- Zach from "The Try Guys" has come out
and said that he has an autoimmune condition.
I'm about to watch the video and react to it.
Let's get to it.
Be whoop!
- I have had really bad back issues,
basically my entire life.
- Perfect, I'm an osteopathic physician.
This is gonna go really well.
- I was going to the chiropractor when I was 10.
I had to have like an ergonomic backpack in middle school.
- I mean, everyone should have
an ergonomic backpack in school.
In fact, my theory is that a lot of the scoliosis
that kids are developing these days
come from uneven backpacks, wearing them on one shoulder,
or even those desks where you can only lean on one side.
- I ache, I get stiff.
It kind of started before I went to BuzzFeed.
A lot of my time would be spent at a computer.
And I noticed I would just...
When I sneezed, I could feel the pain shoot from my back
through the front, through my chest cage.
- The way that he's describing his pain,
right away tells me that there's some kind of inflammation
happening at the rib joints.
Because remember the ribs attach to the front of your chest,
the sternum, at least the upper ribs here.
And then also to your spine in the back, the thoracic spine.
- I have a bit of a hypochondria.
And so, whenever something's wrong with me, I'm like,
"Cancer, it's cancer, cancer."
So I told my doctor about this pain
and he says, "That's not a thing, you're good."
- If you're a doctor and a patient's coming in
with a high level of anxiety about a condition,
and you know they're susceptible to health related anxiety,
you have to right away be ultra transparent
and honest about what you're doing and why you're doing it.
Not just give statements like, "You're good," and move on.
- I decided it was time to go to the chiropractor.
We took an x-ray.
Turns out I have (beep) scoliosis.
- So scoliosis doesn't always require treatment.
We blame a lot of problems on patient scoliosis
when it's actually not the main cause.
It's very easy in a patient who's having back pain,
caused by something completely different, to get an x-ray
and blame it all on the scoliosis.
In fact, it's the lazy thing to do.
A small degree of scoliosis
shouldn't be causing significant discomfort.
In fact, most cases of scoliosis that we see
are extremely mild and are asymptomatic.
- Now, for anyone who has scoliosis,
they'll be the first people to tell you
that my scoliosis is minor.
It's not the kind that you would get surgery for.
I tried a lot of things to help this.
I changed my diet.
- I don't know what the diet would help with scoliosis with,
unless he had a bone mineral deficiency there.
The main thing that you do for mild scoliosis like this
is not even bracing, not surgery, obviously.
Physical therapy.
Doing some exercise, some lifestyle modifications,
to make sure you're not wearing a book bag
on only on one side.
- The pain built to a point where I couldn't sleep.
And I woke up at like 4:45 in pain.
This was every night for months.
Laying down, hurt, being in my bed hurt.
I mean, living hurt.
I'm talking about,
I would wake up in the middle of the night five times.
And all during this, I'm working a full-time job,
but when you're not sleeping, it eats away at you mentally.
- It absolutely does because you don't recover well,
you're constantly in a hypersympathetic state,
where it's like you're basically being chased by a lion,
you're never relaxing, you're never digesting,
you're never repairing and healing.
And, as a doctor, you have to ask these things.
Because when we ask how much disability
a certain injury is causing you,
it's not about whether or not you can walk or run,
or lift or not.
It's also about, can you rest adequately?
Can you sleep well?
Can you sit well?
Can you perform the duties at your job well?
- I start screaming, I think,
and I feel bad for the doctor,
but I was like, "Hey, this can't continue.
I'm losing my mind."
I got referred to a rheumatologist.
And, within minutes, the rheumatologist is like,
"Oh, yeah, I think I know what's wrong with you."
And I'm like, "What?"
- I'm interested what conversation they had
in the medical office
that led him to go to see a rheumatologist.
Who's essentially an autoimmune joint disease expert.
Why they went that route
versus a spinal surgeon, for example.
It could have been that he wasn't interested
in spine surgery,
but there has to have been tip offs
to some sort of autoimmune process.
- I had to go in for an MRI, which was scary.
'Cause at that point, I didn't know what was wrong with me.
He just referred me to an MRI
and I'm like, "Oh, God, what is this?"
- MRI is magnetic resonance imaging
where you have giant magnets essentially spin around you
to give us really good quality images.
It's really loud.
It's very claustrophobic.
Some of my patients actually need benzodiazepine medications
which are anti-anxiety medications
to even be able to get an MRI.
They do a great job at showing soft tissue.
Like an x-ray, for example,
will show bone quite well or joints well,
the MRI would show us cartilage, tendons, ligaments, organs.
- It turns out I have ankylosing spondylitis.
- Ankylosing spondylitis is basically
an inflammatory autoimmune condition
where it usually starts in the sacroiliac joint,
which is the joint between your hips
and one of the lower portions of your spine, your sacrum.
Aching get so bad that it starts spreading
to other vertebral joints moving up your back
where you develop stiffness,
and in the worst conditions,
actually the joints fuse,
and you become very stiff.
It becomes very painful.
Think about inflammation in the joint.
- This was about four months ago.
I am happy to report that since that time,
I've been on medication,
and I have felt better than I have felt
since, like, childhood.
I take a drug called HUMIRA.
So, no matter where I am, no matter what I'm doing,
I have to stop what I'm doing,
and give myself a little shot.
- You ready to get poked? (Zach chuckles)
- We hold on to Zach's medicine.
- I have to take this medication twice a month,
the same time.
So it's 8:40 am and I gotta take this shot.
- This is a medication that's used
as a disease-modifying antirheumatic drug.
And these DMARDs work through different processes
but the medication he takes targets tumor necrosis factor
and it actually allows the decrease of inflammation
where he has an unnecessary increase.
- And so what's great
is that you never actually see the needle.
- Oh. - Right.
- That's nice.
- See this window right here?
Some of the liquid's gonna pop out of it.
(device clicks)
- Whoa. - Ow, ow, ow.
But that's it, I'm done.
So I started my medication
and for a few months, life was incredible.
I was able to sleep throughout the night
without waking up in pain.
I wasn't stiff throughout the day.
- It's important to remember,
as he's talking about his experience with this medication,
that is not a cure for his condition,
it's a disease-modifying drug.
So it changes the course, the development,
making the progression slower.
That's the most important takeaway.
- During this time I was instructed
to keep up with physical activity.
No, no, Bowie!
But, as the months passed, I got a little lax.
I was back to where I was.
The truth is, I started ignoring my disease
the second I could.
The moment that my medicine started working,
I stopped paying attention to it.
So it was time to go back to the doctor,
finally ready to accept and confront my symptoms,
and ready to attack this sickness head on.
And,
he said I was fine.
My inflammatory markers were still low.
- If a patient is coming in
and saying they're suffering again with their illness,
that they feel like it's making a return,
they're going back to where they were,
and I come in and I say,
"No, your inflammatory cells are good,"
that's not adequate medical care.
We never treat lab values.
We don't treat inflammatory cells.
If a patient's coming in and telling me they have back pain,
if a patient's telling me
that they have terrible crippling anxiety
and depressive symptoms,
I don't say, "Oh, your labs look good, so, deuces."
- I decided to make my health a full-time job.
Physical therapy twice a week.
Yoga and stretching first thing when I wake up
and last thing before I go to bed.
Long walks with Bowie every single day,
instead of letting someone else walk him for me.
And, exercise, especially on the days that I don't want to.
Accepting that sometimes being late to work in the morning
is a necessary component to my health.
- The movement component
and the healing that comes from moving is amazing.
Because whether it's a medication,
a massage, physical therapy,
all of that is in place so your body heals itself.
And a body that's not in motion
will continue staying not in motion,
and continue being in pain.
- And, after all that,
I feel okay.
(Dr. Mike chuckles)
I still have a baseline of pain most days.
I don't know that I'm ever gonna fully be 100% again,
but I am done ignoring my pain.
- That's really powerful
because acceptance is a big part of chronic pain.
A lot of times we promise patients
that we can fully get rid of their pain.
Go from 100 to zero.
And, a lot of times, that's not feasible.
Most notably so when it comes to opioid treatments.
Patients that are promised zero pain are given opioids,
their pain goes to zero,
but then we can't continue those in many cases, long term,
unless that there's an endpoint,
there's a goal for something.
Check out my video of Michael Reeves
and his bladder exploding.
What?!
Click it, it's the most fascinating story.
He's actually in the video with me.
Click here to check that out,
and, as always, stay happy and healthy.