because they’re so huge and you got to take so many tablets, so they always prescribe it to you, through the pharmacy. But for dry eyes you can easily go to Target or Walmart or wherever you want to go and get the Omega 3 – 500 milligrams twice daily and you’re good to go. Helps in 2 – 3 months. And they’ve seen people respond earlier than that. So… but I’m just letting you know that after three months, you saw positive, significant improvement.

Lupe:     Wow.

Brian:    That’s awesome advice. Thank you for that.

Dr. Wong:           Oh, you’re welcome.

Brian:    What absolute DONT’s have you found that Sjogren’s patients should be adhering to? What should they absolutely not do?

Dr. Wong:           Oh, that is a good question. I’m thinking, um, I read that they shouldn’t be smoking, which obviously makes sense. Since you have dry mouth, you probably can’t even stick a cigarette in your mouth anyways. Smoking does make your mouth more dry. But I also read that alcohol should also be avoided, which I actually disagree with. Red alcohol, red wine is actually good for the heart. So I don’t necessarily agree with that. I do agree that binge drinking is inappropriate. Um, a little, like a glass of wine, of red wine a night does help with the cardiovascular risk.

Lupe:     That makes me a little bit excited. I cut alcohol out completely.

Dr. Wong:           Oh, did you? Oh no. I think alcohol is fine. If you’re limiting yourself to one serving, once again, one glass. So, when I read that, I thought that was kind of um, maybe a general statement, you know, avoid alcohol and you, that’s kind of a not conducive to patients. You know, patients are going to drink alcohol, but you want to be honest. How much can you drink, you know.

Lupe:     Correct.

Dr. Wong:           Like, no three times a week. No more than one glass. And we’re women, so we can’t have more than one glass of wine and we have two or three of them were considered drunks. But…

Lupe:     Right.

Dr. Wong:           That’s a definition by a different consensus, but typically you’re allowed one glass a night. Red wine is preferred over white wine?

Brian:    The darker the berry.

Lupe:     Yup! That’s that the doc said.

Dr. Wong:           Yes. It’s true. The pigments are good. They’re good for you.

Lupe:     Good.

Brian:    I mean we do our best to, obviously, avoid the sun. Between sunscreen, SPF treated clothing. She’s always in sleeves, hats, visors, ah, sunglasses. Um, we schedule a lot of activity around the weather, unfortunately. But you know, I guess fortunately living, you know, in southern California we get more good days than bad.

Dr. Wong:           Yeah. We’re lucky to be here. To live here.

Lupe:     We really are! Are there any DO’s that you do recommend?

Dr. Wong:           I know that there’s a lot of focus on exercise. And this is kind of important, sounds counter-intuitive,. But fatigue is the most prominent symptom of Sjogren’s. And actually that’s how my patient found out. She had amazing fatigue, like I’m pregnant, you know. Always tired, always sleeping, and she found it very unusual. So through stem cell workup, she found that she had the Sjogren’s. And I told her you must exercise and it was difficult for her. But I honestly, the amount exercise, we’re talking about here is minimal. We’re talking about three times a week, 30 minute walking. You know, it’s not a lot. It’s just keeping you from being sedentary, you know, uh, so no matter how hard you want to sleep, you have to physically walk. You know, even to the bathroom. Walk to your car. Those little trips, walking trips do help and they, you know, increase the flow of Adrenalin and that helps with you up.

Dr. Wong:           So I think the fatigue, that exercise is important. I think that when patients deal with joint pain, which is another common problem, that happens in the late stages. They complain of that and they go, I don’t want to work out now. And you’re, no-no, no-no, if your knees hurt, do something else like swimming or you know, if it bothers you that much then you can take Tylenol or NSAID’s.

D. Wong:             Nowadays with the rise of Opioid addiction, people are thinking, oh, if I just take some Percocet or pile of Codeine that will help it. Yeah would help it, but not in a good way. You know, you might be addicted to it. You’ll be tolerant event. That’s not good. But there are things you can do, like if you have joint pain, Tylenol. You can take NSAID’s, which are things like Motrin or Aleve. Those are good ones to take.

Dr. Wong:           What, we always tell our patients, is that, if you have a lot of GI upset, like heartburn for example, stick with the Motrin. Motrin is actually really good for those kinds of patients. And if you have a history of heart attacks, then Aleve is better than taking Motrin. So there are some differences among over the counter pain relievers.

Lupe:     Are there any good substitutes for sugar? Like for people that have sweet tooth, can’t stay away from candy?

Dr. Wong:           Oh yes, yes. Well, we all know about the controversy about artificial sweeteners. And that is at there are not good for us. Artificial sweetener is kind of trick or body that we’re having something sweet and we don’t and it rises like the amount of glucose that’s comes out for our liver. And in turn we increase more insulin and so we ironically, get fatter with it. That’s the controversy.

Dr. Wong:           Um, personally I don’t believe it. I actually think that artificial sweeteners are not good for us because in rat models there was some risk of cancer, in rat models. So I would probably say for that reason, not because it tricks the body or whatever. We have not seen that proven. Um, if we had diabetic come into the hospital, we actually tell them drink diet coke because it’s a lot better then than regular coke and it’s obviously, water is more superior, but I know them there not going to drink water.

Lupe:     Right.

Dr. Wong:           So it’s lesser two evils, is what I try to tell them. Go with that diet coke. And those patients don’t have worsening diabetes. They just have their sweet tooth and that’s fine. So, that’s where the controversy is, something that’s happening in the… what’s the word that the layman terms, you know. It’s not happening in the hospital in our sector, so we don’t think it’s an issue. But if you want to look at natural sweetener is as a consumer um, there are some there too. There is Monk Fruit and Stevia extract. Monk Fruit is a little nutty. Those are hard to work with, but it’s an option. And Stevia I love personally, I use it myself in my products. The only problem is that used too much of it or you put it in ice cream it will be bitter. So, but yeah, but for like water cola, perfectly fine. Tastes wonderful. Tastes really sweet. You don’t need a lot of it either.

Brian:    That was kinda the perfect segway because my next question I wanted to ask you is… Tell us about these awesome desserts we bought from you, like a week, two weeks ago now.

Lupe:     Yeah, I wanna say about two weeks ago… they were delicious.

Brian:    Tell about My Guiltless Treats.

Dr. Wong:           Okay… um, My Guiltless Treats is, uh, my company and uh, our biggest, most popular product has a Panna Cotta, which is what you’re talking about. A Panna Cotta is actually Italian dessert. It actually has the texture of flan. But unlike flan, I don’t use any egg or soy or gluten or lactose. I try to remove all the major triggers that would cause someone to have a GI problem afterwards. So that’s why there’s no gluten, there’s no soy, here’s no lactose. I use coconut cream instead, which is a healthier, you know, vegetable oil. Obviously, you know, look at a cream has fat, but it’s considered good fat and I’m using a natural sugar, like agave. You reduce the risk of postprandial spikes. A postprandial spike means that when you eat a dessert, your sugar doesn’t go up really, high afterwards. It has a slow climb of sugar. So that’s good for someone who’s diabetic because you don’t want to have that sugar rise and then a crash later on.

Dr. Wong:           I was fortunate enough to actually have a set of diabetic, who tested it for me, using their insulin pumps and they would taste my treats and I would monitor them 15 minutes and sure enough, their sugars never went beyond 138 or 140, which was perfect. And they were just mellow the whole time. Like they never had a peak or crash at all. They loved it. I believe it’s somewhat a good product and I made it better too. I didn’t want to just make it about low calorie, low sugar dessert. I think anyone can do it. I wanted to make it better by any protein because by adding protein you’re going to make the person less hungry afterwards, So you’re not craving for something else. A lot of times they eat a cake or ice cream. We’re like, oh, what’s next? I’m not quite done yet. And so we eat more ice cream or more cake. When you add protein, you actually increased time to satiety, so you’re feeling full longer, basically. So, yeah, like full – full like you want to throw up your full. Or your full to where you don’t want to eat more or less, you’re good. And so the eating stops, the craving stops.

Brian:    You know what, we sampled them and then we bought some and I actually went online and was awesomely surprised that some of the local markets and areas that we go to, on occasion are carrying the product. So how wide is your distribution for, for your products?

Dr. Wong:           It’s getting wider. I’ve actually secured another account, today. Yay!

Lupe:     Yay.

Brian:    Congratulations!

Dr. Wong:           I know, right! I have another location in Santa Barbara. As being the sole entrepreneur in this company, I’m doing everything. I’m doing a slow organic growth right now, but it’ll get done. I have no problem selling it. I never had any leftovers. People are always looking to get a box at a time, so it just finding the right store that will appreciate it. So, those stories on our website are people who get the message, who totally appreciate my mission and…

Brian:    You know, and for all of our listeners who want to see or more information on this product, there will be a link in the show notes.

Dr. Wong:           You know when you asked me those those questions at the market. I could see that you really wanted, because you asked me amazing questions, and you really wanna know the answer, and I just though, ugh,

Brian:    You jumping in and answering the questions that we had, you know, helped us make a decision and take a course of to attempt to alleviate some of what a Lupe’s feeling and we, we’ve shared it already, but it’s the CBD and you were gracious enough to lend us your time and your experience and your knowledge and again affected us making a decision. So we really do appreciate that.

Dr. Wong:           You’re welcome. I’m glad that it was helpful. Yeah, I wish more, my colleagues felt the same way. So like I said, if I can help you, I will. I don’t charge you for anything. I think the fact that I’m helping at least one person out there, hey, it’s all worth it.

Brian:    Right.

Dr. Wong:           You know otherwise, how would you get the information. You know, how would you know? You can go online and read some article written by a 20 year old. You’re not going to get the information hat you need, you know. So, I’d rather give it to you because a lot easier for me to tell you, than to have you look online and look at Wikipedia or something or…

Brian:    Definitely

Lupe:     And we do appreciate it cause I feel like it, it did help me out. So I think it’s been two weeks for me… so..

Dr. Wong:           Great.

Lupe:     Yeah,

Dr. Wong:           That’s a good one.

Lupe:     I’m excited – thanks!

Dr. Wong:           I’m glad it works for you.. yeah! h.

Lupe:     Yeah. What parting words would you like our listeners to take to heart.

Dr. Wong:           You won’t die from it.

Lupe:     Sometimes you feel like you will, but you won’t.

Dr. Wong:           I mean getting diagnosis or may suck. Yes. Right. If I was diagnosed with diabetes or hypertension or heart attack, I’d be more sad.

Lupe:     Yeah.

Dr. Wong:           The life changing diseases, again, diagnosed with that or asthma or broken ankle. Those are just little challenges that you’ll overcome. You know, and there are affordable remedies that you can take and also these aren’t terrible. They’re not like what? Artificial tears. That’s not going to hurt you. You know, taking like chewing gum for your dry mouth. That’s not going to hurt you. Brush your teeth more often. That’s not gonna hurt Ya. I’m excited again. That’s normal. You’re not dating really amazing if you. Mostly. What do we do anyways? We take NSAID’s. I mean we take Motrin or Aleve or Tylenol anyway, so you’re not doing anything completely different if you had gerd or gastritis as you saw what you still would avoid spicy food. So, um, it’s not a life changing disease state and it, um, so you feel sad by it then you misunderstood it.

Lupe:     I know, I find that if I stay on my diet, I take my vitamins and exercise regularly. Very important to exercise. I feel like I have more energy because if I get lazy too tired to whatever, and I don’t exercise for a week, I just feel like I’m more fatigued. So

Dr. Wong:           Everybody exactly like you, but you just have to have sjogren’s are sedentary and once you’re… And it’s not just you, if you’re sedentary for I believe more than a week, your muscles atrophy, your muscles actually will become from taught to like butter, you know, and then it’s harder for you to get up. I mean, imagine you breaking your leg and you can’t walk. Well then it’s important to do physical therapy because otherwise if you don’t straighten those muscles atrophy into butter. And so you can’t. Your legs will become weak because there’s all muscles, the muscles, the muscle fibers are gone. So what you’re describing is true

Dr. Wong:           whether or not

Dr. Wong:           so, but you don’t hear about it because he’ll tell you that if you don’t work out for a week I’ll be flabby. Yes, as almost you know it is. It is tougher. But I’m glad that you found out your magic bullets. You know what works for you. Everyone can be a little different. So once you find what you like stick with it, everyone has their own regiment. People drink coffee in the morning and then wine at night and they drink Kumbacha at night, whatever. That’s what works for them. By the way, Kambucha, I may nock on it a little bit, but are people with diarrhea or constipation or IBS, which is Irritable Bowel Syndrome. They love Kumbacha, so maybe it’s not for me because I have gastritis, but for someone with irritable bowel disease who’s always constipated, that’s their beverage of choice because they can go more regular with it, so I’m not trying to knock anything down. I’m just saying that it’s not appropriate for some people.

Brian:    Well, Doctor. we so thank you for taking time out of your evening and away from your family to share with us and our listeners.

Lupe:     You know, sometimes you don’t want to share your story because like I’ve said before, you don’t want to be defined by your diagnosis, but in this case, we spoke openly, and met Dr Wong, who was very giving of her time, knowledge and expertise. Not only once but twice. For the benefit of me, us not only us, but you the listener.

Brian:    Thanks for listening to another episode of

Lupe & Brian:     Sjogren’s strong.

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A Talk with Dr. Wong

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