Latest / She’s Smart / Dr. Sharon Stoll - Unlocking Brain Health

Transcript

Dr. Sharon Stoll - Unlocking Brain Health · She’s Smart

0:02
Hey, everybody. Welcome to She's Smart. I'm your host, Maria Robotham.
0:07
Today's episode, you're going to want to play twice because we're diving deep
0:11
into something we all care about but don't always understand, our brains.
0:16
My guest is Dr. Sharon Stoll, a board-certified neurologist and neuroimmunologist,
0:22
director of neurology at Stoll Medical Group, and former assistant professor
0:26
at Yale School of Medicine.
0:28
She's also a national speaker, clinical researcher, and media medical expert
0:33
who's appeared on ABC, NBC, CBS, and The Doctors.
0:38
Dr. Stoll's story is remarkable, not just because of her credentials,
0:43
but because of her journey in generology started with her own MS diagnosis in medical school.
0:49
What could have been a detour became her calling.
0:52
Her story is equal parts grit, vulnerability, and inspiration.
0:57
We talk about how the brain grows and changes throughout our lives,
1:01
the gut-brain connection, what happens to memory as we age, and what we can
1:06
actually do starting today to support brain health.
1:09
From holistic habits to innovative apps, Dr. Stoll brings both science and heart to this conversation.
1:16
If you've ever forgotten why you walked into a room, or you're just curious
1:21
how to feel more mentally sharp, this one's for you.
1:24
So get cozy as we connect, learn, and laugh together on She's Smart.
1:30
Music.
1:49
Hi, how are you? Good, how are you? Good.
1:54
It's so nice to meet you. You too. I'm so glad that Mary put us together.
1:58
Her boys are the same age as my boys, and we live in the same town.
2:02
And when she said she had something that could chat with me about the brain
2:06
and memory and everything, I was like, it's great. So I was very excited.
2:09
Oddly enough, my boys are also the same age. Oh, get out.
2:13
Yeah. 14 and 10. I actually really enjoy this age much more than I enjoyed the
2:20
baby age. Oh, couldn't agree more.
2:22
I can talk to my 13-year-old kind of like an adult. He gets my jokes that are
2:27
totally inappropriate sometimes.
2:29
And he's got that sense of humor. So it's fun when someone says something and
2:34
he looks at me and I'm like, I know.
2:36
It's changed the relationship in such a better way for me.
2:39
Yeah. My 14-year-old is more mature than I am. Yes. Awesome.
2:46
Oh, I love that. Thank you so much for coming on. I really appreciate it.
2:50
I'm excited to talk to you about all things brain and memory and aging and the
2:57
holistic part of all of it.
2:59
I'm a true believer that it's not just one part of your body that's not working.
3:02
There's all the parts like something is going on. And I've learned this as an athlete.
3:08
Like, if your knee is hurting, what's going on there? Is there a back?
3:12
And that's like the musculoskeletal part of it. But I have a huge gut-brain
3:17
imbalance that I'd worked with my nutritionist on, which is totally better.
3:22
And I've lived with it my whole life without realizing it.
3:24
But now that's all working and doing what it's supposed to.
3:27
So I can't wait to get into that with you. But I really wanted to start and
3:30
find out what led you to neurology.
3:34
It's like a really incredibly difficult medium.
3:37
So how did you choose it? Was there a moment or an experience that you thought,
3:42
this is what I want to do and go into?
3:44
Yeah, I always wanted to be a doctor. That I knew since I was six years old.
3:49
And I find myself very fortunate that I knew what I wanted to do at a very young age.
3:54
I was very driven and motivated and nothing stopped me.
3:59
I started volunteering in a hospital when I was 16 and I fell even more in love
4:04
with medicine. When I got to medical school, I was determined to be a surgeon.
4:09
I loved blood and guts and watching Grey's Anatomy as a kid. I just, I loved it.
4:16
And all of that gruesome medical stuff didn't scare me.
4:21
Then in second year of medical school, I had what's called transverse myelitis
4:27
where the immune system hit my spinal cord.
4:31
I woke up one morning and I couldn't feel my feet and a few hours later,
4:35
I couldn't feel my back and a few hours later, I couldn't feel my hands.
4:38
Later that night, I thought I was gonna stop breathing and I went to the hospital.
4:44
They said, don't worry, it's likely nothing.
4:47
You're in medical school, you're learning neurology, you're a second year and it's all in your head.
4:53
I went home and I tried not to think about it and I kept checking my reflexes
4:58
because I learned about Guillain-Barre syndrome and I was reassured that I have
5:03
reflexes so I'm not going to stop breathing in the middle of the night.
5:06
But basically that was the first of many relapses and I was diagnosed with multiple
5:10
sclerosis in April, actually this month, 16 years ago.
5:17
Recursors to MS or was it MS just coming out in a flare-up?
5:22
Multiple sclerosis literally means just multiple sclerotic lesions.
5:27
Back then with the first lesion, they just called it CIS, Clinically Isolated Syndrome.
5:33
They said you could develop multiple sclerosis, you could develop multiple one
5:38
of these, or this could be a one and done phenomenon.
5:43
Turned out it was the first of many.
5:45
And then you kept going. Were you like, okay, now I'm going to figure out what
5:50
this is, how I can treat it, what we can do new?
5:53
Actually, I still wanted to be a surgeon after that.
5:57
I wasn't going to let this diagnosis change my career goals or alter my path.
6:03
And I was still gung-ho going to be a surgeon.
6:07
Every time a doctor told me, well, you're going to be disabled by the time you
6:12
finish medical school or residency, it's not worth it. You're not going to be
6:15
able to be a surgeon. You're going to develop a hand tremor.
6:18
You might as well quit while you're ahead.
6:21
That was almost more of a deterrent to go on and be a surgeon.
6:26
It kind of did the opposite. it. But what really made me switch my mind was
6:33
in medical school, going through the surgical rotations, I realized this really isn't for me.
6:39
You don't help a person as much as you think you do as a surgeon.
6:44
You're given a scalpel and a suturing kit, but there's no real relationship that you develop.
6:50
Then the more I got into actually doing a neurology rotation back then was optional.
6:56
There's a saying in Hebrew, in Judaism called beshert.
7:01
And we usually use it to talk about significant others.
7:06
In medical school, I was supposed to do a pulmonology rotation,
7:10
but the pulmonologist I was shadowing happened to have a massive brain tumor.
7:16
And I can say this because it's not HIPAA. He speaks about it all the time.
7:19
And I happened to be doing research in neurosurgery at Penn,
7:24
and in comes my pulmonology attending, who I was supposed to start my pulmonology
7:30
rotation with the week after.
7:33
I see him. He sees me. And I'm like, oh, no, this is definitely breaking every
7:39
HIPAA violation, every code of conduct, because here is the student in the doctor's office.
7:46
And he grabs my hand and he said, I'm glad you're here.
7:50
And he said, promise you'll be in the OR with me to make sure these surgeons
7:55
don't do anything they shouldn't.
7:57
And I'm like, this is too much. This is way too much.
8:00
But basically, I got to see the surgery. He had a massive brain tumor that was fully resected.
8:06
And because he was recovering and I couldn't rotate with him in pulmonology.
8:11
I got a rotation with a neurologist, just family friend, and I fell in love with it.
8:17
I never thought I was going to be a neurologist. To me, it was too depressing.
8:20
I was depressed over my own disease. I didn't want to see more patients like
8:23
me. I cried enough already about myself.
8:26
I didn't want to relive that experience 20 times a day, seeing patients like
8:31
me. and I definitely didn't want to do any other aspect of neurology,
8:35
Alzheimer's, Parkinson's, stroke.
8:38
You hear of all of these diseases and you're like, oh God, that's the most depressing
8:41
thing ever. At that time, we didn't have adequate treatments for a lot of these diseases.
8:45
The more I experienced personally from my own disease with the professionals
8:53
that were supposed to make me feel good or reassured,
8:58
the more I realized there's a huge gap.
9:01
In this subspecialty. Number two, in neurology residency, I realized this is
9:09
kind of like the new frontier. Neurology is a new frontier.
9:11
We have this explosion of new medications coming out in the past few years.
9:18
We now have two FDA-approved Alzheimer's medications.
9:21
We have over 25 MS medications, and we can really not just treat the disease, but stop the disease.
9:29
And yeah, Yeah, I couldn't be happier. So in that sense, I don't want to say
9:34
getting the disease was beshert.
9:36
I would never say that. But definitely being forced to do that neuro rotation was for me, you know,
9:46
I think beshert because otherwise I wouldn't have gone into it and I wouldn't
9:52
have fell in love with the field.
9:54
That's incredible. And you teach as well. You went into teaching other doctors
9:58
about MS, about how to treat it.
10:02
What was that process going into the teaching aspect of it?
10:05
That came easy because up until a year ago, I never really spoke about the fact
10:13
that I had multiple sclerosis.
10:15
For 15 years, I kept it to myself.
10:18
For 10 years, the only people that knew I had MS were my parents,
10:23
my best friend, and my siblings.
10:26
No one else knew. Even very close friends had no idea.
10:29
I did a podcast or a media day with Jamie Lynn Siegler.
10:35
Listening to her and meeting her and having good one-on-one conversation with
10:39
her made me realize I shouldn't be afraid to talk about it and to share my story.
10:47
So when I would teach about the disease and the medications.
10:51
I never spoke about it firsthand. I spoke about it as a provider,
10:56
and this is how every patient deserves to be treated, not just patients with
11:01
multiple sclerosis, but patients with any disease.
11:05
And one of the reasons that I was so passionate about that aspect of education,
11:09
not just here's a book, these are the drugs, these are the trials, you can figure it out.
11:15
You can see this one is better than this, but this one has this side of fact,
11:18
it's not just a science, but there's that art of medicine taking into account
11:23
that patient interaction, that bedside manner.
11:27
Sometimes, unfortunately, it's not as stressed in medical school.
11:33
No fault of the medical school or providers, there's a lot to get through.
11:37
But I think marrying those two ideas should be done.
11:43
And I think because of my lived experience, I do a good job of doing that.
11:49
When was the first time you talked about it in public?
11:52
Really? October. Did it feel freeing? It's not something that I like to delve
11:58
into because for me, I don't want it to be about me. I want it to be about the patient.
12:03
So I still don't really talk about it in terms of what I'm going through.
12:08
I do a lot of clinical trials and with clinical trials, there's always social media.
12:14
We always tell patients and especially myself, since I'm involved in social
12:18
media and media, I always warn the public that when you're on somebody's story
12:24
and you're listening to their experience, you have to look at it as an N of one.
12:29
So with clinical trial design, the population is N like Nancy.
12:34
That person's experience is one experience. When you look at a clinical trial,
12:40
you're evaluating a thousand individuals compared to another thousand individuals.
12:45
So when somebody comes out, like I do a lot of education with vaccines because
12:50
I also did trial work with vaccine.
12:54
Yes, vaccines cause side effects. I see it all the time. As a neuromunologist,
12:57
I saw it in my patients. I saw it with clinical trials.
13:01
There are known side effects, but there are side effects.
13:04
And then what you see online is an end of fill in the blank.
13:09
Let's say you see two stories or three stories or even 10 stories.
13:12
But you think about the millions of individuals that underwent that particular
13:16
vaccine, that's how you have to look at it in that context.
13:19
For me, I can talk about my personal story, but I'd rather talk about a thousand
13:25
stories, a thousand patients that we looked at in that clinical trial.
13:30
I can say I'm part of that. Sometimes when I do educate, I will bring a little
13:35
bit of what I've personally experienced with whatever drug or side effect that I'm going through.
13:41
But I'll never say it's me. I'll relate it to the larger picture,
13:45
that this is what 30% of the individuals on this drug go through.
13:51
And I leave out the fact that I'm one of the 30%, you know, that nobody needs to know in that context.
13:57
Because it also takes away from the volume of people that experience it. It's not just me.
14:03
It's this number of individuals that also have it.
14:06
Yeah, and it also doesn't define you. You're more than just that disease you
14:10
have. My father-in-law has Parkinson's.
14:13
And it's a very hard thing to watch. The way he changes over the years and the
14:18
symptoms that come. He's so much more than his Parkinson's. He's one of the most intelligent men.
14:24
He's kind and he's still moving around. He had the brain stint put in.
14:29
Yeah. Had that surgery done.
14:31
What's he doing with that? You know, it worked for like five years and then the tremors came back.
14:37
So they adjusted it and it worked for a little bit longer and then the tremors came back.
14:43
So, and he's on all these medications just to help alleviate his symptoms.
14:50
But he's, it's pretty incredible. He's sharp as a tack, sharp as a tack.
14:56
But I've seen it in people that I love and, you know, they just deteriorate
14:59
over time. And you want to help them, you can't do anything.
15:02
The only thing I provide is making sure he has the proper nutrition.
15:04
Because we found he wasn't getting the proper nutrition in some way.
15:09
And we couldn't understand why he was failing.
15:12
And I looked at what he was drinking. There's a certain supplement that they
15:15
give people. And it's all crap.
15:18
I was watching him and I'm like, this can't go into your body.
15:21
If your body's already working so hard, you need the easiest things to get all that nutrition.
15:26
So I did all this research and I found a brand that has MCT oil.
15:31
A family created it for their daughter who needed a feeding tube and found that
15:36
everything the hospitals gave them got clunked up in her feeding tube.
15:40
And she wasn't getting the proper nutrition. They created this substance that
15:44
would flow right through.
15:46
They make shakes. I got him the shakes. I ordered like four packages, put them in the fridge.
15:52
And within a month, I don't know, weeks, he completely changed.
15:57
It was incredible what happened over that summer just from changing what he was putting in his body.
16:04
He has one every morning. He goes to the fridge, he gets it out.
16:08
And it just reiterated to me what I always thought about what you put in is what you get out, right?
16:14
So I'd love to talk about how you use this holistic health approach when you're
16:20
talking with people and studying MS or any other disease in the brain,
16:24
how you go about looking at it.
16:27
Sure. I actually, one of the first publications I worked on was in medical school
16:35
and it was about, it's CAM,
16:39
so complementary and alternative medication when it comes to multiple sclerosis.
16:43
And one of the things that I did was I read everything I could get my hands
16:48
on regarding vitamins, supplements, diet, and MS.
16:54
And it was what's called a men analysis where I put together all of these studies
16:59
and I went through what has the best data associated with it.
17:03
Everyone's at a loss. Everyone goes to the doctor or MS patients.
17:08
And I found this to be true of neuro patients, it's interesting,
17:11
not so much with hypertensive patients or diabetic patients or kidney failure patients.
17:17
But with neuropatients, when you're talking about dementia or Parkinson's or
17:22
MS, people come in with articles. They come in with a really good knowledge
17:27
base and they ask the doctors questions.
17:30
My colleagues ask me, does it bother you? You have to spend so much time going over these articles.
17:35
And I'm like, no, because it means they're motivated to do whatever it takes
17:39
to help themselves. It makes my job that much easier.
17:43
So I look at it as a huge positive. In terms of MS, the supplements that we
17:49
found to be extremely beneficial were vitamin D.
17:53
Over the years, I looked at all of the different studies on vitamin D deficiency.
17:58
And I remember when I was breastfeeding my older son, the pediatrician said,
18:03
if you breastfeed, then you have to give vitamin D supplements.
18:06
I asked my mother, did I get vitamin D supplements? She's like,
18:08
no, you didn't get any supplements. Everything's in the breast milk.
18:11
Then I realized the one vitamin not in breast milk is vitamin D.
18:15
Why? You're supposed to get it from the sunlight. Kids are supposed to be outside.
18:19
And then I saw studies that MS is through the roof in Canada. It makes sense.
18:24
Kids are wrapped head to toe. Canada, it's cold. It's further from the equator.
18:28
There's less exposure to sunlight.
18:30
But something else I realized was kids are breastfed longer up until the age of three in Canada.
18:36
Imagine these children that are breastfed up until the age of three are completely
18:42
vitamin and be deficient for the first three years of their life.
18:46
And then I asked my mother, who's very, very European,
18:50
grew up in Hungary, where it's further from the equator, or you see videos of
18:55
babies in Scandinavia and Sweden and Finland, and they literally park the stroller
19:00
with a baby inside, outside of the work.
19:04
And you see like a line of baby strollers, kids that are just left outside.
19:08
Vitamin D exposure, you know?
19:10
The sun is still shining just because it's 30 degrees doesn't mean the sun's not out.
19:16
So in America, there are certain things that we do where there's this kind of disconnect.
19:21
The American Academy of Pediatrics realized not that long ago that in the U.S.,
19:27
we're not leaving our kids outside or you'd be arrested.
19:30
Your kid would be taken away from you. So for breastfed only babies.
19:35
The BISIL is recommended.
19:37
But there is this huge disconnect between what we put in our body and what we expect out of it.
19:46
And something as immunologists that I look out for is, you know,
19:52
this rise of autoimmune diseases and this rise of autism spectrum disorder and
19:57
rise in ADHD and overmedicating our kids,
20:00
but also our diet and what we're putting in.
20:04
So how can we expect it to stay the same for these pediatric illnesses to have
20:11
the same prevalence when the nutrition is there?
20:16
So, yeah, to your point, I think diet and the microbiome and gut health is extremely important.
20:25
And it's something that, you know, I wish we didn't have to do the studies to
20:30
prove that what we're putting in and the chemicals that we're eating is so harmful.
20:35
I wish we could just change it and say, hey, how about we go back to a more
20:40
natural diet and get rid of overly processed everything.
20:45
And then we see what happens if the rates of pediatric conditions decrease.
20:51
Yeah, it seems pretty logical. Europe does it.
20:55
As my mother says, common sense isn't so common. Oh, she's smart.
21:01
Like that one. So when it comes to aging and the brain, I'm mid-40s and many
21:08
of us live very busy lives with many different hats like you do.
21:12
I've found that personally, and I know my friends, we'd start to forget things.
21:18
And we know that there's the perimenopause part of it. But I'm curious,
21:22
as we age, what can we be doing to help our brains, our memory loss, our ability to recall?
21:31
What are some steps that we can be doing to keep our brains healthy?
21:35
So there's two things. Senior moments are called senior moments for a reason.
21:40
They're not called youthful moments, right?
21:42
And one of the reasons is as we get older, our brain actually physically shrinks.
21:48
A 20-year-old brain doesn't look like an 80-year-old brain.
21:51
I have seen brains that do look good for their age, but overall,
21:57
there's no Botox for the brain.
21:59
There's no exercise to get rid of deeper soul sigh.
22:03
I describe soul sigh as kind of like saggy skin. It literally looks like saggy skin.
22:09
And there are certain things that we do for our bodies, but then there are other
22:15
things where it's just a dead giveaway.
22:17
You can get Botox and laser and chemical peels and fillers for your face,
22:21
but you look at somebody's hand or their foot and that gives away their age,
22:24
right? Or their neck. It gives away their age.
22:28
But there's none of that stuff for the brain. So either way,
22:31
the brain is going to show the age of the person.
22:34
But there are, to your point, things that one can do leading up to being a senior
22:41
to save off those senior moments.
22:44
That starts in your 20s. For the 20-year-olds and 30-year-olds that are listening,
22:50
the things to do, one of the things that we already spoke about was eating clean,
22:54
reducing red meats, reducing certain chemicals that are in heavily processed
23:00
foods. This is what I tell my MS patients also.
23:03
It's not about certain diets. It's not about weight loss. It's about proper
23:07
nutrition and eliminating heavily processed foods.
23:11
One of the reasons for that is if a food is processed, you can imagine the amount
23:16
of salt and chemicals in it.
23:18
Once it enters your GI system, you can think of it as a porous cavity where
23:24
inflammatory markers are sent out and bring in.
23:28
So it's kind of like a chemical, these hemokines and cytokines that are released.
23:34
It brings in inflammatory markers and then it attracts inflammatory cells.
23:41
Inflammatory cells are white blood cells. When you have a cold and you blow
23:44
your nose and you see that pus, right?
23:46
Or you have that drip and you see sometimes it's green, sometimes it's white.
23:50
Those are white cells. Those are literally your immune system that's fighting a bacteria.
23:55
So it surrounds itself and then it overproduces.
24:00
Oh, typically you don't have that amount of pus and discharge from your face when you're not sick.
24:08
It's anytime that there's an infection and same thing, anytime you eat something
24:13
that's heavily processed, your immune cells are revved up.
24:18
And those immune cells are kind of what make you feel like you're sick,
24:23
that stuffy nose, the discharge, blowing constantly.
24:29
It's not necessarily the bacteria that makes you sick. It's the inflammatory
24:34
process that gives you those symptoms.
24:36
Now, if you didn't have the inflammatory process, the infections would kill you, right?
24:41
Anything to decrease that overactive immune response is a good idea.
24:47
Those inflammatory markers, right, part of that crosses into the blood-brain
24:52
barrier and affects the brain. So that's number one.
24:54
The other thing is exercise. Aerobic activity has been shown to increase blood
25:00
flow, not just to your muscles, but also to your brain.
25:03
Great, right? So that's 20s and 30s. So later on, 40s, 50s, you can imagine
25:09
the damage that was done in your 20s and 30s is there. It's evident.
25:13
Aerobic activity is still very important. eating clean
25:16
diet and exercise of course still
25:20
all good but as we get older the most important thing is actually brain exercise
25:27
and this is especially true once somebody retires so if you think about exercise
25:34
for your body you go running you go weightlifting you train for a marathon fantastic.
25:40
But brain and, you know, the saying, what you use, you don't lose, right?
25:45
So the same thing goes for the brain. So 40s, 50s, we're working.
25:49
Our memories are active. But we get into this habitual pattern.
25:55
So for somebody that's had a job for 20 years, they're not really learning anything new.
26:00
They're just going to work, doing the same thing.
26:03
If you're an accountant, you're not really learning anything, right?
26:06
If you're a bookkeeper, if you're a librarian, even if you're a lawyer or a
26:12
physician, there are certain fields where you just go in, you do the same thing,
26:16
you're not learning anything new, you're not thinking.
26:19
A lot of patients will ask me, oh, if I read, is that exercise from our brain?
26:24
And I say, no, it's not, because you've been reading for the past 40 years.
26:28
How many times do you read the same page and think, what did I just read?
26:32
I have no idea what just happened, right? So you're literally not learning anything new.
26:37
It's just you're going through the steps.
26:40
Anything that's just going through the steps where you're not using your brain,
26:43
you're not thinking critically, is not exercise. lives.
26:47
So before you get into this rut, or even once you're in this rut and you realize
26:52
that you're in this rut, learn something new.
26:55
Pick up a new hobby. Pick up a new skill.
26:57
I hate doing crossword puzzles. I'm dyslexic. Fun fact.
27:01
So that's something that in my mind, I'm like, okay, once I realize I'm in a
27:07
rut, I'm going to start doing crossword puzzles.
27:09
Because for me, that's learning a new trick. For somebody that's not good at
27:12
math, start doing Sudoku, you know? try those exercises for the brain.
27:17
Once you learn something new, you're adding those pathways.
27:22
So even though your brain is shrinking, you're still developing new tracks that
27:28
memories are forming, and it'll help further save off dementia and cognitive decline.
27:37
So my dad retired, and immediately we were worried because he'd worked his whole life.
27:42
And we were like, what are you going to do? You can't. You can't. He's getting grumpier.
27:48
And he's already an old Italian curmudgeon. And we're like, we can't have this.
27:52
So he started doing Sudoku every morning. We got him the books on them.
27:57
Yeah. And he does it every single day. He went to the local community center and took up Spanish.
28:03
This was right after he retired. He's much older now. I am. I see.
28:06
And I also think with people that I'm seeing older, because I'm in that sandwich
28:10
generation, you are too, right?
28:11
You're taking care of your kids and you're taking care of your parents at the
28:13
same time? Yeah. Crazy dynamic.
28:15
Oh, no. My parents are still very much taking care of me. They have more,
28:18
my mother has more energy than I do. My mother has more energy than my kids do. I love it.
28:24
She retires every year and the retirement sticks for about two weeks.
28:29
And then she goes back to her. And then I say, can you pick up Josh or Jason
28:33
from school or can you do this? And she's like, no, I'm working.
28:36
And I'm like, what? You really don't have to. Can you please pick up my kids from school?
28:39
Nope. Sorry. You get to go to bed.
28:44
I love that. I wish for that. We're taking care of them a little bit.
28:49
And we had to be like, you can't just sit around. It doesn't work.
28:52
He was starting to climb. He just wasn't himself.
28:55
And then he started these new things. And it was something that was really important.
28:58
I've seen that firsthand, especially as you retire. Does traveling work if they're
29:04
going out and exploring?
29:06
Yes and no. Traveling is a little sticky because it's more physical activity
29:12
than cognitive activity, but it is social engagement.
29:15
If you're traveling with friends or family or meeting new people,
29:20
but that as that for the older age, for like our parents that are retired,
29:27
that are trying new things, doing new things, the best thing for them,
29:31
like you said, the puzzles, the Sudoku puzzles, the crossword puzzles,
29:34
but also equally as important is the social engagement.
29:39
So going out, interacting with other people, one of the worst things for the
29:43
baby boomer generation was COVID because everyone was locked inside.
29:48
One of the things that I recommended for my older patients was to join a Facebook group, Facebook Live.
29:54
Stay engaged, stay active. Even if you're not seeing them, you're still communicating back and forth.
30:00
My mother had a little too much fun with Facebook during COVID.
30:04
But it can be so isolated.
30:08
I find that it's older if, you know, if you don't have family around you or
30:12
your close friends, isolation can really lead to depression.
30:15
And then your health failing as you're not getting out and moving around.
30:20
Yeah. I wanted to ask you about your new neurology app that you're starting to create.
30:25
Can you tell us a little bit about that and what it will help with?
30:27
We have a bunch of really great telehealth organizations like MidiHealth,
30:32
which is all about for women and getting the right advice at the right time
30:36
that people can access when they're not able to find someone near them.
30:40
So I'm curious about what you're creating.
30:43
This app called BeCare, B-E-C-A-R-E, link.
30:48
I have to tell the background story because that's what got me involved with this.
30:53
When I was at Yale, the neurologist sitting next to me was a headache specialist.
30:58
The neurology behind me was a stroke specialist and the neurologist to her back
31:04
was also a headache specialist.
31:06
At one point she leaned over and said, Hey, my brother-in-law actually developed
31:11
this amazing app for multiple sclerosis.
31:14
And I said, that's strange. How did he come about that? Because her brother-in-law is a programmer.
31:18
He's a brilliant, brilliant, brilliant, I don't even know what to call him,
31:22
but programmer, developed this
31:24
program that he sold to a hedge fund that helped traders trade faster.
31:29
And made a lot of money. He went to Jackson Hole, met another very rich person
31:35
who managed a VC company, and they were both kind of sharing stories.
31:41
And my colleague, her sister died very young of breast cancer.
31:48
Her brother-in-law wanted to do something meaningful in memory of his deceased wife.
31:54
And her name was Beth. So that's where you get the B-E for Beth.
31:59
And the guy that they shared a private jet home from Jackson Hall back to Manhattan.
32:05
His mother just passed from multiple sclerosis.
32:08
So they decided, okay, we're going to name it after your deceased wife,
32:12
and it's going to be for multiple sclerosis in memory of your deceased mother.
32:17
And out came B-Care, this MS app. And so my headed colleague was like, oh, you're an MS.
32:24
Can you help facilitate this or give feedback and advice? And I said, sure, absolutely.
32:30
Myself and colleagues of mine at Weill Cornell in New York discussed how to
32:36
make it more relatable and fun for patients.
32:40
One of the things we realized, especially for patients with MS that are kind
32:44
of in that next stage, that secondary progressive stage where,
32:49
you know, they're not necessarily relapsing and getting better and worse and
32:53
getting better, but they're kind of on this downward trend.
32:55
It's hard to figure out when they're really declining or what they're declining from.
33:01
Could they be declining from poor diet and nutrition, lack of social engagement
33:05
or depression or poor sleep?
33:07
Or could they be declining because of their disease?
33:10
As a neurologist, I'm only seeing patients at most once every six months.
33:14
Some specialists for some patients that are traveling from far away,
33:18
they're only seeing their MS neurologist once a year.
33:20
You can imagine a lot happens in between those visits.
33:23
When the patient comes back and we say, how are you doing? More often than not,
33:27
we hear, oh, I feel fine. Or my memory is worse.
33:31
But that's not an objective measure. It's not really something that we can grasp.
33:36
By the time we really figure out if they're declining because of their disease, it's two years later.
33:42
And we wanted to help those patients speed up that diagnosis to then implement
33:48
treatment faster, especially now because so many MS medications are hitting the market.
33:53
Every six months, this is really a need to identify these patients that are
33:58
not doing well on their current medications that are worsening because they're diseased.
34:02
To pinpoint it sooner, to then initiate treatment earlier.
34:06
And then BeCare was born. And it's this fun app where patients are engaged and they play with it.
34:12
And I tell patients, you know, download it, do these tests weekly.
34:16
I have to tell them, don't give it to your kids because your kids are going
34:19
to want to play with it because it's so fun.
34:21
You know, like part of the app is actually last week they came out with the
34:26
Parkinson's version of it.
34:27
Part of it is like following a tiger with your finger through the forest and
34:31
then you drop the tiger off behind a bush and it gets harder.
34:34
So you have to trace it down the bush.
34:36
But a lot of these games are fun to play with and you can see your score,
34:40
but more importantly, your neurologist can see your score.
34:43
I use this to monitor patients in between visits and it's been fantastic.
34:48
It's fun and works really well. Back to the beginning, this was one of those moments.
34:52
She just happened to be sitting next to an MS specialist who also happens to
34:57
have the disease, who also happens to, you know, kind of when giving feedback
35:01
for these different features,
35:03
I was giving feedback as a patient, but also as a specialist.
35:08
So I think from those two aspects, it turned out really great.
35:12
Of course, I'm a little bit biased, but then we realized also now with the Alzheimer's
35:18
medications that hit the market, it's the same thing, that by the time somebody's
35:22
diagnosed with Alzheimer's, it's too late to go on one of these drugs.
35:25
They already have moderate to severe disease.
35:28
And Alzheimer's is something that the family member, even the patient knows
35:33
like, okay, I'm having more senior moments.
35:36
I just left my house, but I don't know where I'm going.
35:40
Or I'm in my car, or I came down to the kitchen. So for those listening,
35:44
I don't want you to think if this happens to you that you have Alzheimer's and
35:47
you have to run to your doctor.
35:48
Sometimes I go downstairs and I'm like, what did I want to get?
35:51
What am I here for? You open the refrigerator and it's like,
35:54
what was I looking for? What am I about to do?
35:57
Absolutely. Senior moments, mommy brain, same thing. I find that when seeing
36:02
doctors, I'm very lucky. my general practitioner.
36:05
I found her. I will follow her wherever she goes.
36:07
And she's available when you need to chat with her. If there's a question,
36:11
when my blood work comes in, she scheduled a telehealth call to go over everything.
36:16
Patients want that. People want that. They want to know that you're not just
36:20
being sent off with a medication and you'll be fine in seven days or I'll see you in six months.
36:25
Whereas something so much more personal when you're But that's something that is life-altering.
36:31
I think one of the things that changed with our generation is more self-advocacy,
36:37
that we are not scared to be advocates for ourself, especially when it comes to our healthcare.
36:43
I know so many people that have Apple Watches, and it provides that objective
36:48
measure that you can take to your physician and say, look at my heart rate.
36:52
I'm tracking my heart rate, and it's not normal.
36:55
So it's not just you saying, I feel like my heart's beating too fast.
37:00
Can you do something about it? And then at that point, as a doctor,
37:03
I'm like, but it's normal now. I don't know what I'm supposed to do.
37:07
It's the same thing with this. You go to the doctor and say.
37:10
Yes, I'm getting older. Sure, perimonopause.
37:14
But I feel like this is more than what it should be for my age.
37:18
And now you don't need a doctor or a script to download the app and it doesn't
37:23
cost anything. But you can download an app and you can now go to a doctor and
37:27
say, okay, it's not just in my head.
37:30
Over the past three months, six months, my cognition, my memory,
37:35
this one feature is getting worse. What can be done?
37:40
And as a provider, with that objective measure, I can actually do something
37:45
with that. Yeah, absolutely.
37:48
If I track my menstrual cycle, because I've been doing it for years,
37:51
and I'm usually very regular, I love the idea of being able to see that data,
37:56
just to know it's all the same, or how it's changed, gotten shorter, whatever.
37:59
And I can show my doctor that and say, hey, they are getting closer to,
38:03
yeah, you have to be concerned about this, or heart rate.
38:07
I agree with you. There's so many great tools that when presented to the right
38:10
person for analysis, it's really helpful. You get a little more answers.
38:16
And we are all so into not just how we're feeling emotionally,
38:20
but physically we're so aware.
38:23
And we're able to talk to a doctor about it without being afraid.
38:26
I don't think my parents or my husband's parents would walk into a doctor and
38:29
be like, I think this isn't right.
38:32
I think they'd go in and say, I don't feel good. And they just listen to the
38:36
doctor without saying anything else. But when we walk in the room,
38:38
my dad had heart failure and it was very, very bad. We thought we were going to lose him.
38:44
I go into the hospital, ask me all these questions. I just wanted to understand what was going on.
38:49
My mom was just so upset. It was hard for her to get the right answers.
38:53
But my sister and I would get on phone calls with all the doctors.
38:56
We might not understand the terminology, but we could understand what they were
38:59
saying and what he needed to do. Because when he got home, he was going to do
39:03
whatever he wanted to do.
39:04
So we were the ones to say, all right, this is what they told us.
39:08
Everything was laid out. I think it's our generation that has the ability to
39:12
kind of ask those questions and advocate for ourselves and for our loved ones at this point.
39:18
Yeah. And as, you know, somebody that has to deal with insurance,
39:22
like all physicians have to deal with,
39:25
having those objective measures also helps us get the right tests and the right
39:30
medications approved from insurance companies.
39:33
Because there's so many times that a patient coming in and saying,
39:36
I have this, but then documenting it is not enough to then say,
39:42
I need a brain MRI. It'll get denied over and over again.
39:45
But if I say, I have these metrics that translate into this,
39:49
now I want a brain MRI. It's a lot easier to get approved.
39:54
That's incredible that there's that. You have to fight that hard when,
39:57
you know as the doctor and the one who has
40:00
gone to all the schooling and the education and the experience to then be told
40:05
no that's that's incredible that's a whole other story yeah that i mean it could
40:12
be a whole other episode just about health care absolutely well it's about CoQ10.
40:19
Okay. If that is really something that helps the brain.
40:25
I can tell you that I treat a lot of patients with headache disorder.
40:32
Specifically, it's called new daily persistent headache where somebody has more
40:37
than 15 headache days a month that's been going on for more than three months.
40:41
And especially patients that are pregnant or trying to get pregnant,
40:46
they don't want to take something every day or every time they have a headache,
40:49
what I recommend for those patients is a combination of CoQ10 and magnesium.
40:54
And I used to think, oh, it's just over-the-counter supplements.
40:57
This can't possibly work. It does.
40:59
And I tell patients, you have to take it every day together,
41:02
both MAG and CoQ10, for at least four weeks before you'll notice any improvement.
41:08
But I'll see the patient back in six weeks. And sure enough,
41:11
they tell me, yeah, it really helped. It really reduced the severity and the
41:14
frequency of my headache.
41:16
So that's awesome. So what is one small habit that people can do every day to
41:21
help their own memory or brain health?
41:24
This is something that's easy that most people don't realize how important it is.
41:30
And especially now in 2025, spend the first 15 minutes every morning outside, direct sunlight. Okay.
41:40
So something that we're a little too into is our phone.
41:47
And I think one of the main problems with our society is sleep-wake cycle because
41:57
first thing you do in the morning is you pick up your phone and the last thing
42:00
you do before you go to bed is put down your phone.
42:03
In between, the amount of time that we're staring at a screen,
42:08
scrolling, reading, checking emails, or God knows what, is significant.
42:13
A lot of people have sleep issues, in addition to anxiety, depression,
42:18
insomnia, poor energy, daytime fatigue, everything under the sun.
42:24
If everyone, when you wake up in the morning, you don't lie in bed for another
42:28
10 minutes, you don't hit snooze 20 more times, but you go outside,
42:32
you don't jump right into your car or you don't immediately open the computer
42:36
because you're working from home.
42:37
15 minutes outside, drink your coffee outside, even take your phone,
42:43
take your phone with you and go outside, sit on the porch.
42:46
15 minutes, direct sunlight, resets your circadian rhythm, resets your cortisol level.
42:53
It gets everything basically back in track.
42:56
And I guarantee you do that for a week straight. You'll sleep better.
43:01
You'll leave better. You'll have more energy during the day.
43:04
So I love that. And I do that. I don't go outside. I need to add that to my
43:08
repertoire, just be outside.
43:10
I stopped looking at my phone first thing in the morning, beginning of the year.
43:14
I just said, I can't. I don't want to do it anymore. And it's changed my mornings.
43:18
It really has. I find I'm more focused. I have more ideas.
43:23
It's almost like you are just free to let it flow. Sometimes I'll meditate.
43:28
Sometimes I'll just sit. Or sometimes I'm just doing laundry, but it's not my phone.
43:32
I'm going to add those 15 minutes outside. I think that's a great idea.
43:35
I put the dog out. I might as well join him.
43:37
Absolutely. It's that direct sunlight exposure, that natural sunlight that changes
43:43
the sleep-wake cycle or the circadian rhythm, melatonin that's produced,
43:48
the cortisol that's produced.
43:50
Walk outside. Yeah. I'm doing it tomorrow when I wake up. I love that.
43:54
So at the end, I ask three questions.
43:56
The first question is, is there something that you've changed your mind about recently?
44:02
I'm in my 40s, and the more life I've lived and the more experience I have,
44:09
the less I know, the less I'm sure about certain things.
44:14
One of the reasons that I love my field is because I consider myself a forever student.
44:21
Neuroimmunology is something that's always growing. We're always learning new things.
44:24
We're always finding out about new receptors and antibodies and diseases.
44:29
And I love that about my field. But I also find that about my life that,
44:35
you know, I have two kids and I used to think I knew what was best.
44:39
And I don't know if you felt about this or I'm sure a lot of moms out there
44:42
feel this about the oldest one.
44:44
Like, oh, gosh, really screwed up with that. The first one's the guinea pig.
44:47
I don't think we should have sent him to that school or that camp or let him watch that TV show.
44:53
But he's amazing. And despite all the screw ups, he turned out to be a pretty
44:58
amazing kid. But even with that, the more I learn and the more I experience,
45:04
the less I know and the less I'm sure about different things.
45:08
I think it's important, not just for me, but in general, for us to wake up every
45:13
day and go into every experience with an open mind and open ears.
45:17
Is there something on your bucket list?
45:20
Interesting, different, you've been wanting to do?
45:24
Last year, I went to China. I was only there for a few days.
45:29
I was giving lectures and speaking at a conference.
45:32
And I had no idea. I thought I somewhat understood people, culture,
45:39
environment, politics.
45:42
And this was never on my bucket list. And now it definitely is.
45:45
But I need to go back and I spent like a month there just traveling the country
45:50
because no two cities are the same.
45:54
It was just this incredible experience.
45:56
I definitely need to go back. My husband lived there for six months.
46:01
He did an immersion between grad school and moving into the city and working.
46:05
He went to China because he was like, I want to learn Mandarin. Okay.
46:10
And he lived there. He didn't hear his name for six months. He had a Chinese
46:14
name. and it's just like so eye-opening.
46:18
Yeah. He's a traveler though. He lived in France and he loves to travel and
46:24
experience different cultures and everything, which is wonderful.
46:26
He really loved China. Both of my parents are European and most of my family
46:30
doesn't live in America.
46:32
We travel a lot all the time.
46:35
I did that since I was a kid, but I've never experienced anything like China.
46:40
The culture, the food, the experience, everyone
46:44
kept trying to touch my face they were like what do you put
46:46
on it and i'm like what do you mean what do i put on it they're like how do
46:49
you look so young and i'm like i don't look young
46:52
but thanks and they're like what kind of shark skin
46:55
and i'm like no shark but now i kind of want to get some shark you all look
47:00
like you're 16 years old so whatever shark part you're putting on your face
47:04
can i get some of that i mean this is just botox you know right that's right
47:08
i'm like But if shark is better, like I'll get some of that, you know?
47:12
The last question is, is there one piece of advice that you would give your younger self?
47:18
Yeah, that it's all going to be okay. I can't tell you how many times,
47:22
how many forks in the road or what I thought were dead end.
47:26
We spoke about my diagnosis with MS, second year of medical school.
47:30
I thought that's it. It's not just my career is over. My schooling's over. My life is over.
47:34
I'm going to be in a wheelchair. What's the point of doing anything?
47:36
I wish that was the only hardship I went through.
47:40
There have been many instances exactly like that.
47:43
If I knew what would become of the difficulties I went through,
47:50
I could have saved myself a lot of tears.
47:55
That's great advice. Thank you so much, Dr. Sol, for being on this podcast.
47:59
I'm so grateful that you came on and chatted with me today.
48:02
And I think we have more we can chat about. Thank you so much for having me.
48:06
And I'm so glad Mary set this up.
48:08
Thank you, Mary. Yeah. All right. Thank you.
48:12
Thank you so much for joining me today on She's Smart. New episodes drop every Thursday.
48:17
Don't forget to subscribe and share. Stay cozy.