[00:00]
Hi, and welcome to the Integrative Women's Health Podcast.
[00:07]
I'm your host, Dr. Jessica Drummond, and I am so thrilled to have you here as we dive
[00:13]
into today's episode.
[00:15]
As always, innovating and integrating in the world of women's health.
[00:20]
And just as a reminder, the content in this podcast episode is no substitute for medical
[00:28]
advice, diagnosis, or treatment from your medical or licensed healthcare team.
[00:34]
While myself and many of my guests are licensed healthcare professionals, we are not your
[00:41]
licensed healthcare professionals.
[00:43]
So you want to get advice on your unique circumstances, diagnostic recommendations, treatment recommendations
[00:49]
from your home medical team.
[00:53]
Enjoy the episode.
[00:54]
Let's innovate and integrate together.
[01:02]
Hi and welcome back to the Integrative Women's Health Podcast.
[01:06]
I'm your host, Dr. Jessica Drummond, founder and CEO of the Integrative Women's Health
[01:12]
Today I have a really special guest for you.
[01:16]
Diane Ducarme has created Migraine Heroes.
[01:22]
She and her team have the solution to chronic migraines, but she comes at it from a very
[01:29]
unique perspective.
[01:30]
She is trained in science, technology, engineering, mathematics.
[01:36]
She's an engineer.
[01:38]
She's a technology expert.
[01:40]
She's not a physician.
[01:41]
She's not a clinician.
[01:43]
She has an MBA from Harvard.
[01:45]
She's thinking from a technology and business perspective on how to solve chronic migraine
[01:52]
is where it begins, and you'll hear the stories of why, just like many of us, she got into
[01:58]
this because of a personal story.
[02:01]
But her collaboration through her corporate connections, through her international work
[02:08]
has been through connecting traditional Chinese medicine with Western medicine strategies,
[02:15]
nutrition, lifestyle medicine, everything we do here with a functional medicine perspective.
[02:22]
But where she's taking it to the next level is she's trying to help make this technology
[02:29]
more scalable and more approachable for people who can't afford functional medicine.
[02:37]
This is a question that myself and my colleagues and our students at the Integrative Women's
[02:43]
Health Institute are always asking.
[02:45]
How do we make this kind of healing more accessible?
[02:51]
And it's very, very difficult because to be trained in this, to do the difficult work
[02:56]
of working with the most challenging clients who have been through the ringer, who have
[03:02]
seen all the top neurologists or whatever the top person is in their field, and they
[03:08]
have not found the results, it's because the problem is more complex and easier.
[03:15]
It just simply does not fit into the model, and it requires active participation by the
[03:22]
person navigating the healing.
[03:25]
And all of these things are complex.
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It requires coaching skills.
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It requires bringing together different physiologic systems, not siloing each system across different
[03:36]
parts of the medical system or different parts of the hospital.
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So as you listen to this interview, I want you to get curious about how you can help
[03:48]
people with complex chronic conditions not be forever reliant on a system that keeps
[03:57]
them just a little bit sick, right?
[04:00]
Needing pain relieving medicine, needing migraine medicine, needing insulin, whatever it is,
[04:05]
insulin, there may be a reason that people may need that.
[04:09]
There are Western tools that people need to use for the long term, but is that always
[04:15]
the case and is it the case in the clients that you work with?
[04:18]
And if not, what are some of your thoughts and ideas for building a new kind of medicine
[04:27]
that's scalable and profitable, or maybe not profitable and does that matter, while we
[04:34]
still take care of the people who are providing the healing, right?
[04:39]
So we can't have them being overworked and burnt out.
[04:43]
So dig into my conversation with Diane Dukarm, and I will see you on the other side where
[04:51]
I want you to grab just one nugget from this conversation and bring it to your practice
[05:04]
Welcome back everyone to the Integrative Women's Health Podcast.
[05:07]
I am thrilled to be here with Diane Dukarm.
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She comes to work with women and men, but we're going to talk about what's particular
[05:19]
about working with women and migraines, but not just that.
[05:24]
We take migraines as a symptom of deeper, more complex health challenges in the very
[05:32]
same way that over here, we're often looking at things like endometriosis or MCAS or the
[05:39]
perimenopause transition or any kind of chronic pain as not being in isolation, but a red
[05:48]
flag, a yellow light, a warning sign of something being off with the system.
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So Diane comes to us with a really interesting background, which we just briefly talked about,
[06:00]
and I want to let her share that with you because I think for those of us who are trained
[06:05]
in this kind of one foot in one academic area and one foot in another academic area, we're
[06:11]
lucky to see problems in a different way.
[06:15]
One of the things we briefly touched on before we hopped on here is that I think we're all
[06:21]
aware that AI is going to be absolutely changing the game in healthcare very soon, very soon,
[06:29]
within the next decade at least.
[06:32]
So let's start off, Diane, with why migraines and what is your perspective on migraines?
[06:42]
Thank you so much.
[06:43]
I started to work on migraines when my sister told me she was having migraines that day.
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I was not being a saint because most people, when they hear someone has a migraine, they
[06:53]
will hear they have a headache because empathy is what you can relate to as a human, as a
[06:58]
But that day, we had just lost my uncle and godfather from a glioblastoma, which is a
[07:05]
form of brain tumor, as you know, that grows from a pebble to the size of an orange extremely
[07:12]
And he had been very well operated, but the tumor regrew very fast, and so he left four
[07:18]
And my sister said, I have been having migraines for the last three years, and I've done a
[07:24]
couple of MRI, but they don't see anything yet.
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I wonder if I'm not developing what he's had.
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And so she was very anxious.
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And because I know nothing, my background is in science, technology, engineering and
[07:36]
mathematics, I said to her, I know someone in China where I've worked who is spectacular.
[07:43]
Let's contact her.
[07:44]
And before we do that, I'd like you to write three pages with me of all of the other symptoms
[07:50]
that you experience.
[07:51]
I want you to tell me everything that is going wrong with your body and for how long it's
[07:57]
And so we write the three pages together and we take the call together.
[08:01]
And Dr. Zhang, with whom now I work, is telling her what to eat and why she's in pain.
[08:06]
And three to four months later, my sister stops having pain and I leave it at that.
[08:09]
I don't think it's special.
[08:11]
I don't think it's illogical.
[08:13]
I think it's quite normal.
[08:15]
She had a few problems inside of her body.
[08:17]
Her body manifested like a fire alarm and we extinguished the fire and the alarm's gone.
[08:22]
A couple of years forward, I'm now living in New Zealand and my neighbor tells me, Diane,
[08:28]
I've had this super confrontational conversation with my dad.
[08:31]
I've had migraines for the last seven years.
[08:33]
I'm like, oh, I'm sorry.
[08:35]
And she's like, oh, I just don't like to mention it.
[08:37]
And he is telling me that I need to get medicated for life, including having injections.
[08:42]
And I told her, what?
[08:46]
So that means what?
[08:47]
50 years of injections?
[08:50]
Of course it didn't mean that.
[08:52]
I understand it freaks you out.
[08:54]
And you know what?
[08:55]
I know someone, and I was working full time in a corporate environment, I know someone
[08:59]
who I think can help.
[09:01]
If you don't mind, we do a bit of WhatsApp and WeChat and I'll ask you a lot of questions.
[09:05]
This process might take a bit of time and I'll tell you what to eat and then you can
[09:09]
And so I, you know, we do that a couple of weekends and she eats the food and then I
[09:15]
I'm like, how are the migraines?
[09:16]
It's like, they're gone.
[09:17]
I'm like, oh, great.
[09:19]
And I'm like, why did your dad tell you to take injections for 50 years?
[09:23]
And she replies to me because my dad is a renowned neurologist based in New York.
[09:29]
And I tell her, what?
[09:31]
That doesn't make any sense.
[09:32]
Like it doesn't make any sense to me.
[09:34]
Your father is, of course, super smart.
[09:35]
Otherwise he wouldn't be a neurologist, let alone super connected, be it New York.
[09:41]
And of course he loves you because you're in touch with him and your father loves his
[09:46]
So I thought, oh, probably the foods that I gave her mimicked medication.
[09:51]
So I went online and I made a huge level of discovery, Jessica, that I want to share with
[09:57]
your audience today.
[09:59]
And it really hit me that the medication that she was offered were painkillers.
[10:05]
So they were attempting to mute her pain.
[10:08]
When what I was doing with Dr. Dang, we were trying to listen to her pain and see what
[10:14]
What is your body complaining about?
[10:18]
And I really thought that is so bizarre.
[10:21]
He wants to give her a painkiller.
[10:24]
It's such a weird idea.
[10:26]
And then you think, no, wait a minute, if my child has a headache, I'm likely to give
[10:30]
them a Tylenol, but that doesn't make any sense.
[10:34]
And so I start to deep down in my research and then I realized it was 18% of women.
[10:38]
And now it's actually 22% of women and 5% of men.
[10:42]
And I'm like, oh wow, that's a crispy fact because it means I've lived in Europe and
[10:48]
I've lived in China.
[10:50]
It means Western science is missing the point because here we are in a situation where the
[10:56]
female body is not a proxy of the male body.
[11:01]
And so I digged up and I found it was genetic and then I also felt terrible.
[11:05]
I thought, wow, if it's a fifth of my girlfriends, oh my God, I'm just such a bad friend.
[11:11]
That's how it started.
[11:12]
I love that story because it shows that oftentimes the path of what we choose as health and wellness
[11:19]
professionals is related to just a curious question.
[11:25]
It sounds like because your background is so distinct, you were trained in STEM, went
[11:31]
to Harvard to become an MBA, so you have this business perspective.
[11:35]
When we think about healing migraines from a broader perspective that integrates traditional
[11:41]
Chinese medicine, that integrates nutrition, you know that our organization, our motto
[11:47]
if you will, is don't chase symptoms, optimize systems because the original Western system
[11:55]
that I was trained in is really about doing exactly what you said, quieting symptoms without
[12:02]
listening to what they're trying to tell us.
[12:06]
So tell me a bit more about the Chinese medicine perspective in healing migraines.
[12:13]
What kinds of things is the Chinese medicine practitioner looking for?
[12:19]
So when you look at something, you ask questions and you look for other symptoms, so you look
[12:24]
for what's the body language.
[12:26]
When I started this, I was asking 30 questions and I was told by a very prolific investor
[12:33]
that 30 questions was way too long and no one would answer my questions.
[12:38]
Now I have 100 questions and women, when I was having 60, 70, they're like, oh, amazing
[12:45]
You're missing this, you're missing that.
[12:46]
And women were adding things, whereas men would tell me, oh, 18% of women, are you sure?
[12:52]
And is that really a problem?
[12:53]
And I was like, okay, since you don't get it, that's okay.
[12:56]
But really 100 questions, why?
[12:58]
Because the body's going to have other symptoms.
[13:00]
Now those other symptoms will pertain to other systems, but it's not a one-to-one relationship.
[13:07]
This is where it's ambiguous.
[13:08]
It's a many-to-many relationship.
[13:11]
So if you think of the female body as a factory that produces physical matter.
[13:17]
So in her lifetime, a woman is going to lose 23 to 28 liters of menstruation.
[13:21]
She's going to produce zero up to, I don't know, five, six, seven children on average,
[13:27]
She's going to produce on balance 30 kilogram of matter, of physical matter.
[13:33]
If you were to compare the female body to the man body, which is where I want to start
[13:37]
with traditional transmission, if you want to compare the female body to the man body,
[13:42]
and they were both factories, maybe the male factory produces envelopes, simple product,
[13:49]
And the woman is going to produce a whole car.
[13:52]
It's a car manufacturer.
[13:53]
So when you look at the dashboard of these two factories, of course, the dashboard of
[14:00]
the woman is a lot more sophisticated.
[14:03]
Because oftentimes on social media, there's a joke of what's on a man's mind, and there's
[14:06]
What's on a woman's mind, you have all of these buttons, yeah?
[14:10]
It's a reflection of how people feel, and so then you try to take all of the other symptoms
[14:15]
and look at what else is the body saying.
[14:19]
The migraine makes so much noise that you don't see anything else.
[14:23]
Do we have endometriosis, like you mentioned?
[14:26]
Do we have irritable bowel syndrome?
[14:28]
Do we have a leaky gut?
[14:30]
Do we have really itchy eyes and dry eyes?
[14:33]
Do we have eye discharge?
[14:34]
Do we lose our hair?
[14:35]
Do we have thyroid issues?
[14:36]
Do we have bloating?
[14:38]
Do we have perimenopause?
[14:39]
And what are all of these imbalances?
[14:41]
And when you solve those, then the brain stops making so much noise.
[14:48]
I really love that perspective because, first of all, I want to just pause for a minute
[14:52]
and think about absolutely, of course, we need to look at women differently from men.
[15:01]
The whole notion of building humans, I think that's so rarely thought about.
[15:06]
The fact that our hormones are much more complex, but also our literal production system of
[15:15]
building DNA, building proteins, building enzymes.
[15:21]
We have to be well-nourished.
[15:24]
We have to be well-recovered.
[15:27]
When you think about the lifestyle of most women, being well-nourished and well-recovered
[15:32]
is extremely difficult because we generally have more jobs, if you will, than men.
[15:40]
In a given relationship, let's say a husband and a wife, a wife will have a full-time job
[15:45]
or at least a part-time job, so will a husband.
[15:48]
Paid work, then the woman takes about, I think it's still about two-thirds more of the childcare
[15:54]
responsibility than the men, at least two-thirds more of elder care responsibility, and all
[16:00]
the what's known as the mental load.
[16:02]
When we're talking about the brain, brain inflammation could be directly related to
[16:07]
how many socks does she need to buy for this school year?
[16:11]
Was this permission slip filled out?
[16:13]
Did the mortgage get paid, yada, yada, yada.
[16:16]
Not only that, but women are carrying an emotional load of everyone else.
[16:20]
They're carrying how their teenagers are feeling, how their grandparents are feeling
[16:25]
at the end of life, where is everyone living, how close or how far, who's organizing Christmas
[16:33]
I think when we think about the work that women produce, they're so much more productive
[16:42]
that without the adequate nourishment and recovery, of course, the systems are going
[16:49]
to begin to break down.
[16:51]
So now you've got this perspective on migraines.
[16:54]
It's like you're looking at all of the areas which could be breaking down.
[16:58]
The migraine is kind of the warning sign like, hey, listen, things are falling apart here.
[17:05]
How are you now doing this in practice?
[17:07]
How are you helping women directly with their migraines or any other health challenges?
[17:13]
The way practically I'm doing it is first asking about a hundred questions.
[17:17]
We track every day.
[17:19]
One of the things that is fascinating with migraine is the only way you know a person
[17:23]
has a migraine, you ask.
[17:24]
It's completely an invisible disability.
[17:28]
And so we track on a daily basis where the brain is at, if it's sharp and free, if it
[17:34]
In parallel, we track a lot of other things.
[17:36]
We track how is your bowel movement along the Bristol chart.
[17:39]
So is it more rabbit-like or is it sometimes non-existent?
[17:42]
There's a lot of constipation if, for example, the woman is in perimenopause, which is a
[17:46]
lot of bloating and a lot of dryness in her large intestine.
[17:52]
Then through her vagus nerve, gut-brain axis, there will be a lot of dryness in her brain.
[17:57]
So she's going to feel more dizzy, more foggy.
[18:01]
Sometimes people will call this a Meniere's disease as well, vertigo dizziness.
[18:05]
Or is the person having a really wet bowel movement, yeah, wet every single day and have
[18:10]
quite sharp pain, for example.
[18:12]
So we're going to track every day the pain.
[18:14]
We're going to track, so I have an app that is called the Migraine Heroes app.
[18:18]
And in that, we track also other symptoms.
[18:21]
Are your hemorrhoids gone?
[18:23]
How is your vaginal discharge?
[18:25]
When you had your menstruation, did you have blood clots?
[18:27]
Do you have fibroids?
[18:28]
Do you have cysts?
[18:29]
And so on a daily basis, we ask for a lot of these things and all the symptoms need
[18:34]
And to do that, I don't really ask people not to do stuff.
[18:38]
I don't ask them not to have certain foods.
[18:41]
I'm like, my job, if you have sugar cravings, my job is you no longer have them.
[18:45]
That's my job because the sugar craving is also a symptom.
[18:49]
I'm going to ask them to focus on a couple of foods that we just completely reboot their
[18:55]
systems and usually we reboot two systems at a time.
[18:58]
That's how it works.
[18:59]
And then migraine, where it's very different than maybe some other things, is a moving
[19:07]
Imagine the dashboard of a factory and imagine the cycle of a woman.
[19:11]
Every part of the cycle, there will be different problems exposed.
[19:15]
So maybe if she has hormonal shifts, the fire alarm will be indicated differently, different
[19:21]
part of the cycle.
[19:22]
A cycle is also a day.
[19:24]
So some people might wake up every single day with a migraine.
[19:26]
Do you see what I mean?
[19:27]
And so because it's a moving target, maybe if you have COVID or flu, it will change what
[19:33]
the body's complaining about the most.
[19:34]
And you always have to target what it's complaining about the most and peel the onion from outside
[19:41]
Yeah, and I think that's the same with many.
[19:45]
Migraine is different, but I also think it's the same as many of the invisible illnesses
[19:50]
that we're dealing with because, first of all, they often co-present, right?
[19:54]
We have multiple invisible illnesses at the same time.
[19:58]
And so I think it's just for the woman, which one is the most loud, is the one she's most
[20:04]
dealing with at this moment.
[20:07]
And I think through the cycle, sometimes the migraine is the biggest problem.
[20:12]
Sometimes things are easier when hormones shift.
[20:16]
And I think what you said about the questionnaire is a really valuable point and why we really
[20:22]
do need women as a part of this transition in AI medicine and just STEM transition and
[20:29]
tech transition in general, because I do think that women really appreciate being heard
[20:41]
So when I meet with a client, I'm going to listen to that story for at least 15, 20 minutes,
[20:48]
whereas your average physician appointment is something like three to seven minutes.
[20:51]
So they don't even have time to hear these overlapping issues.
[20:57]
It's not because the physician doesn't want to listen.
[21:00]
It's just because the system doesn't give them that time.
[21:03]
So when a woman has a moment to slow down and really think about all of the things,
[21:10]
not only does she begin to understand the connections, but she feels heard.
[21:17]
I love that you say that because it's so, so, so, so true.
[21:21]
After the tests, there's a few different services that we offer.
[21:25]
If we do it in person, then I have a call with them and the call is on paper is an hour.
[21:30]
Sometimes it goes up to three, depending on the level of history they have.
[21:34]
But one thing that is really common is they will be very emotional at the end of the call.
[21:39]
They say, oh, my God, like my body is making sense.
[21:42]
And no, I'm not erratic.
[21:43]
And also, no, I'm not crazy.
[21:45]
And yes, I've been chasing with the right intuition.
[21:49]
And so they're really emotional.
[21:50]
I oftentimes ask partners to join because they also suffer in a very different way.
[21:55]
They have sometimes compassion fatigue.
[21:57]
They don't really get it.
[21:58]
And when they see their spouse understanding and stitching all of the pieces together,
[22:03]
and for them, it's very rational because there's, you know, AI and sort of data.
[22:06]
It reassures them.
[22:08]
It comes together.
[22:10]
It's extremely true because also emotions play a huge role.
[22:14]
I'll give you an example.
[22:15]
I had this woman really early on.
[22:17]
She had migraines, like, you know, for 30 years, and she was taking six triptans a day,
[22:22]
So that's just to illustrate the level of pain she was under.
[22:25]
She's going better, better, better, better.
[22:27]
And then one day, the pain spikes, it really spikes.
[22:31]
And I'm thinking, wow, I've done something wrong.
[22:33]
I must have given her a wrong food or a wrong instruction or she's too long on the food
[22:38]
or what did I do wrong?
[22:39]
And so I pick up the phone and I call her.
[22:42]
I'm like, I see that you're in massive pain again, this like rocket level of pain.
[22:48]
And she said something I did not expect.
[22:50]
She says, my daughter tried to commit suicide.
[22:52]
I was like, I'm so, so sorry.
[22:54]
I had just no idea.
[22:55]
And we talked about that.
[22:56]
And so back to your point of being listened to, there's the listening of the physical
[23:02]
symptoms, but there's also the emotions also play a role.
[23:07]
So, you know, that mom has empathy.
[23:09]
It's also her daughter.
[23:10]
So she feels the pain that her daughter is feeling and that puts her in pain as well,
[23:15]
if that makes sense.
[23:17]
I've had clients with things like vulvodynia, bladder pain syndromes that have had complete
[23:24]
resolution of pain once they learn to have boundaries with certain people in their
[23:31]
families and the emotion of a stressful time.
[23:37]
So we do a lot of heart rate variability tracking in our practice.
[23:42]
So we'll use, you know, whether it's a Garmin fitness tracker or a whoop, something
[23:46]
like that. And you can see the shift in that heart rate variability will translate to
[23:56]
symptoms, even if the person, one of the things that I see often because I see so many
[24:01]
women with endometriosis, because that chronic pelvic pain syndrome starts generally
[24:07]
around women, they're like eight to 12 years old, they're pretty young, they learn to
[24:12]
really power through.
[24:13]
So they've disconnected from and I'm sure many women with migraines have the same
[24:17]
issue. They're so used to that level of pain that they don't really feel it anymore.
[24:24]
But the heart rate variability catches it and it will also catch it when it gets a
[24:32]
little worse because of whatever stressor, whether it's a family stressor or I noticed
[24:38]
Aura posted on their Instagram a couple of days ago during the U.S.
[24:42]
election, which was pretty stressful around here, people slept 23 percent less or
[24:49]
something like that. I don't remember the exact data, but their heart rate variability
[24:52]
was 19 percent worse on average.
[24:56]
They're looking at thousands of people seeing a big shift just from a national
[25:02]
stressor. So if you're thinking about a family stressor or an individual stressor,
[25:10]
absolutely, that will translate directly to a spike in symptoms.
[25:14]
So with your technology, you're taking a lot of data.
[25:18]
It sounds like you're also monitoring some data as well.
[25:23]
Yes. So we're monitoring so that we see until the pain decreases in intensity and
[25:29]
frequency until it disappears, which feels completely surreal because if we take back
[25:35]
the example of your endometriosis, 8 to 10 year old, these women, they're not born with
[25:41]
pain. Absolutely not.
[25:42]
But they've lived for 5, 10, 20, 30, 40 years in pain to be told that it can only be
[25:49]
medicated. They go from episodic to chronic pain.
[25:52]
It takes completely over their life, their relationships, their work.
[25:56]
They might be fired a lot for that.
[25:58]
So it's really, it completely takes over life.
[26:01]
Yes. So we monitor that it goes down.
[26:03]
And so we monitor it hand in hand with their cycle.
[26:06]
And we explain, I think a lot of what you said is so true on they need to understand,
[26:11]
take the time and understand.
[26:12]
So we try to teach them, it takes me one year and a half to train a new health
[26:16]
practitioner, but we teach everyone themselves and they really love it because then they
[26:22]
feel they have a mastery. Like the weather changes, they're like, and I got that
[26:25]
infusion and I passed through the storm like a flower.
[26:28]
And that was just so cool.
[26:31]
Or they will say we have in the app, it's called the Migraine Now button.
[26:35]
I'm like, you can click on the button if you have a migraine and it's going to guide
[26:39]
you what to do in that instance for you as a person.
[26:42]
And as I did that and I avoided three days of pain, I feel powerful.
[26:47]
I feel the anxiety of the next attack.
[26:50]
So here there's even in the sharpened free days, people will report they have anxiety
[26:55]
of the pain to come.
[26:57]
So they struggle to enjoy the moment.
[26:59]
And that is going to start to really, really slow down.
[27:02]
Yeah, it's beautiful.
[27:04]
Well, and I think that's so important because we do have all of these tools, right?
[27:09]
We have nutrition.
[27:11]
We have supplementation.
[27:13]
We have nervous system regulation tools like breathwork and movement practices and
[27:19]
literally just things like sleep and hydration that sometimes people miss.
[27:24]
And we have medications when necessary.
[27:27]
But I think when the person living with the chronic symptom begins to have mastery over
[27:34]
those tools and how they relate to the symptoms, it doesn't feel so much like this is
[27:40]
random, that they don't know when the pain is going to happen, that they don't know when
[27:45]
the symptoms are going to happen.
[27:46]
And they don't feel as scared that they're going to be like lost at sea without the
[27:51]
capacity to bring it back.
[27:53]
And so just by reducing the fear, you're actually going to impact the symptoms.
[27:58]
Yeah, absolutely, because you decrease the fear, the constant fear.
[28:02]
So they feel more understood.
[28:04]
You know, there's this woman, she was saying, I've been to the doctor for the last few
[28:09]
years. I've had dizziness eight out of ten every single day.
[28:12]
I've done every MRI, every blood test, and they're telling me, you know, everything's
[28:16]
normal. It's in your head.
[28:18]
And she's like, I am dizzy.
[28:20]
And so I think women can be having these really difficult experiences where they express a
[28:25]
symptom and they're completely gaslit.
[28:29]
There's a bit of a death dialogue going on.
[28:31]
Now, you know, you have to go to the doctor.
[28:33]
You have to do your MRI.
[28:35]
You have to do your blood test.
[28:36]
This is extremely important.
[28:37]
There's a lot of other things that need to be ruled out.
[28:40]
But if the doctor says, no, it's in your head, I don't see anything going wrong with you.
[28:45]
I think it's just part of being a woman.
[28:48]
You're in pain. Yeah, that's part of being a woman.
[28:50]
You have a lot of clots in your menstruation.
[28:52]
That's part of being a woman.
[28:53]
You have mood swings.
[28:54]
Yeah, that's just you.
[28:56]
But that's just you. That's just you.
[28:57]
If people say that, you know, then they're not equipped to solve it because we're pre
[29:02]
disease here. The body is not diseased.
[29:05]
It's just communicating.
[29:07]
Unless you do something about this, we're going to go and hit the wall.
[29:13]
So what is next for you?
[29:16]
What do you think?
[29:17]
How do you plan to progress this work?
[29:20]
Look, I think just for now, it's really scale at a human level.
[29:24]
I think last year we were able to take care of 30 women in parallel.
[29:29]
Now we're able to do 100.
[29:31]
We just released a freemium in the app because of one thing I obsess is affordability.
[29:36]
Women can have massive financial distress.
[29:40]
So there may be single mom working sort of two jobs, having children and being in pain.
[29:46]
And so they have they can't get promotion.
[29:48]
They can be really abused in terms of salary.
[29:50]
So there's a huge vocation because it's a business problem.
[29:54]
You see, the best way to make money on top of someone who has migraine is just to leave
[29:58]
them in pain and medicates them.
[30:00]
That's the business model we're in, unfortunately.
[30:03]
And so it's just so the freemium is designed to help people track and start to understand
[30:08]
and start to do a few small things.
[30:10]
And then there's an automatic plan where you don't have a human, but you have an AI
[30:16]
guiding you. It's called Nectarine and Nectarine's only job.
[30:20]
We've been training her for five years.
[30:22]
We're in love with her. Like, honestly, she does such a phenomenal job.
[30:25]
She's just absolutely divine.
[30:28]
And she's always available when it's 2 a.m.
[30:30]
and you're in pain and you need to understand your pain.
[30:33]
She's there when it's 5 a.m., when it's Christmas, when it's New Year's Eve.
[30:37]
You know, in these moments of truth as human, there's three of us around different time
[30:41]
zones in Europe and New Zealand.
[30:44]
But we can never like, you know, it's hard to be in that moment and to have the sharpness
[30:48]
that she has. So we're relying on her more and more.
[30:50]
And so the idea is, can we stop this?
[30:53]
Like, enough is enough.
[30:54]
It's a it's a it's a billion of people.
[30:56]
It's a fifth of women.
[30:58]
It's a fifth of women that we just pop pills to and tell them, stop listening to
[31:03]
intuition. You're erratic.
[31:05]
You're not making sense. You say wine is a trigger.
[31:07]
But when I look at your data, it's not.
[31:09]
And it's not because the cycle and when you consume the alcohol is going to matter and
[31:13]
it's going to change if it triggers you or not.
[31:16]
So women just completely lose their sense of worth.
[31:19]
And then they're told that they're depressed and they say, I'm not depressed.
[31:22]
I'm in pain. But they say it's then you are depressed.
[31:24]
And so the idea is just it's a work of love.
[31:27]
And there's a kind of like a philosopher that says work is love made visible.
[31:32]
This is a massive letter of love to just say, can we just stop doing this to our
[31:37]
women and therefore to our children?
[31:40]
Yeah, well, and I think it's very important that you bring up this financial
[31:45]
piece. I was actually talking about this just today with our women's health coach
[31:48]
students. We're always looking at how do we create more accessible and
[31:54]
affordable models? And yet we're working with the most complex of
[31:59]
clients. So the person doing that has to be well compensated because it's a
[32:05]
very difficult job.
[32:08]
And as you said, they can only really see like 30 people a year.
[32:12]
I'm encouraged because Mount Sinai Hospital in New York City has just launched
[32:18]
their first a very strong looking like sort of center for chronic illness.
[32:24]
And they're going to be doing a lot of research, really looking at these
[32:27]
overlapping issues because and for them, it was inspired because they've seen a
[32:32]
lot of long COVID clients, which is also exploding and will continue to explode
[32:38]
until we have a better solution for acute COVID.
[32:40]
But, you know, the pandemic really isn't over.
[32:43]
But people with long COVID tend to also have well, COVID tends to trigger things
[32:48]
like MCAS and migraines and a post concussion like syndrome and
[32:52]
cardiovascular diseases.
[32:54]
And so it's a place where there's a lot of overlap.
[32:57]
They're also looking at things like chronic Lyme.
[33:00]
But even then, in an academic medical center with billions of dollars of
[33:05]
funding or at least millions of dollars of funding, they can only really see
[33:10]
because they also want to be doing research, which I think is valuable.
[33:14]
700 patients a year, I think, is their two or three year goal.
[33:19]
And it's just, you know, as you said, so whatever, 8 billion people.
[33:24]
So there's like 2 billion people with migraines.
[33:27]
There's 176 million women with endometriosis.
[33:30]
Like there are billions of people dealing with this and we're not really
[33:36]
even touching the people who can't afford to deep dive into some of
[33:42]
these more expensive options.
[33:44]
And yet, I think you're exactly right because the skill set or the tool of AI
[33:53]
bots, if they're well trained, are actually a really good option here.
[34:00]
Yeah, because the solution, we're trying to make it super easy to implement.
[34:05]
We're really a solution in your pockets that you can have anytime you need and
[34:10]
that you can not have anytime you don't need.
[34:14]
And it's in your kitchen.
[34:15]
You know, when I started this, investors said, oh, you're solving the problem.
[34:19]
Can you make them sick longer?
[34:20]
It's a problem that you solve it.
[34:23]
Can you make them sick longer?
[34:24]
I'm like, no, no, we're not doing that.
[34:27]
And I really thought, wow, this is really ingrained in the way we do things because
[34:33]
we have a gross domestic product.
[34:34]
So we have to produce more money.
[34:36]
Therefore, leaving these people in pain is profitable.
[34:41]
And I'm not on my watch.
[34:43]
It's just not okay.
[34:44]
And so I completely bootstrapped.
[34:46]
I did everything in a way that I'm like, you know what?
[34:48]
For me, what matters is efficacy.
[34:50]
And my husband and I, we decided that he would do well and I would do good.
[34:55]
And he says, okay, reinvest.
[34:57]
Every penny I've ever been paid has been going into making the system
[35:01]
better and improving more lives.
[35:04]
I've cut on shopping.
[35:05]
I've cut on all of the female stuff.
[35:07]
And I'm like, you know what?
[35:08]
It just fulfills my heart with purpose to so much that we change.
[35:13]
We transform people's lives.
[35:14]
My hairdresser, he says, oh, but if you give them food, you tell them what to do.
[35:17]
Then they know it.
[35:18]
They don't need you anymore.
[35:20]
He's like, but it's very bad for money making.
[35:23]
I'm like, it's my hairdresser now.
[35:26]
No, I want you to know what you want to do in your kitchen.
[35:30]
It's, you know, life threatening at times.
[35:33]
If you're driving and you have a migraine with aura, it's life threatening.
[35:36]
And so sometimes I said to my team, there's not enough money and they cut
[35:39]
on their hours and still work them.
[35:41]
It's extraordinary.
[35:42]
And yeah, we're making it happen.
[35:44]
And it's really true what you see, because at the same time, I want to pay
[35:47]
my health practitioner really well.
[35:49]
And at the same time I tell them and they say, oh, but this one, she really has no
[35:53]
money or this one, she really is in distress.
[35:55]
I'm like, I see, embrace, neck that she's helping us solve.
[36:01]
So what I'm trying to do here is I'm trying to, we have a lot of common ality keys.
[36:06]
So it's one of a kind service and app it's we're patenting it.
[36:10]
It's very special.
[36:12]
With that, we can solve all of the things we've already seen, but we
[36:15]
continue to see more things.
[36:17]
So the health practitioners, then they get focused on the very complicated things.
[36:21]
And we get, and Nick Dahin, she goes where we've already seen.
[36:26]
It doesn't mean it's not complicated.
[36:27]
We've seen crazy things.
[36:29]
And I have a podcast called the migraine heroes podcast.
[36:32]
And in that podcast, you will see, for example, that the stimuli of Cassie's
[36:35]
Cassie said, I've seen the most senior neurologists of all of the U S I've
[36:40]
traveled to different States to see them.
[36:42]
I've seen people who have written books on, for example, the topic of
[36:45]
vestibular migraines, they were very kind.
[36:47]
They did not solve it.
[36:49]
It goes back to your point, Jessica, of Dr.
[36:52]
Jessica, of, um, of, uh, listening, like listening, what is she saying?
[36:58]
She's saying she has liquids in her inner ear.
[37:02]
The doctor is saying there's nothing and that it's wrong.
[37:05]
And I'm telling her, if you feel you have liquids, I will use foods to remove
[37:10]
liquids and then it goes, I'm making it sound a lot more simple than what it
[37:15]
actually is in practice, but then it goes because you know what she's right.
[37:20]
She'd never, why would she lie about that stuff?
[37:22]
Of course she's right.
[37:26]
I think it's important that we begin to challenge these business
[37:29]
models because you're exactly right.
[37:31]
Healthcare is very expensive right now and the best business models for it or
[37:37]
the most profitable business models, I should say, are all reliant on people
[37:42]
being attached to a chronic illness model, you know, needing constant insulin
[37:48]
or needing constant pain medication.
[37:52]
It's a treatment over the long haul, rather than these moment to moment
[37:57]
tools of reconnecting the autonomic nervous system to the digestive system,
[38:03]
which is really just about things like circadian rhythm alignment or eating
[38:09]
foods that are not going to promote yeast overgrowth, which is kind of what
[38:14]
you're saying from a Chinese medicine perspective, the tools actually can be
[38:19]
much more simple and much cheaper, but they do require, so do any of your
[38:25]
clients struggle with the amount of kind of time and commitment that
[38:30]
it takes to do some of these?
[38:33]
I'm a lazy cooker.
[38:36]
And so there's always lots of like, you take the food, you put it into hot
[38:41]
water, don't even need to boil it.
[38:43]
And then you drink the water.
[38:44]
You don't even have to necessarily eat that given food if you don't have the
[38:48]
time, there's always foods, there's always, you know, infusions and what I
[38:52]
call decoctions, so where you let the water boil the food for a bit longer,
[38:56]
makes the nutrients absolutely massively bioavailable.
[39:01]
You know, we're dealing with real people.
[39:02]
Also, we give them always a lot of choice.
[39:04]
Like, you know, you know, you can take this, this, this, they all do the job.
[39:07]
Just pick the ones that suit your organic needs or financial needs or taste buds,
[39:13]
you know, just see what works for you.
[39:15]
But these are the possibilities that will work with you and not create damage and
[39:20]
not interact with your medications, things like that.
[39:22]
It took forever to build.
[39:24]
And my friends were like, okay, can you not grow bigger, grow bigger?
[39:26]
I'm like, I'm dealing with real people and I'm aiming to solve
[39:29]
100% of everyone's problems.
[39:31]
So no, it will take the time that it takes because it needs to be safe and
[39:34]
inclusive and good and make a huge difference.
[39:37]
And so it's becoming possible.
[39:40]
So we look forward to having a board of doctors and yeah.
[39:45]
Having worked with chronic illness patients for almost 25 years now,
[39:49]
that's the right way to do it.
[39:50]
You can't scale it if it's not complete.
[39:54]
Because you're going to, like you said, they're going to be missing the
[39:57]
things you haven't seen yet.
[39:59]
Look, you have to also put yourself in our shoes.
[40:01]
Like, you know, I'm doing lists, you know, sometimes I have like, okay,
[40:05]
25 lists I need to do today.
[40:07]
It's, I'm like, my brain is like, let's not do that because it takes so much brain
[40:13]
power to look at all of the data and assemble it, et cetera.
[40:16]
And so now it's more and more feasible.
[40:18]
There's also your own health where you have to do what you preach.
[40:22]
Therefore you have to be a bit on time.
[40:24]
You can't have too much screen time.
[40:25]
You can't speak too much.
[40:27]
You have to preserve your own health.
[40:28]
And so it's about new business models where health can thrive and we can solve
[40:34]
problems while we can also respect the people who actually do the work.
[40:39]
And currently we have reliant on a subscription to medication model, which
[40:44]
works very well for a part of the population.
[40:47]
But it's just for the common population.
[40:49]
It just doesn't, you know, just makes us, I think, collectively a lot less
[40:56]
Yeah, yeah, no, for sure.
[40:57]
I think taking a little more time up front and prioritizing the health of the
[41:01]
team, prioritizing those basic, you know, is really a leadership way of changing
[41:09]
how we address health.
[41:10]
Because if you look at the average healthcare professional, they're
[41:13]
not particularly healthy.
[41:15]
Yeah, it's very true.
[41:17]
Yeah, it's very true.
[41:18]
And so that's why, like, I think it's really a labor of love.
[41:20]
And I think if my sister had told me I have a migraine and I had known I had
[41:25]
been a doctor and I had known everything I would have known, I would have told
[41:29]
her, hey, I'm sorry, lifetime of medication.
[41:33]
These are some of the ones that statistically work the best, but it's
[41:38]
going to be a moving target.
[41:39]
I'm going to have to mitigate a loss and you should start planning how you're
[41:43]
going to think about work.
[41:44]
You know, that's what I would have said.
[41:45]
But I think the fact I didn't know anything, you're like, wait a minute,
[41:48]
let's rethink how, how that is.
[41:54]
Well, thank you so much for sharing that with us.
[41:56]
If someone is right now struggling with migraines, where can they find you and
[42:04]
So you can go on the App Store or Google Play and download the app called
[42:09]
I would really encourage you.
[42:10]
There's a myriad of podcasts.
[42:12]
They're in the app, actually gathered in the app.
[42:14]
This one will be too.
[42:16]
We also have our own podcast called Migraine Heroes, where people come and
[42:20]
share their story.
[42:21]
They share this way, not because they're paid, but because they're like, oh my
[42:24]
God, this is a such a bittersweet moment.
[42:27]
Sweet because I have just the life of my dream, but bitter because I'm like,
[42:31]
wow, I've just lost so much time.
[42:34]
And then my website is actually called MyNectarHealth.com and there you can
[42:39]
You can book a course.
[42:40]
You can really take the plan that suits your needs.
[42:43]
If you have a few migraines, go on an automatic plan.
[42:45]
If this is really taking over your life, get more help.
[42:48]
We'll be there to cater to your needs.
[42:51]
Our goal is you live a life free of pain.
[42:53]
That's how we measure ourselves, that we're allowed to measure ourselves and
[42:58]
that's how we thrive and we're happy, basically.
[43:03]
Well, thank you so much for dedicating your STEM training to helping people
[43:10]
living with chronic pain and migraines in particular.
[43:13]
I think what you're developing here is really revolutionary and I think you're
[43:16]
doing it in the right way to protect yourself and your team and your patients
[43:20]
and just taking your time with it.
[43:22]
So thank you for sharing all that with us.
[43:24]
Thank you so much, Dr. Jessica Edgerman.
[43:27]
Thank you for having me.
[43:33]
I don't know about you, but after that interview with Diane Ducarm, I'm
[43:37]
thinking very differently about how we can approach complex chronic illness,
[43:43]
like chronic migraine, like the work that she does at MyNectarHealth, MyNectarHealth.com.
[43:50]
Let's start getting curious about how we can use technology.
[43:54]
Technology is accelerating the growth of AI technologies, of machine learning
[43:59]
technologies are absolutely going to change how healthcare is delivered.
[44:03]
It is going to change the role of clinicians.
[44:06]
We have to be thinking about what our role is once an AI-generated tool is able to communicate
[44:17]
better than us and is able to be more accurate than us.
[44:22]
But we have to build the models.
[44:26]
These things aren't built out of thin air.
[44:29]
So when we think about building a model, how can we start doing that with the technology
[44:35]
you may have in your practice right now?
[44:37]
How can you scale something that you might be working with people one-on-one
[44:41]
to working with five people at once?
[44:44]
Because not only do you then get the benefit of being able to leverage your skill set,
[44:50]
but the people in your programs get the benefit of community.
[44:54]
And if we think about a tool like whether it's Oura Ring or even Peloton or...
[45:00]
this app that she's talking about, Migraine Heroes, when people feel like other people
[45:06]
are going through the same thing as them, even if they're not in the same room together,
[45:11]
there is a sense of community, right? So we had that little story about how everyone was
[45:16]
feeling stressed by our election last week. When you see that as a community, people are
[45:23]
going through stressful things or going through celebratory things, or we're seeing some people
[45:28]
getting improvement and other people's cheering them on. How can you bring that sense of feeling
[45:34]
not alone, but also feeling a sense of commitment to the process over time? That accountability
[45:41]
is much more fun within a community. That's why Peloton was so successful during the pandemic,
[45:48]
because everyone kind of was connected, even though they were exercising at home instead
[45:54]
of at a gym. So I think there's really important shifts coming in the world of technology and
[46:02]
healthcare, and I think they're going to go in two different directions. I think one
[46:07]
direction is going to be more technology leveraged digital community that's more scalable because
[46:16]
we can put complex questionnaires and solutions into machine learning models and have them
[46:23]
be more and more accurate over time. How those models are built does matter. So women
[46:28]
need to be involved. Healthcare professionals need to be involved, not just technology experts
[46:34]
and people with business degrees.
[46:37]
And then second, I think there's a really accelerating opportunity in creating small,
[46:46]
in-person group experiences, either through art or through nature or through song movement.
[46:55]
Any kind of physical in-person collaboration in a more and more technologically accelerated
[47:01]
world becomes so much more valuable. So think about how you can get your clients together
[47:07]
and outside, children outside, people dealing with the same thing outside and communicating
[47:14]
or together and maybe in an art space being more creative. I think we're going to see
[47:20]
that both of these things become increasingly necessary and valuable as healthcare transitions
[47:28]
continues to transition. It's been transitioning for years now, but continues to transition
[47:35]
into an age of accelerations of technology.
[47:39]
Thank you so much for listening. Get curious in your own practice, and I will see you next week.
[47:50]
Thank you so much for joining me today for this episode of the Integrative Women's Health Podcast.
[47:57]
Please share this episode with a colleague, and if you loved it, hit that subscribe or
[48:03]
follow button on your favorite podcast streaming service so that we can do even more to make
[48:10]
this podcast better for you and your clients. Let's innovate and integrate in the world
[48:18]
of women's health.
