 Okay. Hey everybody. I am so excited today on another episode of Dr. Jill Live to have my friend and colleague Dr. Terry Walls. Many of you have heard her story and if you haven't today you are in for an incredible treat. She has a story of recovery similar to mine from illness that is we always say irreversible and yet both her and I have evidence that auto immunity can be reversible in the right circumstances. So I am so excited for her to tell you her story today. Just a little background if you want to hear other episodes you can find me on YouTube on my channel on iTunes or anywhere you listen to podcast under Dr. Jill Live. Dr. Terry Walls, welcome today. I am so excited to have you here with me. Oh, thank you for having me. You're welcome. So just a brief introduction. Dr. Terry Walls is an Institute of Functional Medicine Certified Practitioner and Clinical Professor of Medicine at the University of Iowa where she conducts clinical trials in the setting of MS or multiple sclerosis. In 2018 she was awarded the Institute of Functional Medicine's Linus Pauling Award for her contributions in research, clinical care and patient advocacy. She is the author of The Walls Protocol, a radical new way to treat all chronic autoimmune conditions using paleo principles and the new cookbook, The Walls Protocol Cooking for Life. If you're listening to this on iTunes or YouTube or Facebook, I will be sure and include those links there. Learn more about the current study. We're going to be talking about this, efficacy of diet on quality of life in MS at, I will leave that link. It's walls, w-a-h-l-s dot lab dot u-i-o-w-a dot edu and pick up the one page handout for The Walls Protocol on her website, terrywalls.com slash diet. And again, I will be including these links wherever you're listening, so don't worry if you're missing them. You'll find them in the show notes and everything else. Dr. Teri Walls, welcome. And I'd love to start in your story of before you've got diagnosed, how did you get into medicine? And then we'll go into the journey of what happened after that. Well, you know, I'm a farm kid. So I grew up on a farm. I was outside. I thought I wanted to be an artist. So I did art school, a lot of oil painting, metallurgy. Then I decided I didn't want to starve. So I was going to go be a vet. And along the way, I ended up deciding to go to medical school. And, you know, I was so thrilled to be in gross anatomy. So I probably have three times the formaldehyde exposure to my classmates because I'd go back to the gross lab, unwrap the cadavers, and I'd draw them and draw them and draw them. So I have these beautiful notebooks. And then I end up during medical school, I start getting my trigeminal neuralgia. And that's where my symptoms first begin. Wow. So it was in, so you and I, I had no idea. I grew up on a farm as well. And I did not want to go into medicine. I thought some other, I mean, some other healing profession, but it's very interesting how we were drawn to this. And then in medical schools, when I got cancer, so not this isn't about me today, but I can so relate to your story and how that kind of happened. And so interestingly, I just wonder too, I think that there were things on the farm exposure. Atrazine. Right. Okay. New York has me too, right? Atrazine in the farm well, yes. Yeah. And I look at, I'll tell you what, I remember 10 years after my breast cancer diagnosis, I looked at the map of Atrazine in Iowa and Illinois are like the most heavily used and it's banned in the EU. It's still used in the US today and it's a massive endocrine and toxic disruptor. So interestingly, we have that similarity too. So, so, so we have the atrazine. I'm an artist. So I did oil painting. I started in middle school in high school. So cadmium, orange. Yes. Mercury, red, lead, red. And so I'm getting heavy metals and the solvents. And then I do metallurgy. So more lead. And then I get formaldehyde. So, so I'm diffusely toxic. And then I decide to be a rebellious teenager and I quit eating meat. And so, yeah, become a vegetarian. I go to medical school, very low fat diet, because, you know, that's what I should do. And now I'm taught to be afraid of the sun. So I put on sunscreen. And of course, instead of being outside, getting a dark tan, I'm inside. And I'm not getting as much vitamin D. I'm not getting, you know, I did manage to maintain my exercise. And I was jump roping and doing push-ups, doing a lot of exercise during medical school. So at least I kept that up. But certainly my vitamin D plummeted. My stress level went through the roof. And my toxic exposure was continuing to climb. Wow. Again, so my similarities when I was 14, I was like, I don't want to eat meat anymore. Teenager, rebellious teenager. And I always joke, because then at 25 when I got cancer, I was like, it almost killed me being a vegetarian for me, because I was severely B12 deficient. I was celiac, so I was eating all this gluten-grain filled Yeah, same process. So I like, so there are so many similarities. So when were you formally diagnosed and how did that actually? So it's in 2000. And that's when I developed leg weakness. And, you know, I go to see the neurologist who says, you know, Terry, this could be bad or really, really bad. And I'm going to send you down to get an MRI tonight to decide if you need to be admitted. So I called Jackie to say, you got to pick up the kids because I'm going to get an MRI. And I think I may be getting admitted. So, you know, I'm laying in the scanner thinking about bad and really, really bad. And I'm thinking about the fact that I've already had 20 years of worsening electrical face pains. And I also think about my father's worsening pains in health of the legs that he had had this, you know, intense electrical pain. They developed a weakness that which was diagnosed as mononuritis multiplex. So I'm like, okay, I clearly have a progressive problem. And I don't want to be disabled. So I'm actually praying for a rapidly fatal diagnosis, as opposed to a disabling one. Wow. What a perspective. So were you post medical school when this started when you went to get the MRI? Or where were you at? So that's 20 years ago. So it's 20 years after medical school. So I'm 45. And, you know, I have young kids. My kids are five and eight. And I had just resigned from the Marshall Clinic. I was starting at the University of Iowa. I'm like, oh my God. So, yeah, at least I was at a university setting. So I should be able to get the very best people. And, you know, I get the diagnosis and decide like, and like many physicians, I really go to the internet, I'm reading all that I can. And Jackie sets me out, says, Terry, you're just getting yourself upset. You got a promise where you're going to stop reading. We'll find the best MS center in the country. We'll have you go there, let them take care of you and quit trying to take care of yourself. So I agree. And I do that. And I start the newest drugs. And it's interesting, two years into this, my physicians talk to me about Ashton Embry. And he's a geologist whose son has MS, who had remarkable improvement after he adopted the paleo diet. So now I'm introduced to the work of Lauren Cradane. I'm reading his papers. I'm reading his books. And after a lot of prayer and meditation, I decided to go back to eating meat. Now, what's interesting, Jill, is that my father died when my son was two. My mother had died about three months earlier. And so as I'm reintroducing meat into my diet, I have all these conversations in my head, apologizing to my parents like, you had told me for years, I was really wrecking my health by being a vegetarian. And now, apparently, you were right. I was wrecking my health by being a vegetarian, at least for me. My version of being a vegetarian, for me, turned out to be part of why I think I became so well. So in 2002, I'm still walking, although not as well. I go back to eating meat. And that was a big deal. The next year, I keep declining, the next year I need a sort of kind wheelchair. My physician says, Terry, you're in the secondary progressive phase of the illness. She asked me to take Matizantron, a form of chemotherapy that you maybe know well. And it doesn't help. So we do several cycles. It goes, now, Terry, we're making a neutropenic. We're not going to keep doing this because it's not helping you. And then Tizabri is released. So she says, let's have you start Tizabri. So I take Tizabri, which, by the way, gives me a horrible headache every time I take it. But I figure that's really good because it's going to my brain doing whatever it's supposed to be doing. But that doesn't help. And so my doctor said, okay, we can't give you this to you because it's not helping you. You're continuing to rapidly go downhill. And so they put me on cell set. Wow. And then I'm like, am I really doing everything? I know how bad that's going to be. I'm clearly on track to become bedridden. I think I'm going to go back to reading the literature. I can't get any worse than I'm already looking. And so at first I'm looking for more drug studies. And then I'm like, well, I can't get these drugs anyway. So then I'm looking for off-label use of drugs. And then I finally said, well, maybe I should be looking for things I could access. Like I'll look for supplements. And then I start looking for supplement studies for the animal models of MS. And then I realized these are all relapsing remitting forms of MS. And I'm in the progressive phase. I've not had a relapse. I've had two relapses in my entire disease course. I should be looking for progressive neurologic diseases. So then I switch over and I start reading Parkinson's, Alzheimer's, Huntington's, ALS. And my conclusion is it's the mitochondria. Yes, it's the mitochondria that are not giving enough energy to the neurons. And that's causing the progressive decline. And so now my thinking is, okay, so what can I do to help out my mitochondria? So again, I'm doing PubMed searches. And I have creatine, carnitine, coenzyme Q, and ZB vitamins. And not a lot's happening. So I'm doing this about six months. And the professor of medicine is like, you're wasting your money. So I stop everything. In 24 hours, nothing happens. 36 hours, I just really can't function as well. 48 hours, I can't get out of bed. 72 hours, Jackie comes in and says, honey, why don't you why don't you take these again? So I take the supplements. Not much happens the next morning I can get up and I can go back to work. Now mind you, yes, I still have severe fatigue. It's hard to walk around. I need my two walking sticks. I need to walk around in the house. I need the tilt recline wheelchair. But you know, I'm back to my usual level of disability. And I think, wow, that's really interesting. So I tell Jackie I want to try again and she's intrigued like, okay, let's wait two weeks. So I stop everything. The scientist, ever the scientist, right? Let's experience. So again, it takes 36 hours. And I'm not feeling very well at 40 hours. I really can't get out of bed. We wait 72 hours. I take my supplements. The next morning I can get up and go to work. And I'm back to my usual level of fatigue. So now I'm like, I'm figuring stuff out that my neurologist doesn't know that my primary caretact doesn't know. And I am excited. So I imagine, not mind you, I have severe fatigue. And, and I'm not a neuroscientist, I am not a neurologist. But I'm like, I'm going to be reading more of this basic science stuff, slogging through it. And I gradually add a few more supplements. You know, at first I go to my primary caretact because I want to add this and she adds it to my bed list and says it's okay. And after a while, you know, I, I don't check in first. I just add stuff. And then when I schedule for my next visit, I say, okay, this is what I've had goes, okay. Right. And she adds and said, well, I guess it's not hurting you. Yeah. And let's just bring this really quick, because many people know this, many people don't, when we're trained in allopathic conventional school, excellent training with stroke or trauma, whatever, we're not taught a lot about nutrition or nutritional supplements. So it's not that they, and many times like, oh, don't take any of those just because they don't know. So I just want to clarify because what you were coming against is what we all come against. And what even our education like lended itself to is these either don't work or we don't know enough science. And the problem is they're not reading, there is studies and there is science. I mean, granted, it's coming out. But what we, what we're coming against is two worlds that are colliding and the allopathic medical world, like you and I were trained, we don't get education in nutritional supplements or even dietary or nutritional advice. Correct. Well, the education that I got was follow the low fat diet, lots of grain, low fat, and moderate your meat intake. So the diet that I've been following very, very low fat vegetarian diet would have been very heart healthy and would have been viewed as the, you know, the, the absolute best diet to follow. I mean, I was trying hard. And, you know, the swank diet, which is a low fat diet, the Pritikin diet was advocated as a way to manage MS. So I had been trying. Yeah. And then, you know, I did the paleo diet, and it's like, well, I didn't know how long it would take to to repair my brain. Because I knew, clearly, there was a lot wrong in my brain and my spinal cord. So, and, you know, science would say it takes about seven years to rebuild your brain. So like, okay, maybe it takes seven years before I see any changes. So I got to be patient about this. And I love that you also figured it out. Like, I loved your story of like, to your parents, because it's so similar, 14, I'm like, I'm going to be, do my own thing. I'm going to become a vegetarian. But again, both of us kind of didn't know what we were doing. At least for me, it was more of a carbitarian process diet. It wasn't super healthy. And then I say, just like you at 25, like, ooh, for me, with my genetics, with my celiac proneness, and with my issues with grains, and all of that inflammation and the auto immunity, that diet almost killed me. And then I did same as you put the meat back in. One of the interesting Unfortunately, I waited till I was 45. So I had a really deep hole. Oh, yeah. You try to take a while to get used to making stomach acid again, right? Was there a little transition in getting back? Oh, yeah, it was not easy to introduce me. Oh, and I love what you're saying, because it's not like there's one diet that fits all for a severe cardiac person that might stem. There's, there's this you and I are talking about is this auto immune realm, this inflammatory realm and neurological realm. And they're really clearly as good evidence for what you're presenting. I want to think I want to mention, as you mentioned, cell sept, I haven't announced, and you know, this to cell sept is from mycophenolic acid, which this is not a bad thing for someone who needs to suppress the immune system. But what your doctor was doing was trying to suppress the inflammation, the immune system was causing to create damage in your nervous system. But cell sept is literally from one of the mycotoxins that I treat every day in my office that causes immune suppression, mycophenolic acid. So it's so interesting to me that we use drugs that are actually toxins because we want to suppress the immune system when if we could actually reverse that inflammatory response. So go on, I interrupted you, but those are fascinating little tidbits. So you change diet, you started to see the change with the supplements and experiment and see wow. So I changed the diet. I'm adding supplements. And what what I what is exciting is I slow down the speed of my decline. Yes. So, you know, in my neurologist, and I've seen neurologist at this world famous MS center, and then traveling was too difficult in the total claim wheelchair. So now I'm just at the University of Iowa and I've seen a variety of neurologists here. Everyone says that with when you're in the progressive phase, the secondary progressive phase, that functions will not come back, that the whole name of the game is to slow the decline. And so I accept that. So I'm doing all that I can to slow my decline. I can see that I am slowing it down. I'm not, it's not, you know, getting worse at such a fast pace. So I'm very, very grateful by it. I'm slowly adding a few more supplements by and the the paleo diet that I'm following is the AIP diet. Great diet. Of course, at that point, they're really about what to not eat, not about what to eat yet. That's about what to not eat. And then I by 2007, my trigeminal neurology is more frequent, more severe, much more difficult to turn off. I'm on the maximum dose of gabapentin every day. I'm making frequent chips to the pain clinic when it turns on to get injections, trigeminal nerve. Ooh, that's, you know, difficult to think about. And I'm going to the infusion center to get a gram of salumetrol every day. At the first time I do this, it takes only three doses of salumetrol to get the pain turned off. That's not too bad. Now, in 2007, I'm up to five doses before the pain is turned off and visits to the pain clinic every day for five days. And then it's finally turned off. And I'm thinking about the natural history where my dad's pain was continuous and horrific. When my pain is turned on to give people a sense of that, you're a farm kid, you know what I'm about to describe, a cattle prod stuck right here. So 10,000 jolts across my face for just an instant. When that pain is turned on, all my sensory input is obliterated. All I see is white. I can't hear. I'm deaf. I just I'm blind for an instant. My motor nerves are impaired. So my knees buckle. I'm not falling to the ground yet. So I can maintain enough tone that I don't fall. And I have this involuntary grimace and grunt. And so when the pain turns on, I can't see patients. You know, earlier in my life, I could see patients, but you know, eventually, you know, I was no longer able to control it enough. So when it turns on, I go to the pain clinic, get my injections, wait for things to turn off. I understand that it is eventually going to turn permanently on. Yeah. Yeah, into that the salumetrol is not going to turn it off. Oh, and I'm going to stop here because you know what your father went through and you're in the midst of this. And you and again, the difficulty of a physician is you know a lot, but sometimes we know too much. So you had to know, like, how did that feel? Knowing what you knew could be the next thing. So when this is on, like triggers the pain, sound triggers the pain, a breeze triggers the pain, talking triggers the electricity, chewing triggers electricity, swallowing triggers electricity. So Jack, my wife and I, we have this very big conversations. And I change my durable medical power of attorney. I change my living will such that if my pain turns on, and I stop swallowing, and I'm just drooling, and I stopped talking. And I knew that would happen because when all of your sensory input is transmuted to this intense electrical, horrific level of pain, you're not going to talk, you're not going to swallow. There'd be no feeding tube, there'd be no IV fluids. And so I was like, okay, I would eventually the pain would stop. It might take, you know, seven 14 days for dehydration to cause renal failure, enough that I would die, maybe 20 at the most, but it would eventually stop. That gave me tremendous comfort. Wow. And that, you know, and when the pain would turn on, you know, in this agony of pain, Jackie, we'd send the kids and the dogs to another home. Because I couldn't, you know, the sound, I just couldn't deal with anyone talking to me. I couldn't deal with the dog barking. And I'd be in a dark room. And Jackie would take me in for my injections and bring me back. And I'd be in a dark, quiet room. And we'd do that, you know, the last time we did it, five days before I finally had relief. Wow. That is unbelievable, Terry. Like I've known your story, but I did not realize there, I don't think there's anything to that. Well, you're talking about the nerve types of pain. I don't think there's anything worse than a human could experience, honestly. Trageminal neurology is described as the worst pain known. Zebi was, my daughter was telling me that she was reading this. Oh yeah, that checks out. That clearly is the worst pain that a human can endure. Because I've watched you endure that. Yeah, yeah. Wow. So where did you go from there with this? Obviously, we're starting to see little glimpses, but you were in a pretty severe state. So that, that's in July of 2007. My chief of staff, you know, I'm beginning to have some brain fog. Like, oh God, this. So now I'm going to become bedridden. I'm going to become demented. I'm going to have intractable pain that I'll die by. This is a pretty terrible future that I'm looking at. My chief of staff pulls me into the office to say, I'm going to assign you to the traumatic brain injury clinic. You know, you'll start in six months because you have to finish up what you're doing. So you'll start in January and he described the job. So I'd be part of a multidisciplinary team. I'd be examining these vets and doing the primary care. And I came home and told Jackie, he goes, there's no way you can do that job. So yeah, I know. And so come January, I'm going to go and either I can do the job or I have to come home and apply for medical discipline. So that was distressing to us both. Right. But two weeks later went, because I've been assigned to the institutional review board. I'm review, I'm part of the committee that reviews clinical trials for the University of Iowa. And I had told them, give me all of your brain and psychiatry stuff. So the study that I was asked to review was traumatic brain, pardon me, traumatic spinal cord injury, and they were using electrical stimulation of muscles. I thought, well, this sounds interesting. So I did a quick search. They're only 212 studies. So I didn't take long to look through the 212 abstracts. And I convinced my physical therapist to let me have a session. Hurts like hell. Yeah. But when it's over, I feel great. He says it's the endorphins. Yes. So we add an e-stamp to my physical therapy. I'm doing 10 minutes of exercise every day with my little e-stamp. And, you know, I really appreciate it's doing great things for my mood. Then I discovered the Institute for Functional Medicine, and they have this interesting course on neuro-protection. So I get that course. And it's a lot of biochemistry, but to talk in mitochondria, I'm so thrilled that I have a long list of supplements. I'm like, I can do this. So I'm up to 18. Wow. But, you know, hey, I'm good. Yeah. Yeah. And not a lot's happening yet. And then I have this really interesting aha moment. And Jill, it's embarrassing to think how long it took me to have this aha. What if I redesigned my paleo diet based on, you know, the supplements I'm taking and say like, you know, what are these nutrients in the food supply? Yes. Yes. So instead of being focused on what to not eat, I'm focused on what to eat. And so that's more research. And December 26, I start this new way of eating. Now, mind you, at December 26, and I should say, you know, at my native in July, I cannot sit up in a regular chair. I have a zero gravity chair where I lean back with my knees higher than my nose. I'm having brain fog. I'm having, you know, this progressively severe trigeminal neuralgia. So in December, I'm eating, but you know, I'm eating for my zero gravity chair. I'm sort of lean back. My family's always nervous. I'm going to aspirate because I'm so far lean back. And then January comes, I got to go to this new clinic. And, you know, I'm sort of bummed. I'm going to have to take retirement. But, you know, the first two weeks, I'm just watching like, okay, I should be able to watch. So the third week, the first day I do my exams, get out of the wheelchair, do my exams, write my notes. And at the end of the day, it's like, well, you know, that wasn't too bad. Wow. And at the end of the week, Jackie and I having this conversation like, you know, maybe I can do this. And at the end of the month, I told Jackie, you know, I want to try sitting in a regular chair. And I have supper sitting at the table, sitting upright in a regular chair. I was like, wow, that's pretty wild. And then I think in February, I think my energy is a little bit better. And I think my mental clarity is definitely better. And then at the end of February, my physical therapist says, you know, you're definitely stronger, Terry. I'm advancing your exercises. Wow. So she's giving you some data. And so we're advancing my exercises and I can do e-stem twice a day. And then in March, I am walking with walking sticks. And, you know, my partners at the hospital are like, oh my God, Dr. Walls, you are walking. Like, what's happening? Because in medicine, we're not, again, this is not something we're typically taught that's possible. And then, so now I'm walking around the VA hospital, first with my walking sticks, then without walking sticks. And then in April, it's time for me to have my every two year visit with the chair of medicine at the university. But I think, you know, that's too far. So I decided I'm going to take my scooter over. But my scooter dies on the way over. So I disengage the flywheel and I push it up the hill. And I leave it by the entrance and I walk to my chairman's office. And I come in and it goes like the secretary explains that, you know, my scooter died because always you had to wait for the patient mobile. It's well, no, actually, I pushed it up the hill and I walked over. He goes, what? So I explain my story. I show him my electrical therapy device. And he tells me he's a rheumatologist. So he really gets like auto immunity and like, this is really interesting, Terry. We need you to write a case report. Wow. I go like on myself because yeah, yeah, yeah. So he gives me some guidance on how to get that to happen. Then he calls me back and wants me to do, because I had been doing a different type of research program, diagnostic error. And now he wants me to do a safety and feasibility study to see if others with progressive MS can implement what I did. To see if he's safe to eat good food, right? Basically, like if it's safe to eat really sort of radical, sort of radical. So I took about a year to really write the protocol that I'd use for my own recovery, write it in the IRB. And then it turns out I would have to get approved. I would have to do exactly what I did. So big list of supplements, electrical therapy devices. And then we have to have a bunch of safety labs. So now this is suddenly become really expensive. Yeah, fairly expensive. Now I have to raise about a hundred thousand dollars. But Ashton Embry in his nonprofit in Canada raises that money for me in the electrical therapy company device, the device manufacturer that I used gave us devices in this electrical supplies that we could use. And in 2010, that took me a couple of years to get all the approval. So we finally were able to start doing our study. So we enrolled our first patient in 2010. Wow. What an amazing journey. And what I love is you bring the medical background, the researchers brain, because what you've done in our community and in our world and in this type of medicine and this new way of thinking about that auto immunity may be reversible, surprise, surprise, is actually bring studies and bring the science, which is so important for us as practitioners, because if we want to start talking to patients and bringing, we really want to shift medicine, we need the science and we have to have trials, we have to have clinical trials. So the sequence is you write a case report, then you write a case series, then you do a single arm safety and feasibility study, based on what you observed in the case studies in the case series, which we did. And then you start doing small randomized pilot controlled studies, which we did. Then we did a larger study. And so we keep getting larger studies. And I tell you, Jill, it's really interesting that first study, which was basically things I did for myself that we did now for 20 people. It was very radical diet supplements, meditation, exercise, electrical stimulation of muscles, you know, five things. If you can't all the supplements, that's really like, oh my God, way too complicated. Getting it published would take me. So we got it done in 2011. We wrote up our first 10. It was not until 2014 that I could find someone to polish it, because it was such a radical concept. And I tell my postdocs and my other junior scientists that if you're doing something really new, they'll think you're nuts. They'll think you're crazy. They'll vilify you. They will not be able to get published. You will have to go into a incredibly low impact journal. That's just because what you're doing is so new, so innovative. And you got to be okay with that. I love you look back historically. This is the way any new concept turning things on its head, you know, and this is the but this is also the way we shift medicine like you are a leader in that. And so and you have to be okay. And you know, and I think part of the reason I have been successful, well, there's several things. One is I'm sort of introverted. So the outside noise is sort of noise. I don't really notice it. So that's helpful. And the other is, you know, that that I'm gay. I grew up in a small town, knowing that I was different from all the other girls. It took me a long time to finally come to terms with that. And I finally was okay, like, I have to lead my life. And, you know, and I didn't get comfortable that until I was like 28. So it took me a long time to be okay with being comfortable and being able to acknowledge who I really am, which meant that I was okay with people thinking I'm a little odd and eccentric, and being berated and being called quack, quack, and the nut, and being condemned in the neurology community for a long time, just like, you know what, I got my life back. I'm willing to tell others with progressive MS that you could get your life back to that if you think vegetables are pretty safe, that meditation is pretty safe, that exercise is pretty safe, working with a physical therapist is pretty safe, and electricity, if you decide to add that, that will be uncomfortable. And depending on how much current you give yourself, it could be quite painful. And you could, you could start now if you want, or you can wait for the randomized double blind trials, and that's okay too. I love how you frame that, because what happens, and I've done this in my career too, so often like, okay, we add a little bit of vitamin C, okay, the benefit risk ratio, right? Risk is almost, I mean, very, very minimal unless you have a G6PD deficiency or whatever, but generally, these things we're talking about are considered very safe and very low risk. And I'm always like, well, what if there is even a 10% potential of benefit, always in my mind, it's that weighing of that. And when we're talking about diet and lifestyle, and some of these things that we know are quite safe compared to a brand new drug that has potentially massive adverse effects, this is a whole different realm. And it doesn't mean that we can't have the same scientific rigor, but it is different in clinical practice because I do the same thing. I talk to my patients to say, hey, I don't have a lot of evidence for this, but it's very safe, there's very low risk. Are you willing? And then they get to decide with me, we make a decision together. But that's, that's how medicine should be because some of these things that we're talking about are extremely low risk, even if they're radical in their minds. And I make clear that you can make a clinical decision. Do you need to take the disease modifying drugs? And I make clear that I was thrilled to take incredibly toxic drugs because I did not want to become even more disabled. And I went to slow my decline and I had profound disability. And so I was okay taking with those drugs. Now, eventually, as I began to recover and I'm reading the side effects, I talked to my neurologist and said, I really would like to get off these drugs. And he took me off. I've been off them ever since, again, with my neurologist blessing. It's a clinical decision. Yes. And let's talk just briefly, because I have people all the time that comes in, come in with severe Crohn's, severe MS, and they are on the meds, they're on the disease modulate and immune modulating drugs or whatever. I don't take them off those meds. But what I do is start to do the structural foundational work. And as they get better, they can decide with their neurologist or the rheumatologist. And many of them do get off the meds, right? That's what we both do. That's what we see. Neither one of them is very clear. Yeah. So I love that you don't come off. Yeah. Correct. If you stop the abruptly, you will have a severe flair. Exactly. And what's happening if you haven't dealt with the underlying issues like for example, Crohn's or any of these things we're talking about, if they are on mirror or any of the immune modulating drugs, that's like the structural foundation that's stabilizing them. I need to go underneath the framework and fix that problem. And it could take six months, 12 months, 18 months. Eventually that framework then will be stronger and they may be able to get off the med, but it's actually a disservice if we think that it's going to change like that anyway. Because like you said, the diet and the nutrition, you solve some pretty dramatic changes, but often it does take many months. And then the other thing that I've learned, and I'm sure you're doing this as well, Jill, is I make it very clear that diet and lifestyle is now your disease modifying drug treatment. If you abandon that, you're going to have a severe rebound and severe flare. Okay. This is so critical. You're like, how long do I have to do this? Right? This is critical for me. And I know for you too, for 20 years ago after breast cancer, I started eating meat again. I started eating lots of plant based, very similar to what you use. And I will be people asking, well, how long that's forever for us, right? There is no, I have no problem. I love my diet. I don't feel restricted, but that is not something that I ever mess with because I feel so good and so vibrant. It's not worth it. And I have to stress to people that when you, when you recover and you're feeling really great, you're off your disease modifying drugs and you're feeling like I'm normal. I think I'm normal again. And you're at your brother's son's wedding, and he offers you a wedding cake and some wine and beer, and you have it. And you think like, you know, I'm fine. And then you have a severe flare of your Crohn's or also colitis or your MS or your rheumatoid arthritis. And you go see your specialist in your specialist says, see, I told you the walls, you know, she's full shit that, you know, this, you should never have stopped your DMT. And what I want them to remember is that I'm in your ear saying, see, I told you, you could never go off your disease modifying lifestyle treatment. That this is what now is keeping your, you healthy in your immune cells, taking care of you instead of attacking you. Because if I have gluten, dairy, or eggs, accidentally, if I came to your house and you accidentally contaminated me with those foods, in six to eight hours, my trigeminal neuralgia would turn on. And so what's interesting, Jill is, I now see my trigeminal neuralgia, and I'd had 27 years of progressively more severe levels of horrific pain. I now see this as this amazing gift, because I have this amazing biosensor of the happiness of my cranial nerves and the happiness of my cervical cord in my brain. That if my sensation of my face is normal, and there's no electrical twinges, I know that my microglia are very happy. If I begin to have abnormal sensation in my face, either my right side or my left side, I'm like, okay, what was the trigger? What food might have been contaminated? Was I in a moldy environment? Yes. Was there some air pollution release? Did I do too many 8am podcasts? And so my schedule is too intense. So I have this little checklist I'm going through my head like, okay, what's the trigger? How's my self care? And then when Jackie gets home, I say, okay, honey, I'm having a little flare. What do you think is going on? And we have a little conversation. It always I can identify that there was a trigger. Yes. Or that my self care routine was slipping up. Yeah. I love that you're sharing this because if we could teach all of our patients, I am the exact same way. Same thing. And sometimes it's my skin. Sometimes it's my gut. Sometimes it's my brain. And but I always know the same way as you know, I know, oh, something's not right. And I do the same thing. Did I not get enough sleep? Have crazy schedule? Did I get gluten, dairy, egg, or soy? Those are my big ones. So I love that you're saying this because if we can teach our patients to be that in tune with ourselves and what your body needs. And really it comes from I came from this workaholic farm girl background like you where we just push ourselves, we suppress all emotions and all sensations. What we're actually describing is getting re in touch with yourself. What do I need? What does my body need? What do my cells need? We at least for me on the farm, we did not think about that. We kind of suppressed that and we just pushed and we worked and we got absolutely, you know, and the medical training is even more like that because it teaches you to basically deny your needs, deny yourself and push through and you can suppress anything, right? But now you and I are talking about part of the way to be true health is like getting back in touch with yourself and trying to check in with your body and listening to the signals that it gives us. You know, and we teach our clinicians to use these biosensors. We teach our patients to use these biosensors that pain is an amazing gift. You know, pain is so helpful because most of us don't want more pain. We would rather have less pain. And so when the pain signal comes through, I'll like, what should I do about that? Skin changes can be helpful. But pain is really the most instructive. Absolutely. And if we can think of it as a teacher, then we can, we can embrace it more and like, okay, how do we stop or change this? But let's talk in our last few minutes about your new study and enrollment. Tell me about what you're doing now. I'm sure everybody hears about this. So we have a new study, efficacy of diet on quality of life. It is a two-year study. We're comparing a ketogenic diet to the walls elimination diet that diet that I follow to usual care. People will come in at baseline again at three months and again at 24 months. We'll have measures of walking function, hand function, vision function. We'll have an MRI with a research magnet. So there's no gadolinium, no contrast. But that will let us see. And I'm really excited about this, Jill, because one of the things we'll look at enhancing lesions, not enhancing lesions, so active inflammation or not. But we will also be looking at brain volume. And one of my hypotheses is that if we improve diet quality, we can get the rate of brain volume loss back to healthy aging. Because if you have MS, your rate of brain volume loss is three times that of healthy aging, which is why cognitive decline is such a big issue for people with MS. So the primary outcome is change in quality of life. And I'm very hopeful that we'll see significant improvement in quality of life as people improve their diet. And are you using neuroquant or another technology to do the volumetrics? What kind of? We're doing something that's even, it's a software here that we have the University of Iowa Auto Workup that measures brain volume at an even much more precise level than neuroquant. I've heard there's better technology. Correct. And we'll also be looking at serum neurofilaments, so some blood biomarkers. We're freezing blood and saliva. So we can look at the microbiome. And we'll look at metabolon, metabolomics as well. So it will be an amazing study. And we're able to do this because we have a gift from a grateful patient whose life I've transformed that said, I want to make this real. So they gave us the funding to do this. It, we will be working at this for the next four and a half years. We've enrolled 50 people. We will enroll 156. And so everyone who's listening, we're looking for people with relapsing, remitting MS, tell your friends, tell your physicians, spread the word, help us get the next hundred folks in. I love this, Dr. Walls. I've included, if you're listening here on Facebook or on YouTube, you will see the links below. If you are on the podcast, you can go to my transcription page and you'll find the links. But I have included those wherever you're listening. You will find those links to check out. Not only a description of the study is one link and the other one is actually to get enrolled. And I love this. I want to be helping you to get those 156 people. And I'm so excited for this to come out. Dr. Walls, what's one last takeaway that you would say? I mean, we've talked about so many things. Maybe someone out there is listening and either they have a lot with MS or they have MS or they know someone they care about. What kind of takeaway would you leave us with? If I can come back from profound disability due to progressive MS and the secondary progressive where I can hike, bike, I can jog in my neighborhood, then there's hope for them as well. And to help us change the standard of care, I need to do these randomized controlled trials where I can compare the ketogenic diet, the paleo diet, the usual care, usual diet. And helping spread the word is one of the most important gifts that you can give everyone with MS and everyone with autoimmunity. I love that. And where can people find you if they want to know more? Again, we'll include the links, but give us a look. So come to terrywalls.com, T-E-R-R-Y, walls, W-A-H-L-S dot com. If you're a physician or a healthcare provider, think about getting certified. We train physicians how to use these concepts and I train them how to use the concepts I used in my VA clinics where we did this with people who are living on food stamps, using VA kinds of primary care labs, using VA basic kinds of supplements, which were B vitamins, fish oil, and just a smidge of vitamin D. So we were able to have really remarkable results within the VA using these kinds of concepts. Love this. Dr. Walls, thank you so much for your time and energy today. It was a priceless gift. I sure appreciate you. Love what you're doing and thank you again for taking the time with us. Thank you.