From Managing Symptoms to Healing: A Rheumatoid Arthritis Journey

Introduction to Amber's Functional Medicine Journey 0:00

All right, well welcome to our next episode of our journey with Thriving and we are here with Amber Fish who is one of our fabulous pharmacists on the farm-to-table team from Texas and she is going to tell us all about her journey to getting to a place of thriving um through functional medicine. So, thanks so much for being with us Amber and just tell us a little bit about your journey as a pharmacist and sort of what sparked your interest in functional medicine. >> Well, thank you so much for having me and I'm just excited to tell my story and I hope that it will relate to some patients um on their journey. So, I pretty much got started with my functional medicine journey back in 2019. However, my health journey started um several years prior to that because I was diagnosed with rheumatoid arthritis and I went through all the conventional providers. I was on some medication for RA and it just wasn't working. I felt worse and I just felt like there was pieces of the puzzle missing. So, I started doing my own research. I looked into the Mediterranean diet. I went to a a dietitian slash chiropractor who helped me start an elimination diet um and then I started listening to podcasts and um Dr. Mark Hyman was one of the um the uh host of the podcast that I listened to and that triggered my interest in functional medicine. I then found a provider in Houston, Texas and started seeing her and that was my start to my journey of health or healthy living and healing my body.

Um it it's a continuous journey, but um you know, I am so much better off of conventional medications um and so that was how I got started into

RA Diagnosis and Frustration with Conventional Treatment 2:00

functional medicine. >> Yeah, so what was like the conversation like with So, I'm assuming you're going to a rheumatologist that was like, "Hey, here is the treatment for RA. This is what you need to do." I mean, they probably counselled you on side effects of medications. But as a pharmacist, it's interesting because you people think that we're like pro-medication just because we have that pharmacy hat on. But I'm sure there's lots of things going through your mind of like So, take us back to that. Like what went through your mind about like long-term side effects of medications or even just like why the medication's needed in the first place. >> Um well, I My my symptoms came out of nowhere. I mean, I just one day woke up and I had excruciating pain in my arms and my hands. Um so, I started with my primary care doctor. She ran multiple tests. And at this time, like you know, I was all conventional medicine. Like as a pharmacist and working in academia and teaching about medications, it was conventional medicine. Okay, this is what you do. So, then she referred me to a rheumatologist. I saw the rheumatologist and um they put me on Plaquenil or hydroxychloroquine. And um I do remember her telling me to exercise.

And she looked at me and she said, "You You need to exercise." And I'm like, "Okay." But you know, I just I felt that there was no end. Like I felt that Oh my gosh, this is going to be my life. I'm going to have RA. I'm going to have um deformed joints. Um I taught a lecture in pharmacy school or when I was assistant professor on rheumatoid arthritis, so I knew all of the um devastating effects of the disease. And you know, it just was sort of a Okay, well, let me just figure out how to maneuver this through the conventional medicine and I had once I started hydroxychloroquine, you know, I had to do eye exams and um and I just felt like I wasn't getting any better.

Um also I had terrible migraines. I I remember I would be at work and I would get a migraine and I would have to come home and I felt like I was just starting to take more and more medications because of this and I felt like the hydroxychloroquine was affecting it. Um also I had to go on prednisone and I had a lot of weight increase because of the prednisone. Um so, you know, it was I mean, I don't want to say dread or doom, but that's sort of how I felt because when you go to a rheumatologist and they do conventional medicine, it's just like, oh, we can try this or, you know, we can try this medication or we can try this medication and um you know, I remember her asking me if I wanted to be on um methotrexate, but because of my age and potential pregnancy down the road, that's one thing that I wasn't wanting to be on just because of, you know, you have to be on birth control medication.

So, you know, it was just very um depressing, I guess you could say. >> Yeah, and ultimately you're left with your symptoms are still there, right? And maybe a little lessened um so that you weren't in such excruciating pain, but they weren't like going away, your body wasn't healing and you're just frustrated. And I feel like that's so many times what our patients are experiencing is that they're coming in, they're frustrated, they're being told that the only path forward is a medication. And we're not saying that all medications are terrible and you should never take a medication, right?

That's not what we're saying. There's a time and a place for treating things with medication. And I feel like but when it comes to chronic conditions, there's so much that can be done by diet, lifestyle, addressing some of these causes. And certainly there's autoimmune conditions that do need some of these medications we're talking about because of the extreme nature of them or the disformities that they may cause. And so I don't want this to come across that no one should take medications for RA because there are people that do need them. Um but when you're at the beginning stages like you are, there's so much that can be done as a starting place. And so talk to us through what when you found functional medicine, what was your sort of first step when that provider met with you for the first time?

>> Um I can I mean I was overwhelmed when I found functional medicine because there were all of these um systems that I hadn't really thought about as putting together. And I remember her saying like, "Okay, well, I can test X, Y, and Z, but let's just start with your, you know, like a a nutritional evaluation and then let's do a gut test. And so

Discovering Functional Medicine and Initial Testing 7:00

um after, you know, listening to podcast about functional medicine and doing some research, it was like I really think this is it because so before I found functional medicine in the sense of functional medicine, I did look at like the Mediterranean diet and I looked at research papers around diet and rheumatoid rheumatoid arthritis. And so um I did eliminate. So I eliminated um dairy out of my diet first. And um or no, I'm sorry. I eliminated a first. And I I did improve, but it would there were still pieces of the puzzle missing. So, once I started seeing my functional medicine practitioner, um it made so much sense. But I remember the first I was super excited, but at the same time I was overwhelmed because I just felt like there was so much to learn and to take in as a patient and a pharmacist, um that, you know, I had to just break it down step by step. Um >> Yeah.

>> So, >> I love what you said about like you were like excited. So, you had this like new found hope that like all is not lost and there's there's options beyond just being told to take these medications that aren't really helping me, but at the same time you're overwhelmed cuz I feel like so many people sit in that spot, right? Of like I am so thankful I found this option that is is has promise and hope, but at the same time it's just so overwhelming cuz there's so many different paths you can take, so many different tests you can do, like and I think that speaks to why people need a provider to help them navigate this because if you, even though you are a healthcare professional, are trying to navigate it for yourself, like it's a little bit one-sided and there's a lot of emotion that comes with it and things like that. So, like having that other person to say, "Hey, this is what I think you should do first based on my clinical experience with other patients like you." is like such a game-changer, right? To like helping you go through the path. Um so, what was the first type of testing um from a functional medicine standpoint that you did? >> So, I did I did multiple tests. Um I did a stool test to look at my gut. And I also did a breath test, a SIBO, a small intestinal bacteria overgrowth test to um because my per the provider thought that I had um, overgrowth depend because of my GI symptoms. And um, I also did a micronutrient test um, just looking at the cells at a, you know, at a microscopic level pretty much to see how they were functioning, what um, macro and micronutrients I was needing, what vitamins I was needing. So, those were and along with blood work, so you know, general blood work. Those were the the first um, three tests I did. And um, and I think I also did maybe a mold test. Um, I know I did a mold test because one of the first things my provider said was a lot of times patients with RA have mold toxicity.

So, um, so and those were pretty much my my basic test in the beginning. Um, and uh, and once those were completed, then it was the saga of the supplements, which, you know, I think that like supplements are important just like sometimes, you know, like prescription medications are really needed. Um, and in functional medicine, I think that as a patient experiencing this firsthand, um, I was on a lot of supplements and I just it it that part was even more overwhelming than my first visit and you you just sort of have to figure out a um, a breakdown of how you're going to take your supplements. Um, but also as a provider, it taught me a good and beneficial um, lesson because I try not to overwhelm my patients with supplements because I think we can become supplement happy. And through my educational journey of functional medicine, I have discovered that, you know, supplements are a bridge and that's what I tell my patients is that we're bridging to a healthier, better life, right? So, it's the bridge to help your body overcome the diseases or the illnesses that it has so that you can live a better life. And And granted, there are some supplements that you're going to probably take for the rest of your life. I mean, I'm still on supplements.

Um but it's just not that laundry list of supplements that I'm on now. >> And I think there's also like some people in the functional medicine space that do it like crazy. Like I've had patients come to me from some of these online practices that are getting like I mean, just like herbal concoctions upon herbal concoctions and they have this list of like 65 steps of this like protocol that they're doing. And I just think for a lot of people, that's not like realistic, right? Like to do all of these different things and take things five times a day. Um but with gut stuff, it is hard because if we're adding like an antimicrobial to help address the balance of the good and the bad bacteria or kill off some yeast or something like that. And then we're adding digestive enzymes to break help down your food better. And then we're adding something to heal the gut lining. And then we're adding a probiotic. And so, there's four things right there that we're asking you to do. But the nice

Gut Healing as the Turning Point 13:00

thing is that generally a lot of that is just, you know, 2 months. Like give me 2 months of an antimicrobial, 2 months of a like a healing, a support. Um but the probiotic and the digestive enzymes might stay on board for longer. So, it's sort of what you're saying, you know, it's not It seems like a lot at the beginning and trying to Even as a pharmacist, and we know like compliance for medications, if you go from one time a day to two times a day, it drastically drops off, right? And so, same thing with supplements, we have to be mindful about, you know, what we're asking people to do because it's not like, oh, just take all of these things and that all of a sudden happens at their end.

>> Right. And I think that, you know, in my case, I was I I'm going to call myself sick. Like, I was pretty bad off when I first started seeing um my functional medicine provider, but um you know, as I changed my diet and because the diet is like one of the most core foundation principles of functional medicine, and we can get all of our nutrients through the diet, or the majority of them. I wouldn't say all, but the majority. And I think that learning that through my process was um at like very beneficial and very educational. >> Yeah.

Yeah, I think I mean, certainly our N of 1 patient, we learn so many things. Like, oh, this causes this side effect, or this does this. It like brings it home for people to be able to counsel patients as well. I mean, the more I think that's why patients gravitate towards people that have experience, you know, with themselves for and whether that's an online influencer, provider, whoever. They're like, oh, they know about me because they've they've been this. I mean, the best endocrinologists are type 1 diabetics, right? And type patients that have diabetes. Um because they live it every day just like their patients. So, um Awesome. Well, what else do you feel like was really impactful to you on your journey? >> Um the most impactful thing was healing my gut.

Because it was a night and day difference. Um and I mean, I that was just one of the biggest eye-openers for me. Um is that when I started on um healing my gut, it was like my pain went away, my swelling went away. I, you know, I had some brain fog and all of that just cleared up and even, um, I mean, it reflected in my labs and, uh, like my HS-CRP became normal, my ANA, you know, became normal and so the gut healing was the game-changer for me and I feel like that is one area that I am very focused in, especially for my patients, is because, um, you know, I mean, in functional medicine everything starts in the gut and I think healing the gut helps reduce so many symptoms.

Um, and it and and it helps patients feel better. >> Yeah, absolutely. I mean, it's sort of, I mean, whole quote from Hippocrates says all disease begins in the gut and I and I think that's true probably 70% of the time. There's the times that like stress and, you know, other conditions or viruses trigger things that might not necessarily be like an overgrowth or gut, um, but there's normally something we can do, especially in our modern world of pesticide exposure and stress and, you know, improper digestion because we're eating so fast and all of those things. There's always a little bit to do. Um, but talk to me about, I know we talk a lot about like the core lifestyle things. Like how do you keep things at bay now that you've done all of those, um, gut healing things at the beginning, but what do you do when you're talking like movement and, um, I know we talk about, you know, stress reduction a lot, we talk about, you know, maintaining gut health, but are there sort of tips that you have for people that have autoimmunity once they've sort of come out of the big, um, I guess, symptoms and now they're just like, how do I prevent this from coming back?

>> So, um definitely, you know, the the core, the five core things. So, diet, movement, stress management, sleep, and um and relationships. Those are the the five core things that we focus on. And And for me, I really try to um stick with no dairy. Um I can't say I'm completely gluten-free now, but when I I'm very conscious of like if I do have gluten that it's um wheat from like Europe or um that, you know, I I guess I'm more aware of like what ingredients is are in

Lifestyle Habits for Managing Autoimmunity 18:00

products so that I'm not eating products with like a laundry list of ingredients, that my products are clean or my food is clean. I really try to focus on fruits and vegetables, um fats and protein and in my diet. So, as long as I am consistent in that, um my inflammation and pain is um and swelling is minimal. Um and then of course, it you know, it just takes determination and motivation because I know how I was prior to this journey and I don't want to go back there. So, that determination and motivation helps me like, you know, I walk every day. Um I have two dogs, so we go on three walks a day and I I try to go to the gym a couple times a week.

So, I just try you know, it's all a balance, right? So, and then with stress, I definitely do prayer and I do breathing techniques. So, if I get into a stressful situation, I'm taking deep breaths and holding my breath and um releasing breath through my nose and in through my mouth. So, that kind of stuff is how I manage my stress. Um, and then I'm very mindful of sleep. Sleep is very important. I try to get 7 to 8 hours of sleep a night. Um, and uh, I have relationships, you know, I have to work at this. I work from home a lot. So, whenever I am working from home, I'm making sure that I'm going out and talking to men my neighbors, meeting a friend for exercise. So, um, and sometimes just combining some of these core, um, health pillars is um, is beneficial because, right? We're all all all on time constraints and um, or restraints. So, um, and the other piece to eating is that I have switched grocery stores. So, we have a, um, more of an organic grocery store here in Corpus and so, I I try to get buy more of my produce and everything there because I know it they're or it's organic and um, but I I don't want to make people think that I'm perfect because I'm not. I will indulge in in different some foods and and then I do suffer the consequences the next day, but I think that as long as you really try to maintain, um, that that's the key is just and not beating yourself up. If you if you mess up or if you get off the bandwagon, per se, you know, just realize, "Hey, I need to get back on. I need to really clean up my diet for 6 weeks and um, and get back on that, you know, the the health train if you want to go with that. So, you know, it's just and it's an ongoing process. It's It's you're never finished, right? Like you always have to just maintain. >> Yeah.

Yeah, and I think that's I'm with most things in life. Like we don't just get to scoot on, right? There's always something we have to work at and and continue to do, whether it's you know, nutrition or just even I know a lot of people with past trauma um struggle with some of the mental health components of that, but like continual engagement with mental health resources and for people that are introverted and not as likely to be out in community and and doing all the things. Um So, it is it's, you know, every day sort of putting one foot in front of another.

Um And it gets easier, I think, over time as you start to build it into your lifestyle. Like you said, finding where to shop is, you know, the best for you. I mean, we I feel like we go to like three different grocery stores depending from like a feeding a family of four plus a um, you know, cost savings of which place has the best prices for what. Um but it is and it is and it that takes effort, right? Some people are like, "I'm not doing that. I'm only going to one grocery store. I can't go three different places." Um but with the avenues of grocery ordering and all the things that COVID brought us in that space, it is definitely a lot easier um to do maybe than it once was. Um but I love, you know, summer's farmers markets and trying to we participate in a CSA with a farm that's completely organic. So, I just go and pick up this box of vegetables from a house, you know, in my community that they drop it off to and So, there's lots of different ways, but it does take the effort, right? I have to research that. I have to figure out like, is there a CSA in my community that has these resources? And um it's not all just like I think so many people want like the quick fix in our society. >> Right.

>> They want the supplement that's going to cure them or the this and that and it's not that's not a thing, right? There's not one thing that's going to change the world, right? When you were doing your gut health work, it was multiple things, nutrition, lifestyle, plus some targeted supplements. Um And it takes time, and I think that's another thing people don't realize. They're like, "Okay, I want to feel better in a month. Like, I want this supplement this protocol to be like game-changing right now." And that's also a little bit of a falsehood, right?

Like, for you, what how long would you say like I mean, I know that there was a drastic reduction in your symptoms after the gut healing protocol, but when you were sort of back to your like baseline or as close to your baseline as you got, and like how long do you think that was? >> I think that took a couple of years. I mean, I you know, I definitely um it it wasn't, you know, like I was going to see her at least 9 months, but probably before I started I you know, I would improve a little every month or um at each appointment, but this drastic turn was whenever I um I started working on my gut. And um you know, there So, and I and I still feel like that I can always improve, right? So, even now, I'm like, "Okay, I need to go back on a gut protocol for about 6 6 to 8 weeks, and um get everything um all like lined up again, but um but I I mean, I can function. I wake up and I don't have pain. I um you know, it's it's just it's amazing how you know, you take care of yourself, and eat eat healthy, exercise, um sleep, and get and you know, like doing the gut health stuff really really helps.

Um I do want to say that sometimes, you know, I de- definitely felt a little stressed at some points along the

Closing Remarks and Where to Find Amber 25:00

journey just because it was a lot of information. Um also, I had some mold toxicity and you know, I live in South Texas, mold's everywhere. You walk into a restaurant, you look at the AC vents and you you just like, "Oh my gosh, there's mold." But, I mean, I live in a very humid environment and I think um one of the things that I've had to come to terms with is that I'm not going to be in a mold-free environment, but can I live with that? And um and I, you know, in functional medicine, we talk talk about the total toxicity, right? Like, how much how much toxicity your body can handle. And I think that I've For me, I personally, I've um my total toxicity isn't as high as it used to be. So, my body's able to eliminate probably the mold that I still encounter, but um so that it's not affecting me. >> Yeah.

>> Um so, I think sometimes we have to take a step back and just look at your situation and and say, "Okay, how can you live with this? How can you You can't get out of it." So, you know, you might not be 100% better, but what can you live with? >> Right. Right. Yeah, and that's I mean, I think it's just like a reminder that it's a daily daily steps towards whatever your goal is. You know, it's going to be slow and steady, but slow and steady wins the race, right? >> Exactly. So. >> Awesome. Well, thanks so much for joining us today and just sharing your story. And where can everyone find you? >> So, I am at farmtotable.life.

And so, you can if you are interested in, um, getting in touch with me, you can book a a 15-minute appointment through, um, farm to table and, um, so that's pretty much my one and only platform right now, but, um, >> And you're licensed in Colorado, North Carolina, and Georgia, and Texas? >> Um, and let's see, and Wyoming. So Wyoming, Colorado, Louisiana, Georgia, North Carolina, and Texas. So I do see >> Right. I have a wide variety of, uh, licensures. So if you are in any of those states, um, you can, um, I would love to be one of your providers if you are interested in this journey of functional medicine and, um, also I I do have a, um, a little bio on the ifm.org website under the provider. So, um, >> Yeah, well, >> Melanie, thanks for so much for having me and let me tell my story. >> That's awesome. Well, thanks for your time. Have a great day. >> You too.