Overcoming Pain in EDS: Building Stronger Bodies with Whealth Founders Katie & Andrew Dettelbach (Ep 108)

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Dr. Linda Bluestein: [00:00:00] Welcome back, Every Bendy Body, to the Bendy Bodies podcast with your host and founder, Dr. Linda Blustein, the hypermobility MD. If you're like me, you have struggled with trying to find the right amount of movement that works for your body. with joint hypermobility. This could be so challenging because the target is often moving, right?

So like what works one day in one year is not the same thing as what works another day or another year. I'm so excited to chat today with the founders of Wealth, Katie and Andrew Dettelbach. Both Katie and Andrew have hypermobile EDS. Katie combined her background as a critical care nurse, her love for movement and Pilates, and her frustrations as a patient to develop an online method to address the [00:01:00] limitations of chronic pain and hypermobility.

She's spoken in the U. S. and internationally, educating other professionals and sharing her personal story about pelvic health and chronic pain. Her program Wealth has helped thousands of people worldwide overcome limitations and return to doing what they love. Andrew has a degree in kinesiology, clinical experience in sports injury rehab, and has coached tens of thousands of people around the world, helping them overcome their chronic pain.

He has overcome a myriad of chronic injuries since the age of eight. He is excited to share how it is possible for everyone to make profound, positive impacts on their lives. I'm so excited for you to hear from them so you can get some ideas of how you can improve your functional capacity as well. As always, this information is for educational purposes only and is not a substitute for personalized medical advice.

Stick around until the very end so you don't miss any of our special hypermobility hacks. Let's get [00:02:00] started.

All right, Andrew and Katie, I'm so excited to chat with you both and learn more about hypermobility. What you've been up to and your program, your program Wealth, which is incredible and how you've been teaching people to work better with their bodies, their hypermobile bodies. Um, but Katie, let's start with you.

Can you start out by telling us what struggles in particular that you have had with your hypermobility? 

Katie Dettelbach: Yeah, so, um, I, like many people, was diagnosed later, uh, in life after I had had my second child and had, um, experienced pretty significant pelvic organ prolapses, uh, multiple prolapses, um, after what was not, you know, like a traumatic birth or anything, a very straightforward word.

Fast, um, labor and delivery. And, um, that kind of just took me in a direction of looking for answers as to why. And, um, ultimately that, um, You know, led to [00:03:00] me finally being diagnosed with hypermobile EDS. 

Dr. Linda Bluestein: You're super passionate, both of you, about helping other people. And, and I see Andrew with a dog toy, so I'm going to just let people know if they're watching it on YouTube, you have a puppy, right?

So we may hear a puppy. We may, we may see a little distraction here and there, but, um, I apologize 

Andrew Dettelbach: for that. No 

Dr. Linda Bluestein: worries. No worries. I just thought I'd mentioned it because, uh, I, I've had puppies. I've had plenty of puppies, so I know how that is. Okay. So you are both super passionate about helping people with hypermobility and helping them regain function, um, as much as possible.

So, um, Katie, can you also tell us like, How, how you became so passionate about that and, um, and what continues to drive you? 

Katie Dettelbach: Yeah. I mean, I think I struggled, um, again, like a lot of, um, us with this diagnosis have had the similar background of just struggling for a lot of years with [00:04:00] kind of, you know, unexplained frequent pains, injuries, you know, things that just always seemed a bit more challenging.

Um, I tended to push through a lot of that stuff because I was very active and I, you know, wanted to continue to be active, but it was just very frustrating that I felt like everyone around me could do all of these things and not be getting injured all the time. And I was, you know, constantly in pain and injured, and it just felt like it was so much Harder for me.

Um, and it wasn't until I began learning about hypermobility and, um, Ehlers Danlos syndrome. And as a registered nurse, um, I was very surprised that, you know, it was something that we maybe covered like a tiny bit in like one day of lecture on. And it was, of course, the most extreme, uh, You know, um, cases that, that they kind of showcased in that lecture.

Um, and so, you know, it was not anything that was ever on my radar as a possibility. And then when I learned more about it and it was like, you know, checking all of the boxes, it [00:05:00] really began to steer me in a direction of, you know, Being able to train my body differently. Um, and I trained as a Pilates instructor at that point and began changing the way that I was trying to do strength work.

And that was so profound for me in terms of pain and how I felt and how I was able to function. Um, it just hands down for me was one of the biggest things that helped me. Um, but it did require a slightly different approach than the typical kind of group classes or strength work that ultimately would lead to injury every time for me.

Dr. Linda Bluestein: Yeah. And a lot of people struggle with that, right? They, they're told that they need to move more, but then when they try different things, I mean, this definitely happened to me as well. And I know. Um, a lot of people can resonate with that, that you might try different things, but it seems like it sometimes can be hard to find the right thing.

So, um, I'm really excited. We'll kind of in the second half, more so dig [00:06:00] into the wealth program and, and that's that specific aspect. Um, Andrew, I want to talk about your background a little bit. So, so you also are diagnosed with hypermobile Ehlers Danlos syndrome. And, um, you know, your case is, rather unusual.

I mean, of course, we've talked to other males that, that have hypermobile EDS, but a lot of people looking at you would be like, Really? Because you're obviously a, you know, strong guy and we're going to talk about shirtless dude in a minute too. Um, so how you got that, that handle, but, but tell us about your diagnosis experience and what life is like for you.

Andrew Dettelbach: So I was diagnosed because Katie was like, if I have hypermobile Ehlers Danlos syndrome, you have to have it. So I ended up going to a geneticist with Kaiser and he Diagnosed me right there. Uh, did a bunch of tests that I'd never seen other people do. Like he even looked at how my, my big toe kind of turned a [00:07:00] relative, not, not at the proximal joint, but the distal joint, how it like rotated and where he used that as one of the guides, but he, he looked at all kinds of stuff and, um, he's like, you definitely have it.

I didn't end up getting tested for Marfan's cause he was concerned. He's like, I don't see. That being an issue for you, um, and if we do get you tested, it could increase your insurance a lot and, you know, mess with life insurance and whatnot. Um, if that's correct, I was, so for me, I've experienced pain since I was eight and I just kind of figured that was normal.

So when Katie was like, you should go get tested for this thing. I'm like, I don't know what that is. And I've never heard of it. And I just kind of assumed that having chronic. Pain was just a part of life and we would have members come into our program be like I'm 31 years old This is my first pain and I'm like what like that's wild.

Like I've had them every Month of my life since I was a little kid 

Katie Dettelbach: I think I would add [00:08:00] for context that I had seen him doing he did a lot of party tricks Which was why I was like he was much much bendier than I was 

Andrew Dettelbach: Yeah, I mean, I've done a lot of things with my shoulders, my toes and my abdominal region to grab attention on social media, which has been beneficial.

Um, I don't do them all day, every day, but they definitely grab some attention. So that's, that was my introduction to it and everything I know about hypermobility comes from Katie. And, um, all of the stuff that she has read. So she's the ultimate kind of person in this situation. Um, as far as my, my strength and physique goes, I do find that like, sometimes people accuse me of being a liar.

Like I don't actually have Ehlers Danlos syndrome or hypermobile Ehlers Danlos syndrome, and I. See that people also accuse me of being on steroids and that's also not true. So I think people kind of see what they want to see on social media. 

Dr. Linda Bluestein: I'm sorry there's some vicious [00:09:00] people out there and I posted something not too long ago and got you know, mostly positive feedback But there were a couple people that said like it was actually related to the klk research findings And I said something about you know, did they find the gene and they're like you were so misleading and I was like It says, the blog post says, did they find the gene?

Like it's phrased as a question for a reason. Um, so, but then someone else sent me after they knew, like, we get upset about these things, right? It's hard not to be impacted when people say mean things on social media. And someone sent me an article, a journal article that said, trolls just want to have fun.

And, and it was literally an article about the, uh, psychological makeup of. So, anyway, I digress. 

Katie Dettelbach: Yeah. I might need you to send that to me. I mean, 

Andrew Dettelbach: how much, how much jealousy and self frustration and stuff is in that article? Like, I find that a lot of it [00:10:00] comes from a place of unhappiness within that individual.

Dr. Linda Bluestein: Yeah. Yeah. Yeah, absolutely. And, and, you know, there's such an incredible heterogeneity, heterogeneity between the amongst these conditions, right? So, um, I want to back up a second and talk about when you went to the geneticist and, because you mentioned about possible marfans, and I'm, I think some people might hear that and go, Oh, wait a second.

I thought if I might have marfans, I should get genetically tested. Because if you have potentially vascular EDS or marfans, then, you know, Sometimes we might do things to like lower the blood pressure or other, you know, more intense vascular studies and things. So was the geneticists in terms of like their threshold of concern, like really high?

Because of course we have various different clinical findings that can overlap. So. 

Andrew Dettelbach: He wasn't concerned. He said, I didn't have a lot of like the physical features. Katie was more concerned about that. Like Katie's like, I feel like you should just go and like get evaluated and make sure you don't have this.

Because I [00:11:00] have really long kind of lanky arms 

Katie Dettelbach: and he's he's six foot fives, very tall. And when he was younger, before he had a lot of muscle was very lanky. And I just You know, he was like, well, why would I go to the geneticist to get diagnosed with EDS if there's nothing to do for it anyway? Like, what's the point?

And I was like, well, it would just be good for a professional to like, evaluate you and just make sure that they're not concerned about anything else. Yeah, 

Andrew Dettelbach: more my heart than anything. So yeah, I, I never have gotten tested. I could possibly get an echo at some point in the future just to see, but I, I haven't done that either.

Dr. Linda Bluestein: Yeah. That's, that's something that I personally do normally get when people are newly diagnosed. I usually do get an echo just for a, for a baseline and just to make sure that, you know, the aorta usually is not enlarged, thank God, but you know, just to, to rule that out. 

Andrew Dettelbach: I mean, if you, if you feel I should do it, I'll go do it.

I'm totally, it's, 

Katie Dettelbach: I, I did definitely on the side of 

Andrew Dettelbach: like, go do those things. And 

Katie Dettelbach: he's definitely more like, if it's not broken, don't mess with it. You know, I understand 

Andrew Dettelbach: that if it breaks, you're [00:12:00] done. So, 

Dr. Linda Bluestein: right, right. Yeah. Yeah. I will. You're not my patient. Right. But I will say that if you were, I would definitely be saying like, Go get an echo because if you think about it, it's, it is like one of the lowest risk, highest yield information test that you can do.

So you know, there's, it's not invasive, it's, it's, it's very, very beneficial. So obviously you're incredibly fit, but yeah, 

Andrew Dettelbach: so she tells me to do it, but what she says 

Dr. Linda Bluestein: doesn't matter. I'm glad. for saying that. And by the way, we did not discuss this beforehand. This is, we did not. We did not set this up, but, but I think, you know, it's one, it's one of those things where if you, if there is any enlargement of the aorta, and for those that are listening that are not familiar with what that is, that's the biggest blood vessel that comes out of your heart and takes blood to the entire body, which is obviously a large area.

So that blood vessel is huge. And so if that does get enlarged, um, and it [00:13:00] ruptures at some point, like that's, that's a terrible, like usually deadly complication. So you do want to catch that as early as possible. And thank you. You know, it's one of those things where 99. 99 percent of the time, you're not going to see that.

You probably don't even have, you know, mitral valve prolapse or any of those other things, but it's just, it's such an easy way to rule that out. 

Katie Dettelbach: I think sometimes having the healthcare background, like as a cardiac nurse, having seen patients code from like dissection, I'm like on the same page with you.

Like it's so low risk, just get the echo, just be sure you have a baseline. And I think sometimes that's the difference of like, Having the background in like acute care, not, I think sometimes we go worst case scenario. Yeah, totally. Because having seen it, you know, 

Dr. Linda Bluestein: yeah, yeah. I have a family member who had a fracture recently and it was like the, the wound wasn't closing well, and I'm thinking of all the cases of osteomyelitis that I've seen in my lifetime and yeah, you, you, you, it's easy to go to that worst place in your head, but I think on balance, like super [00:14:00] important.

to do that. So, okay. Um, all right. So I, I just wanted to ask how you got started as the shirtless dude. 

Andrew Dettelbach: It would have been about 2015. I was starting to make content with my previous company and previous business partner. And, um, We needed to take the shirt off to show something for the scapula and the social media video just did incredibly well.

So then I put the shirt on and keep the shirt on for some videos. The videos weren't doing well. I took it off again. The video did really well. So I just left it off for every beats doing something for the foot or the knee. I leave the shirt off and the video would do well. And our social media grew exponentially over that period of the year.

And people just started referring to me as the shirtless dude or the shirtless guy in the video rather than using my name. Um, so that's, it just kind of stuck. 

Dr. Linda Bluestein: That's awesome. I love it. Okay. Katie, let's go back to you. Have you had some, besides the prolapse that you talked about, which, um, definitely [00:15:00] can be so devastating, especially when you're, when you're young and everything.

And, um, A lot of, I feel like a lot of gynecologists are not necessarily even really looking for that amongst younger patients. And so that's, can be really, really frustrating. Have you had other significant injuries and, or can you tell us a little bit more about your diagnostic process? 

Katie Dettelbach: Yeah. So, um, you know, once I did start diving in and learning more, you know, a lot of things made sense even all the way back to, um, when I was an infant after I was born, I had, you know, they called it like floppy baby, uh, syndrome or whatever back then.

Um, I didn't hold my head up for a long time, like past the age when babies are supposed to be able to hold up their head. I just didn't, I guess I was just kind of like a limp noodle. My mom said I was like holding wet spaghetti. Um, and she had. been referred to like a neurologist and they had done a bunch of tests on me and like they just didn't know what it was.

They had ruled out everything they knew how to test for. Um, and you know, [00:16:00] they said, just take her home and love her. And, uh, you know, by the next year, my mom took me back and said, you know, she met all her, like caught up in all her milestones. And the neurologist said, this is now the second time in my career that I've seen a baby with like that much, um, you know, floppiness or whatever, like.

catch up. And he just said, I don't know what it is, but keep doing whatever you're doing. Um, and then, you know, just frequent injuries, um, specifically shoulders, um, a lot of low back pain, even as a teenager, um, my shoulders still sublux really, really easily. Um, so I've done a lot of strength work on that.

And then neck, neck stuff has kind of been, you know, just an ongoing challenge where strengthening is helpful. Um, But, you know, there's, I got in a car accident, got rear ended, and that really set off kind of a cascade there for a couple years where I was just struggling with a lot of, a lot of different [00:17:00] issues during that time.

And then a lot of the, you know, I've kind of always had low blood pressure and, you know, the fatigue and, um, was finally diagnosed with the mast cell activation syndrome, which has been really helpful for me. One of my actually biggest issues or complaints I've had is the GI, um, issues that I've had, um, was diagnosed with IBS very young and just, it's like, I've never been able to figure out the right, um, Combination of things to really improve the GI issues and, um, actually treating the, the mast cell stuff has been.

extremely helpful for that, which has just really, really improved my quality of life in that area. 

Dr. Linda Bluestein: Yeah, that's, that's so fascinating to me because I feel like gastroenterologists in general should know so much more about mast cell activation syndrome than they do. Um, I also was diagnosed with irritable bowel disease.

Probably older than you, but I had GI problems going back quite a ways [00:18:00] and definitely that was not on anyone's radar then. And I see that with my patients and my clients that are seeing gastroenterologists, you know, usually they'll, they'll scope you and rule out. You know, some of the clear cut things like inflammatory bowel disease or ulcers and things like that.

But yeah, working with nutrition and supplements and other things to improve mast cell activation or medications does not seem like it's really on their radar. Yeah. 

Katie Dettelbach: Yeah. It was actually just a primary care doc that put me on the Bonolucas and that just improved IBS symptoms more than, you know, anything else that I've done.

Dr. Linda Bluestein: Yeah. Oh, that's really interesting. Okay. Andrew, what about you? What has been your most significant injury? 

Andrew Dettelbach: Um, my disc herniation in 2013, that was a two year long process. I had a 10 millimeter herniation. [00:19:00] I, um, you know, my uncles had six back surgeries before I had that surgery, that herniation. And I knew I didn't want to go the surgical route because he's still in severe pain and, um, you know, he's got a pump in his body and he can push the pump and it injects fluid into his spine and like, but they missed, so it doesn't work.

So you'd have to have another surgery to move that. I'm like, it just looked like an arduous, ridiculous, expensive and. Fruitless process. So I decided to go the more conservative route and I just did the smallest amount of exercise I could possibly do on a daily basis. I was given a sheet with five exercises on it from a physical therapist at Kaiser.

And he's like, you need to do these. And I did them religiously and I was struggling heavily. I was taking a bunch of medications. I went through a thousand ibuprofen in three months. Don't recommend [00:20:00] doing that. Uh, on top of all the other things that they had prescribed to me. And I felt like my life was just a blur during that time.

Um, you know, I'd struggled to go to the bathroom and couldn't sleep and couldn't stand up straight. I was kind of curled over and just like hobbling around. Um, It was a brutal existence and I did, I, but I did everything that I could on a daily basis to try and make marginal improvements. And I did. And it was like these 1 percent improvements every two weeks that I saw.

And I'm like, Oh, I'm able to walk a little bit farther. We're talking like 30 steps more. I'm able to do a little bit more extension in my, in my lower back. Um, 

Dr. Linda Bluestein: and 

Andrew Dettelbach: You know, I can sleep for 15 minutes longer a night. I was looking for these tiny wins and I just kind of held on to those things over time.

Um, and then I met a CrossFit coach who was like, Hey, you should come to my gym. I could really help you. And I'm like, but CrossFit hurts people. How's that [00:21:00] possible? And he's like, not the way I teach. So I went to his gym and he taught me. A few ways to move my body that helped really stabilize my core and my torso.

And as a result, I made like a 20 percent improvement in like a month. And I'm like, what? So I stayed with him and I, I didn't touch a barbell. I didn't do any like heavy lifting or anything for about a year. And I just did some of his, his just strength training. And, um, I made huge improvements everywhere in my body as a result.

And I was at the two year mark. My sciatica was finally gone. Um, you know, I had sciatica down both sides, uh, bulge the herniated to the left bulge to the right. And it was just this constant burning sensation down my legs at all times of the day. And, um, it was just amazing when that was finally. Over, um, I've had hip impingement, I've had shoulder impingement, I have a spur in my heel, I've had plantar fasciitis, meniscus issues, [00:22:00] labral issues everywhere, um, I've landed on my head trying to do a backflip on a trampoline, that was a nice little process for my neck.

Um, I've had probably 20 rib, uh, rib subluxations. Um, I've experienced pain in every joint and I am grateful for it. And from my standpoint, because I've been able to help so many people as a result of my misfortune. Which kind of has been a fortunate thing for a lot of other people. 

Dr. Linda Bluestein: We have that similarity of, you know, kind of taking the things that have happened to us and trying to help other people because, you know, all three of us have a diagnosis of hypermobile EDS, right?

But each of our stories is different. And, um, it's great that you, that the two of you are together, uh, have this company and, and helping so many people. And I think it, If you can take these things that have happened to you and help other people, it just, it just completely changes the narrative for you.

And I think that's really [00:23:00] amazing. Um, I think it's important for people to be aware because I hear people talk all the time about disc herniations and, and you mentioned 10 millimeters. So, you know, discs herniate all the time. Um, and so that's something, you know, like. Like, don't panic if you have a herniated disc, but the amount matters dramatically and it matters where it's going and how far it's going, like out to the nerve sheath and that kind of thing.

And, and so, um, oftentimes if there is a bigger, uh, herniation, then that's when surgery is more likely. recommend, you know, recommended maybe by the surgeons. And if you have like a, uh, if you have like foot drop or something, then that's, you know, a definite consideration. So if you have a disc herniation and you literally cannot walk, you can't, you can't actually lift, you can't activate your anterior tibialis to, to walk.

Um, then that's an important consideration, but hopefully, you know, you see somebody, you see a neurosurgeon who is, conservative enough and or you have another doctor who is making sure that you don't [00:24:00] have those red flags. You don't have like a bladder or bowel problem. Um, because yes, if you can avoid back surgery, you're absolute.

I totally agree with you a hundred percent. Like it's, it, it's like the, Oftentimes the beginning of a cascade of things. And I do have a number of patients who have had intrathecal pain pumps. I think that's probably what your uncle has. Um, and so then it infuses, uh, usually morphine through the, through the pump and talk about a Band Aid, right?

I mean, that's, you're putting, uh, an opioid directly into the CSF. And so, and well, of course, people who are coming to see me are not, you know, They're in pain, so it's not working for them. So there's a lot of people that have those kind of pain pumps that are not getting relief. 

Andrew Dettelbach: Yes. And I do want to say, I think we probably turn away one or two people a year because of those foot drop issues or bowel or bladder or sexual dysfunction related to their injury.

So it isn't something that is super common that we see. We usually get a lot of [00:25:00] people that have Been struggling for a year to 15 years with their pain. Um, and oftentimes they'll look at their MRIs or their x rays and say like, I have these things and we have to educate them and say, well, everyone's going to have bulges and herniations at some point in their life.

Um, and talk about all the research around pain and how you can take a hundred people. That don't have any pain or have never had any back pain, give them an MRI and all of them are going to show something that is abnormal on that image. 

Dr. Linda Bluestein: Yeah, yeah. And 

Andrew Dettelbach: again, they don't have pain. 

Dr. Linda Bluestein: Right, right. For me, when I realized that the amount of pain that you have and the amount of damage that you have in your body are not normal.

Always directly related. And it was like that, that's when like a huge light bulb went off because I was struggling with so much pain myself. And it was like, okay, no, it's, you can have things in your body that are, I mean, none of our bodies are perfect, you know, uh, we can have all kinds of things going on in our bodies, but we can function well.

And so at the end of the day, for me, it's really about [00:26:00] function and obviously for you guys too, which is, which is fabulous. And, um, I was, that was one of the things I definitely wanted to ask. in the second half probably is about the wealth program and how you assess for things like that. So that's great that you, that you do that, making sure.

Yeah. One more question before we're going to take a quick break. So Andrew, what are some really important things, like maybe three important things that you do in your daily life to mitigate your symptoms? I know you've I think maybe already, but, 

Andrew Dettelbach: um, well exercise for one. And for me, I need to alternate between kind of lifting heavier loads and really pushing my body to build mass and create stability.

Um, and then also doing just more steady state kind of cardio or lightweight exercise and like finding that balance between not pushing my body too much with. Too much heavy load, too many days of a week, and then, you know, [00:27:00] not doing enough. So it's like this, I need to find this middle ground between the two.

And as a result, I feel great. Sleep is huge. Um, if I'm not getting adequate sleep and everything goes downhill, my, from my mind and my body, um, and you know, if you wanted to hear about the things I do to improve that, we can talk about that. Uh, and then it's, I, I think stress management, uh, and anxiety, like, We've had some stressors and anxieties in our life recently.

As a result, I've had to stop pushing myself as hard in the gym, but also just making sure that I'm doing things that help to reduce that stress and anxiety. Because when you have a lot of stress and anxiety, and you're trying to push your body and your mind too much. Things will inevitably start to deteriorate, like fall apart.

You might have pains pop up, and we see that so much with all of our people in our communities. That when they have a life stressor pop up, their job changes, they have a kid, [00:28:00] you know, good or bad stress. When they have a huge life change, there's oftentimes a quote setback or a new pain that pops up that coincides with it.

Exercise, sleep, stress management. 

Dr. Linda Bluestein: I literally, I interviewed Dr. Tina Wang yesterday. She's an incredibly brilliant person in the fascia space. She's a PMNR doctor. And she was talking about some of the, uh, actual like biochemical things that happen when we're under stress that actually make us more susceptible to pain.

And we know that physiologic or excuse me, any kind of stress could be physiologic, could be psychiatric stress, psychologic stress increases mast cell degranulation, which also makes us more sensitive to pain. So there's physiologic reasons for, for what you're saying. And I think it's important for people to understand that because I know for me, when I was in a lot of pain and these things would happen, I'd be more stressed and I'd.

be in more pain. I thought it was my fault. I thought I'm really doing something wrong and the pain must [00:29:00] just, just be in my head. So, um, I think that's an important point about stress. 

Andrew Dettelbach: Yeah, it becomes a cycle as the pain increases, your stress increases, other things in your life get worse, and then it just kind of cascades, and it's like if you can stop that cycle, which is hard to say because there's just so many, everyone's lives are so different, so it's coming down to like pinpointing the easiest things that you can kind of get rid of or change quickly.

To help kind of break that cycle. 

Dr. Linda Bluestein: Yeah, definitely. And I, and I've noticed anxiety is of course, a very common thing with joint hypermobility. And so often, you know, we get anxious and then we blame ourselves for being anxious or we're anxious about being anxious, which of course, you know, that's also a feed forward cycle.

So we shouldn't be 

Andrew Dettelbach: anxious. 

Dr. Linda Bluestein: Yeah, yeah, exactly. Exactly. Uh, yeah. So I do want to, um, talk about. What you were saying about, about sleep. I do want to talk about that a little bit more, but we're going to take a quick break. And when we come back, we want to [00:30:00] hear some of your tips for sleeping better. We'll be right back.

We're back with Katie and Andrew, and we were talking with Andrew about some of the things that he does to manage his symptoms. And you were talking about sleep. Can you share just a couple of specific things regarding sleep that you do? 

Andrew Dettelbach: Sure. So a lot of the sleep information that I'm about to say comes from Matthew Walker, and I think Andrew Huberman's had him on his podcast many times.

Um, there are some negative things that have been said about Matthew Walker, but regardless, these are the things that I find helpful. So reducing the amount of light that you're experiencing at night. Huge. So turning off overhead lights, you know, trying to use like hallway lights rather than the lights in your living room, your kitchen to kind of light the room can be really helpful to just get your brain in the place of, okay, it's dark, it's time to get ready for sleep and to start to produce some of that melatonin [00:31:00] if you're on your phone.

If you can set it to that nighttime mode or, um, I forget what it's called, but there's a mode where it turns the screen more yellow. And if you max out that yellow changes the color a little bit, but you get used to it and that'll also help your brain kind of get ready for sleep temperature. Is important.

So if it is too warm in the room and your brain isn't able to drop it's four degrees in order to fall asleep, then you're going to toss and turn a bit. So 68 degrees room temperature is ideal. Not everyone is able to do that. However, if you can find a way to decrease the room temperature with a fan or the air conditioning, um, that can be really beneficial for getting you to fall asleep much faster.

Um, making sure not to. Drink or eat food too close to bedtime. So if you drink too much water before bed, you're going to wake up and have to go use the restroom. Um, and if [00:32:00] you eat too close to bed, we're talking like an hour, hour and a half, if you can go two hours without eating before bed, then you're going to have a much more solid deep and REM sleep as a result.

Um, if you're eating like we, I love potato chips. If I'm eating potato chips or like popcorn or something like that, right before I go to bed. My deep sleep and my REM sleep will decrease significantly that night. I'll toss and turn more. I'll have trouble falling asleep. So that, that increase in sugar right before bed really prevents my mind from relaxing.

Um, so if you do find yourself hungry, then eating a protein of some sort would be a better option. Like peanut butter or Yes, so those are the big things that I find to be the most beneficial for getting your body ready for sleep and then staying asleep. 

Dr. Linda Bluestein: Yeah, and I definitely have seen and read a lot of Matt Walker's work and I think those are all really great.[00:33:00] 

And I think so often people want to jump into medication or something that seems like it's going to be a quick fix, but yeah, doing something like the things that you've described are so much more sustainable. So I think that's great. 

Andrew Dettelbach: So that root, there's valerian root, I think. Is that what it's called?

Oh, uh huh. So, you know, I've been prescribed all kinds of things from like medications to stuff like that, but it's like when you take these things, then you find yourself being exhausted the next day. Like sure, they might help you sleep, but then you're not able to wake up and then live your life. So there's usually some sort of a side effect associated with those that doesn't help you for the rest of the day.

Dr. Linda Bluestein: Yeah, yeah, definitely. No, no, no. Um, okay. So Katie, I want to come back to you. So, um, as a nurse, you've obviously worked with a lot of different patients and had a lot of training and various different things. What have you noticed about, especially maybe let's focus on younger people [00:34:00] even, um, in terms of, you know, people being like prescribed to rest versus, uh, finding that sweet spot, like Andrew was talking about where, you know, kind of starting to.

Increase your activity, increase movement, um, working on strength, trying to get back some of that function. Do you find that to be challenging in the people that you, that you work with? Because I feel like it's a common thing that I'll be working with a patient and they've been told by their doctors, like, well, you need to rest.

And it's like, Maybe, but probably not complete rest and, and not for the duration that you have been resting because oftentimes that the body just gets weaker and weaker. Right. So how have you approached that? 

Katie Dettelbach: Yeah, I see, um, you know, kind of a wide range. I definitely see some people come in and say, I was told to rest.

I was told I can't do all of these things. I need to stop running. I shouldn't do, you know, I should only swim. Um, [00:35:00] so there's definitely these people that have, you know, interacted with a provider who has kind of instilled a bit of that like fragility mindset in them. Um, versus then there are some people that come in that say, yeah, my doctor said it was no big deal.

I can just do everything like everyone else. Like it doesn't matter, you know? And then there are some obviously that are kind of more in the middle of there. But yeah, there's definitely, um, a lot of education that we do around people really being able to listen to their body, um, and get to a point where, the sensations in their body, um, aren't adding to their anxiety or fear, but that they're able to kind of listen to it and start to distinguish between good pains and bad pains.

You know, when you are exercising, um, there is soreness, there is muscle fatigue. There are sensations that sometimes aren't, you know, I wouldn't necessarily say that they're good, you know, um, but they're not hurting you and they are sometimes [00:36:00] an essential part. And so, We do a lot of work with people of just learning their own body and learning when to push and when not to push, and teaching people to also, again, look at the other factors in their life.

Like, if they're having a flare, um, in another area with, like, mast cell or POTS or something, then, you know, that's probably not the time to, like, their weights heavier or double down with their workouts. Um, also with women and their menstrual cycles, you know, we talk about that because there are certain points in the cycle where it would be good to try to lift a bit heavier or push yourself a little more.

And then there are other points where that's not, you know, something that we would recommend cause we just tend to see a lot more flare ups and stuff. So, yeah, I think it's You know, they're also personality types. I find some people are very like type a, like they want to go all in. They want to do their workout every single day.

And those people often do need the message of like, you know what? You do need to rest more. You need [00:37:00] to dial it back. You can't show up a hundred percent in every facet of your life, you know, and think that you're going to be. be able to sustain that. And then there are other people who, you know, err more on the side of like, well, I'm in pain.

I can't do anything. And they kind of need more encouragement of like, but actually moving can help your pain. You know, I know that it can be scary, but that sometimes is exactly what you need. 

Dr. Linda Bluestein: Yeah, and I think knowing where someone is in that, uh, mindset is very important because of course that also can change over time, right?

So I generally, like for most of my life, was more the type A, but then when I was having a lot of pain, I definitely didn't push myself and got, less and less and less active. And I would be like, okay, I can go up the stairs one time today, so I better plan ahead. And now I go up and down the stairs as much as I need to.

So, um, it's It is very important, I think, to assess where someone is in that [00:38:00] process because that greatly influences the recommendations. So that's great. Um, tell us about the WEALTH program. We want to hear, um, and either of you can start with this, um, what it is, why you developed it, and then we'll talk a little bit about like who, who are good candidates for the program.

Katie Dettelbach: Yeah. So, um, so we have a couple of different programs, um, but we made one program that is specifically for people who are hypermobile. Um, I was pretty passionate about making that resource, um, because I just wasn't finding much available like that. Um, you know, we had our limitless program, which is geared toward people with chronic pain, but not specific to hypermobility, just anyone with chronic pain.

And, you know, You know, over the years, more and more resources like that have popped up for people with chronic pain, but I just wasn't seeing much available in an online format that was easy for people to access from [00:39:00] home, you know, when it's convenient for them, that was giving really good education on hypermobility.

So that's why we Um, you know, made that program, um, with a lot of our teaching, we work with a local medical illustrator, and so she comes and she paints our bodies, um, and so throughout the process of making that program and filming it, um, we did a painting with her every single day for a couple of weeks, uh, during the filming process.

And that helps us teach people, you know, for a specific exercise, where they should be feeling it. And that's something that I've seen to be very valuable, um, for everyone, but especially for us hyper mobile folks who sometimes aren't as good at kind of knowing where we should feel things or, um, a lot of us are very good at compensating and like imitating.

So, you know, someone can demonstrate a movement. And a hypermobile person a lot of times can copy them, but [00:40:00] oftentimes there's a lot of compensation going on, um, and so helping them understand the point of the exercise, why they're doing it, where they should feel it, um, is part of our education and, um, is something that we've, um, found to be really helpful.

Um, and then we cover just, you know, all of the, you know, systemic things that we can see in folks that are hypermobile, which a lot of people coming in, um, aren't aware of. Um, you know, we have some folks who have been diagnosed with hypermobile EDS. We have some folks that, you know, joint hypermobility syndrome.

We have some people who have never been diagnosed with anything, but, you know, they're like, yes, they're hypermobile. I'm definitely bendy. Um, and so that education for some folks, it's, you know, things that they are already aware of, but for others, it's, it's stuff that they've never heard before. And that's, it's always fun to see those light bulb, like, wait a minute.

Oh my gosh. This explains, you know, so much. Um, yeah. Yeah, and we, you know, we go into exercises. Um, it [00:41:00] starts at the very basics. Um, I mean, anyone can come in with no exercise background. Um, we also have people who are very high level athletes who come in. And sometimes we have to prep them a little bit of like, I know it's gonna feel boring, but we have to go back to the basics and really create that solid foundation.

Um, and when they do that and then they return to their sport, um, they often find that they have a lot less injury. And that, you know, a lot of times some of that foundational stuff is just lacking for them. 

Andrew Dettelbach: You did a good job covering it. 

Katie Dettelbach: Yeah. And then we, we delve into, you know, we have like our five pillars, which are movement, which is, you know, kind of a lot of our forward facing education is around movement.

I think that that is, um, sometimes easier for people to grasp onto than like nutrition, stress management, sleep. Sometimes those things are, it can be more challenging, I think. So we do [00:42:00] a lot of outward education on movement, but the program then covers. Stress management, sleep and restoration, um, nutrition, what else?

Andrew Dettelbach: Environment. Environment, yeah. The environmental aspects of, are, are very important and often overlooked. So we do have a community that goes with our, our program where it is just really great to have hundreds of people that have. been diagnosed or think that they have hypermobility of some sort. Um, to be together in the same group and you've got some veterans that have succeeded, they're back to doing all the things they wanted to do again.

And for those people to be able to share with the new people. Um, what they've been able to achieve and then also have, you know, a group of people going up together through this process is really awesome to have them kind of supporting each other. Uh, but also just teaching people like, you know, the people that you surround yourself with in your life, not on the, not online, but the people you surround yourself with in your life.

[00:43:00] Also makes a pretty dramatic impact on how you're going to be able to take care of yourself. If you're around people that are not interested in doing exercise or being healthy, it's going to be harder for you to do the same. So trying to make sure that you're around individuals that have similar goals to you.

Dr. Linda Bluestein: Yeah, that makes sense. There's so much data that shows that if you are around smokers, you're more likely to smoke if you're around people that are, yeah, you know, not, not eating as well, or, you know, like you said, paying attention to their, to their health. So I think that, that makes a lot of sense. So there's also the, the community, they can communicate with each other somehow, either via an app or the website.

Andrew Dettelbach: So we keep it in Facebook. That is, you know, people, Say like, you know, a forum could be great or an app, but Facebook is by far the most versatile platform that I've ever used for groups. Um, the fact that people can upload, you know, 20 videos if they wanted to at a time and get [00:44:00] evaluated on their exercises and how they're moving, I'm able to then provide feedback.

We have another coach, um, I, who also provides feedback. Her name is I, she's from Japan. And, um, and, uh, That's been really beneficial for people. And then, you know, we can do our live coaching calls in there and whatnot. So, 

Katie Dettelbach: yeah, I think it's something the community, I think is really special and it's something that I really wanted to be a part of the program because when I was learning about hypermobility, there are certainly.

Um, a lot of groups and forums and Reddit threads and things like that, um, which can be helpful. I find them to be very helpful in terms of finding like local providers who are, you know, EDS aware or things like that. But I found that those groups sometimes had a very negative focus. It, it almost felt like sometimes it became a competition of like, who was worse off and it wasn't very solution focused [00:45:00] or.

You know, no one was like looking for the silver linings or the positivity. And I just often felt more anxious and more depressed when I would read through those groups. And so it was important to me to have something that was a community, but that stayed like, it's okay to vent about the challenging stuff.

We're not going to pretend like it's not hard because sometimes it's just, it's really hard and that's okay. But always encouraging people to come back to a place of, okay, now what can you do about it? What are the actionable things today that you can do to improve the situation, no matter how bad it is?

Um, and the community has just been really special. I think, you know, with healthcare and HIPAA. you know, sometimes it can be really isolating, especially if you're a young person and you're dealing with some challenges and you look around your friends in real life and it's like, why is it so much harder for me?

They're, they're not dealing with this. Um, and so then to be put into a community of like minded people who have similar challenges, but who are also focused on improving, um, you know, has been really beneficial. And it's been so cool to see [00:46:00] people, you know, in certain cities, like become friends and meet up in person and do workouts and stuff.

So, 

Dr. Linda Bluestein: Oh, that's great. So it sounds like there's a lot more than, you know, a lot for a lot of us anyway, for me, I should say, you know, I've, I've seen some of the videos, which are fantastic. And I love how you give modifications and, you know, you say, okay, if you, if you, you should be feeling this in this particular spot, if you're not, then, you know, make these adjustments.

And, um, I think that's, that's really, really important, but it sounds like there's a lot more to the program then. So is it possible to have Um, you, you mentioned about the coaching or uploading videos. So if someone is, because the program is mostly online, right? So, or it is online, I should say so, but somebody can get feedback on their form, I guess is what I'm trying to ask.

Katie Dettelbach: Yes. Yes. That is part of the, the program is you have unlimited feedback. feedback so people can post in the community and some people prefer to post anonymously. Some people are not comfortable uploading a video of themselves doing an exercise, so [00:47:00] they may just describe with words what's going on, what they're feeling.

We can give feedback that way, but we do definitely encourage people to give a video because it just shows us we can coach you so much better if we can see what's happening. 

Andrew Dettelbach: I always say, I'm like, if a picture tells a thousand words, then a 60 second video is going to tell you a lot of words. 

Dr. Linda Bluestein: Yeah.

Exactly. Exactly. Okay. So that, that's really, really great to know because we know that moving more is, is important for a lot of us. We're moving as much as we can, um, without causing problems. And I totally agree about the str, different stressors in your life and at different points in your life, you're going to have different thresholds for, for, for movement.

But we also want to make sure that we're doing it the right way. So I think that's, that's great that you do that, um, actual coaching. So who would not be a candidate for the programs that you do, the limitless program and the hypermobility program? 

Katie Dettelbach: Yeah. I mean, our general, um, kind of guidance that we give people is, You [00:48:00] know, if anyone's ever not sure if the program's right for them, we just tell them to consult with their medical provider, their physician, you know, if they're explaining something specifically going on, um, like with a disc herniation, you know, we'll say, you know, have you spoken to your neurologist?

Are they okay with you doing exercise? Um, you know, if not, then ask them for a referral to like a physical therapist who may be able to help you hands on in person. Um, obviously any of those concerning symptoms, any anytime someone, you know, ever has any foot drop or loss of sensation or bowel or bladder sexual dysfunction, anything like that, you know, we're going to tell that person you're not like, we're not the right thing for you need to go see someone in person right away, you know.

But, you know, most of our Our clients are people who have done, a lot of them have done physical therapy, um, either haven't found it beneficial enough, or it's not convenient enough with having to [00:49:00] drive there physically in person. Um, and in the hypermobility group, you know, a lot of people go to PT and, and actually end up worse off.

Um, I mean, that's something I also experienced with, You know, I think it's just important to have a PT who is knowledgeable about hypermobility and who isn't trying to do things that are going to, you know, make it worse. Um, we have a lot of people that are like, I did this exercise in physical therapy for months, and I, I like, I was never doing it right.

I didn't feel it where I was supposed to feel it, and it wasn't helpful, and like, with a little bit of cuing and adjusting, you know, they're like, Oh my gosh, it's, it's so helpful. Now I know why they were trying to have me do that for months, you know, 

Dr. Linda Bluestein: not all physical therapists do that, but some of them, you know, when you come back for the next session, of course, they always ask like, how are you doing?

Um, but I think it's also good when they have you show them, the exercises because number one, if you, if you can't remember what they are, then you probably weren't doing them. Um, and, and then they can see like, are you doing it [00:50:00] right or not? Because oftentimes, yeah, they, they show us the exercise and we're like, yeah, we got this.

And then you go home and you're like, you know, form isn't right or, or whatever. So, 

Andrew Dettelbach: So I guess to go off, you know, anyone is able to do the program as long as they're cleared by the doctor. And, uh, if they're ready to put in effort, then. That's, that's really it. That's kind of the requirement. If you're ready to do the work, then 

Dr. Linda Bluestein: there 

Andrew Dettelbach: you go.

Cause it's not just gonna, you can't just get it and then you feel better. You have to do it. To 

Katie Dettelbach: actually do, we have, we have to remind people that sometimes like buying the program is great, but if you're not, if you don't actually do the work, it's not going to help you. 

Dr. Linda Bluestein: Right. Yeah, no, that's an excellent point.

So. In terms of doing the work, is there a certain amount of time per day that people should be thinking, okay, like, do I have this much time to devote to my health and to improving my Function and that kind of thing. Is there a certain amount of time per day that like is the minimum and or the ideal amount of [00:51:00] time?

Andrew Dettelbach: So this is a fun question because everyone has a different schedule and what we often see is that some people will be incredibly busy. And they're able to get an hour done each day. So other people are also busy. We all have the same 24 hours in a day. So I think it ultimately comes down to how much are you willing to sacrifice to put into this?

Now, if you're like, I'm not willing to sacrifice that much, then we say at least 15 minutes a day. And that can be broken up. So if you're like, all right. You do the heavy lifting of watching the videos. You learn the exercises and then you're like, I don't have time to do a formulated workout in my life schedule.

We'll just pick a few of those exercises and do them throughout your day. Do multiple repetitions all day long, whenever you can, you know, you walk in the front door, you do them, you're doing the dishes, you're doing something with your feet or something like that. Like you're constantly working on this stuff throughout your day.

It doesn't have to be a structured workout. Although. You will be able to really [00:52:00] dive deep into how your body feels and it will become a meditative process when you're able to sit down and focus on you and your body and how it feels. Um, so if you can take that 15 minutes a day, minimum and then increase it over time, um, that would be ideal.

Katie Dettelbach: I think anything's better than nothing, right? But at least 15 minutes is kind of what we tell people for the minimum. And we do sometimes, um, in our coaching challenge people a little bit, like Andrew was saying, there are some people who are like, I'm just so busy. I just don't have time. And sometimes we'll say, I want you to get your phone and I want you to pull up your screen time.

And I want you to tell me how much time every day you're spending on social media. And sometimes it's like, Oh, wow, look it, I do have an hour, you know, it's so we definitely. We challenge people sometimes a little bit like we're not too pushy, but also Some sometimes people get in their own way of succeeding.

Dr. Linda Bluestein: No that that makes sense And I [00:53:00] think that you know, if people you said you start kind of at the with the basics I guess are you starting with a certain part of the body or how does that work? 

Andrew Dettelbach: So another fun question. We do full body with everyone. So if your main issue is your neck, you're going to be working on your feet and your wrists as well.

And the reason being is that there's a few reasons, several reasons, uh, Well, first of all, we're all connected, you know, everything can impact just so what your feet are doing could possibly impact how your neck is feeling that can be far fetched, but it's worth it neurologically. We often so there's pain senses that pains.

I have trouble saying this pain sensitization where you have kind of trained your mind to focus so heavily on this area of pain and just for the purpose of the YouTube video the neck and you can see it. If your neck is the problem area and all you think about is your neck and how when you wake up, your neck's gonna [00:54:00] hurt, you know, you're brushing your teeth, your neck hurts, you drink water, your neck, like, if that's your only thought throughout the day, then your brain is literally being trained to focus more on the neck and your pain can get worse as a result.

So, when you have someone focus on their feet. And their wrists and their knees and their hips and their back and their, they're having to really take their brain power and focus elsewhere. It can help to desensitize the area with pain. Um, and that's been profound for people. They just, they're like, Oh, you know, I realized that while I'm doing this work, my neck isn't hurting and I'm able to, you know, get some relief during this process.

But also we need to have a strong body everywhere. Um, so we take people from the basics. We start generally with isometric exercises. Isometric would be like a plank for those of you listening where you don't move. You just hold that position. That's an isometric exercise where you can do that with the biceps.

You can do that with the neck. You can do that with your feet, your knees, your hips, your back. Um, any joint in the body you can [00:55:00] do an isometric exercise for. And then that kind of helps people instill confidence. Oh, my joints are okay when I do some strengthening and then we can start to do some full or larger range of motion exercises, and then we can start to add resistance and eventually you see these people doing pushups and pull ups and squats and deadlifts with load and feeling confident doing so.

Dr. Linda Bluestein: Yeah, that's amazing because we know that we need to put load through the joints and through our tendons and ligaments in order for them to get stronger, but it can be scary. 

Andrew Dettelbach: Yes, and to that point, you know, people will do like a bridge on the ground where you're lying on your back and you lift your hips upward and they'll be like, this, this is hurting me.

And I'll say, you know what, you should probably put 10 pounds on your pelvis. And they're like, well, why? It hurts me right now. I'm like, well, actually. Using a little bit of resistance can force those muscles to really fire and you'll feel more stable as a result, which I'm not saying go put a hundred [00:56:00] pounds on there.

It's a light load. 10 pounds is something you pick up throughout your day and just putting that on your pelvis or for various exercises, increasing the resistance a little bit can actually make it feel better. And that can be really counterintuitive for people to hear. 

Dr. Linda Bluestein: Yeah, that definitely can be counterintuitive.

That's really interesting. I suppose that also might help with that proprioceptive feedback if you have that, yeah, so, which is important because proprioception knowing where your body is in space without looking can lead us to having dysfunctional movement patterns and working on that can really be so helpful.

Andrew Dettelbach: And that's where people recording themselves or watching themselves in a mirror can be really beneficial and if you're uploading that to our groups, then we're like, Hey, you know, you're doing this if you didn't notice and then they'll start to pay attention to the faulty pattern that could be contributing to the pain that they're experiencing.

Dr. Linda Bluestein: So I asked people if they had questions for, for both of you. And I did get a couple of questions that I want to throw in here before we get to the hypermobility hacks and start wrapping [00:57:00] up. So the first question was about osteoarthritis and hypermobile EDS. And basically, you know, is it safe to exercise?

Go ahead. 

Katie Dettelbach: I was going to say, I'm like, you're the doctor. Anytime anyone has like a medical, we, we do try to reiterate frequently that, you know, we're not giving medical advice. Right. Please. You know, I don't know your history. I don't know all of your stuff and I don't want to know. Like, I want you to go to your medical provider who knows you well.

Um, yeah, but that being said, 

Andrew Dettelbach: So let's say for the knee, that would be a hotspot for people. If it's your knee and people are saying, is it okay for me to exercise? I'm like, are you walking around? Because that is technically a form of exercise. You could keep walking and that would be your exercise for the day.

The answer would be yes. As long as you're moving in ranges of motion that feel good after you're done. And that's an important thing because. We work with a lot of people in pain and it is impossible to do exercise [00:58:00] without some discomfort or pain a lot of the time. So when people are like, I'm doing this and it feels bad and then I'm done and I feel okay.

I'm like, that's okay. If you're doing an exercise and you feel worse after doing that exercise that we need to modify it by reducing the weight, reducing the range of motion, the number of repetitions, the sets. Uh, the range of motion. I don't know if I said that, uh, I did. Um, but modify it in some capacity.

And if those modifications don't help, then we avoid it. And so it really comes down to what are the exercises and have you tried them? And once you do, then we can determine whether or not that exercise is okay for you, because there's going to be some exercises in the program that aren't going to be ideal for you right now.

That doesn't mean you should avoid them forever, but there's going to be other exercises in the program that you will be able to do and feel great doing. It's very nuanced. 

Dr. Linda Bluestein: Yeah, no, I totally agree. And that's the thing. If you have knee arthritis. Then that's a great, it's a great example because of course, that's something that, you know, if we live long enough, we're all going to [00:59:00] get that.

So avoiding moving is not the right approach to that. We really want to strengthen the muscles around that area because that will, you know, actually help offload the joints. So 

Andrew Dettelbach: when, when I was graduating with my degree in kinesiology, we had a woman come speak to us. She's a marathon runner. She was 95.

And she had severe osteoarthritis and she said the first three miles of every run was agonizing. And then the remaining 23 miles that she did, I think every couple of days she did a marathon, um, she would feel amazing and she would feel amazing for a couple of days as a result of doing that. But it was always that like, you know, It was getting that synovial fluid into the joint, the lubricant in your joint that was the most beneficial for her.

And she found that that like 3 miles of agonizing pain was nothing compared to the freedom that she would have for several days afterward. [01:00:00] So, when we have arthritis, we want to get some movement to get some lubrication in there. 

Dr. Linda Bluestein: So, so I, I, I have to ask, so this 95-year-old woman, was she still doing marathons?

She was, I, 

Andrew Dettelbach: I'm, 

Dr. Linda Bluestein: oh gosh, this was, 

Andrew Dettelbach: this was 2013, so I don't, I don't know what's happened to her at this point. Right. You know, what's happening 

Dr. Linda Bluestein: with her. But, but, but at that time she was 95 and she was still doing marathons. 

Andrew Dettelbach: Yes. And uh, oh my gosh. That's crazy. She was incredible. 

Dr. Linda Bluestein: Yeah. Wow. Wow. That's amazing.

Um, and I tell people all the time that a big thing is not just how you feel. Like you said, it's how you feel during, it's how you feel afterwards and how you feel the next day and where you feel the soreness. If you feel sore in your muscles, like I love that. I miss that. Feeling 'cause I don't get it as often as I, as I used to.

But, um, I love having that muscle soreness, those delayed onset muscle soreness. Yep. That's, I love that. 'cause that means I worked my muscles hard. Um, but if you feel pain in your joints and if it lasts for a long time, like I, I, I taught Zumba [01:01:00] for a short period of time and I, I loved Zumba. I was like so addicted, but I really couldn't teach the cl.

I had such a difficulty. time learning the choreography and then teaching the class and not putting myself into such a bad flair that sometimes would last for months. So it was like, this is, this is too much. Cause it was too repetitive, you know, trying to learn the choreography and I would be doing a lot of it just like without moving my body.

But, but anyway, I think it's, it's really paying attention to those things, how your body feels and how long it is. It.

Another one of the questions was regarding upper cervical instability, and we could probably all answer this question with literally just one word. Somebody asked if strong shoulders, upper backs, and necks make upper cervical instability less symptomatic. And the answer would be yes. And 

Katie Dettelbach: it can be tricky.

I mean, it definitely can be tricky because some of that strength work, even very simple movements [01:02:00] can flare things up. Um, when I was dealing with my next stuff, I mean, that was definitely an incredible learning experience. I think that was probably the most frustrating injury that I've ever navigated.

Um, definitely more tears around that than anything else. And Andrew was really amazing with me during that time, just working on it. I would try something and it would make it worse. Try something. And so we really had to get creative with making it so simple. Like the littlest, tiny, like literally just sitting and just contracting my muscles without even providing any type of resistance at all, um, in very short, like, I mean, I had to start at the very basics and build it up and it can be scary sometimes to do something.

And, you know, if you do it, do a little bit of strength work and it causes the pain to be worse, it can make you want to just avoid it altogether. Um, but that's also not the answer. Cause getting weaker, you know, You know, we all know where that takes us. Also, 

Andrew Dettelbach: vicious cycle. Yeah, 

Katie Dettelbach: so it's, [01:03:00] it is challenging.

And I, you know, I definitely have a lot of empathy for people who are in that situation because it is, it is really hard. It's very frustrating. 

Dr. Linda Bluestein: Yeah, it is very frustrating. And upper cervical instability is such a wide spectrum. So mild cervical instability is extremely common. And Severe, thankfully, severe cervical instability, thankfully, is much more rare.

And there was a great article, and I've interviewed Dr. Leslie Rusick, who is an amazing physical therapist. I've interviewed her a couple of times for this podcast, and we talked about this article that she wrote with my very dear friend, Dr. Patty Stott, who I rent space from here in Colorado, and they talked about like red flags.

So kind of like what we were talking about for the. for The red flags for cervical instability are really important, but most people, thankfully, don't have those red flags, or at least it's much more common to be on the mild spectrum. But you still, like I've been, Katie, I've been where you've been, where my neck is so [01:04:00] flared up that trying to find those little tiny things that you can do to just start.

Start making some gains can be can be hard. Okay, so I like to finish every episode with hypermobility hacks and You could probably each give us lots of hacks, but we'll ask for each of you to give us, you know One or two maybe and we'll start with you Katie. 

Katie Dettelbach: I mean obviously movement strengthening My number one hack number two is probably hydration.

I'm just staying really thoroughly hydrated Um I add electrolytes and I drink, I like Bloody Mary mix. Um, it has a lot of salt in it. And like, that's kind of, I having one of those once a day just helps me feel so much better. Um, and then like learning, I guess I would say self. Self massage has been really, really helpful.

I had a tendency to want to stretch. Like I would feel tight a lot and would want to stretch, but ultimately that would make things worse. Where [01:05:00] learning to use a soft ball, not a lacrosse ball, it's too tough, but a soft ball to do some self massage gave me a lot of relief. And didn't cause the pain to be worse.

Like stretching would, so yeah, 

Andrew Dettelbach: you're taking all of them. She's like, you guys probably have a million things. I had nothing in my head and then you started taking it. And I'm like, I could have picked 

Katie Dettelbach: different ones. Sorry.

Andrew Dettelbach: I felt so stressed the whole time. I can, do you want 

Katie Dettelbach: me to throw another one? I can answer one for you. I know this one you do also. Both of us do this when traveling, traveling can be tough for us when you're stuck like sitting on an airplane, sitting in an airport, sitting in an Uber, like that for both of us can just, we get pain, you know?

And so taking those massage tools with us and also just muscle activation of some kind. It doesn't even need to be like any kind of structured workout, but those little loop resistance bands. We carry in our backpacks every time we travel and just even on an airplane, slipping that up [01:06:00] around your knees, you can do it in your seat and just doing like some seated clamshells can help so much with any like SI joint, low back pain.

Um, so yeah, I would say just incorporating some form of muscle activation into travel. 

Andrew Dettelbach: I'm going to add one. Um, get away from anything that Is negative. Like, I feel like any thing that makes you kind of go through a negative spiral about your diagnosis or about your pains, if you can avoid those things, that would be super helpful.

I think a great example of this would be our current political system. There's like this, this extreme spread. From what the right and the left and they both just kind of have this, um, self fulfilling prophecy where they focus on only listening to their sides and it creates a lot of anxiety, frustration, anger.

So the same thing could be said about your pain and injury. If you're around people or in, in these groups that we were talking about earlier, where there's a lot of [01:07:00] negativity, that's going to breed negativity in you. 

Dr. Linda Bluestein: Yeah, no, I, I totally agree. And I think those, those online supports can be super helpful.

Um, but like you said, Katie, they, they need to be solution focused and not just, you know, who's the sickest and, and, uh, yeah, the negativity can really impact you a lot. So totally 

Katie Dettelbach: sometimes seeing, I think it's, you know, a lot of times it's the people who are the worst off or who are in a period of like a flare up who are frequenting those groups.

I don't see very many people that are like, yeah, I feel great in those groups, you know? And so I think sometimes just continually exposing yourself to like, yeah. The worst case scenarios of everything too, can just sort of lead you to believe that that is your future. Like that's all there is for you.

Mm-Hmm. . Mm-Hmm. , you know? And so, uh, just a healthy break from that can be good. 

Dr. Linda Bluestein: Yeah. Yeah. I agree. I had, uh, actually I had tarof cyst surgery. So, uh, we're gonna be talking about, actually, we're gonna talk to my surgeon in a few weeks, and, [01:08:00] um, it's. When I was trying to understand and learn more about that, and I was on social media and trying to, you know, connect with other people.

And, but then I quickly realized that, yeah, the people who are doing the least well are usually the ones who are spending the most time online. And I understand why, but it, We also just have to remember that we're getting a skewed perspective at the same time because of that. So, okay. Um, thank you so much to both of you for, for joining me today.

I, I'm just so grateful to you for, for coming on the podcast and sharing this incredible work that you're doing. It's, it's just helping so many people. And before you go, I want to hear, uh, what kind of projects you're up to, what kind of things you're, you're working on. Looking for in the future and where we can learn more about about each of you.

Katie Dettelbach: Yeah. I mean, um, in terms of the future, I think at, um, some point here, we'd like to get back to some kind of in person. We used to do some workshops where we would travel [01:09:00] around to different cities and do some in person workshops, or, um, we've done some presenting at, um, different conferences, um, overseas and stuff.

And we're, you know, then COVID happened and we stopped traveling for a while. And I think we're. We're both pretty introverted, but we're feeling like ready to start doing more in person stuff again. Um, 

Andrew Dettelbach: dog's going through REM sleep right now. Um, as far as current projects, we are currently updating our programs.

Um, our system is getting improved. So that is our, my, my big task the last few weeks has just been doing that. Um, as far as everything else goes, we just keep Grinding away, trying to reach more people on social media and 

Katie Dettelbach: yeah. And, uh, to answer the question of where you can find out more about us, our website is www.

spreadwealth. com and that's spelled spread w health. com on Instagram. We're at wealth, um, on Tik TOK it's [01:10:00] at wealth underscore and YouTube. I think is also at wealth underscore. Um, and on YouTube, we have a playlist, uh, specifically for hypermobility. It's a mix of like exercises that are helpful. And also sometimes we make just kind of some funny, funny videos that a lot of people, you know, sometimes we'll resume with, and I 

Andrew Dettelbach: didn't even know that 

Katie Dettelbach: we like to have fun.

Look, you're learning things. I, I run our, our YouTube, so he doesn't know much. 

Dr. Linda Bluestein: Oh, that's funny. That's funny. I think sometimes injecting a little bit of levity like that is, is really helpful because people really, including myself, by the way, um, we can really get into that like dark place of, Oh my gosh, if I'm having this much difficulty now, what's, what is it going to look like in 10 years and in 20 years?

And you know, it can be really, that can be scary. 

Katie Dettelbach: Yeah, I think we try to incorporate humor, you know, and some people don't always appreciate that. Some people definitely want a more, um, like academic, um, [01:11:00] you know, standpoint, uh, but we try to keep a healthy balance. I just, I saw so many patients. When I worked in the hospital that it's like, if they could have some, some humor, they just did well.

They, they recovered faster. They did like the open heart patients that were so serious. And so just kind of stuck in the negativity. Like they just, they just didn't seem to recover as quickly as the ones who could kind of laugh at something, whatever it is, you know, no matter how How dire the situation?

Andrew Dettelbach: I, um, yeah, there's even like cancer patients. There's someone in my extended family, what is he, stepbrother, he's going through some, some cancer right now. And he just has a very comedic outlook on it, despite the fact that he's, you know, in a lot of pain and struggling. And, um, you know, obviously he's, he's in the very beginning stages of it, but we often see those positive people and like that comedy kind of [01:12:00] go really far for those individuals.

I'm hoping that's the case for him. 

Dr. Linda Bluestein: Yeah. I hope so too. We'll, we'll be, we'll be thinking about him and, and definitely there's so much research on humor in medicine. I mean, there's lots of research on that. So I think that those are great points. Well, thank you so much again to both of you for having us.

Yes, you're so, you're so 

Andrew Dettelbach: well known amongst the hypermobility community and pretty much everyone we talked to knows who you are. And it's really awesome that you're willing to speak with us. 

Katie Dettelbach: It's great. Like, I love it having like red disjointed and your chapter in there and then getting to actually speak with you was, I was like, it was my like star struck 

Andrew Dettelbach: fan girl.

Dr. Linda Bluestein: Oh, that's so sweet. That's so sweet. Well, I'm, I'm so glad. I think that that's the other thing is people. In this space that are suffering and looking for resources, I think it's so important for them to see people connecting and working across different disciplines and seeing that, you know, [01:13:00] uh, you need to have a wide variety of resources because no one person, no one thing can really do it alone.

Give you everything that you need. You need a lot of different resources and a lot of different, um, things to try. So thank you so much. Not 

Andrew Dettelbach: everything resonates with some people, like you might resonate more with someone else than we will for them. So it makes total sense. 

Dr. Linda Bluestein: Absolutely. Well, thank you so much again, and we'll, we'll see you next time.

That was such a great conversation with Katie and Andrew, and I just love hearing their stories about how they got involved in training people to build stronger bodies. And also working on a lot of different components with joint hypermobility and their programs are online, so they're really accessible.

And with Katie being a nurse and Andrew having his degree in kinesiology, they bring such a, an interesting combination of backgrounds to their, to their programs. And I think [01:14:00] it's really a cool thing that they're doing. And I want to thank you for listening to this week's episode of the Vendee Bodies podcast.

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