On this Q&A plant-based doctors answer questions and discuss the many ways lifestyle medicine can improve your health.
Questions Answered
- (02:38) – Introducing Dr. Saray Stancic
- (10:31) – Can you tell us about your film “Code Blue”?
- (15:55) – Where can I watch “Code Blue”?
- (21:18) – How do the chronic disease epidemic and the coronavirus pandemic intersect?
- (30:40) – What can I do as a preventative measure to help support my immune system, if I get exposed?
Complete Transcript
Complete Transcript
Dr. Laurie Marbas
(00:00)
All right. We are live on Facebook.
Dr. Saray Stancic
(00:06)
Okay, wow.
Dr. Laurie Marbas
(00:08)
Yeah. Thanks everyone. It is like magic, and speaking of magic, we have the magical Dr. Saray Stancic with us today. So, how are you?
Dr. Saray Stancic
(00:17)
I'm good. So happy to be with you and to finally see Dr. Miller's face after having met her through email and heard so many fabulous things about her. So, it's wonderful to be with my friends today, and I'm happy to see we have, what, 21 participants with us-
Dr. Laurie Marbas
(00:36)
Just the webinar, but we have more on Facebook Live. That's a great point, that everyone, if you're on Facebook Live, please share this to your groups, your feed. We'd like to share Dr. Stancic's wisdom with everyone, as many people as we can. If you would like to ask a question in particular … hey, Dr. Kay. Dr. Kay's available-
Dr. Saray Stancic
(00:59)
Oh, I see Dr. Klaper. Hi.
Dr. Michael Klaper
(01:01)
Hey, Sarah. Great to see you.
Dr. Saray Stancic
(01:05)
Wow, you have a lot of degrees back there, Dr. Klaper.
Dr. Michael Klaper
(01:07)
Yeah, I get them off the internet. You just order whatever ones you want.
Dr. Saray Stancic
(01:13)
You must be a really smart guy.
Dr. Laurie Marbas
(01:16)
Oh, my goodness. That's perfect.
Dr. Saray Stancic
(01:18)
He's just done it all. So he knows.
Dr. Chris Miller
(01:20)
I know.
Dr. Laurie Marbas
(01:20)
But, the best is Dr. Klaper, his little sayings, like, “The flea's navel.” I will never forget that. It's so much fun.
Dr. Saray Stancic
(01:27)
That's a new one. I haven't heard that one before.
Dr. Laurie Marbas
(01:29)
Oh, there's more. So,-
Dr. Chris Miller
(01:31)
We do have a [inaudible 00:01:33] that I have to share, and I'm sorry, but I have to share this-
Dr. Laurie Marbas
(01:35)
Go for it.
Dr. Chris Miller
(01:35)
With all of our community and Saray today. The new one is, for Dr. Marbas actually-
Dr. Laurie Marbas
(01:39)
Uh-oh. Oh, Dr. Marvelous.
Dr. Chris Miller
(01:39)
The auto-text corrects it to Dr. Marvelous, which is-
Dr. Saray Stancic
(01:47)
[crosstalk 00:01:47]. That is very appropriate-
Dr. Chris Miller
(01:49)
Telling us what she is. I love that.
Dr. Laurie Marbas
(01:52)
Hilarious. Oh, my goodness. All right. Now, back to where we were. If you'd like to ask a question of the lovely Dr. Sarah, or Dr. Miller or Dr. Klaper or myself, please go to the Plant-Based Telehealth Facebook page. That is where you can ask your questions. That's where I'll be monitoring, and of course, the webinar folks, you can always just put that in the Q&A box. That would be super helpful, and we appreciate you joining us.
Dr. Laurie Marbas
(02:16)
So, we'll start with Dr. Stancic. Could you please just tell us a little bit about yourself, your journey, your book, your movie. Oh, my heavens. There's just so much.
Dr. Saray Stancic
(02:26)
Oh, my God. That's a lot of stuff.
Dr. Chris Miller
(02:28)
But maybe definitely start with your story, because some people don't know your story, and it's so incredible. I just listened to it recently again. It's incredible. So, I would love people to hear who you are.
Dr. Saray Stancic
(02:38)
Oh, thank you. Well, I should begin by telling you that I am, by training, an internist and infectious disease specialist. I practiced as such for many years. Today, my focus is primarily lifestyle medicine, but let me back up and explain why that is, how it is that an infectious disease physician became so passionate and a big advocate of lifestyle medicine. That is largely, of course, embedded in my personal story. So, let me just share that with you.
Dr. Saray Stancic
(03:07)
Back in 1995, as a young medical resident, I awoke during a busy call to find that I could not feel my legs. I had no prior medical history. Everything was fine. I walked into this on-call feeling fine, and before I knew it, on this one day at 2 or 3:00 in the morning, I found I couldn't feel my legs. I ended up in the emergency room. An MRI was done, and a diagnosis of multiple sclerosis was made. So, everything changed, just like that. I was no longer that young, healthy physician. I was now a chronic illness patient.
Dr. Saray Stancic
(03:43)
From there, it became apparent that I would have these recurrent debilitating events, probably every three to four months, where I would have another exacerbation, and I found myself within a few years dependent on a dozen medications. To be frank, I started to lose hope because, despite being compliant with the regimen that my doctors were prescribing at the time, my disease was progressing.
Dr. Saray Stancic
(04:09)
Then, in 2003, at which point I was about eight years into the MS diagnosis, dependent on a cane or set of crutches and 12 medicines, I came across an article that discussed the connection between diet and multiple sclerosis, and my eyes opened up for the first time. It was really quite interesting that, in all of my training, 10 years of training, four years of medical school, four years of internal medicine residency, another two as a fellow in infectious diseases, I couldn't think of any examples in which these connections were made between diet and disease.
Dr. Saray Stancic
(04:45)
So, when I read this article, it was really quite striking, and it was actually published in 1952 in the New England Journal of Medicine by a physician named Roy Swank. In that article, he writes about this connection between saturated fat and multiple sclerosis in Norway, where he's describing high incidents of MS, particularly in the community that is consuming the highest amounts of saturated fat, in the dairy community. He hypothesized back then that somehow, saturated fat was playing a role in the pathogenesis of multiple sclerosis, and I was really quite interested in this.
Dr. Saray Stancic
(05:24)
Dr. Swank didn't leave it just at hypothesis. He actually started treating patients with a low-fat, plant-based diet, believe it or not, in the 1950s. He ultimately followed about 140-plus patients over 34 years and published his data, his findings, in the journal Lancet in 1990, and he concluded that 95% of his patients who consumed this low-fat, plant-based diet and followed his recommendations remained disability free.
Dr. Chris Miller
(05:55)
Wow.
Dr. Saray Stancic
(05:56)
That to me-
Dr. Chris Miller
(05:56)
Incredible.
Dr. Saray Stancic
(05:57)
Was miraculous, because my doctor, every time I saw him, would remind me of the likelihood that I would be in a wheelchair within 10 to 20 years. So, when I read this, I was amazed. Suddenly, a lot of hope ran into me. So, that was the beginning, but that triggered the curiosity to delve deeper into the literature and really understand the connections between diet and disease, not only in MS but in all the chronic diseases that I was seeing in clinical practice as a physician. It wasn't just, of course, diet. There were other aspects that were incredibly important when we talk about, in the field of lifestyle medicine, the other spokes on the lifestyle medicine wheel, which include exercise, stress, substance abuse issues, sleep, the importance of social interconnectedness.
Dr. Saray Stancic
(06:50)
As I read the literature excitedly, I learned that, in fact, I wasn't defined by my genetic predispositions but instead that my decisions were much more powerful and that the lifestyle choices that I engaged in were really much more predictive of my outcomes. So, in 2003, equipped with all of this evidence that I had put together, I realized that I needed to implement changes in my life. So, I decided that I was going to responsibly taper off of every one of those medicines, and instead, I would optimize every aspect of my lifestyle. It didn't happen in a week, and it didn't happen in a month, but over time, I started to see signs that things were traveling in the right direction for me.
Dr. Saray Stancic
(07:38)
Then, ultimately, to make a long story short, I went from a woman that was dependent on a cane in 2003 to one that crossed the finish line at a marathon in 2010. That's really been what drives me. These are simple prescription that we're offering here. This is not a complicated … we can all do this. We can all engage in healthy behaviors and live our best life, and that's really what I want for all of us.
Dr. Saray Stancic
(08:07)
I think as physicians, regrettably, this is a missed lesson. We don't get this in medical school. When we go to medical school, we're trained to become disease detectives. We're very good at this idea of pathogenesis. We study the disease state, illness. I always tell my medical students, “You're going to become a really good disease detective.” We're so good at taking a good history and physical exam and then collecting additional clues like labs and imaging studies. Ultimately, we take all of this information, and we make a diagnosis. Once we have that diagnosis, what is our treatment plan look like? It's typically a pharmaceutical agent, a procedure or a surgical intervention.
Dr. Saray Stancic
(08:54)
All of that is important, and it's part of being a well-skilled physician, but what's missing in that is this idea of salutogenesis, which is the mirror image of pathogenesis, which we don't learn. Of course, salutogenesis is how do we maintain health and well-being? That's the piece of the puzzle that's missing. Regrettably, it results in physicians being ill-equipped to manage the world that we live in today, which is primarily chronic disease. We spend about $3.6 trillion in healthcare in our country, and 86% of those dollars are allotted to the management of chronic disease. By the way, chronic diseases that we know today are largely preventable. The literature tells us we can prevent about 80% of the chronic diseases today.
Dr. Saray Stancic
(09:44)
So, I think we have to … that's where we have to invest our time and energy, is in the idea of prevention. Prevention is not very interesting to most people. We're very excited about precision medicine and biotechnology and all of these advances, which of course are so important and should be part of the clinical medicine space, but my goodness, if we have the knowledge and understanding today to prevent 80% of chronic diseases, then we need to start there. I think we can make really meaningful impact if all physicians and all healthcare professionals pay attention to this all-important therapeutic approach.
Dr. Laurie Marbas
(10:31)
That is fabulous. You really speak to … but you also do something about it, to actually help people learn by your movie and your book. Can you tell us a little bit about those projects?
Dr. Saray Stancic
(10:44)
Sure. So, for me, as I said, Laurie, I started my career in infectious diseases, and in 2003, as I came to know the power that lies in lifestyle, ultimately, I really felt, although infectious diseases was important work, and I thought I was contributing there in a meaningful way, at some point, something just kept sneaking up into me, saying, “You have to do this full time. You have to dedicate the latter half of your career to moving this idea forward.” That might be by teaching medical students, by helping patients introduce change in their life.
Dr. Saray Stancic
(11:22)
As I was on this path, “How do I reach more individuals across the spectrum, general population, medical students, my colleagues, my peers? What could I do to further this message?” So, it wasn't just moving from infectious diseases to full-time lifestyle medicine. It wasn't just teaching medical students. It was, what else can I do? One of the things that I noticed, so many patients would come up to me and say, “I saw the film Forks over Knives, and it changed everything for me.” And I thought, “Wow, that's another mechanism, another opportunity to reach more people.”
Dr. Saray Stancic
(11:56)
So, then we, in 2015, decided that we would make a film. That was the beginning of it. It was always about how do we educate, and it was just another vehicle to get there. So, in 2015, the film Code Blue was born, and the film is really about … certainly, it shares my story, but it's really about shedding light on the regrettable fact that we don't learn this in medical school. The number one … we know, we know that the number one contributor to premature death is our diet. It has surpassed tobacco as the number one contributor to premature death, and yet, in medical school, we learn little to nothing about nutrition.
Dr. Saray Stancic
(12:39)
So, I wanted to make a film that would shed light on this, because after all, the hope of the filmmaker or the documentarian is to shed light on a lapse in society or culture and hope that, by shedding light on that, we can gather interest in community to create change. That's really what I hope. So, for me, the film is about sharing what is today, and what we need to do to change it, and how we can all participate in shifting that paradigm. It's not just doctors and healthcare professionals, but community. We can all work together to shift that paradigm. So, that was the film.
Dr. Saray Stancic
(13:19)
Then, the book was just another blessing that came my way about 18 months ago. I was approached by a wonderful publisher in Texas and proposed this idea of a book to share my work. So, really, the book is just a very simple handbook that anyone … and I wanted to make it simple. I wanted it just to be a conversation between myself and the patient, or the individual, whoever it is that is interested in change, and just really going through the aspects of lifestyle. They're so simple. It's not all that complicated. We can all do this, and hopefully, anyone who reads the book, that message is communicated, that we can all do this, and we can all do this at our own pace and when we're ready to do it, because I think that's another thing in lifestyle medicine, that we have to be very respectful of where people are and support them on their journey, because everyone's journey, as you know, Laurie, is different.
Dr. Saray Stancic
(14:21)
So, we want to meet patients where they are and help them, support them, on their personal journey to improve their personal outcome, because my hope for everyone is that at age 98 or 102, after spending an amazing day with your loved ones, you go to bed and you don't wake up. Peacefully pass to the next stage, instead of what we see today in clinical practice, and what I've witnessed over my 25-plus years of practicing medicine is that book-end of suffering in the nursing home. I did a lot of this. At the end of my day, when I was practicing infectious diseases at the VA, my last stop would be the nursing home, and I would, on average, have three or four consults at the end of the day, and you know, walking into a room, you have a patient that's contracted with a fully catheter, pneumonia, UTI, an infected … that's what I saw every day.
Dr. Saray Stancic
(15:24)
We know how to prevent that, and I think it's incredibly important that, as healthcare professionals, we speak to this all-important message. I just want to take a moment to celebrate the three of you for this plant-based telehealth organization that you've started. It is so critically important. I know that you're helping so many patients across the country, and I'm actively referring patients to you. I think what you're doing is fabulous, and congratulations.
Dr. Laurie Marbas
(15:55)
Ah, thank you. To do so … it's Code Blue. Someone is asking the name of the film. Where can they watch it, and where can we get the book?
Dr. Saray Stancic
(16:04)
Okay. So, Code Blue is available on several platforms, and of course, I can't remember them all. But if you go to Amazon, Apple, just about all of them, Google Play. We're available on all of them. Then, the book is available on Amazon, Barnes & Noble. It is on pre-order now. The release is January 12, 2020. We were supposed to actually release it on October 11 of this year, which would've been my 25th anniversary since I was diagnosed. I was diagnosed on October 11, 1995. So, this was 25 years this year, and actually, this year on the 25th anniversary, I walked 25 miles to celebrate that moment. I was told, mind you when I was diagnosed, that I would be in a wheelchair within 10 to 20 years. So, I'm happy to have proved my neurologist wrong.
Dr. Saray Stancic
(17:02)
It was a very joyful day for me because I am medication-free, disability-free 25 years into this disease, Dr. Klaper, and I feel amazing. I have a lot of energy. I feel so blessed, and I just want to … this is a simple thing, Dr. Klaper, right? It's not that complicated. We have to effectively communicate the message to as many as possible.
Dr. Michael Klaper
(17:28)
Well done.
Dr. Laurie Marbas
(17:29)
Dr. K, any questions? Comments? Chris?
Dr. Michael Klaper
(17:32)
Oh, what a wonderful, inspiring story. Thank you for sharing that with us. I don't know if people caught that lovely word salutogenesis go by. One of the first times I've heard that word [inaudible 00:17:47]
Dr. Saray Stancic
(17:46)
I know, yes.
Dr. Michael Klaper
(17:50)
Exactly. So, salutogenesis. Yes, we need to get as many of those in our lives as we can. The National Salutogenesis Society or [crosstalk 00:17:57]. But, thank you for sharing this wonderful story and for who you are. You yourself are a statement against, “I can't,” against accepting limitations. That's a great-
Dr. Saray Stancic
(18:16)
Thank you, Dr. Klaper, and I also want to celebrate. I know you've been doing a lot of work in traveling across the country, and even internationally, speaking to medical schools and talking about this. So, I'd love you to share that.
Dr. Michael Klaper
(18:28)
Well, thank you. We got to wake up the younger generation and let them know it's the food your patients are eating. A little clue there. You might want to ask about that. What a profound improvement you got from changing your deity, that you found out through Swank's work. So, that's more validation of a plant-based lifestyle for that disease as well.
Dr. Saray Stancic
(18:53)
Yeah, and I think … as I travel, obviously now because of COVID, traveling has been limited. Prior to COVID, when I was traveling to medical schools and lecturing in-person and meeting young men and women in medical school, I have noticed in the past few years, there's a definite sense … there's movement. There's an interest, and it's growing in this generation. You see these young physicians in training who get this, and maybe my generation's a little slow to warm to it, but what I have seen is that this younger population is really very, very interested in understanding how lifestyle affects disease outcomes, and they're very interested in this idea of prevention, which I think, in my experience, was really not something that we … it's interesting, because when I was in medical school, I actually took a course called Preventive Medicine.
Dr. Saray Stancic
(19:57)
Do you know what we talked about in Preventive Medicine? We talked about early detection. We talked about colonoscopy. We talked about mammography. All of that stuff is important, but that's not true primary prevention. Primary prevention is preventing the disease altogether. So, I think the terminology is catching up now. This generation of students gets how important these lifestyle choices are and their effects on health and well-being. Salutogenesis is becoming much more mainstream, much more interesting.
Dr. Saray Stancic
(20:37)
Tomorrow, I'm giving grand rounds at Northwell in New York City, a hospital system, to talk about lifestyle medicine. So, that might not have been an invitation I would've received five years ago. So, this is very mainstream, and we're going to talk about lifestyle medicine. One of the topics that I'm going to introduce when I speak to them tomorrow … so this will be a great opportunity because it's going to be all physicians in that healthcare system. We're going to talk about lifestyle medicine, present the evidence that supports this therapeutic approach and also connect because this is so primary our mind right now, of course is the coronavirus pandemic.
Dr. Saray Stancic
(21:18)
So, how do these two intersect, the chronic disease epidemic and the coronavirus pandemic? When we looked at surveillance data, the CDC produced some early surveillance data early summer, and what did they show us? They showed us that the individuals who become infected with this virus and also have a chronic disease, they're six times more likely to be hospitalized and 12 times more likely to die. We are a country drowning in chronic disease, now battling this acute infectious contagion. So, we are ill-equipped, because we are at great risk of having a bad outcome, if we're infected with coronavirus, because the foundation of this country, 50% of us, are living with at least one chronic disease.
Dr. Saray Stancic
(22:08)
Obesity rates are exploding in our country. 70% of Americans are either obese or overweight. In fact, Laurie, when I wrote the section originally for the book on obesity, when I did the research, the CDC … so, this was September 2019, when I was writing the section on obesity. At the time, the CDC reported obesity rates at 39.8%. September 2020, I was running through the last edits of the book before it went to print, and I'm checking all of my facts. So, I went back to the CDC to check … the obesity rates in one year went from 39.8% to 42.4%. So, in one year, 2.6% climb.
Dr. Saray Stancic
(22:58)
So, if anybody thinks that we're plateaued, like it can't get worse, it's getting worse. We now have 12 states in our country that have obesity rates greater than 35%, if you look at the behavioral risk factor surveillance system that the CDC started in 1985 to collect obesity data. Back in 1985, there was no state in our country that had obesity rates greater than 14%. So, every year … and seven of the top 10 causes of death in our country, between last year and this year, seven of them have climbed or become even more prevalent.
Dr. Saray Stancic
(23:39)
So, we have a lot of work to do. The obesity epidemic, the chronic disease epidemic continues to grow, and on top of this, we're dealing with this coronavirus pandemic. Who are the folks that are most likely to have severe, significant disease? Those with a chronic disease like heart disease, a chronic lung disease, obesity, hypertension. This is a huge problem. So, my hope is that we get through this very difficult period in our history dealing with this coronavirus, but the silver lining after all of this is that, I hope, we awakened … our country awakens to the need to change, to really create change in our lifestyle choices so that we realize how important the prevention of chronic disease is, because it's really quite dramatic what we're seeing, in the fact that we've lost so many and largely because of this chronic disease epidemic, underlying the coronavirus pandemic.
Dr. Laurie Marbas
(24:50)
Yeah. Absolutely, and I think … go ahead, Chris
Dr. Chris Miller
(24:51)
Thank you. [inaudible 00:24:51] this is a good time where we can really make more of a difference, because people are scared. They're listening. They're looking for what else they can do. I have a question. So, when you improved and you went back to your neurologist, I am curious if your neurologist is now recommending these dietary changes? Also your peers, our generation let's say, not the new students coming out, because those guys, I agree. They're totally interested in this. But are you seeing more change, more people recommending it, more people jumping on board easier? Or are you still meeting a lot of resistance from them?
Dr. Saray Stancic
(25:30)
Yeah, no. I think you're right. The younger generation is on board. My peers, I have seen a lot of movement. One of the things that always surprises me. I started my lifestyle medicine practice here in New Jersey, I think it was 2012. When I opened my doors, no one knew what lifestyle medicine was. Everyone knew me as an infectious disease specialist. She's lost her mind. She now opened something called lifestyle medicine. We have no idea what that is.
Dr. Saray Stancic
(26:03)
So, when I opened my doors, Chris, I had zero patients and zero stream of referral because everyone knew me as the ID doc, the hepatitis expert. What is she doing? When I started that practice, it was very hard because trying to get patients into the door, it was challenging, but they started to trickle in, and we started to do the work. Then, word of mouth spread, and the practice grew really effectively. But, one of the most amazing things about the practice that, again, I could've never predicted is that, by the time … I just recently closed my practice, but I probably had about 40 to 50 patients in the practice who were also doctors.
Dr. Saray Stancic
(26:47)
The way that they became my patient is because at one point, we had a patient in common. A poorly-controlled diabetic came to see me, poorly controlled for 15 years, struggling, dealing with weight issues, hyper cholesterol … you know what I'm talking about. The whole thing. We talked about lifestyle modification, and of course, you know the story. We introduced these changes. Good things happened. Hemoglobin A1Cs improved. We start to discontinue medications, and then they would go back to see their internist or their endocrinologists six months later, a year later, and, “Wow, what did you do?” “Oh, I went to see Dr. Stancic. She does lifestyle medicine.” “What is that?”
Dr. Saray Stancic
(27:25)
Then, they would call me really concerned and skeptical, like, “What are you doing?” Then, we would have a conversation, and the first thing I would say is, “Give me your email address. I'm going to send you the scientific evidence and the literature to support … because this is not my subjective opinion. I'm not just pulling this out of the air. Let me present to you the evidence that supports this approach.”
Dr. Saray Stancic
(27:50)
So, then they would call me back, and they'd say, “Wow. This is great. Can we meet?” And I said, “Of course.” I'm thinking they want to come and have a cup of tea, like two colleagues. “No, no, no, no. I want to come see you as a patient, because I'm dealing with hypertension, or I'm dealing with some issues with my blood sugar.” So, they would become my patient. Of course, every patient that I had the privilege and honor of caring for was amazing, but when I had a patient who was also a doctor or a nurse, it was amazing because I knew that, if I support them in behavioral change and optimizing these aspects of their lifestyle, that that, in turn, would change they way they practice moving forward.
Dr. Saray Stancic
(28:32)
All of a sudden, my little role becomes exponential because now I'm not only affecting that patient, but I'm affecting all of his or her patients. That was, to me, the coolest thing. One of my patients who is a doctor is actually featured in Code Blue. She's a general surgeon. We keep in touch, and she's doing great. She talks to her … she teaches her students, her residences, and she talks to her patients about plant-based nutrition, about lifestyle medicine, and that's amazing. I feel incredibly blessed to have had that experience in arriving at helping other clinicians create change, not only for themselves but how they practice medicine.
Dr. Saray Stancic
(29:22)
So, yes, I think there's movement everywhere. I get email all the time from doctors across the country and outside of the country telling me that, “I saw the film. It really resonated with me.” A couple of months ago, I received an email from a cardiologist in Arizona who said to me, “I'm 58 years old. I've been practicing cardiology for X number of … whatever it was, 30-somethings years. I teach fellows. I know nothing about nutrition, but I saw your film. I'm inspired, and I want to learn. Even though I'm 58 years old, I'm willing to do it, and I'm going to learn, and then I'm going to teach my fellows so that they understand the importance of nutrition, and we really need this. Thank you.”
Dr. Saray Stancic
(30:04)
So, those type of email just are priceless. They're invaluable. So, every time I get one of those, it's a blessing.
Dr. Laurie Marbas
(30:14)
Hey, Saray, I'd love to introduce that doctor to Dr. [inaudible 00:30:17] if you haven't already.
Dr. Saray Stancic
(30:19)
You got it.
Dr. Laurie Marbas
(30:20)
I'd like to connect them.
Dr. Saray Stancic
(30:21)
Absolutely.
Dr. Laurie Marbas
(30:21)
Excellent. Well, I have a … there's a comment that I think you'd like. Chad, I'm sorry if I butcher your name, Hodgin, “You don't check the engine to see if it is damaged before changing oil. You change it before problems occur. Same mindset should be for our body.” So, I thought that was-
Dr. Saray Stancic
(30:38)
Love that.
Dr. Laurie Marbas
(30:38)
Really good.
Dr. Chris Miller
(30:39)
Brilliant.
Dr. Laurie Marbas
(30:40)
Yeah. Then, because you're infectious disease, and we're in the middle of this pandemic and a lifestyle medicine expert, what advice would you give someone who's just understanding the value of lifestyle medicine and these amazing interventions to maybe, not only protect themselves should they get sick, but what can they do as a preventative measure to maybe even help support that immune system, if they get exposed?
Dr. Saray Stancic
(31:05)
Right. So, obviously, the first thing I would say, and this is important for everyone, is that we practice those all-important infection-control parameters that Dr. Fauci talks about. Hand washing, wearing masks, maintaining your distance, and I know Thanksgiving is coming up, and this is a holiday where we all come together, and it's so hard because this Thanksgiving is going to be somewhat different than our previous ones. But, we all have to make sacrifices. I really think we're going to get through this, and we're going to get through this soon, but we have to hang in there a little bit longer.
Dr. Saray Stancic
(31:38)
Lifestyle medicine, this is a great opportunity for you to begin, and this may be the incentive that you need to introduce some changes in your life. So, even just adding plants on your plate. Just think about those wonderful foods that are rich in fiber and antioxidants, phytochemicals, that's what you need to enforce that immune system and prepare you. By the way, it's not just COVID, but we're going into flu season and there's so many other viruses that are prevalent in our environment that lead to the common cold or bronchitis, bacterial infections that are commonplace.
Dr. Saray Stancic
(32:18)
One of the things that I always noted, and I bet the three of you have noticed this as well. I've had so many patients say to me, “Doc, every year in the winter, I always get bronchitis. I always get some type of viral infection, and I've noticed since I've implemented these changes in my life, I don't get sick in the winter months anymore. I manage to get through the entire winter without having an upper respiratory infection.”
Dr. Saray Stancic
(32:49)
Everything that we're talking about in lifestyle medicine, making sure that you're sleeping effectively, that you're engaging in daily exercise, that you're eating foods that are rich in fiber and antioxidants that are plant-sourced, all of this is going to strengthen your immune system and allow you to, again, age gracefully. So, I think that this is a great opportunity for you to start doing small things. Increase the plants on our plate. Get moving. Learn about effective sleep hygiene, and managing stress. We have a lot of stress that we're dealing with at baseline, and then the coronavirus pandemic on top of it all. We've had so many issues that society has dealt with this year that have been very challenging and very difficult for many of us.
Dr. Saray Stancic
(33:41)
This is a good time for us to consider what are you willing to do today? You don't have to do everything all at once, but what could you do today that will put you on the path to improve your personal health?
Dr. Laurie Marbas
(33:55)
That's wonderful. Absolutely wonderful.
Dr. Chris Miller
(33:57)
Love that. Coming from an infectious disease person, I hope everyone is paying attention. That's wonderful advice.
Dr. Laurie Marbas
(34:03)
Absolutely. Dr. K, any other thoughts, questions, comments?
Dr. Michael Klaper
(34:10)
I'm curious, have you ever run into the neurologist that diagnosed you and said you were going to be in a wheelchair in 25 years? Have you ever had any contact with him again?
Dr. Chris Miller
(34:19)
I wonder about that, too.
Dr. Saray Stancic
(34:22)
Actually, I did. I met with him right around the time that we were filming Code Blue. I actually wanted to interview him. I wanted him to share his perspective, because I wanted to present both sides. By the way, I never tell patients not to take disease-modifying therapies. That's not my role. I'm not a neurologist. I think that's a decision that they make with their specialist in MS. All I'm saying is that it's regrettable that MS doctors largely ignore … if you have, for example, and one of my patients who's featured in the film, Kelly, is an MS patient. When she originally came to me, Michael, she was newly-diagnosed MS, and that's why she seeked the consultation with me.
Dr. Saray Stancic
(35:11)
But, she was also obese, pre-diabetic, hypertensive, hypercholosterolemic, and she wasn't at all worried about that. It wasn't even on her radar. So, that's the problem, is that we know … and there was an article published just this week on vascular comorbidities and their effects on outcomes in MS. The average MS doctor just sees you, the MS patient, with this diagnosis, and the prescription is the disease-modifying therapy, and we ignore the fact that the patient's pre-diabetic. They smoke. They're sedentary, and yet we know there's evidence in the literature that all these parameters, these variables play a role in worse prognosis in patients living with multiple sclerosis.
Dr. Saray Stancic
(36:01)
My physician, who's a wonderful man, and he was actually one of my professors when I was in medical school, he's an expert in MS. I did see him and asked if he would do the interview. He was not on board with the interview. He thought that my perspective could be damaging to MS patients. I don't see it that way. As I said, I never tell patients not to go on a disease-modifying therapy. All I'm saying is it's not one or the other. We should all be optimizing every aspect of our lifestyle, because guess what? Just because you have … if you're a young woman living with MS, that doesn't mean that you can't develop breast cancer or diabetes or hypertension.
Dr. Saray Stancic
(36:48)
Typically, we see … this is a disease that's diagnosed in young women, primarily. So, what a great opportunity it is for them to address these aspects of lifestyle so that we not only help them to better manage their MS, but we could also, in a preventive fashion, prevent other chronic diseases from developing in the future. At the end of the day, my physician said to me that he didn't think that changing my lifestyle had led to this improved outcome. He felt that probably, I would've done just fine had I not changed anything-
Dr. Chris Miller
(37:29)
Wow.
Dr. Saray Stancic
(37:29)
He was very resistant, yeah. But by no fault of his own. Little bit older. Very much stuck in his way, and he wasn't going to move, but it's okay.
Dr. Chris Miller
(37:44)
I heard a lot of that from my own doctors as well, that food didn't matter. Why would I take away these luxuries from myself? And I was like, “No, it absolutely … and I would bring in my literature. I was so proud of myself and so excited, and I was told the same thing. They just shot me down. So, it was very discouraging. Since then, I've gone with my card, saying, “I would love to work with patients. I don't take anyone off medications. I defer that to you, but please … or at least their D marks, their disease-modifying. I'm not telling people not to take those, but what I am doing is working on their diet so they don't need them, and then we can taper them off.
Dr. Chris Miller
(38:22)
Now I am actually getting some referrals from my rheumatologists.
Dr. Saray Stancic
(38:25)
Yeah, right. [crosstalk 00:38:28]. There are neurologists and rheumatologists that do refer patients and understand and acknowledge that this is of value, particularly some of the neurologists here in the New York City area. I live in Northern New Jersey. So, yes, there are many neurologists that have come to see that this is important. I can tell you … here's an example. I think it was last year or two years ago, I was invited to speak at the University of Buffalo at Neurology Grand Rounds, which was amazing. So, I had a room full of neurologists, many of which treat MS.
Dr. Saray Stancic
(39:06)
They were very happy to hear what I had to say, and it wasn't just sharing my story and talking about my subjective impressions, but I presented the data. There's a lot of evidence in the literature that speaks to how a fiber-rich diet, a plant-based diet affects the microbiome, and the microbiome in turn signals to the immune system in a positive or negative way. So, there is evidence. There are studies that have been published in the past two or three years that are pretty significant.
Dr. Saray Stancic
(39:43)
It's so interesting. When Swank said, “If you change your diet to a plant-enriched diet, it's going to improve your MS outcomes.” And everyone was like, “What, is he crazy? How could what you put on your plate affect a neurological autoimmune disease that affects your brain and spinal chord? What's the connection?” That's the connection. When you eat a fiber-rich diet, you change the makeup of the organisms in your gut, the microbiome, and the microbiome is communicating with your immune system.
Dr. Saray Stancic
(40:15)
There was a wonderful study published … it was done in Milan, Italy, that illustrated this. Another study from Mt. Sinai that again spoke to how the microbiome and the makeup of the microbiome affects the immune response and, ultimately, on patient outcomes in MS. There was another study published in Oregon State done by Vijay Yadav, who's the doctor that's feature in Code Blue, where looking at a plant-based diet and outcomes that were favorable there as well.
Dr. Saray Stancic
(40:47)
So, there's evidence that … it's not just some patients subjectively that are reporting, “I feel better on this.” We have published data that supports why patients are improving.
Dr. Laurie Marbas
(41:00)
That's phenomenal. So, any last questions, Dr. K, Chris?
Dr. Michael Klaper
(41:08)
Are you [crosstalk 00:41:08]-
Dr. Chris Miller
(41:09)
Go ahead.
Dr. Michael Klaper
(41:10)
Go ahead. I'm sorry.
Dr. Chris Miller
(41:12)
No, I was going to say. I have a million things I want to ask you, Saray. I feel like I got to have you to a tea. We can do it online so people can watch it, but I just want to have a tea talk with you and ask you so many questions-
Dr. Saray Stancic
(41:23)
I would love that.
Dr. Chris Miller
(41:25)
About … well, just a few things, but you don't have to answer all this now, but just if you had any pre-symptoms before your MS even came on? I would love to dive more into some of your lifestyle, because a lot of people that I'm working with, as we know, as I know you know, there's up and downs, and it's challenging, and we're all different. We don't all immediately get good responses, and we get worse often before we get better. It's very depressing, and it can be very discouraging for a while. But you've done so many lifestyle things in addition to your diet that I think are paramount to your healing, and I know that you've managed them. Maybe you can just say a thing or two about that-
Dr. Saray Stancic
(42:02)
Yeah, I want to say two things about symptoms before I was diagnosed. You mentioned something else. You get worse before you get better. That happened to me. So, on the pre. Yes, when I was in medical school, I couldn't get through an exam without having to go to the bathroom. So, this was MS attacking my bladder. I just didn't know. Some of the preceptors like, “Is she cheating? Why does she keep going to the bathroom?” It was my bladder that was … multiple sclerosis can affect your bladder.
Dr. Saray Stancic
(42:32)
So, I had a hypertonic bladder. So, I couldn't really go more than an hour without having to go to the bathroom. So, that was something that I … so, I thought as a young … “Do I have a UTI?” I kept getting … didn't have a UTI. But, you're in medical school. You're so busy with everything. You don't really pay a lot of attention to it. The other thing I noticed is that I would have tingling in my toes, and I thought, “Well maybe … I used to like to wear heels in my early 20s. “Maybe it's that.” So, I stopped wearing heels, but those were early signs that I was having sensory symptoms from MS. I would just brush them aside and think it's something else.
Dr. Saray Stancic
(43:12)
After I made the changes, in 2003, a year later, I actually had a pretty bad exacerbation. I remember it well, because it was daughter's … I think it was her second birthday, and all the pictures from her birthday, I have an IV in my arm, because I was getting Solu-Medrol for that bad exacerbation. So, as you might imagine, when I had that bad event about a year into my lifestyle change, everyone was like, “Oh, what did you do?” My doctor said to me, “I told you not to do this.”
Dr. Saray Stancic
(43:52)
But I knew there were so many other good things that were happening. I was having more good days than bad. I knew I was traveling in the right direction. And when that happened, Chris, it was really scary because I started to question the decision I had made, because I had at that point had interrupted the disease-modifying therapy that I was. I started to think, “Oh, have I done irreperacable damage? I recovered from that pretty quickly and then forged forward. I just felt good with what I was doing. There was something intuitive about it.
Dr. Saray Stancic
(44:34)
I think the other challenge that we have, particularly in our country, is that, regrettably, we fall into this trap, the “quick fix.” We want things to happen overnight, and that's not the way lifestyle works, this idea of lifestyle medicine. It doesn't happen overnight. So, that's the challenging part, and that's the role of a good clinician to support that patient through those periods where you might lose them, to stick with it.
Dr. Chris Miller
(45:05)
Mm-hmm (affirmative). Wonderful point. So true.
Dr. Laurie Marbas
(45:09)
Absolutely. Dr. K, what was your question?
Dr. Michael Klaper
(45:13)
Since you had a brush with this fearsome foe here in your nervous system, are you doing anything on a daily basis now to keep any recurrence from happening? Do you take extra Vitamin D? Are there particular foods you eat or don't eat, outside of animal products? Is there anything you're doing as a prophylaxis against recurrence?
Dr. Saray Stancic
(45:36)
Well, every aspect of my lifestyle, I'm on it every day. I take no breaks from it. I sleep eight hours every day. I go to bed at … don't tell anybody, because you're going to laugh, but I go to bed at 9:00, like clockwork, and I wake up at 5. So, I put in those eight hours, and every day, I wake up and I exercise. I typically will run or hike or do something for at least 30, 35 minutes every morning. So, it's usually three miles, something like that on average. Twice a week, I engage in lifting weights of some sort, and once a week, I do yoga. So, that's my physical activity regimen.
Dr. Saray Stancic
(46:16)
Then, everything I eat is plant-based, and it's whole-food plants-based. I don't eat any processed foods. I don't eat any animal sources. I don't drink alcohol, on exception. I'm going to a celebratory dinner, but I don't drink every night. I don't use any drugs. I don't smoke. I manage my stress really well. I have this perspective on life. Everything that happens to me, even on the difficult moments, when things don't work out the way I wished they had, I have this wonderful way to solve the problem. I just say, “Well, that's the way it was supposed to be.” I accept it. I don't push on it. I accept it is what it is, and I move forward.
Dr. Saray Stancic
(47:02)
I really, truly believe that whatever comes my way, was supposed to come that way. Even if it's something that's unpleasant, it was an experience I needed to have. So, when you have that perspective, it's all good.
Dr. Michael Klaper
(47:16)
Beautiful.
Dr. Saray Stancic
(47:18)
[crosstalk 00:47:18] Worrying about things, it doesn't work, and it's wasted time. There are challenges in life, for sure, but you do the best you can with what you have, and you accept whatever comes your way.
Dr. Chris Miller
(47:34)
Beautiful.
Dr. Laurie Marbas
(47:35)
That's a beautiful way, I think, to end our hour, because I know Dr. K has to go really short, right on the half hour. So, Saray, thank you so much. Is there any final words you'd like to share with our audience? It was just a blessing to hear everything you're doing and your story.
Dr. Saray Stancic
(47:51)
No. I just want to thank you for inviting me today. It was a great pleasure to be part of this. I, again, want to share my book. My publisher will always remind me. It's called What's Missing from Medicine. I hope it reaches many people and it influences not only them personally but really shifting the paradigm across our country, our culture, society so that we can all live our best life.
Dr. Laurie Marbas
(48:17)
Absolutely. If people want to connect with you or follow you, where should they find you on social media or website?
Dr. Saray Stancic
(48:23)
Yeah. My website is DrStancic.com, but I'm on social media, on all the different platforms.
Dr. Laurie Marbas
(48:31)
Great. What's your handle on Instagram-
Dr. Saray Stancic
(48:34)
It's DrStancic on Instagram. On Twitter, it's StancicMD, Saray Stancic on Facebook.
Dr. Laurie Marbas
(48:43)
Perfect. Okay, great. Well, thank you guys, everyone, for joining us. We will be editing this. It will be live on our Facebook … well, it is live on our Facebook page, but it will be … the recording will be there if you want to watch it again. It'll eventually be edited on our YouTube page and our Facebook page at Plant-Based Telehealth. We thank you for joining us, and thanks again, Dr Stancic, Dr. K, Dr. Miller. Thank you again, everybody.
Dr. Saray Stancic
(49:08)
Thanks guys.
Dr. Chris Miller
(49:09)
Thank you.
Dr. Saray Stancic
(49:09)
Have a great day.
Dr. Chris Miller
(49:11)
Thanks, Saray.
Dr. Saray Stancic
(49:11)
Bye. Bye.
Recorded on 11.12.20