Dr Nisha Manek Rheumatologist and Clint Paddison discuss RA Treatments

Rheumatologist Dr Nisha Manek Interviews Clint Paddison

Rheumatologist Dr Nisha Manek Interviews Clint Paddison to discuss medical vs natural treatments for Rheumatoid Arthritis. In this episode you will learn
– The current pharmaceutical approach to Rheumatoid Arthritis
– How most patients are treated from the outset of their disease
– Why Dr Nisha feels so positive about the Paddison Program for RA sufferers
– The side effects of pharmaceutical drugs and why it motivates Clint to continue to raise awareness for other sufferers on self-empowerment
– The challenges involved in balanced drugs, patient expectations, compliance levels and side effects

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Clint: This broadcast does not constitute medical advice. All changes surrounding medications, diet and exercise should be made in consultation with a professional who can assist your unique, health circumstances.

Announcer: Welcome to the Paddison Program where you’ll learn how to improve your health from the inside out. And now, your host, Clint Paddison.

Clint: Welcome back to the Paddison Program. Today we’ve got a very interesting episode. This one came about because our guest on this episode actually listened to a recent one with Richard Matthews, the author of The Symbiont Factor. And she reached out to me and said she would like to have a discussion about the progress that I’ve made, about the Paddison Program and what I’m doing to help others. She’s a rheumatologist and she is based in the United States. She goes into a nice little background about her work history and so I’ll let her share that once we pick it up now with a conversation with Dr. Nisha Manek.

Dr. Manek: One of the reasons for me to reach out to you is I’m a rheumatologist. You may have done some homework on your side to find out who I am.

Clint: I’ve read your bio. That’s about all but that’s enough.

Dr. Manek: Yeah, so I am an M.D. by training from Scotland University of Glasgow. I have done internal medicine training in London. I’m now a Fellow of the Royal College of Physicians and Surgeons so I’m very conventionally trained, just so you know. I’ve done rheumatology training at Stanford University in California and then after that I joined the Mayo Clinic in Minnesota.

Clint: Famous – right?

Dr. Manek: Yes. I was on the Division of Mayo Clinic Rheumatology Department for 12 years until I decided to seriously look at complementary therapies, particularly energy medicine and I’m also looking at this notion of information healing or information medicine. But that’s beside the point, in a sense. Along the way, because I’m still a clinician, part of my time is seeing rheumatology patients mainly with rheumatoid arthritis every day. And some of the consultation is really opening up this area of the physical which is dietary supplements, the things that you’re doing.

Then we also look at mind/body things, meditation and all of that, guided imagery and all of that and with some patients even the spiritual aspect. It depends on where they’re at. You try and meet them at their goal level and it changes, every patient is very individual.

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So sometimes when I come across with ideas for them, I think they’re very surprised, let me put it this way, they actually have more control than they think and I think you’ve found that out. With a lot of bumps along the way I think you put your nose to the grinder and you really did your homework. I read the Paddison Program. There is a lot of information there. The core message here, as I looked at the Paddison Program, was the gut microbiome. It’s the darling of the medical world right now. It’s understanding the bacteria and how they contribute to wellness and dysfunction in the physical body.

The second thing was very interesting to me. So you really picked up on that, by the way and you emphasize it. The other thing I enjoyed very much was the relevance of enzymes. We don’t talk like that in western medicine. We don’t talk about bromelain, or papain or how to replace the enzymes. We just don’t know actually. We don’t measure those things. We don’t understand it as yet but I think it’s going to come especially because now we’re paying more attention to the gut and the leaky gut as you call it.

So there were these aspects which I think are very valuable here but let’s go to your history. You were 31 when your arthritis really started. How old are you now?

Clint: I’m 39, so we’re talking about eight years.

Dr. Manek: It’s been eight years so you have an established diagnosis. Do you remember if you were seropositive? Did you have the rheumatoid factor?

Clint: Oh yeah. I had both. I was seropositive. I had a high rheumatoid factor and a very high C-reactive protein. It got to about 55 mg per liter at one point and I also had a correspondingly high sed rate. What I did because I have a science background and I’m fascinated about charting everything, I used to chart my sed rate and my C-reactive protein every month. I’d get my blood test results done every single month even if I wasn’t meeting with my rheumatologist because I would ask for multiple blood test referrals so that I could keep track on it and chart it. I’ve got my blood test results going back from Day 1. I used to chart them and I would watch my C-reactive protein and sed rate track beautifully. You could see my hands and they would just move like parallel lines on a chart.

So in answer to your question, all of the indicators from a blood point of view of the diagnosis as well as, I want to say that it felt like 80% of my body was affected. So I had it in my chest. I had it in my jaw. I had it in both elbows, both wrists, all of my fingers, my thumb, the side of my hand, my ankles and all of the metatarsals in my foot. I mean, I was a right mess and my left knee was so bad that it looked like a cantaloupe. That’s where I was at.

Dr. Manek: As a side bar, you’re a physicist by training.

Clint: Yes.

Dr. Manek: I saw your TED Talk too, by the way. It’s a good talk. You’re a stand-up comedian now?

Clint: Oh yeah.

Dr. Manek: What? I’m interviewing you, that was really funny.

Clint: Let me explain that because sometimes people, they can at first think that that’s a lack of credibility but let me put it in a way that makes sense. I actually became disenchanted with the corporate environment. I felt stifled and I felt there was a glass ceiling working for other people when I was working in the high-tech, fiber optic business.

So what I used to do, coming out of the university where I was given the highest thesis grade ever issued by the department at the university. I was a success story for our university. I was in the media and stuff because of the research that I had done and I published my first scientific journal paper when I was only 23 years old. So I came out of that thinking I was going to work in the fiber optic business for the rest of my life and I spent five years there eventually and I wanted to start my own business and move out of it because I really didn’t like being told what to do by everyone. Although I got to a senior level of management at a very young age, I guess for me I just always wanted more.

And so I wanted to start my own fiber optic business and I was exploring options in that area and then in 2000 that was the year that the tech bubble burst so the NASDAQ stock market fell from its peak down to about, I’m guessing about 20% of its figure and all the money that I had in shares in the company that we were part of was lost so all of my finances were lost because I had all my eggs in one basket, so to speak. And also, I then thought, “I can’t start a company in an industry that’s completely collapsed.”

And so I wondered what I was going to do. Part time I had been doing stand-up comedy because I had been giving a lot of presentations about how optical fiber technology worked, and about fiber bragg gratings and game flattening filters and all these things that were relative to undersea optical fiber networks.

And in giving those presentations I used to get very, very anxious so I started doing stand-up comedy to minimize my anxiety and nervousness that I would have before presenting talks to technical geniuses. And as a result I thought, “Well, now that I’m unemployed,” and I got a reasonable payout as a termination clause and I thought, “Why don’t I just see how I go with stand-up comedy until I find something else to do?” And I just never, ever did anything else. I just kept at it because I started to get paid more and I started to enjoy it. And, yeah, it was something that came about because of the collapse in the industry that I had been educated in.

So that’s what happened and then I learned that I could speak well in the corporate field because I came from the corporate background so I became a corporate entertainer and I was able to tailor a lot of business-related material to company events. And that’s where I was able to support my family because there’s a lot more money in performing for companies than what there is performing at comedy clubs.

Dr. Manek: Yes, very, very clever. And, you know, this is a whole area for you to actually explore this. But any way thank you for that. It does explain a lot because when I saw that you were a stand-up comedian I though, “What?” I took a double take. I thought he was doing physics. So here you are, 31 years old and out of the blue unable to move. The first time you heard the diagnosis of rheumatoid arthritis, what was your reaction?

Clint: So there were two things. First of all I thought, “What is that?” I had never heard of it. Honestly, I had actually never even heard the phrase “rheumatoid arthritis”. Now maybe I had my head in the sand because I studied really hard at university and then I worked really hard at my career and then I kind of partied pretty hard after that. I just wasn’t paying attention to much outside of my little world so I hadn’t heard of it. But then secondly, and this sort of stems from an upbringing that I had, is I thought “It will be fine. I’ll be able to solve it. It’s not a problem. Whatever it is can’t be that bad.”

And then because my knee was so bad so quickly because the same week I had got diagnosed I actually also tore my ACL in my left knee. And I since learned from my wonderful rheumatologist here in Sydney, Australia. He explained that the damaged joints tend to be the ones where the disease migrates to the most. And so because I had a very severe injury to my left knee right at the same time the rheumatoid presented itself and because, as I learned from him also, the rheumatoid tends to get off to a very quick start. In some people and especially in my case, it got off to a flying start.

I thought, “Look, it’s going to be fine,” and I naively felt that with my track record of solving problems in the past and achieving everything I had ever wanted in my life, I thought I can just get over this myself so I refused his suggestion of Methotrexate at the start. And I gave it 12 or 18 months, thinking, “I can beat this with using natural techniques and stuff.” I think I’ll stop there because that’s only just the start of the story.

Dr. Manek: Yes, and so Clint, am I correct to say that you didn’t have a family history of rheumatoid arthritis?

Clint: That’s right.

Dr. Manek: Because you’re the atypical patient. You’re a man first of all. Women get this 2:1 so already you’re against the odds and it came, as you said, with a flying start. It was formanent [SP]. We call it formanent, quick-onset rheumatoid arthritis. I think you mentioned in your book it’s symmetrical, you’re right. Large and small joints, both sides of the body, above the diaphragm and below the diaphragm if you look at it very simply. So no family history. Did you ever smoke?

Clint: No, I didn’t smoke but I did drink a lot. But what you’re going to love is that I had acne as a teenager and my dad’s approach for treating his own acne, it was almost a carbon copy of his upbringing, about the age of 14 or 15 he started to get acne. He really hated it. He took pride in his appearance especially how we all do when we’re teenagers and we’re very susceptible to criticism. He took about five years of antibiotics and he said that fixed it for him. Even though he’s a farmer, he just intuitively tried to discourage me from doing that but I thought, “No, it’s just too bad,” so I took it as well. And every time I would go in and get repeat scripts to be able to fill for my antibiotics over a five-year period, not one doctor ever asked me whether or not it was a good idea or suggested that maybe this was bad for me in some way.

And so although I should have always taken that as my own responsibility, I didn’t get a warning once from anyone that it might be a bad thing. And now knowing what I know and like you mentioned at the top of this call about the microbiome, I believe that played the biggest role of all the negative pathens that I participated in and I think that’s the main reason that I was susceptible to having a microbiome collapse.

Dr. Manek: Yes. You know, there has been so much work in epidemiology and this is part of medical research where we look at large numbers of people. Often in a particular geographical location you’ll see Framingham studies in Boston and Mayo Clinic in Minnesota has Olmsted County in southern Minnesota which is actually very stable. It’s Norwegian, usually Scandinavian background people that for generations have lived there so it becomes a very natural experiment. Mayo Clinic has done incredible research on rheumatoid arthritis asking the question “Why do people get this? Why do women get this?”

And a couple of things have come out of this and one is that smoking is a risk factor. It’s interesting, you don’t have that. The second one is periodontitis so gum infections and gut infections actually mess up the gut microbiome and appear to be a very strong risk factor. So is the antibiotic treatment for acne also a risk factor? It could be but it’s interesting we have never seen that and we have lots of kinds on antibiotics for acne. I mean, this is almost like a rite of passage. You get braces, you get your tonsils out and you get antibiotics. And you pose a very interesting point. Is there a small pocket where certain individuals have susceptibility based on their unique environment? In your case, it was antibiotics.

I also have to say, Clint, that in medicine antibiotics, just like aspirin, is like a double-edged sword. Who is going to do badly with our medicines? They’re not benign by any means and when this teenager comes into your office do you say “No, no, no, this is bad for you?” Actually there is no literature strongly saying no so I take your point and it’s very difficult. You want a teenager who is confident and who has a good skin versus are you setting him up for rheumatoid arthritis really statistically speaking?

The second point, we just don’t have the data to really say that but I take your point. I think you may be right. I think you are right. It is a question that perhaps we should be looking at more closely and remember, research is very, very difficult when you have diet, and when you have antibiotics and all these other variables plugged into it. But it’s important. That’s why doctors didn’t tell you, we didn’t know. In a sense, we didn’t know.

Clint: That’s right. And I appreciate that the likelihood of developing rheumatoid arthritis from five years of low-dose Doxycycline is that you might be only looking at a 1% risk factor and therefore is it really even worth mentioning? Well, to me it would have been but would I have even listened? Because at the time I felt invincible. When you’re 20 years old you’ve got other things on your mind than being sick.

But then I do believe that it’s a combination of things and I believe that I had a platform that had been depleted in its robustness because of the antibiotics but I also believe that I was under extremely high stress because of a different company that I had started at that point. And then in addition to that, I don’t think I had the ideal diet. I used to think that the ideal diet involved just having a bit of meat and some cooked vegetables at each meal and maybe Coco Pops or some kind of cereal that you’d buy that’s well advertised on television with milk. And so that was kind of my diet and living a high-stress life.

And I don’t know if you’ve listened to the podcast episode I did recently with Richard Matthews who is an expert in the microbiome and wrote a book called The Symbiont Factor. Our listeners will know the book because I just interviewed him recently. He talks about the massive impact of stress on the microbiome. And that on top of the antibiotics and not having the ideal diet I think has led to the problem.

Dr. Manek: So here you are with your rheumatologist, you have a cantaloupe sized left knee, it has been injured. You’re given the diagnosis of rheumatoid arthritis and you’re a physicist at heart. And you’re saying, “I can unravel this and take care of this.” This is excellent. So tell me what happened for 18 months. He was giving you Methotrexate which is the gold standard by the way. There is so much literature now showing the beneficial effects of Methotrexate. He was correct to offer that to you but you were not so sure, so tell me what happened to your health?

Clint: So it went downhill faster than I could ever imagine. He actually said that someone with a strong immune system can actually deteriorate faster than someone with a weak immune system. And I think what we understand about that is that if someone’s got an ability to create a lot of antibodies to the particular antigen that are entering the bloodstream but in the unfortunate case of rheumatoid arthritis, if those antigen are being created in vast numbers to parts of your body you then you can deteriorate yourself faster by having an “inferior”, a good immune system that is just innocently confused.

And so I went about destroying myself internally. I had to have an elbow surgery on my left elbow and have a complete synovectomy within, I think within 18 or 24 months of getting diagnosed. So my left elbow deteriorated to the point where I could barely get movement out of it at all. I was lucky to maybe get a 10 degree range of motion out of my left elbow. The experts that I was seeing about my elbow were saying, “You’re best off not to move it. It’s inflamed, and so forth.” And since I’ve learned a lot more about the disease and helped a lot of people I’ve found that on the contrary, movement is so essential to joints that even are inflamed and the situation is to create exercises that are doing more harm than good. That’s a bit topic that we could spend a lot of time on. That’s actually joint specific so what works for one joint doesn’t for others.

So back to my story. I was resting and trying to avoid bumping my left elbow which was in agony. I was limping around everywhere and I actually didn’t get onto the Methotrexate until about six months before the elbow surgery. I basically conceded that I had failed but up until that point I had been outsourcing my problem to experts. I was spending thousands of dollars on naturopaths, and homeopaths, herbalists and all sorts of different natural therapies and felt that someone was going to be able to fix me. That was my mindset in the first year and a half. It was to find that expert in the natural world who could give me an alternative to the drugs and help to fix me.

So it wasn’t until I reached absolute rock bottom. And I was, after the elbow surgery and my Methotrexate dosages continued to rise despite my worsening symptoms. I got to a point where I was having to look at an alternative to Methotrexate and discussions were coming in about more drugs from the medicine cabinet. That’s when I just decided, “Enough is enough and whatever it takes, whatever amount of time, energy and dedication it takes, I’m going to have to look into this myself with all my heart and soul and stop outsourcing it.”

Dr. Manek: Yeah, wow. So the Methotrexate was sharply escalated, you continued to have a lot of joint activity and you were looking at a major surgery. I mean, synovectomy they remove the synovium from your left elbow. Often we see contractions of the elbow. It’s one of the signs of damage of longstanding rheumatoid so you were bounding along and in 18 to 24 months. You have a very robust immune system, let’s put it this way.

Clint: What I did get out of the Methotrexate was about a year or so. The doctor said it would take three weeks before I felt the effects of the Methotrexate and you could actually have set the calendar by that. Literally on the exact 21st day of taking it, I woke up feeling quite different. It was just amazing to me that it had the exact lag time that he said to the day.

Dr. Manek: Yeah, so it sounds like you had some benefit from the Methotrexate but it wasn’t enough. The monotherapy was certainly not enough to keep your disease in remission.

Clint: No, it was not but I just want listeners to understand that it did give me about, I want to say, about a 60% pain reduction after the 5-week mark. After the 5-week mark I felt 60% better than what I did but then holding it at 60% was difficult. And so maybe three or four months went by and then discussions started to arise. “Blood tests are starting to creep outside of the normal range. Maybe we should look at increasing it a little bit,” and so the process of increasing Methotrexate definitely went on beyond a year before I made that decision where I’m going to need to take this.

Dr. Manek: You know, now the paradigm for rheumatoid arthritis treatment used to be you step up the treatment so we’d give a little bit of Methotrexate and we’d titrate it, as it were, by a pill every week. It’s dosed once a week. And then there was research out of Europe where they took a very different tactic. What they did was step down. In other words, you put out the fire. You put out the fire of rheumatoid arthritis with Methotrexate, Prednisone, Plaquenil, you may have heard the word Plaquenil, it’s another tablet, and Sulfasalazine, a lot of tablets here. But what happened was once you put out the fire over six months after initial diagnosis and you step down, you actually take away the medicines and you follow these people for five years, 10 years, they did better. They had less joint surgeries.

And so we came around to this notion of “Let’s stop faffing around,” but really putting out the fire early on and we’re treating to target. That means you can now really put patients with rheumatoid arthritis in remission and they can stay there. We can’t cure it. The word cure is not there but remission is. It’s very achievable. And so you’re smiling a little bit, Clint.

Clint: Yes. You’ve raised a lot of things to talk about in that subject.

Dr. Manek: Yeah, your rheumatologist may have even offered you the new biologic era. We’re in a completely different era of immune disease treatments where we are understanding the immune system in much more detail and can pinpoint certain, what we call, proteins or cytokines that are over produced. They’re the ones that make you have inflammation and if you have molecules, the biologics you can actually target them very specifically. Were you ever on biologics?

Clint: Thank God, no.

Dr. Manek: Okay.

Clint: You’ve said a whole bunch of stuff there. You have to understand that I have a large network. Thousands of people have communicated with me over the last three to four years and I have a large network and online forum of people that I help out in the community basis. A lot of those drugs that you’ve mentioned have caused many of those people a great deal of heartaches, side effects and problems. And so whilst I completely understand that it can be used as a sort of like a “throw everything at it” kind of approach to get people’s inflammation down into the normal range and to use the medical term “in remission”.

As I understand it, that means the disease isn’t detected actively because of either the suppression of the inflammation or the immune modulating drugs but essentially the blood tests are coming back normal and the body isn’t worsening month to month. That can be done with those drugs but having been on just the Methotrexate and seen the side effects of that drug, particularly the fatigue but also it just made me a foggy-headed person and I just wasn’t my happy bumbling, Labrador kind of self.

And hearing the stories from everybody else who are desperate to get my input and those of my sort of graduates who also had great success, to get their input on how to actually minimize these drugs, I think that yes, there just needs to be that balance between wanting to get the inflammation as low as possible so as to protect people’s joints long term without also putting them into some kind of existence that’s very unpleasant with all the side effects of the drugs because we’re well aware of those side effects. And when I hear them every single day from multiple people, that’s why I’m so passionate about doing everything possible from a health point of view – everything that is available to a patient from a point of view of natural healing – so that the amount of medications required is only enough to take care of the job that doing it healthy won’t do, if that makes sense.

Dr. Manek: So this is the balance. How can you use conventional therapeutics safely? And now we have about a decade’s experience with the biologics. They are expensive. I think it’s the cost, the financial aspects not to mention they are biologics and they have problems. Infection is the one that comes most to my mind. I have to say however that having hundreds and thousands of patients, with very careful care and patient education, they have to work with you, I’ve actually not had anyone really run into trouble. And these are older folks, younger folks, children and all age groups but you’re right. You have to educate them. It’s not the Holy Grail but it does offer joint protection and safely put people into remission and do all the things you’re doing. And that’s where I want to turn the conversation.

Clint: Just before we jump back to me because I can talk about me all day but I’m also curious to get your input. A lot of listeners don’t have the benefit of having someone of your esteem and in your profession to hear from as well.

So the biologics, I mean, I specifically hear from people who’ve been unable to tolerate Enbrel and Remicade and some people with Humira as well. Of course people coming to me are those people that can’t tolerate those biologic drugs and so I only get a skewed or small subsection of the larger group of people who are on those drugs. And so therefore, I’m probably seeing more of a problem with those drugs than your average, say, medical practitioner. But have you seen that most people tolerate those three drugs and others in that range and also do people on those medications, do they also need to be on the Methotrexate, maybe also on Plaquenil or a Sulfasalazine? Because I’m also seeing that normally when people are on the biologics they’re also on a hybrid or a tertiary mix.

Dr. Manek: Yes, it’s called combination. So to answer your question about biologics, have I seen good effects? I sure have. And when I was at Stanford University Enbrel was undergoing trials, as was Remicade. It was stunning to see young people coming in wheelchairs. You know we’re blinded. There are placebos. There is no medication in those syringes and yet at the end of the treatment they were suddenly getting up. It was quite exciting.

But we now know that even with the biologics there is a limitation. There are different cytokine profiles in every patient. We don’t know enough about each individual immune signatures. Some patients may have an excess of interleukin 6 and another one may have an excess of interleukin 1. Or another one may have truman necrosis factor alpha, etc. but no matter, the biologics have definitely improved, dramatically so, many people’s lives dramatically. They’ve gone back to work and we can see definite evidence of economics. So Scandinavia, for example and countries like that where there is socialist medicine, they can really see the cost of the drug and going back to work. And the high cost is offset by people going back to work and getting their lives back on track.

And along the way, yes you have to keep a close eye on fevers, make sure they’re screened for tuberculosis and to be honest, I’ve not seen that. But again, we counsel them, we screen patients and if we do those things wisely there is definitely a role, okay? If patient’s are terrified we do all of what you’re going to tell us to do. Which is, “What is your diet like? What are you eating? Not just eating but, what are you thinking? What are you watching and taking in? What are you hearing and taking in?” And so this is all part of your diet. What you take as part of what you watch, see, hear, eat and if you want to then start to seriously look at your lifestyle and be intense, like you did, you can make gains.

And some patients do that. They go fasting, they do juicing and they’re starting to meditate. Patients have taught me a lot of what’s worked for them so it’s like a collaboration between them and myself. There’s always this back and forth. “Tell me what helps you. Tell me what’s your goal today.” You know?

Clint: Well, I’m just going to say on that point that you are a unique, rare, wonderful individual as a doctor because one of the biggest problems that people have when they start changing their diet or they start meditating or they start looking into natural therapies, supplements and so forth, is that their medical professional, who is their prime point of contact for their disease handling, is often very skeptical about those particular changes that they want to make. And I’ve had stories that I hear all of the time. Sometimes people tell me that their doctors have thrown a pen across the room. Some people have wanted to make changes in their diet because of what they’ve heard from me or other people online and the rheumatologist has said that they won’t work with them anymore.

Dr. Manek: Oh my.

Clint: That’s really going on still within the medical community and it’s far more than what we’d all like. And so I’m very, very pleased to hear what you just said. It really has made my day because I’m sure that people in the area that you service will be really, really keen to come and see you. So I expect that you should a lot of inquiries.

Dr. Manek: Well you know, yeah, I think rheumatologists essentially as a group, certainly I’m talking about the United States here, there has been a National Institute of Health, or what we call the NIH survey, of complementary therapies and rheumatologists’ attitudes toward complementary therapies. This was actually done in 2006. They sent out a survey to about 600 doctors randomly picked across the U.S.A. and these doctors answered these questions about meditation, massage, supplements and what did they think. And the core diagnosis that doctors were really addressing or asked to address was osteoarthritis. So rheumatoid is different but nevertheless let’s just put osteoarthritis and these doctors were answering questions. And wouldn’t you know it, this was quite a surprise. I was the lead author on this particular paper. And what we saw was the traditional antagonism between traditional rheumatology or conventional rheumatology and complementary therapies, we call it integrative medicine, has softened a great deal. In fact, the gap is much less than you’d ever think. Well, I was surprised.

Clint: I’m very surprised and I remain skeptical.

Dr. Manek: I can get you that paper, Clint.

Clint: Would you like me to send you 50 emails of people just in the last 12 months of people that have got stories of their rheumatologist and their complaints. The most commonest most quote that I get is, “Hi Clint. I went to my rheumatologist and told him about the changes and about what you’ve written about. And I was very excited however now I’m really unhappy because my rheumatologist said there is no relationship between diet and rheumatoid arthritis.” And so that’s the challenge that most people have is that they’re still hearing that. Again, I’m very encouraged by the study results that you’re able to gather. Maybe things are changing slowly and maybe again I only hear from people who have had the bad experiences.

Dr. Manek: Yes, I think there is definitely the so-called or this perceived antagonism is not as wide as we think. The one area that rheumatologists were less keen to recommend or there was less perceived benefit turned out to be energy medicine, which surprised me. Only 10% of physicians would ever recommend go do some Qigong or acupuncture and I think there’s value again, in all of these things.

Clint: I wouldn’t recommend that either. Let me take that back. If acupuncture falls under that then yes, I know people who have really seen benefits through acupuncture.

I like to jump occasionally and play the other role for a second and think of it as a rheumatologist. Let me tell you why I think that a lot of rheumatologists say that they don’t think diet plays a role. This is a nice segue into what I recommend. It’s because everyone when they go and try different dietary changes and so forth, 99 out of 100 continue to come back month after month and they’re either the same or worse or maybe slightly improved for a while and then the disease comes back just as it was before. It’s because what people think are good dietary changes and the ones that they’re trying aren’t either good for them or they aren’t trying it to the full extent that’s necessary to combat what I believe is one of the worst diseases you could ever get.

And so you need to have an incredibly powerful leak-free system or approach to really see the effects so that a rheumatologist would then be able to say, “Okay. Actually I agree. Yep, you are way better, you’re way happier, and you’re on less drugs and you’re in less pain. Therefore I’m now convinced that diet does play a role.” And because so few people engage in that type of dietary change. They might just, for instance, go home and a common thing these days is people say, “I went gluten free.” Well, that’s not going to do anything. If you have rheumatoid arthritis and you go gluten free, good luck. Nothing is going to change much. And that’s why the doctors are seeing this and their own personal experience over decades will reinforce that position. And so I can understand that that’s probably why they believe that.

Dr. Manek: Bingo. Exactly. You just hit it. So when patients say, “I want to go natural,” I say, “Tell me more what you mean by that.” And in fact, sometimes I tell them, “Take a big piece of paper and put it on your kitchen wall like a vision board. Write every aspect of what you think needs to go there or what you call natural.” The next visit, “Where is your board? Take a snapshot.” And there is no work done. To say natural, there are a lot of steps. You discover the steps on your own. To juice cabbage and drink that is not for the fainthearted.

Clint: It’s not for the fainthearted. That’s right.

Dr. Manek: It’s unpleasant, okay? But it can be done. You’ve shown that it can be done and I totally understand that.

Clint: It can be done and I believe that, not in every case, but I’m just talking about okay so could it be done that a person could climb Mount Everest? Yes, it can be done. Can it be done that we sent human beings to the moon? Yes, it can be done. Can it be done that people can get to a point like I have where I have zero pain, zero inflammation and had no RA event in over three and one half years? Yes, it can be done. However is it difficult? Oh my gosh it is extremely difficult.

Dr. Manek: Yes. And so you bring me to this point where when patients tell me, “Dr. Manek, I want to do the natural things.” And I say, “Tell me on your mind. You’ve done some reading so you’re asking me questions. List me three things that you feel are natural and let’s talk about it in the context of your lifestyle or your eating habits.” They’re all these variables there. So my question to you, and by the way, even in this conversation with my patients, many of them are still confused. Maybe their resources aren’t as robust. They’re reading loads of stuff and trying to distill it is confusing.

Clint: Very. Everything is conflicting.

Dr. Manek: Yes, when patients come through your program, Clint, what is the one thing that you tell them apart from, “It’s going to be very intense and extremely difficult.” What is your success rate, basically? How many people stick with this program at one year or two years? Have you gathered that sort of data?

Clint: So there are kind of a couple of questions in that. I’ll try to answer them one at a time without forgetting them all. First of all is the success rate. Let’s break it down into the components. There are four phases of the Paddison Program. The first phase is to measure existing condition. What we need is a before situation. This isn’t just so we can take nice pictures later and get a nice video comparing how we went before but it’s to actually quantify the improvement.

So the first phase is to have a blood test taken before you begin or at least have a recent blood test taken before your start this process because once people are a couple of months into it and they start to wonder how much they’ve improved, if they can refer back to a blood test that shows their C-reactive protein used to be 20 mg/liter and now it’s 4 mg/liter then they can feel great about that.

Secondly within that is measuring the joint motion because I’ve found personally that one of the best ways to know if a joint is improving is the range of motion that that joint can go through, especially the big joints like the knees and the elbows. So we want to measure the range of motion. Pull out a physical measuring tape, and get in there and measure those distances.

The second phase is a two-day juice cleanse. Now this includes no sugar so that the person who has . . . I consider someone with rheumatoid arthritis someone who has a severe gut disorder. Now the severity of that could be only a bacterial overgrowth or it could be a bacterial overgrowth and depleted mucosal lining. It could be bacterial overgrowth, depleted mucosal lining and severe leaky gut and it could be all of those things. And so we don’t know whether or not it’s an absolute disaster or if it’s just really bad but it’s between those two ranges, okay?

And so what people will do during the two-day cleanse is avoid all sugars because most people with RA have trouble with everything basically. They have an incapable digestive system across the board but sugar is a general trigger for bacterial overgrowth because normally the overgrowing bacteria is often in part a sugar-loving bacteria and so we only drink celery and cucumber for the two days and some leafy greens with no oils to keep the bowels moving just a little bit.

And what people don’t realize is that the moment they stop, well not the moment, about eight hours after they stop eating, the pain starts to dissipate and in around about 95% of cases, after two days of just doing cucumber, celery juice and some leafy greens, people feel better than they have in their entire life since they got the disease and that’s because the two things irritating them in their blood are the proteins in the bacteria that are leaking into their bloodstream and the proteins in the foods. And most of it is the proteins in the food so when we remove all food there are no proteins to leak into the blood and as a result the person’s molecular mimicry stops momentarily until they then begin eating again.

And so then we take them through an elimination diet over the following 10 days that eliminates all of the things that the scientific studies tell us based on epidemiological studies or based on human groups put through actual trials, that most people have the biggest problems with the cereals grains like the wheat and the barleys. They also have massive trouble with meat products so we avoid animal derivatives including cheeses and obviously the flesh, but the cheeses and the milk and so forth.

And so what are we left with? Well that took me years to work out. I struggled for years to, “Well, how can I eat? If the science tells me don’t eat meat because one study said that it’s the number one aggravator for all people with rheumatoid arthritis. Then another study tests everyone with the cereal grains and says, “This is the worst thing.” Then of course the dairy products are always copping it because I consider dairy not even a human food at all so cow’s milk has got to go.

So I eventually worked out that I could eat pseudo grains, things like buckwheat, and quinoa, and millet and amaranth and these things that aren’t really a cereal grain. They’re actually a seed from plants and so you’re eating a very, very gentle, easy-to-digest seed. And so I include those as well as some sweet potatoes in the first 10 days. And it’s a very basic approach but also in there I keep people with their green juices, their celery and cucumber as well as a ton of leafy greens because that’s all prebiotic food for your healthy bacteria. And we include miso paste which is a Japanese staple for digestive health which includes live bacteria.

So what we’re trying to do is with feeding people’s digestive system the food that the bacteria need to eat to start to regrow their population, we’re supplementing those healthy bacteria with live cultures so that you send in some troops and a little bit of support and we’re taking the pressure away from the digestive system with its weak digestive capacity so that you’re giving it a rest and you’re helping to replenish the areas that have been overgrown with other bacteria. Now, then we move into the third or the next phase.

Dr. Manek: You’re going to be in Phase number 4 now.

Clint: That’s right. Thank you. I was getting confused.

Dr. Manek: I’m listening, Clint.

Clint: In Phase 4, actually there are some foods that we have not yet introduced into our diet that can offer us more assistance but they require testing because they include some fruits. Now I find that about 50% of people in this stage have trouble reintroducing the fruits. Some people can get right back into it. And it’s just because I mentioned a minute ago, some people’s bacterial overgrowth, well everyone’s bacterial overgrowth may differ. If you’ve got an overgrowth of sugar-loving bacteria then it’s going to be hard at this point, even after the 12 days, to successfully reintroduce the fruits without causing a little bit more pain increase in the body and that’s what we’re looking for here in the reintroduction phase is just to find out whether or not this food causes you to have a little bit more pain in the body.

There are a couple of fruits that if you are able to introduce at this point it’s a huge step forward. Those fruits include in priority the papaya. And as you said before earlier on with regards to the bromelain and the papain which extracts, enzyme extracts from foods, if you’re able to eat those foods directly then you’re not just getting the wonderful proteolytic enzymes that come with that papaya, let’s say, but you’re also getting all of the vitamin and nutritional benefits from having that fruit in its original format as well.

And so we then try to expand into some specific foods just like the papaya that serve a digestive benefit for the body. So we try to prioritize the reintroduction phase based on two criteria. Is this food going to give you sustainable calories that are useful for the body and is it going to be a convenient food to eat like rice?

So rice is a convenient food so you can have it for lunch and for dinner and it just becomes a platform of food to give you your daily energy requirements. Or is it going to be a food to introduce that can serve a digestive support function such as the papaya which can assist with the digestion of course of proteins because the papain can help break down the proteins? Some barbequers even use it as a tenderizer for meat when they cook on barbeques and so forth but we can ingest that food just to help us break down our foods.

And I found that papaya was particularly helpful for me when we spent a stint in Hawaii on our honeymoon. I ate them like crazy and I noticed a steady improvement in that three weeks more than I was able to notice without it. So that’s just a little bit of a sample of the reintroduction phase. And it goes on from there as we start to introduce more support for those bacteria by adding probiotics. We also eat probiotic foods like sauerkraut that hasn’t been pasteurized because if you pasteurize the sauerkraut of course you heat it to high temperatures and lose the enzymatic activity, and so on. So what we’re trying to do is replenish the gut bacteria. We’re trying to allow time to pass so that the leaky gut can heal and we’re because the bacteria and we’re starting to get a little bit now into speculative territory as we try and understand what’s going on in an area of the body that’s hard to study.

But I believe that the leaky gut can tend to heal itself just like a cut on the skin as long as you don’t continue to slap the cut and to irritate the cut so healing the leaky gut is more about allowing enough time to take its course and we want to replenish the mucosal lining. And this is, for mine, the hardest and the last part of the healing process. It’s trying to replenish the mucous on the inner part of the small and large intestine. And for me, that last part was only achievable by then actually reintroducing some of those original cereal grains that I was unable to eat right at the start.

And so the weird twist at the end of this story is that at this current stage of my understanding, and of course I’m learning all of the time as well and watching the results of people in my community and also customers who I support on email support. And I’m watching them and in a way their progress is giving me a constant feedback loop as to what’s working best. But I believe the last part of this story, which was the last part for me, was to actually use some of those cereal grains and in particular just conventional oatmeal for breakfast which has a glutinous, mucosal kind of feel to it.

And according to Dr. Shinya, who I mentioned several times in my book and is the gastroenterologist out of Einstein Research Center in New York, he talks about the importance of those sorts of foods to recoat the mucosal lining. And so I’m very, very interested in learning more about replenishing the mucosal lining right now because that’s the final frontier after the bacterial balance is restored and the leaky gut has healed.

Dr. Manek: Yes, that’s really . . . I think that Phase 1, 2, 3 and 4, yes. So, it is intensive and I think if people are committed . . . and actually it’s not just people with rheumatoid arthritis. My feeling here is that it’s really applicable to everyone if you want to just rest, and rebuild yourself and youthify yourself, this is the way to go.

You know, Clint, you may have seen the anti-inflammatory diet, the pyramid. You have fruits and vegetables and some fish there and then chocolate at the very top. These are the anti-inflammatory pyramid diets. Have you looked at them and do you have a Paddison Pyramid? Have you thought about really actually doing that?

Clint: You’re absolutely spot on. You know, the world works in funny ways. So this morning I was literally asking my members, “What information do you want to hear from me next?” And I listed a whole bunch of things and one of them was the Paddison Food Pyramid.

Dr. Manek: There you go.

Clint: And by the way, it got voted to number three so it’s actually not at the top but it’s in third position.

Dr. Manek: I would encourage you to actually step back. You’ve used the four phases but if you work it into that triangle I think at a glance in this information overload age people can look at this triangle visually and get a lot out of it. It’s something for you to consider actually.

Clint: I will definitely do it and I’m really, really pleased that you’re interested in seeing it. I will put that together and I’ll make sure you get a copy. And I’ll also put it under the show notes of the recording as well.

I’ve got some comments to add about earlier mentioning . . . Actually, I don’t think I fully answered your question about the success rate so I didn’t quite get to the end of that. Let me complete on that and then I also want to jump back so don’t let me forget to give you my input on the feedback of people on specific drugs and how it affects their digestive health. So let me just come back to that in a minute but first of all is the success rate. If we move through the phases, the first ones having things recorded, obviously everyone does that. Then 95% of people feel tremendously better after going a couple of days without any substantial food. And of course people need to speak with their practitioners and get medical advice as to if their current medications and if their health levels support even doing that and the whole program of course.

But then after that, I would say. . . I want to say and of course people are going to say I’m biased but I want to say that nine out of 10 people feel dramatically better after 12 days and even after reintroducing into the third phase where they’ve got those pseudo grains and the sweet potatoes and the juicing, and so forth. The challenge then becomes holding that and keeping that pain reduction which can quite often be substantial. I would say it’s not uncommon for people to experience a 50% pain reduction after the first 12 days. That is completely not uncommon at all, okay?

Now, the hard part is then how to then successfully and as efficiently as possible reintroduce a lot of these other foods so that you get to a diversity range of foods from both an enjoyable point of view but also from a nutritional and diverse sort of health point of view so that you can stay on it for a long period of time? You’ve got to quickly get to a point where it becomes able to be kept up from a lifestyle point of view, otherwise people will give up.

Dr. Manek: Yes.

Clint: And I tend to see some people sort of stick with very basic stuff like I did. I stayed somewhere between Phase 3 and Phase 4 for a good year and a half. Every time I would introduce more and more foods I would then get what people call a flare or what I call a reaction. So I would then get a reaction and then I would immediately jump back to what I call the baseline foods which are just the stuff from the first 12 days. My pain levels would settle within 24 hours and then I would quickly reintroduce foods that I knew were safe. And then I would pay more caution with whatever it was that I just tried to reintroduce that failed me. And I would quickly get back to that point within a day or two and then start my introductions again.

And the way I describe it is that you get longer and longer periods where you aren’t having the reactions to the foods so it might be that at first you might try and reintroduce foods and over just a couple of . . . you might straight away have a reaction, get back to the baseline and then try something else. Then you might have success and then have to go back again. But what happens is after a while your food base can become quite broad and you’re able to eat quite a nice range of different foods and then actually the pressure isn’t on you as much to try and find new foods to eat and it can just be done at a nice, sensible rate.

But some people find that it becomes too difficult. And the most common comments about our program is that it works. It gets unbelievable results. We get a large number of people saying that it’s just too hard for them and that’s fine because it’s not designed for everyone. It’s fundamentally designed to get the best possible results. That’s all I care about. I want people to reduce their pain safely and sensibly but it’s not easy. So they are the two things.

So, yeah, to put a number on a success rate, yes, nine out of 10 people, and this is based on my own feedback and from email surveys that I send out. After three months an email goes out automatically to every customer that we’ve ever had that says, “Can I ask you a favor?” They fill out four survey questions and we get an uptake of responses of about 80% to that email. And of those email responses, we track at about 8.5 out of 10 in terms of people’s happiness with the program. And the way that figure comes about is that most people give it a 10 and then every now and then one person gives it a 5 or a 6 because it was too hard and it drags the average down but we get more 10s than any other number. And everyone says that they improved to some extent so that’s why I have great confidence in what I’m saying.

Dr. Manek: Yeah, yeah.

Clint: So I could continue to talk all day.

Dr. Manek: As a physician looking at this, you know, it’s safe, actually my sense. The main thing in Phase 2, the juice cleanse, you’re not doing it for weeks. I think with two days of cucumber and celery you’re getting minerals and you’re getting your chlorophyll. When I looked at it I thought, “Boy, he’s smart. He’s figured this out.” No, reallyI think it’s actually quite excellent.

The other thing I also like that you mention in the Paddison Program, we are obsessed with protein. There is whey protein and raw pea protein. I lose count. And people are terrified that they’ll wither away and die or something. I almost sometimes have to remind patients, and maybe this is a little unfair of me but just humor me, but I do tell them that humans are related to the primates and primates actually eat vegetables, fruits and roots all day, the gorillas, so I think you’ll be all right. You don’t have to have your filet mignon every night so just calm down.

Clint: Okay, I’m going to reach. I’m reaching through . . .

Dr. Manek: Don’t put that on your podcast, okay? And you’re right and it’s amazing that leafy greens and those, actually a good 20% or so is protein and it’s bioavailable.

Clint: It is bioavailable and also what people find surprising is that buckwheat and quinoa, particularly quinoa, is very high in protein. And there’s actually a dichotomy here that actually confuses me right up until this moment. I actually can’t fully explain this but the protein in the quinoa seems to have no impact or very little impact on the effects on the joints as the equivalent protein in just about anything else. I haven’t quite gotten my head around that but it’s high in protein, the quinoa, it must be about 22% or something protein. And so by consuming a lot of quinoa even during the baseline days, people are actually going to be consuming more than their daily requirement of protein, even if they’re worried about it.

But the good thing is, and I will understand this one day and maybe I’m overlooking something simple, it just does not have that same degree of aggravation that the equivalent amount of protein would from another source. And I’m still working on that.

Dr. Manek: Well the quinoa is a complete protein. It has the full complement of amino acids that the body requires so you don’t need to have animal protein or eggs or anything to supplement any missing amino acids so I think quinoa is safe. I think you showed a picture of the Peruvian trail hiker people. I was quite impressed. You know, I think you’re right. Amaranth again is very high protein. Buckwheat is a weed, it’s not really a wheat so you’re safe. There’s the brown rice, the spouted rice and there’s mung beans. You mentioned the sprouts and these are all really very good. I think you’ve really got a well-balanced program.

Yes, people may crave their hamburger but if they’re feeling this great . . . I mean, I was raised as a vegetarian by the way in Kenya. We grew our food. Coming out to the United States it’s very abnormal for me, to be honest, how people buy things in the supermarket. I don’t drink milk, as you know. I don’t do that. It doesn’t taste good, either. By the way, I wonder if you know the name Seamus Mullen. Does that ring a bell at all? Okay, let me help you. Do you know Iron Chef Competition in the United States?

Clint: Is it a TV show?

Dr. Manek: Iron Chef. It’s a show. It’s on Food Network and Seamus Mullen was in the competition for the Iron Chef title in Season 3. And I’m a foodie. I mean, this is Dr. Manek, food expert and vegetarian on top of it, but I love watching this. He’s in Japan, he’s in the final three, I’m rooting for the guy. And you can see this on television. He cannot work his knives. He’s hobbling around the kitchen, he had to be wheeled back home in a wheelchair. I didn’t know this but he has rheumatoid arthritis and he write about it. And it’s called Hero Food. He’s an Iron Chef. If you give me one moment, I’m going to bring the cover of the book. You need to look at this, okay?

And I think in some ways your program is excellent and then you’re going to see a similar story. A young man, a chef of all things and an expert in Spanish cuisine who is literally, his career is ended but it hasn’t. He discovered a whole new way of life and he writes about the Hero Foods although you won’t find celery there. But I think, if you’ll give me one second I’m going to run upstairs and get that book, okay? Then I’ll put my video camera on and you can see the cover.

Clint: Okay.

Dr. Manek: All right, Clint. I’m back and let me see if I can figure out how to do my video camera.

Clint: It’s Seamus Mullen.

Dr. Manek: Yes. He has rheumatoid arthritis.

Clint: I’ve got it. I will read his book and see if I can recommend it.

Dr. Manek: Well, you know, I recommend you read it first because you might be a little bit surprised but don’t be too much. Like you said, everyone’s constitution is actually markedly different. We don’t understand the bacteria makeup. We don’t understand a lot of things yet but Seamus also asked himself the questions, “Do I now just cook cucumber and celery as an Iron Chef or what do I do here?” But his history is fascinating. He’s written a bestselling cookbook. I’ve read it, I like it. Clint, you have really given a light for many, many people and Seamus Mullen has done the same. So I think you should be congratulated. I congratulate you.

Clint: Thank you.

Dr. Manek: Really. This comes from . . . because I’m watching you and thinking, “This man does not have rheumatoid,” but you do and you have found the answers through the thick and thin of life. And here’s what I want to do. We’ll keep in touch. It’s about [7:30] here in California so I will be heading to the dinner table soon and it’s going to be cucumber/celery juice. I’m just joking but actually you made me think. I’ve done this and it does make me feel a lot better. I’ve done, I call fasting or juicing for a few days. It’s very beneficial so I could see where this fits. It fits totally.

But read Seamus Mullen. Just quietly look at it and reach out to him. You might say, “Wow, this is the program I formed. Tell me your discoveries.” And you might find that there is some collaboration perhaps. Iron Chef is very famous. And you know, maybe we should all sit down in a room and talk about this because people have so many questions

Clint: Absolutely. I’ve got a couple of ideas along those lines. First of all my wife’s from Florida, and I know you’re about to have dinner so I’ll keep this short. My wife is from Florida so we come to the U.S. all of the time. In fact because as earlier mentioned, my line of work I can schedule my own performances and stuff so I can take time out of Australia whenever we want to. So yes, certainly if we come to California or if we want to specifically come to California to meet with you and some others and get together and work on this then I would love that.

Dr. Manek: Yes.

Clint: I’m certainly becoming more and more passionate about making change in this area than telling jokes to BHB or Quantas. So it’s certainly something we’re passionate about and we’re allocating a lot of our time and resources to helping people so if you have something like that that you’d like to initiate then I’ll certainly put out my hand and be there.

Dr. Manek: Okay. Do you have in Australia an Arthritis Foundation or a similar kind of group?

Clint: Yes. I was made an ambassador for the largest state’s arthritis organization here

Dr. Manek: Holy moly!

Clint: I host an event each year as a big fundraiser for them and they featured me on the cover of one of their quarterly magazines and ran a story on me. So I’ve crossed the charity side of things and of course all of the public speaking at health conferences and stuff. But there becomes actually a point where there’s a limited opportunity for me to speak here in Australia to health organizations because natural health have all seen me before. They’ve all hired me and all heard my talk and yet my presence in the U.S. has barely scratched the surface. So that’s where I think . . .

Dr. Manek: I was very surprised because I was looking for your program on Amazon and I thought, “Oh, it’s only $10 but to Android.” I don’t have Android. That’s why I wrote to you and I said, “Hey, I want to look at your program. I think you have something valuable to say.” And so I read it and I thought, “Yeah, okay, I get this. It’s not quackery. I think the guy knows what he’s talking about and I think we should talk.” In the meantime I was getting Seamus Mullen. By the way, there are a lot of Hollywood people who have RA. Did you know that?

Clint: No, I did not.

Dr. Manek: Do you know the actress Katherine . . . ? She was with . . . Hang on. She’s got a very nice sultry voice. She was in . . . not Crocodile Dundee . . . Oh God.

Clint: Is she an Australian?

Dr. Manek: Actually she might be. By the way, Lucille Ball had RA. Do you know what I’ll do, Clint? I will send you the name but it’s a Hollywood actress. It’s another person I want to talk to. She was suffering like you. She didn’t do the dietary thing but she did more of the minerals. And she says that one thing absolutely saved her life and in a way I can see it because I do physics and I can see the spectrum. Spectrum means photo spectrum. Things are not inert. In medicine we say, “If you wear a bangle, who cares? It doesn’t show any effect. If you drink celery and cucumber juice it won’t have an effect on the majority of people.”

This is the problem with medical research. They sort of debunk everything and it’s unfair. I think in here you’ve shown that, “No, it’s not a debunk. Not for Clint Paddison. I’ve reclaimed my life. I’m married, I have children, I’m fine and I’m showing the others that if they’re able to do this I will guide them through.” So this woman, Katherine . . . I will send you her name but she has RA and in fact she stopped being on the big screen. She went to Broadway instead. And I had patients at Mayo Clinic also who were actresses. Some of them you diagnosed with Lupus or rheumatoid and you have to sort of rethink your career as you did. You said, “Okay, I can’t be in the stress in corporate. I don’t like it anyway. Let me go back to stand-up comedy. It makes me feel better but I’m going to take control of this.” It’s a very unique story, I enjoyed it but let’s stay in touch, okay?

Clint: Now I want to give people a chance of being able to maybe have you as their rheumatologist if you have any openings because I’m sure people . . .

Dr. Manek: I do. But, you know, I work I Arizona. It’s very easy to google me, by the way. You can google me.

Clint: Should someone just google Dr. Nisha Manek?

Dr. Manek: Yes, and rheumatology, it will all come up. Sometimes my time at the Mayo Clinic is very sticky. What I mean by that is people still look for me at the Mayo Clinic in Minnesota even though I’m no longer there. It has stuck with me. You can try and remove it but I’m now in Arizona if they want to come and see me. It’s a small town near Las Vegas.

But I’m also writing a book on rheumatoid arthritis. Bringing these programs, your Paddison Program, for example, would be definitely there because it’s a very fine resource, okay? I can see that. I hear you. You’ve clearly done your work and you have proof of the program in a sense and avery powerful, actually so I want to bring it, “Here’s a program, absolutely tested. There are others doing it. It’s in Australia but Australia is not in Timbuktu. It’s Australia.” And you have to start thinking, “How do I then make my book available through Amazon, whether it’s Kindle or something?” I think you need to really actually explore that.

But my own book won’t be for another, I would say, several months because I’m just putting all the framework down. But I want to focus on self-empowerment programs like yours, okay, and some of the clues and not frighten people that you’re going to starve. Say, “Look, this is one way. Take it easy. You can do this,” but also give other hero stories like Seamus Mullen and this Hollywood actress. There are all different ways. They may do a combination, it’s fine. I want to say to people, “Don’t feel desperate. Work with your physicians.” And I told you that in the U.S. this antagonism is much less than you would believe.

Clint: Right, that’s wonderful.

Dr. Manek: Yes, it is wonderful. And I’ll send you my paper on the attitudes of rheumatologists to integrative therapies. It’s a little technical but you’ll get it. I discuss that, hey, as a group we’re waking up. I think this is good.

Clint: I still maintain that you’re a long way ahead of the general group. I’m really thankful. I just want to say, I know you’ve got to go for dinner but I just want to really thank you for getting in touch with me and for having this conversation. It means so much because what it does is it just helps to validate and it helps for people to hear and to understand that someone of your pedigree or prestige . . .

Dr. Manek: Pedigree!

Clint: Yup, like a dog! Haha. But that someone of your esteem is able to read through this, see that it makes sense and that it’s something that you might even recommend to patients. It’s very reassuring to people and also makes me feel like I’m making more progress into the area where we need to reach which is people speaking with their doctors. Because if they’re getting information like this from doctors then they’re going to be able to ultimately do things that support them on the inside, not just the medical treatments that are suppressing the symptoms.

Dr. Manek: Yes, absolutely. And I’ll send you a couple of other resources along the way. One is Immune System Recovery Plan by Susan Blum. She had thyroid disease, autoimmune thyroid disease and she had a shock about it. She goes into this, “Why did my immune system do this?” Like you’re saying, did the antibiotics and the bacteria imbalance really contribute to this young man getting rheumatoid at such a young age in formanent way? I can hear the agony, the surprise and the desperation. I see it every day so I hear it.

I actually tell my patients, “Listen, rheumatoid arthritis you will never end up in a wheelchair,” and it’s true. If you really are proactive now, give up the cigarettes, you have to counsel them. They do fine. And I have kids who when I left Mayo, I diagnosed when they were just becoming adults. I’m an adult physician. When I left Mayo 12 years later, they had gotten married and had their own children. You now are saying, “Goodbye. I’m now leaving,” and they suddenly realize, “Whoa, you have known me since I was a young adult. You’ve sort of shepherded me through all of these stages and I feel fine. I feel grateful and I’m doing well.”

But it takes conventional, it takes mind-body. It takes all of these aspects to have a robust human life. We’re intelligent beings. We have a responsibility to use that intelligence. Anyway, we’ll stay in touch, Clint, okay? And I will send you some of these resources and my paper.

Clint: Thank you very much, Nisha.

Dr. Manek: All right. Take care. Bye-bye for now.

Clint: You too. Bye-bye.

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Clint Paddison

Clint Paddison has recovered from crippling Rheumatoid Arthitis and now assists others with this disease via the Paddison Program for Rheumatoid Arthritis, the Paddison Podcast and the blogs on www.paddisonprogram.com