Misdiagnosis, Pain & Symptoms with Erin Nance, MD

Hello everyone, I'm Diane Grissell. I'm also known as Silver Despedience, and this is the Silver Despedience Perception Dynamics podcast. And we're recording in iconic Manhattan center. We have a very interesting guest that we're going to learn about today and we're really going to learn more about is it in your

head or is it real? And what we're talking about is pain. There are times when we feel pain, we can't get it diagnosed, or worse, it gets misdiagnosed and we get further and further away from finding the answer that we might need. Well, my guest today is Doctor Erin Nance, and she is a specialist in helping people understand pain that might have been misdiagnosed or uncovering what that pain is and where it's coming from and why. So welcome. Thank you so much for being

here. Oh, thank you so much, Diane. It's a pleasure to talk with you and your audience. OK, let's start with just plain the idea of it's not all in your head. How many times do you think people hear that, and what's the impact of hearing you know this is in your head? So for I would say the vast

majority of people when they start experiencing symptoms, you you kind of dismiss it yourself, right? Like that'll go away. It's nothing. I must have slept on it funny. And that's a universal experience, but when something. And often that's the case. Correct. And often that is the case, but when something is lingering for days, weeks, months, that you know, is a sign or a red flag that this is something that we really should be addressing with a healthcare professional.

And if pain is just kind of the only symptom, it is very difficult to determine where that pain is coming from or what happened, right? Sometimes you're talking about your son who's a skateboarder. He fell, he hurt his wrist. He probably has a fracture. But for most people, there's not that immediate connection. And that pain comes on what we call insidious and gradual, right?

There was no one time event that caused this to happen, just those one time events that are pretty easy actually to diagnose, right? I, I was sitting down, I heard a pop in my back. Probably have a herniated disc, right? You know, I, I was, I was walking down the street walking my dog and I rolled my ankle and now my ankle is swollen, probably have a sprained ankle.

But for a lot of conditions that are more what we call systemic or part of like your bloodstream or autoimmune, rheumatological, there's no one one like smoking gun, right, as to what is causing this. And I think that's probably one of those difficult areas people find themselves when they go seek out help and they don't have that one diagnose, you know that that one symptom that a doctor knows immediately.

OK, I know exactly what this is. And people are finding themselves in this position more and more often. You know, that is so interesting for for many years you used to hear the term fibromyalgia and people used to say, Oh my God, that's what doctors call it when it's all in their head. You can't identify it. There's really no reason for it. So they were just going to give it a name.

Now you see no see plastic pain and which seems to be the new way that that cluster that not necessarily identifiable or as you said root cause necessarily being clear. What can you tell us about that? Where? Where does that all go and where did it come from?

So I think First off is we have to build systems that are rooted in believing patients and believing that they have a problem, that there is something wrong. Because what you asked earlier about what does it do when a physician tells someone it's all in your head? Well, it shakes the confidence, right, that we have in our own ability to trust our gut that something is wrong.

And what I have found is that in the vast majority of cases, when someone tells you it's all in your head, it's just because they have not figured it out yet. And it's, it's a way of kind of pushing, you know someone. Pushing the boulder way, correct? And as I said, there are like established diagnostic pathways. You got a whole lab panel. I have great news. Your labs are normal. Well, that doesn't help me, right? I have great news. We didn't find anything on your MRI.

All right now, yes, that is. It's funny. You're reminding me of when my mother was in her 90s and dying and we were going to a super fit woman. We went to the oncologist, the rheumatologist, the pulmonologist, the this, that. And they're all like, you know, I have no idea what's going on. Nothing wrong with you. And the day she said the oncologist said, well, I just want to let you know you don't have cancer. And she goes, oh, crap. I, I just looked at the

oncologist and laughed. I said, you're going to have a funny dinner conversation. I'm sure you don't have many of those. You know the patient who said oh crap. I can tell you. I bet you see this and you've heard this kind of thing. Correct from interviewing so many people who have a misdiagnosis or an autoimmune condition when and multiple people have actually had a diagnosis of cancer in addition to these other diagnosis, when they hear they have cancer they go. Yes.

OK. Because they know this is something that has a name, it has a treatment and I know what the prognosis is. And that to them is a better prospect of just not knowing or trying to chase something you don't even know what it is. So to get back to your original

question about the fibromyalgia, you know, there, fibromyalgia is a disease or condition that we call a diagnosis of exclusion, OK. And what that means is we have tried to find cancer and we didn't find any. We have tried to find rheumatoid arthritis and we didn't find any. We tried to find Lyme disease and we didn't find any. But you still have these symptoms. We believe you.

We we, we understand that they're real, that they're affecting you and they're in a similar pattern to what a lot of other people are experiencing. But they also don't have positive labs and they don't have positive CT scans. And so we're going to diagnose you with fibromyalgia. Now in giving that diagnosis, and I say this all the time,

diagnosis is power, OK? When you have a diagnosis, that then opens up a whole variety of potential treatment options of new specialists of new medications, right? Because you have a diagnosis, you have to think about what's going on behind the scenes when you get a diagnosis, that diagnosis carries an ICD 10 code with it. And for anyone who's ever seen an EOB or a bill that you get from your insurance company, OK, correct.

But you need that ICD 10 code in order to get that that treatment in order to get that IVIG in order to get that new medication, right? So having a diagnosis is power not just for your own emotional state, but also from a very practical standpoint in terms of how insurance works. So I am glad that people are getting some diagnosis right. But in my opinion, for the vast majority of people, they have a root cause that just has not been discovered yet.

And. In some cases then a misdiagnosis, which is potentially even worse because you're going down a pathway. It's not, it's not even that you're you're the pathway is stopping. You've just stopped because they say, OK, we've figured out your diagnosis. But for a lot of these fibromyalgia POTS MCAS, the treatments are drink more water. Yeah. Exercise more and when you're. Well, those two factors do help a lot. Of course. Of course, pretty much anything.

Of course, but it's not specific to your particular problem. So that's where I feel sometimes when people are given these diagnosis of exclusion, it prevents them from doing the further investigation to something that might actually be treatable. What do you find if someone's,

let's say, been diagnosed with fibromyalgia? What are underlying things that are often missed once that diagnosis is given? So for fibromyalgia, right patients are usually complaining of pain in multiple areas of their bodies at different times. Sometimes it can. People can have brain fog or extreme fatigue and there are many different either infections, EBV or mono, you know the kissing disease. I find that a lot of people have had undiagnosed chronic EBV that have been diagnosed with

fibromyalgia. EBV as in Epstein Barr. Correct. Epstein Barr virus, same thing. Lyme disease, right? You might have been diagnosed with fibromyalgia, but your underlying cause was untreated Lyme disease. Or sometimes there's a, a, a huge, well, I'll talk about two large categories of disease. 1 is called dysautonomia. And that is when your nervous system is just kind of off the, the, the, you know, off the walls and firing in ways that it shouldn't be.

And then a connective tissue disorder called Ehlers Danlos syndrome, which I find more and more women are being diagnosed or trying to be diagnosed. And that is that is the root cause, right? That is your connective tissue, which is your skin. Everything that holds your organs together in place, everything that's deep inside of you, it's not at the right can. Think of it like tension. Is that tied to lupus? No, Lupus is an autoimmune disorder that is your body kind of attacking itself.

Eller's download is a. There can be associations. And comorbidities, because I've heard of associations between those, right? So people who have Ellers Danlos, it's actually called the unholy Trinity, they are often diagnosed with POTS, which is a form of dysautonomia, Ellers Danlos and MCAS or mast cell activation syndrome. And they probably what's going on is there is one overarching problem and it's displaying in these different ways.

So people with MCAS get hives, get food allergies, get allergic reactions out of the blue. You've been eating strawberries your whole life and then one day you eat a strawberry and now you can't breathe. OK. You have hives and rashes all over your body. It's not I didn't try a new body wash. I didn't do any new, you know, detergent. And all of a sudden you're having these hypersensitive kind

of histamine reaction. And then POTS is a case where your blood pressure, when you go from sitting to standing, drops like that. And you, you faint. And this is now being connected to post viral syndromes. So when this exploded was post COVID because people had COVID. And then later on, basically the virus caused this disorganization of your, your, you know, autonomic system, which manifested itself as POTS. But post virus syndrome has been going on for as long as viruses have been along.

There just has been added attention because of COVID and the effects. That's very interesting. And it's interesting too since you mentioned COVID, because so many different things are coming out post vaccination of all different problems people are having. Correct. And I think one thing that, you know, as part of the medical community and one of the, you know, physicians who I was one of the first people to get the

COVID vaccine. I got the COVID vaccine in December 2020, you know, had all the boosters. And I myself had a reaction where I developed very heavy bleeding during my periods. And I, I have a large social media page and I told my story and the beginning I said, I am one of the first people to get the vaccine. I have had all the boosters. This is not some type of anti vaccine post or commentary but I want to share my story about a side effect that I had and that post was taken down for

community guidelines violation. I believe it all right. So here I am a, you know, credentialed, verified physician just talking about, again, the effects of a vaccine that I had. This is not a post about passing judgment up. People got vaccines or didn't get vaccines. But I think if we withhold the information, that's what breeds the mistrust. Well, I'm a I'm a big believer. Popular or not, I really don't care that science went out the freaking window for the past five years.

I mean, as I said to you right before we started, I worked with biotechnology, medical device, pharmaceutical companies for 29, well, since 1996. So that's a long time. You know, you know, that's a solid 30 years. And so much of what I saw and the lack of debate, I mean, if that, if I had ever propagated that and pushed that out, I'd have been in jail any number of times or censored or barred from

the industry. And the fact that the discussion got removed, I mean, I don't care what anybody thinks about this either. I'm a big fan of X now because you can actually post things and it can get debated. I mean, you don't have to like it, but at least it can get debated. And that's to me what science always was. And it took a nasty, a really nasty turn. And I think it's going to take a long time for that trust to come back.

And maybe it maybe an evaluation is important because there's, there's a lot of people that are expressing what you're, you're saying right now. And I think that again, as scientists, we do the best with the information that we have at

the time. And I, I say this all the time in my podcast where we go through people stories of misdiagnosis that it is very easy to to Monday morning quarterback the situation. Now we have, you know, more information and data. And what I do hope is that what is preserved is the discourse, is the transparency, because as an institution, right, as I'm part of the healthcare institution, I think what we've learned is that trust is no longer blindly given, right? It has to be earned.

And I see this with the younger generation of. Google doctors. People using Google, but what I will say is that, you know, to to the physicians who get, I would say miffed or kind of upset when people are bringing to them things that they read on Google or something they saw on TikTok or whatnot, they're going to those sources because they're not getting the answers that they need from the traditional

pathways. And I think it was a real eye opener to physicians to understand that, you know, if you ask someone how, if I said I'm going to give you a referral to a neurologist, how long do you think it would take them to get that appointment? Well, I can tell you first hand because I woke up with no hearing two years ago with sudden sensorial neural hearing loss.

And I will say my probably my biggest shock is when I actually went to a doctor and told him I had had three confirmed concussions within the pet prior three months. He told me it was unrelated. And I remember thinking I'm where this is what hospital? I mean, I might as well be in La La land that somebody actually just said that to me. Not that I thought it was going to resolve the issue, but I was pretty sure they were concussion.

It was concussion related. So for some people, they're waiting upwards of six months to see a specialist, right? And then you may see a specialist and just not be aligned with what they're saying. And we have to remember when you go to see a physician, you are asking for their opinion. And I say this all the time. I'm a hand surgeon, right? And a patient may see me in my

office. They may see my colleague down the street, they may see another colleague, you know, in New Jersey, and we may diagnose them with the same problem, which is carpal tunnel syndrome. And I may recommend you do a cortisone shot. Someone may recommend wear a night brace at night. And the other surgeon may recommend surgery tomorrow. And it's not necessarily that any of. Us are wrong, right? Correct. I agree. That they are different opinions.

And you know, I tell people if you are in the position to get a second opinion or multiple opinions, please do. And no surgeon should ever feel threatened if someone says I'm seeking another opinion. Because in the end it is. It's an opinion based off of our experience, off of what we see our own patients go through. And I may have a very different reason for recommending A cortisone injection to you as opposed to the surgeon who's recommending surgery.

You know, that, that perspective alone, I bet the more that people become aware of your, you having that perspective, I bet it could have people lined up outside their, your door if they're not already, because, because it's, it's, it's great to hear. And you know, one of the, I'm sure I drive my, our children crazy because I'll, I'll say, well, let's go get a second opinion. You know, I, I think that's, I love and oh, you don't trust that doctor. I said I didn't trust him.

I said, this is the practice of medicine and you know your body better than anyone else does. And you're not 100% in agreement. You know, there's a doubt you have in your head. I'm not the one who's facing surgery. You are. So why not look at another and see as you said, it might be a cortisone shot that helps and alleviates that inflammation before you need that scraping of your ankle or whatever it is.

Correct. And you know, I use this line all the time, which is a line from one of my mentors at at Lenox Hill. Actually the father was named Chit Roundelwatt, but he always said the eyes only see what the mind knows. That's such a good line if. You see a doctor and you just don't think that they have come to the right conclusion or you're uneasy with the treatment protocol that they're suggesting see someone else because you don't know what they don't know. Yeah.

And sometimes they don't even know what they don't know. Now, that is to say, we are in a Really. Privileged position where we are in New York City where there is an abundance of physicians to go to and there are probably some people listening to this podcast. So they're like, there's only one rheumatologist in town,

right? And that's that's who I got and that's when I also feel like listening to other people's stories online, researching for yourself, using pub Med as a great if nobody here knows what pub Med is, it is, you know, for physicians, it is our gold standard. What is the actual peer reviewed literature being published? And I often tell people, because I get thousands of messages a week, people asking me, could you help me?

Could you? And I tell them the same thing I say #1 put your symptoms into ChatGPT and ask for the top five differential diagnosis so that you just have an idea of what it could be. Then go into pub Med and look who are the people actively researching this topic. What great advice. Well, you know, pub Med is it's, it's behind a firewall for most articles, but for most people you can get the gist from the abstracts. And again, it's not your job to have a PhD in these subjects.

But I do think being able to connect with someone who is up to date in the area that you are looking for help. If anything, they may tell you you don't have this. And that is also valuable. Getting back to the, your labs look normal and everything that's also valuable pieces of of data, right? And sometimes it's collecting all of the different pieces of data. But the real question is who is going to piece that together.

And that I find is what is really lacking in our interactions with doctors is that we no longer have that quarterback for our care. And that used to be your primary care doctor, but nowadays you ask someone who's your primary care doctor. It's whoever I saw at City, MD. You know, they're they're such truth in that medicine has

changed so, so much. I wish we could go back to the days of this really dating me, but there was Blue Cross and Blue Shield. You know, you knew you had your primary care doctor and they would help you find, you know, other people if you needed it. And now things have become so specialized and so diffractioned and divided in ways that and, and I really see it when I talk with older people. And I say, does your cardiologist know what the rheumatologist or the whoever has prescribed you?

Because like I said, I work with clinical trials for over 30 years. I can count on one hand the ones that would do cocktails. Usually it was only with cancer drugs where you had somebody test this drug and this drug at the same trial to find out what were the interactions that might

be causing. And I bet you could even narrow down a lot of that when you're talking with people with misdiagnosis, that sometimes you may have two medicines just plain interacting poorly and causing that fainting or those drops or spikes in blood pressure or any other things. Absolutely. I just I have a podcast called the Medical Detectives and we interviewed. That's a good one, the medical. Detectives, detectives and we

interviewed. Actually, it was the patient's wife, but it was a fascinating story because he had a history of substance abuse and he started having the symptoms that mimicked and looked very similar to alcohol withdrawal. But he had been sober, had been passing every drug test, but people just categorized him. You know, this is who you are, this is what your problem is. And all along for two years, it was a side effect from a medication that was prescribed

from his primary care doctor. And again, this is where I feel like the integration of AI into our, you know, think of yourself as the CEO of your own healthcare. You can use AI as a tool, all right, to help you really proactively take care of your health. Because to be honest, I don't think the physicians are taking the time to really go through all. Of that, and I'm not even sure they have the time anymore.

No, they don't. With the, with the, you know, the, all the things that have happened in medicine where you've got my mind's blinking on the word, but you know, everybody's in the silos and you've got the insurance

companies. And we're not going to go into the whole insurance company issue, but we've got the insurance companies And then the doctors have to see X number of patients a day. And if you have to get, you know, you've been assigned that many patients within your insurance company or your responsibilities. I mean, how can you talk to someone? So I feel for the doctors, too. It's like things have really

gone awry there. Yes. And I feel that the vast majority of patients have that perspective that a doctor is not intentionally trying to blow you off. They're not intentionally only wanted to see you for for 5 minutes. They are put in a system where there are time constraints and resource constraints, right? Not everyone can just get an MRI for every headache every, every time you have 1. So they are, you know, balancing that as well.

But for a patient, you're like, well, I think I need the MRI for my headache, right? And that's when, if you have, I would say either a longer standing relationship with someone like a primary care doctor, they're able to see like, you know what, you are really off. And I, I think we need to, you know, do something about it.

Whereas if you're just unfortunately showing up to the ER because probably you weren't even able to get to see someone, they don't know your background, they don't know what your normal is. But the irony is you're more likely to get that MRI right then and there or. Not not in the ERMRIS are actually very, very difficult to get to the ER again, depends on what it's for. So for example, if you hit your head and you could possibly have a brain bleed, right, that could kill you.

I mean, eminently and so, so you're going to have either CT scan of your head or an MRI of your head. If you go skiing and you injure your knee, you're going to be checked out to make sure your knee is still, you know, stable, but you're going to get the MRI. Out weeks later. Correct. Because that's not an emergency. So that's what we're talking about, the rationing of these

resources. It's not that you don't need it, probably eventually, but in this moment like what needs to that's in the ER setting, it really is about triage.

You've got a book coming out. What's your book about?

South my book is called Little Misdiagnosed, which is the same name as my TikTok channel and I actually started that Channel when I diagnosed a woman's 10 year medical mystery in three seconds. Not in my office but over TikTok and I thought why should it take this woman 10 years to get diagnosed with something that I knew immediately? And so I started to tell. Can I ask what that was?

It was a glomus tumor, so probably very few people listening may know what that is, but this woman sent me a direct message, she said. I don't normally talk to strangers on the Internet, but I'm desperate. I have had 10 years of severe fingernail pain, and nobody can tell me what's wrong. I've seen five doctors. They tell me nothing's wrong with me. They make me feel like I'm crazy. But I swear if I just rush my fingernail against something,

I'll jump to the ceiling. And so I messaged her back. I said I also don't normally talk to strangers on the Internet, but out of curiosity, do you have a little blue dot under your fingernail? She said. I do have a little blue dot under my fingernail. So I said you're going to ask your doctor to get an MRI of your finger. It's going to show that you have a mask called a glomus tumor. Hand surgeon is going to take it out and you're going to be cured immediately.

So you messaged me back six weeks later. Oh my God, I got the MRI. It showed I had a mask. They took it out. It was a glomus tumor. I'm I'm completely healed now. What that woman didn't know is that if you go on to Google and type in pub Med glomus tumor, my name pops up. Or my maiden name, Erin McDermott, because I'm one of the world's experts on glomus tumors. OK, but she didn't know that when she reached out to me, right?

She was just looking for someone who would believe her, because if someone believed her, then someone could help her.

So I then started telling stories about my time in residency when I had kind of these interesting cases or, you know, examples of what would happen when someone would come in and they didn't have insurance, right? And they had to have surgery. And what, what did that feel like? Or, you know, someone was actually here illegally, didn't have papers and they had to have major surgery, but they, they, they didn't want their name, you

know, published anywhere else. They thought they could be picked up. So it was really about stories of what it was like, you know, as a as a female orthopedic surgeon also. And those stories went viral on TikTok. And yeah, so that's the this book is about those. It's a memoir from my time in residency talking about these cases and how they those cases, how they impacted me and how I practice medicine today.

Oh, that's very interesting. So if you've watched The Pit, I would say it's very similar to The Pit or like a Grey's Anatomy behind the curtain scene. What? What are what are some standout stories somebody might find?

What's another one? Well, I think the story that kind of jump started it all was actually a story that I had to ask my brother permission to tell because it involves him as well. But it was my first day at work as an orthopedic surgeon, as the general surgery intern, right? It's July 4th weekend. Everything is crazy. People are, you know, running with, they're like, you know, all over the place. And I had started on night

float. So I came in at 7:00 ready to, you know, take care of all the patients at night. It's kind of scary because there's no attendings with you. You're doing it on your own. And I was about to admit my first patient and work them up for a pre op and I kept getting calls from my mom. I was like why is my mom calling me? You know I told everyone I'm at work please don't call me. You know I need to focus. But she wouldn't stop calling me. And I finally answered. I said mom.

I said what what's going on? I'm at work. And she said it's your it's your brother. He, he was in an accident. And So what kind of accident? He said, well, he was in the Hamptons and he dove into a pool and his friends, they, they had to bring him out of the pool and, and the reception was really bad. So I couldn't, I couldn't hear them Well, but they're taking him to the hospital and I said, OK, well, you know, it's, it's the first weekend of July, right?

Make sure in attending, make sure he looks over his scans and make sure he's, he's going to be OK. And then I went back to the pre op and then I got a call from my younger brother a couple minutes later and I said I know, I know. Kev hit his head and he said no, I don't. I don't think you understand. He he can't walk. Oh my gosh. He can't move. He's being airlifted to Stony Brook. And so at that moment I realized he's a quadriplegic, all right.

And I kind of walked back in shock to the, the surgery room or all the residents were getting ready to go home. And I just, I said, I can't, I can't do this pre op. Like, what's, what's the matter? What's going on? I said, I think my brother's paralyzed and I just dropped to the ground and went into shock. And so that was kind of the first, you know, that's I always wanted to tell that first day of work story from my perspective back.

Of a first day, Oh my. As an orthopedic surgeon, but being on the other side right as the family member and watching him go through waiting, waiting for his name to be called for

the add on surgery. Going through, you know, being in the ICU, not being able to move a muscle, going to rehab when you're 21 year old NCAA, Team USA All American with 80 year old people who've got in their hips and knees replaced, you know, and then just the resilience of what it's like to recover from a spinal cord injury. And that really set the stage for how I approach the next five years of my training. It doesn't surprise. Well, the story certainly surprises me.

I didn't expect you to tell me that story, and I feel like I still need to catch my breath from it. But having listened to you for the first bit of this podcast,

there was something in my gut saying something happened that impacted you in an interesting way because you're, you've got a high level of compassion in how you speak. And, and we never met before this podcast. And I didn't know you till I read a little bit about you and thought, wow, this is going to be a really interesting interview. But you, your compassion is extremely high, which makes you exceptional in a medical in the

medical world, well. I really appreciate you saying that it is always the the highest compliment when someone compliments me for my empathy or my, you know, compassion towards others. And I find that there are other physicians who are quite popular on social media. And what I have realized the common denominator is that we have all had some personal, you know, family event that has affected how we, you know, our doctors ourselves.

You know, one of my close friends, her name is lady spine doc Doctor Betsy Grunch. Her mother was an officer who in the line of duty was in a car accident and became paralyzed, another neurosurgeon whose son was killed in a drunk driving accident. And so, you know, we carry these stories that then, you know, come out in our interactions with our patients. And I, I know that I am a better physician because of Kevin's accident and what happened to

our family. And I feel that now what I do on social media is really, I'm spreading that compassion at scale because it seems that there is a large, I would guess or call it a compassion gap between doctors and their

patients now. I think it's, it's very interesting because that you say the community that is drawn to you by the Internet because in some places people describe the Internet as super cold, because people flip off comments and physical comments and everything else that they would never do anywhere else. You know, they just say things and do things that they would never do. And so I think there's then there's that side of finding compassion and finding someone that someone, I think people

just want to be heard. And it sounds to me like you're an excellent listener and that you're sometimes I think the biggest part of healing starts with you, when you feel someone's hearing you. Absolutely. I you know, we were talking earlier that I had given this

Ted talk about the stages of misdiagnosis and. Oh yes, let's get into that. Well, I'll, I'll, I'll start at the end, but to, to get to your point, but really, I find one of the most important pieces to someone who's going through a misdiagnosis is having a North Star believer, right? Whether that is a family member or a friend or a doctor or someone online who you've never actually met in person.

But these are people who make you feel seen, who make you feel heard, who make you feel like your story matters, right? And that you are worth fighting for getting that diagnosis. So I hear it all the time on my podcast. Everyone that I have interviewed, they all have a North Star believer. And going back to the original conversation we had about saying it's all in your head or making you feel like you're crazy. If you hear that enough, you start to internalize that and you believe it.

And it's those North Star believer people who say, no, that's not right, you know, trust yourself. I believe you and they they give you the courage to re enter this cycle. One that's very heart warming, one of the things you mentioned was when we were talking just before we went on air, was your Ted talk about the stages of grief with misdiagnosis. Can you tell us about that?

Of course. So, you know, this is based off of Doctor Kubler Ross. She had a book called On Death and Dying and she outlined the the five stages of grief. And this has been a framework in use for over 50 years. And it has been really helpful for people to process these emotions. And what I saw was that there was a very similar pattern of stages going on in people who

had been misdiagnosed. And I thought it would be helpful to give them a framework to be able to process these complex emotions, to start the conversation about the the pain and the trauma that happened from being misdiagnosed, which a lot of doctors don't talk about or understand that they can be part of the problem. And, and then also just give people that ability to finally someone see them and hear them for, you know, this journey that they've been on.

So as I mentioned earlier, the first stage and many of the stages are very similar to the stages of grief. And, and they can people cannot go through stages. They can skip stages or do stages in different orders, but typically they are, you know, denial, right? That's what we talked about earlier. I just slept on it Funny. It'll go away. But then when those symptoms, they linger, right? They don't go away. Then the next stage is gathering

the research, right? Gathering the like, OK, now I'm going to go to Google. I'm going to, you know, see a bunch of doctors. I'm going to join a Facebook group. I'm, you know, going to look on, use AI. And then it turns into anxious optimism, right? OK, I saw a specialist and they, they want me to do this test and they're positive that this is going to give me the answer, right? And you put all your energy and all your hopes into getting this

CT scan. And then the next stage is self doubt when that CT scan comes back as normal, didn't find anything. You think are they? How could they not find anything? Maybe I am wrong, maybe I am going crazy. And then when you realize again the symptoms are not going away, that fades into anger. Like no, I'm not crazy.

I do have pain. I do have symptoms and you're you're mad at the system and you're mad at your doctors and you're mad at your family and friends who maybe don't think this is a serious problem or you know, you're mad at someone suggesting maybe you should, maybe you should talk to you know, someone, a psychologist or a psychiatrist. And then once all that angry energy fades, you are in depression, right? You're tired. You're tired of seeing all the doctors.

You are grieving the life that you had before you got sick, right? And you're grieving the life you thought you were going to have before this happened to you. And it's incredibly isolating. And you're really, and you're really sad. And then in the end, you're just in the stage of apathy. You've just given up. There's nothing more you can do. Like I've been to all the doctors. I've told everyone my story.

There's nothing left. Now that I said, I don't want everyone to leave this podcast being sad, you know, and depressed. That's I don't want to cause millions of people crying on the Internet today. But I tell these stages because I think it's helpful to normalize that these are the possible emotions you could be going through. Well, what I find fascinating

that she said that is I've, I've always been very complementary medicine oriented and worked in very traditional medicine for 30 years. So I always look at everything as a blend, but I believe in the whole body connection in a big way. And when I have people come in to me that are, are a lot of different doctors groups have always referred their patients to me to work with them with hypnosis. So I have a very and I always start with, when was the last time you had a full physical?

And so often they'll say to me, why are you asking that? I'm like, because whatever's going on in your mind is somehow impacted by your body. Now, I don't know what that is. I'm not the MD here, but I think we need to start you with a good physical with someone so we can just see if there's a reason you're feeling constantly stressed or why that, you know, you you can't. Maybe it is just because you're hunched over your computer or because you can't.

You feel like you're walking in egg shells in your home. You know, those are all very possible. And we can look at those with hypnosis all day long and we can, you know, come up with ways we can move you through things. But there might be something physical here. So absolutely what you're talking about, and you'd mentioned it before, but having the silos, right, of expertise, but there is also a silo of physical health and mental

health. And what we have to understand is that it is a continuous spectrum and that one affects the other. And where I see the major issues are, is that on the physical side, if they can't figure out what's going on physically, they're going to punt it to mental health, right? If you are a woman, well, you have anxiety, right? Well, you have depression, You're having a panic attack. No, actually, you're having a heart attack. Yeah, actually you're having a stroke. OK.

But these are some of my most popular videos are just even talking about this, right. And so there's there's that. Then there's also when you are going through a physical condition, the help you can have from working with a mental health counselor can be the main difference.

And I find that people who have been diagnosed, whether it's cancer, whether it's a, you know, autoimmune disorder, they are so helped by either talking with a therapist, finding a group, A community group with the same problems.

OK, because that your mental fortitude is what's going to help you with your, your physical ailments and getting back to those stages of, of misdiagnosis, I would say, you know, the three things that I can recommend how to shortcut or divert from those final stages of misdiagnosis are #1 finding your North Star believers. OK, That may mean going to

multiple different doctors. That may mean opening up to family who you wouldn't normally talk to about medical issues #2 is having the courage to re enter the cycle right? It's really hard to find another doctor just to be told the. Same thing. Right. That is physically and emotionally draining. So it takes different I call this the will to fight. It takes courage to have the will to fight and re enter that

that cycle. And then finally, we are living in a day and age where we have access to tools that were not available even six months ago, right? I mean, there there's an AI facial recognition app where you can upload your picture and you can diagnose you with a rare genetic disease in three seconds. OK. I remember years ago working with a company that was doing that with the Irish that ultimately became part of Clear, correct, correct. But it was to diagnose mental imbalances.

It was psychiatric originally. Correct. So, you know, the putting together all of these, you know,

my social media channel and my podcast and all things has been building towards what I am actually building, which is a social media platform called Feel Better, where you have access to credible health information from health experts, but then also be able to find a community of people who are going through the same problem as you. That's fantastic. What, what I, you know, one of my thesis is that it's an, if you're a woman with endometriosis, there's no one you trust more than another

woman with endometriosis. And I really believe in the power of combining the medical expertise with the community support. Again, attacking it from the physical health and the mental health is how we're all going to be able to help take care of each other. Oh my gosh, I could keep talking to you, Doctor Aaron Nance, for another hour, but our time is up and I wish it wasn't because, well, first of all, that was one heck of an ending. And I. And what was the name of this

community you're creating? So it's called feel better, feel better BETR it will be an app launching in June. Not sure when the podcast is airing, but yeah, we are, you know, as I said, taking the best from medical social media and then working with health foundations and really trusted communities that are rooted, you know, in in health and and community support. And that's, we just want to make it as easy as possible for you to, they say, help us, help

ourselves. And that's the ultimate goal.

Well, this has been an absolute pleasure. Thank you for your time. Well, thank you, Diana. It's a pleasure. And thank you for inviting me on and getting these types of stories on because as I said, I think so many people are feeling isolated and lonely going through these health challenges. And I just want them to know that you're not alone, you do matter, and that your stories are worth listening to. That comes across loud and clear and it's heart warming. Thank you.

Thank you so much. That's Doctor Aaron Nance and I'm Diane Griselle. I'm also known as silver disbedience. This the silver disbedience perception dynamics podcast. There will be all kinds of information below this podcast where you can follow doctor Aaron Nance and I highly recommend you do because she's a heartworm warming, fresh breath of air so and also happens to be very intelligent and smart and accomplished too. So what a combo. So please hit subscribe, share

this with your friends. Follow Doctor Nancy's information below. Thanks again everybody and thank you. Thank you.