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Guest: Dr. Micheal Lentz

Release Date: 10/6/2022

Welcome to Trulyfit the online fitness marketplace connecting pros and clients through unique fitness business software.

Steve Washuta: Welcome to truly fit. Welcome to the show effect podcast where we interview experts in fitness and health to expand our wisdom and wealth.

I am your host, Steve Washuta, co founder of truly fit and author of fitness business 101.

On today’s episode, I speak with Dr. Michael Lenz about fibromyalgia. He is a board certified pediatrician and internal medicine physician. And he is a expert in fibromyalgia, he wrote a book called conquering fibromyalgia and his podcast also has the same name. So I implore you to go check that out if you’re interested in this conversation. First, we discuss the definition of fibromyalgia from a clinical perspective and anything that he has to add to it, we go over common signs and symptoms, how most PCPs deal with this, the difference between this and let’s say autoimmune diseases, or rheumatic issues, as personal trainers, who have clients that might bring in a health history form that says they have FM, how exactly do we go about handling this, he gives great insights into this.

And a host of other things we talked about surrounding fibromyalgia, it was a great conversation. This next piece should not deter you from listening here. So I’m a little bit lower than Dr. Lens. But that doesn’t matter. Because he’s the featured guest. I’m just the interviewer throwing out a few questions. He does the vast majority of the speaking and it was great. I hope to have him on again down the road to maybe dive into other specifics around FM. With no further ado, here’s Dr. Michael Lentz. Dr. Michael Lynch, thank you so much for joining the truly fit podcast, why don’t you give my audience and the listeners a little background on you, and what you do in the medical field?

Dr. Micheal Lentz: Well, thanks for having me. So eager to get this finally set up after a couple of rescheduling. But I’m a doctor, I am a internal medicine doctor and a pediatrician. I’ve been a doctor for over 26 years. And then I got extra training in something called Clinical that pathology has to do with heart attack prevention and cholesterol management. And then also have been interested in lifestyle medicine and got certified in lifestyle medicine a couple years ago, that is the blending the best of both exercise, sleep, diet, all of those other things that are so important in battling things like we’re talking about today with fibromyalgia.

So I get a chance to see the whole age spectrum through from babies through adults and all that range. And just as a background, as far as truly fit goes, I love exercise, I do a lot of exercise on a regular basis for myself, I enjoy it. I think it’s not only good self care for myself, but so many for others. So I highly encourage that.

Steve Washuta: Yeah, and there’s a lot we could talk about just for that introduction there, you being involved in sort of lifestyle medicine, and, you know, fusing that with your practice. As a pediatrician, my wife is also a pediatrician. So I know how difficult it is to do your job you have somebody come in at any given time, and I know you’re a specialist, but still they typically come in and they might have three or four or five issues. You have a 15 to 20 minute span to solve all of those issues, and then move on.

That’s that’s very difficult. And we I admire that somebody in my industry who doesn’t have that, right. We there’s no regulation, I could spend three hours with a client if I want to. So So that is certainly difficult. But we’re here today to mostly talk about fibromyalgia, can you give a clinical definition of fibromyalgia and then a slight caveat on that is secondarily is there’s something missing from that definition that you would like people to know that’s very important.

Dr. Micheal Lentz: So at a basic level, Fibromyalgia is a combination of three core symptoms. One is chronic diffuse pain in multiple areas in the body, and that can wax and wane in intensity, and locations. There also is significant amount of fatigue, and there’s also brain fog. There’s a lot of other symptoms associated with it. But those are at the core. Brain fog are problems with concentration, focus, staying on task just to name a few, and fatigue and these are all going on typically for at least three to six months. And you’ve had a clinical evaluation with a physical exam and history trying to rule out some obvious causes like thyroid disease, inflammatory conditions, cancer, you know if somebody’s fatigued, and they’ve lost unexplained 30 pounds and they’re having symptoms of cancer, obviously, that’s a separate story.

But you might also have and these are some of the newer definitions is that you might have rheumatoid arthritis, about 40% of rheumatoid arthritis. Patients have fibromyalgia so it’s used to be well if you had rheumatoid you can have the others it’s one or the other and it’s there’s a lot of comorbidity or things that occur together. And under the umbrella of fibromyalgia or a lot of other we call regional pain syndromes. So those include things like painful periods, migraine headaches, tension headaches, chronic neck pain, back pain, irritable bowel syndrome, irritable bladder, chronic pelvic pain, there’s a lot of other areas kind of labeled regional pain.

And often they may start that way. You know, as a pediatrician, I might see a child where see somebody who when they were in childhood and may see children with this up parents who have fibromyalgia who start with chronic abdominal pain might have had growing pains, which we now understand maybe restless leg and then as they get through puberty, girls made felt very painful periods out of proportion to their friends, and you might start getting migraine headaches, and then a neck pain then progressed into multiple areas in more than one area, and then maybe then meet kind of the official criteria for the diagnosis of fibromyalgia which which we could talk about, how do you make the diagnosis.

Steve Washuta: Well, I do want to get into that. But first, I want to take a step back, you said a word that’s very particular to your industry, the jargon of the medical landscape is an umbrella term. So you’re saying that this is an umbrella term, meaning you could potentially tell me if I’m wrong, see, 10 clients, patients, sorry, different business 10 patients in a day. And those patients all have fibromyalgia, but they’re all presenting differently, with potentially with with different sinuses and different weaknesses, because they don’t, they’re not, they don’t all have the same sort of clinical issues. Although it’s falls under the umbrella of fibromyalgia.

Dr. Lentz: You know, it’s very interesting. I just saw a patient yesterday who her primary symptom was hip pain. Now looking back, she’s had this for about three, four years, she’s been to a doctor, different doctors, ortho physical medicine, rehab chiropractors, and it’s persisted. What’s funny, she came in, I want to see you doctor lens again and want to get your opinion. And it turned out, she had fibromyalgia. But she her complaint was her left hip was hurting. But she also had chronic neck pain. She had chronic shoulder pain or back was hurting.

Yeah, and she has irritable bowel syndrome. But she didn’t volunteer that because, well, that’s just my normal. And I often kind of compare it to, you know, you’re a teacher with 30 kids in your classroom, and maybe five or six of them are naughty. Well, there’s one really naughty one, so that one gets in trouble. But there’s other four or five ones and they get, they never get in trouble. It’s not fair to that one really naughty kid who always gets all the attention. But often, you have to ask those questions.

And I often, you know, I had to phrase it ahead of time by saying, Okay, if you have any soreness or achiness, or discomfort, because if you if they, I think they realized after a while, if they told somebody everywhere they hurt, the doctor would think well, there’s nothing wrong, and they often have normalized, being sore. So if that is helpful, and with that, so they may present one may be hip pain, one might be neck pain, one may come in with terrible abdominal pain, they might see a neurologist and complain of migraine headaches and see a different doctor for the chronic back pain or their hip pain. And no, and may not volunteer all those information to the individual specialists. And when you ask the right questions, you can often find that so it’s very interesting.

Steve Washuta: yeah, my wife calls it what else? She just says, what else? What else? What else until they have nothing else to say, and we deal with that my industry, we have a, you know, what’s called basically like an intake form, we all use a little bit different intake form, but unless you sit down and have the conversation with them, like I had an instance I tell about this podcast all the time, where I said, Do you have any injuries?

Do you have any past medical things bla bla, and took the intake form, and I was working with this client for a full month before they had mentioned in casual conversation that they had heard or had a heart attack, but they didn’t see heart attack fitting into injuries and medical issues, right, because it was that they looked otherwise. But I also think there’s an there’s an amnesia aspect where we forget about the things that we’re dealing with. So that’s why we don’t talk about them, if that makes sense. So, for instance, I have a really bad finger injury.

But I’ve just I’ve come to live with it. And I forget that I have it. I don’t even think to mention it when someone says like, Hey, do you have any like serious injuries? No, I say no, that’s the first thing I say. I think there is a sort of a people aren’t hiding it. But like you said, it was just a regular occurrence. And this girl’s day to day life where she didn’t think to mention it because it wasn’t out of nowhere. It wasn’t out of left field, it wasn’t a new issue.

Dr. Micheal Lentz: And it wasn’t as disruptive in her mind as this left hip pain. And there was probably a mechanical component, maybe 20%. But they had done MRI, special MRI testing and all of these imaging and he still couldn’t find anything. There might have been a labrum that might have been off slightly but probably 80% of the pain is a Fibromyalgia component.

The other reason that I think sometimes people don’t want to bring up a lot of these is because there’s a stigma and they don’t want to be perceived as a hypochondriac, as a somebody who’s whining and complaining about everything hurting because they’ve had it so long that they’ve normalized that their abnormal symptoms are They’re kind of normal. And there’s a lot of masking that goes on to hide that.

So I think part of it if people who are listening who are working one on one for rehab is to normalize that. That’s part of what my goal is with the book in the podcast. Often I like to say, you know, you’re not that special jokingly, after I, you know, to say there’s a lot of people who are struggling with this. There’s a lot of athletes who actually, I am Kevin a podcast that I’m going to be editing, it’ll be out probably in a couple of weeks with a patient man, he was an athlete, and he was told he had chronic Lyme. It turned out he had really fibromyalgia and he had eight years of struggle.

He was a former athlete and the where he was at this point in time, was a lot of he was extremely, a lot of pain, fatigue, brain fog. But that’s not how he was he was a three sport athlete, and played up into college and then getting into life and struggles, different things that set it off, in his case was a viral type infection and then not exercising, often a lot of things start to unravel. And can kind of unmask somebody’s predisposition to fibromyalgia.

Steve Washuta: I’m sure this is very nuanced, but feel free to, you know, go go down the rabbit hole here. How does someone like you over let’s say, a regular PCP who doesn’t have the background in this diagnose Fibromyalgia over rheumatoid arthritis over lines to see some of these things that have a lot of things that crossover with one another where some of these symptoms can be seen, and and in all three of these?

Dr. Micheal Lentz: Sure. So one is rheumatoid arthritis is a unique clinical inflammatory condition. And you can make diagnoses of that. And I’ve had a number of patients who have both, they can have both of those, and sometimes, we’re the rheumatologist boy, we’re trying these different medications and you’re plateauing. But they haven’t really also addressed the fibromyalgia component. So you can have both. And there’s diagnostic criteria for making both the Lyme disease series that I’m in the middle of now is there as acute Lyme.

And then there’s these post Lyme treatment of post Lyme Disease Treatment syndrome, which falls under the umbrella of what we’re learning about long haul COVID, that you have persistence of symptoms in, in, in my mind, it’s similar to how you can have a whiplash and that whiplash for you. If you don’t have a predisposition, the Fibro gets better in a week or so. And then somebody that might be the trigger that causes persistent long term pain, often, if you see somebody they may say, I was fine, but then I got in that car accident at age 25.

And I’ve never been the same. What they don’t tell you is, I used to be working out every day for two hours. And then I got the whiplash and oh, yeah, I was going through a new job, and I didn’t have time, and then I was stressed, and I never got back to exercising.

And that whatever gets them off, they’re consistent. Self Care of great exercise, stress, good sleep, all of those can get off level, but they may not identify that. So getting back from regular PCP to myself, is just having that awareness. And looking forward and making sure you ask the right questions, but it’s tricky. Because there’s a lot of coexisting things that are going on and and then in the middle of this, somebody could get colon cancer or could get Metis breast cancer or could get rheumatoid arthritis conditions on top of this that are separate but happen, you know, people with migraine headaches could develop a brain tumor, right?

Steve Washuta: For example, correct and correct me if I’m wrong, something like rheumatoid arthritis, there is lab work, there are specific thick markers that a physician can see. Yes, that would lead them to believe that someone has rheumatoid arthritis and fiber miles but that’s not the case.

Dr. Micheal Lentz: Fibromyalgia is not the case. But I would compare it to similar to diagnosing a migraine headache. There. Most people are aware of migraine headaches. And if you’re around people who’ve been through that, you can say it’s episodic, severe pain in the head with light sound sensitivity, typical with or without an aura. And then they’re relatively better in between, they might have some mild tension headaches, versus a brain tumor doesn’t just come and go once a month, round your period or a couple of times a week and you have that clinical diagnosis. We don’t have a blood test for migraine headaches.

We don’t have an MRI for migraine headaches. But people commonly accept Oh, that’s a real thing. We have the same kind of criteria for diagnosing it’s called the widespread pain index and the symptom severity score in combination with the clinical exam and history that we use to help make that diagnosis. So similar to how we make migraine headaches or an irritable bowel syndrome diagnosis. And part of again, my goal too has helped to take that stigma away. Often people feel like well My doctor made this diagnosis because they couldn’t find anything else wrong. So it’s sort of made up and it’s not real. And my point is the title of my book called conquering your fibromyalgia, real answers in real solutions for real pain.

This is 100% real. What we do know from research through functional MRIs is that looking at blood flow in different parts of the brain, there are differences in how people process the pain, we do know that one simple study, an example of this is they had a machine that would apply, increasing gradually increasing pressure to your thumbnail. You had two groups, one didn’t have fiber and the other did.

You said, Okay, tell me when you have pain that’s moderate, we need to stop right. At the same time, they were looking at blood flow to the brain, and looked at different parts of the brain, it turned out that people with fibromyalgia reported pain, and half the threshold of pressure compared to the normal people. So, but the same parts of the brain were activated, but it was at a lower threshold. So we both have a sensitivity, eventually, a pain is protective, right?

If you push hard enough on your thumb, you could cause damage, but their level of pain was at lower levels, the same thing happens with light sensitivity, people with on that Fibromyalgia continuum will be much more light sensitive, put in a dark room gradually increase the lumen, the light intensity, until it’s uncomfortable. Same thing with doing that with sound, you hit that threshold. And that’s interesting, because you have people with fibromyalgia may not want to work out with the loud music blasting, they might be going that want to come and they’re like what’s matter. And that may come across as well, that’s I have high energy I want we want to get people pumped up.

But it might be too many lights, too much noise for them. They often like the lights low, I walk into my exam room, I have some windows and I’ll have shades, I often turn the lights off, and they just the body relaxes. They’ve done another study with irritable bowel syndrome will they’ll put a balloon in the colon, they’ll dilate the colon with gradually increasing pressure. Also looking at where the blood flow in the brain is.

And the people who are in that IBS spectrum, which fall under that central nervous system sensitivity will report pain at a significantly lower threshold of pressure than somebody who doesn’t have so in other words, they don’t tolerate as much stretching. So that’s often when you hear people go, Oh, do you have gas pain, we all have gas in our intestines, but they report pain at less lower pressure. So these are real symptoms with real pain. It’s not just an imaginary thing is how the central nervous system, the brain, the brainstem and the spinal cord are processing those.

And there’s a lot of factors that go into that from genetics. It’s kind of like having a volume control on a pain amplifier, there’s things that can turn it up or down. There’s, we call ascending pain pathways, things that increase pain sensitivity, and then there’s descending pathways that act as a brake on it. Exercise. And speaking of the podcasts, exercise, helps turn down that volume. And we can talk about ideas with specific exercise and things to know working with trainers because I think it’s such an important part of their getting better both healing and then maintaining their health exercise is really important. But there are some nuances with fibromyalgia, if you want to talk about those would be happier.

Steve Washuta: Let’s, let’s quickly bookmark that that’s going to be the next question. I do want to go down that rabbit hole of not only exercise, but other lifestyle things because I thought it was interesting that you said turning the lights down and things of that nature, just whether it’s anecdotal things that you notice or otherwise. But I want to go to one other question because you’ve said this three or four times in the podcast, you you’ve already mentioned that this pain is real. And I’ve noticed that there are some patients through my, you know, two hours of reading about this, who gets sent to psych, who have fibromyalgia, do you think this is the wrong thing to do? Do you think this is what they should do sometimes? Is this just bad practice? What is your thoughts on that?

Dr. Lentz: Oh, that’s a good one question. So it’s a little bit irritating. When you look at there’s a symptom severity testing that I do called the fibromyalgia impact questionnaire, revised form. One of the questions there’s a lot of nuances zero to 10 questions that you’ll ask, like, how much does this bother you? And one of them is from zero, not at all to 10 very high. how depressed Are you? And most of my patients actually aren’t depressed, but they are highly frustrated. So a lot of times it’s very insulting to them saying Oh, you’re just depressed.

Well, I’m frustrated because I’m in pain. I’m in fatigue, and I’m frustrated that the medical community keeps brushing me off episode, my podcast called it’s not my thyroid to get a new doctor. I will check your thyroid, which is get some labs gets you out the clinic will come back and you’ll get a call that you’re normal, you’re fine, there’s nothing wrong. Oh, you’re so stressed out with that. Now, I will say that talking with a therapist and kind of a coaching and that’s where getting that coaching, empathetic coaching, but and there might be stress going on.

You know, a lot of people who have fibromyalgia have had traumatic life experiences of various types, PTSD activities, and working on helping get through that. There are often some comorbid issues that go along about half of people who have fibromyalgia have ADHD. Some psychiatrists make the diagnosis. A lot of times pediatricians do. That’s where I’ve been able working both as a pediatrician and an internecine adults, it’s something that does occur more often. So I will often screen for that as well and get that identified. But so that is not a routine thing I do for referring to psychiatry. But I do routinely screen also for depression.

And looking at anxiety and also looking at the whole person, I do get a chance to at times, and I always like to have my fibromyalgia patients, especially new ones, be my last patient of the day and get to spend two, three hours with them, or have them come back because I want to make sure I get their whole story. Often I tell people who are coming to see me and I’ve had a recent patient have found me because their daughter was struggling with the symptoms. Then she read and was listening to the podcast. She’s like, wow, I am pretty sure I have this. Then I realized my mom who was diagnosed as having quote, arthritis, and in her 40s, which is pretty young for wear and tear arthritis. Unless you’re severely obese.

That was actually probably Fibromyalgia the whole time. So she’s reading through that. Getting that information. She came in. I said on a podcast, write down your whole story. It started with Well, when I was in childhood, I remember going to the school nurse and having stomach pain, my periods were horrendous. Putting that whole chronological timeline, I went through a divorce such and such time.

That was when I could tell my you know, there was a lot more stressed a lot of those just laying that out writing that story out is helpful. I wished in the world there were more Fibromyalgia type coaches who were able to help work with that. But if you’re working as a trainer, having you do a lot, it’s probably like going to the banker and you’re getting your hair cut. Sometimes we talk about a lot of intimate things in life and having that empathetic tone of understanding that. Sometimes I think people may feel that people that care if people are in the caring fields, whether it’s training or medical field of some kind, may feel that they’re being dismissed, like oh, here’s this crazy person hypochondriac making up this thing’s Oh, she’s just so stressed.

Gosh, she’s every time she comes in, she’s stressed but legitimizing that, that what they have is real. And while that’s an impact, and can amplify pain, and it’s kind of how their brain somewhat is wired to be much more sensitive.

Steve Washuta: Yeah, that’s the personal side to personal training. And we have to work with our clients on a day to day basis, listen to them, and adjust accordingly. I have you know, I wrote a book fitness business one on one with the certifications don’t teach you and one of the things I talked about is the update phase. And this gets into my next question here. So as let’s go ahead and say, You are my client, Michael comes in, and it’s 4pm. And I say How you feeling today, Michael?

What did you do yesterday? How did you feel from the last workout? Did you sleep? Well, when’s the last time you ate? Did you drink water today? How’s everything going in your life, because I want to make sure that both mentally, psychologically, and physically, you’re ready for this particular workout. Because if you’re not, maybe you’re having a bad day to say, You know what, Michael loves to box, and I had a really difficult leg workout for him. He hates legs, might he had a really bad day, he had a tough day clinic. So today, we’re just going to box because he needs a light day, we need to be able to adjust on the fly.

I talk about that a lot. So let’s give a little bit of an example here. Let’s say I have a client who has fibromyalgia. And it’s just the if let’s go ahead and call it standard Fibromyalgia where they have fatigue, they have full body soreness here and there sort of unexplained, and maybe a few of the other, you know, sort of standard symptoms. What am I looking out for on a day to day basis in my checking phase before I give them their workout?

Dr. Micheal Lentz: So I’m thinking of somebody who often is pretty low on their activity level. Now, not to make generalizations. But often if I’m referring somebody, if they were starting, they’re starting pretty low and recognizing where they’re at and how quickly they can accelerate is going to be start low. Go slow. From gentle stretching to doing some slow movement, core lighter movements, trying to also encourage them to pace themselves, it’s going to be much harder for them to quickly ramp up. So talking about Power Strength. It’s like, how are we doing? What are some goals outside of this as well, but steps and pacing yourself.

So I will often have as a simple measure, you know, these activity counters, how many steps are you getting, and then for many people with fibromyalgia is they sabotage their efforts, because you look at their step counter, and one day, they might get 7000, at a high level, which there’s many clients of yours might be getting 30,000 steps a day, but that might be high for them.

And then on other days, they only get 500. And what happens is when they overdo it, which for them might be 7000 steps, and hard workout, they feel really sore, extra sore, the next day, post exertional, fatigue beyond, and then they overdo it, then they don’t do anything. So part of it is is trying to be consistent, and pacing, and doing maybe a full body workout, but light or in general and then gradually build up their activity over time and recognize this might be is to not have them overdo it.

And then having those check ins How are you doing with your steps throughout the day? How was your activity in between, and having that coaching and probably much more laying out plans in between of just general being active and it’s depending on where everybody’s at. They Adam, who had the chronic, was told he had chronic Lyme, but he had actually Fibromyalgia he just before we met, he was pushing super hard. He had support from his family.

And he really just on his own really pushed hard with working out and push through that pain. He’s an exception. Most people get highly frustrated and actually are sometimes insulted. If they say it, we just got to push through the pain and not being empathetic to say, Okay, wait, this is somebody who can get better, but it’s gonna be much slower than somebody who has not prone to this and just needs to get in the shape, you know that?

You know, you want to get them better quicker, but you don’t want to lose them to it’s and it’s often that importance of consistency. The other thing is you talked about how’s your sleep? We got to keep consistency. How’s your schedule? Are you eating consistently in healthy and good ways? All of that which you are talking about? As you know, it’s not just the exercise? The are those other lifestyle factors that are so important?

Steve Washuta: Yeah, that’s great information too. And, you know, a lot of the cues that we take. Or right on spot from our clients. Meaning I can see if they’re breathing heavy. I can tell if they’re struggling with the last few repetitions that you centric or concentric motion. Is it slowing down? Are they changing body positions? Are they sort of relaxing, what’s going on there? And then and that gives us an idea of if they’re struggling with the exercise. But if somebody has fibromyalgia. They we have to worry about the next day sort of delayed onset muscle soreness.

And two days later, all these things that could potentially happen from the workout. So we’re not trying to work to failure. We’re not trying to get them to the point. Always where there is a struggle. It’s more about movement, and assessing what went on in that session. In that next session to see, okay, we you seem to be a little bit sore from from that. We’re going to dial it back down, we’re gonna take it back down to steps. Then we’ll sort of repurpose everything. We’ll go from there. Because a lot of trainers take their cues only on site. And they’re not thinking about how that how’s that client gonna feel the next day. And especially with someone with fibromyalgia. They’re more likely to feel that delayed onset muscle soreness.

Dr. Micheal Lentz: Correct. So I think for people we’re gonna say people working with, if you can get them gradually up. And get at that level, then helping them maintain that that’s so important. There are people who don’t hurt whether or not they exercise or not. If they don’t work out for a week, that doesn’t hurt. But people who are have fibromyalgia. When they are doing the best, they’re at a higher than average level of activity. They’re stresses in a very tolerable range.

And they’re eating a very healthy diet with lots of whole fruits and vegetables and whole grains and legumes. And they need to do that consistently. But when somebody’s struggling for years. And then you help them get better, it’s so rewarding. Because for myself and for people working with training. Just having that patient like hope that we can get through this. We can help you get better and when they get better maintaining that.

Steve Washuta: Yeah, adherence and consistency, or why diets work or why fitness works. That’s that is what that is what changes people’s lives. It’s not one special diet. It’s not one special modality and fitness, not CrossFit, not powerlifting, not keto, its adherence and its consistency. And that’s, that’s something we preach on this podcast. Let’s end on a hope on a good note here. What, if anything, are you hopeful for in the ways of new studies. And new medications, and new procedures in the landscape for fibromyalgia?

Dr. Micheal Lentz: I think it’s understanding and education are so important. Because it’s so complicated, there isn’t likely going to be this magic medicine that comes out. It’s understanding the integration of all of these important things. As I say, in the podcasts, I’m trying to bend blend the best of medical management and lifestyle medicine. And those are so important. Unfortunately, that is not something that’s well taught in medical school. It’s not taught in for doctors, and it’s easy to cure somebody with an antibiotic.

To cure somebody or control or the fibromyalgia symptoms. It’s a combination of a lot of different factors that have to be working together. Using analogy, sports analogy, talking football. You have to have 11 players working perfectly. That’s to get a five yard gain. Now we have to do that 20 times more to get from the 20 yard line for a touchdown. Then you could have one thing that’s off.

You got up too early for a flight, you got to sick. And now you’re gonna sack and now you have having to regain that ground. So working together, in most of the interventions in fibromyalgia. Using another sports analogy with most a lot of people used to do in sports. Or we’re probably in the training world, in baseball. Most of the interventions are singles, occasionally doubles. We rarely get triples or homeruns. And it’s all it’s partial intervention.

You know, I had a patient I just saw today, he’s like, Oh, I tried this medicine. AtI only well didn’t help completely, it didn’t take away the pain. I said, you know that it’s not going to nothing one thing, I really tried to push it hard, and I really pushed it, I really took the dog for a walk and I did all this exercise. I’m like, you know, I never told you to give it your all until you collapse.

That’s not he’s like, but sometimes you have to just constantly re educate with my own patients. And that’s part of why I started the podcast and wrote the book. Is because I needed, I could not explain in 20 minutes, all of these factors, you know. I don’t, you know, it’s so many different things. And hopefully, as trainers listen as a resources. Whether the book of the podcast. They want to learn more to help their clients that are going through this. And for people who know people who have fibromyalgia, their loved ones who don’t get it. To go, Okay, I understand this better. And, hopefully, work. I think a lot of times when people have fibromyalgia, and there aren’t the traditional medicine doesn’t give good answers. Then they’re much more susceptible to alternative medicine.

Without good evidence based results. Putting them at risk of being prey for maybe taking money from them. And offering just hope that’s not real hope, you know, offering. You know 1000s of dollars of supplements and testing every month and leaving them with just placebo effects. So it’s frustrating, but actually, it’s kind of one of these things, it’s become one of my favorite patients. Because when somebody has been struggling for so long to help them get better. is so rewarding.

Steve Washuta: Yeah, and well put in the you know, this or the educational management is in itself a technology. It’s we don’t just need medicine, we need education in the management. And if we advance in that area. It seems like we’ll be doing more than enough hitting enough singles and doubles to that 400. To give another sports analogy here. What Why don’t you let my listeners Dr. Michael know where they can find you where they can find your book. Where they can find your podcasts and anything else that you want to pitch here.

Dr. Micheal Lentz: So you can the podcast is called conquering your fibromyalgia. The book is called conquering your fibromyalgia, real answers in real solutions for real pain. That’s available on Amazon, you can order it through your local bookstore. I have a website called conquering your fibromyalgia with some blogs.

So a few things that are trying to get that out. I might do some other social media down the road a little more. And I’m going to be at through the fibromyalgia care conference. I’ll be speaking about sleep on the topic of sleeping in November 5. So and if you ever have any questions from this podcast, you can email me at Dr. Michael lens@gmail.com I love answering any questions. There’s so much more to cover and, and like I say on the podcast. There’s a lot of different episodes that try to take take a deeper dive off and my patients.

I will say, you know, listen to this. I had a patient recent patient of mine who listened to all 62 episodes at the time in two weeks. From seeing me and she’s like I said, I think you have this. Her mom had seen me five years ago didn’t believe Leave me. So she didn’t come again. It was taken her history and she’s listened. She’s like, Oh, my mom totally has the same thing I have, she needs to come back to you. But people don’t like being told these kinds of things.

They don’t like these answers that are complicated, so to speak. But anyways, but it was, again, thank you so much for having me on the podcast. And it will have to have you on my podcast talking about the things that when it comes to training. Getting, how to work with them. I’d love to have you on to get some good tips for them as well.

Steve Washuta: I would love to do it. My guest today is Dr. Michael Lentz. Thank you so much for joining the tour with the podcast. Thank you.

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