In this episode, we have Dr. Stephanie Vertrees. She is a board certified headache specialist neurologist. And today, we will be talking a lot about the different causes of headaches and how they can be treated through medicine and lifestyle modifications.
We know that many of you get headaches, and sometimes, even if you pop a pill, it just doesn’t go away. Headaches can persist and the reason why it does might be a surprise to you. You might be triggering your headache with things that you do or certain stressors that you have around you. Sometimes, a Tylenol isn’t the answer to your headache.
We want to help you so make sure that you listen to this episode to know more about headaches!
Let’s talk about:
0:11 – Introduction to today’s guest and today’s topic
0:53 – Common causes of headache that Dr. Stephanie sees in her clinic
2:00 – The genetics and the nurture side of headaches and how certain aspects like trauma and lifestyle play a part in getting headaches
3:29 – Headaches as a syndrome and not simply a symptom and how medicine is not the long-term solution to headaches
5:33 – The correlation of pelvic floor symptoms, jaw pain, and headache and how everything in our body is interconnected
10:37 – Dr. Stephanie on migraines
11:55 – How lifestyle affects and plays a part in what you are feeling in your body and the importance of being aware of your body movements
13:43 – Headaches vs. Migraines and the common headache syndromes and their symptoms
20:52 – Some lifestyle modifications that you can do to treat headaches
23:13 – Medication management for migraines that Dr. Stephanie does for her patients
27:44 – Medication management for cluster headaches that Dr. Stephanie does for her patients and the different symptoms of this type of headache
32:31 – Dr. Stephanie’s top four lifestyle recommendations for migraine and tension-type headache
35:42 – Conclusion
If you want to know more about Dr. Stephanie and the work she does, check out their website. https://vertreesheadache.com/
If you have any other questions or topics you want to talk about, send me a message on Instagram. https://www.instagram.com/drmarypt/
And if you loved this episode, please leave me a rating and some comments. Please share this with your friends and loved ones, too!
I also have a free resource for you if you want to reduce your leaking while exercising. Just sign-up for our newsletter here: https://resilient-rx.com/reduceleakingexercising/.
I’ll see you in two weeks!
Hello everyone and welcome to the sex and wellness podcast with Dr Mary today I am here with Dr Stephanie vertrees she is a board certified headache specialist and neurologist and she’s here to talk to us about headaches and how they can be treated in medicine and in lifestyle
So thank you for coming thanks for having me yeah I’m excited we’ve been like kind of back and forth on chatting and getting you on here so um she has a clinic here in Austin Texas so we will link that in the podcast below but we’re going to go
Ahead and jump into headaches so what are some of the common causes of headaches that you see in your clinic so so most headache syndromes are related to a genetic disorder um and the genetics basically make the brain more sensitive than the general population in terms of its Su sort of susceptibility
To um environmental triggers so meaning your brain is going to be more sensitive than the normal person who to things like lack of sleep stressors uh muscular skeletal issues and the neck and shoulders and those things generally are things that can build up it’s usually not one thing that triggers a person
It’s the additive effect of things that pushes them over the edge and then they will trigger a headache they’ll go over their threshold and they’ll trigger a headache and that can happen in the setting of migraine it can happen in the setting of tension type headache it’s not just
Exclusively um one headache syndrome that does that so what you’re saying is you know genetics are a part of it mhm do you feel like if somebody maybe has like a history of like PTSD or trauma like that could tie in with genetics or would it be you know like nature versus
Nurture type stuff what do you typically see with that so I think there’s a component of both things going on so you know for example the genetic side of it would be that you have a susceptibility to migraine headaches or tension type headaches or cluster headaches but the
The nurture side of it would be that PTSD is acting as the trigger or stress is acting as the trigger or lack of sleep is acting as the trigger and generally it’s not just one thing that triggers a person it’s usually the additive effect of these triggers that
Then pushes a person over their threshold and then they will get their headaches as a result so you can have that genetic predisposition and not necessarily have headaches so as long as you’re working on your trigger burden so to speak it doesn’t necessarily have to push you over that threshold so lifestyle is
Actually really really important in terms of managing headaches yeah I think that’s so important because a lot of times people in general especially if you’re dealing with chronic headaches want like a quick fix right because the pain can be unbearable and debilitating but that piece the lifestyle piece is is massive and I
Don’t think that’s talked about right much at all except obviously with you right but that’s why you’re here cuz I want to talk to you about it but incorporating medicine with lifestyle right because they’re all intertwined we can’t look at somebody just as somebody with just a headache right like what are
Their lifestyle and the things that you’re talking about I think a lot of times people view headaches as a symptom and not as a syndrome and the reality is that it’s really a syndrome it’s really a condition and you have these things that influence you know that condition
And you know a lot of times you know when you’re viewing it more as a symptom oh well let’s just go pick up that Tylenol or that Advil or whatever and let’s pop a pill and let’s just knock it out and we’re done with it and that
Might work a few times but left unchecked um over time that can get worse and worse and then that’s often when people come to see someone like me is that they’ve been kind of managing it on their own but not really managing it and then it all builds up and then they
Have this out of control headache syndrome yeah the like compounding effect over and over and over correct I think a lot of that comes too just from our society and just teaching us how to not be in check with our bodies you know and I’ve seen a lot of people just kind
Of be passed through the system because almost like it’s just like oh we don’t necessarily have the time to sit down and talk with somebody about lifestyle it’s just easier to kind of give medicine and like move forward right I think unfortunately a lot of even our
Primary care doctors will do do that again they’re you know patients are complaining of headaches they’re get it’s getting treated like a symptom they’re not necessarily getting a diagnosis of migraine or a diagnosis of cluster or a diagnosis of tension type the doctor may not even know how to make
Those diagnosis and so then and so then again it’s treated as a symptom it’s undertreated and then because it’s undertreated it just over time gets worse and worse yeah and then it just like affects people’s lives and could be pretty debilitating and you know we’ll jump
Into this later but I see a strong correlation with pic floor symptoms jaw pain and headache yes you know and I think that whenever I bring that up to patients a lot of people’s minds are blown because they’re just like wait what I’m like yeah the beginning and end
Of digestion right and how that like affects how the jaw can affect your headaches as well I think people think just sometimes it’s either just the head but not as not as understanding that hey it could be coming from the neck too and the jaw and you know internally as well
Just the combination of all it right I think over time as my practice has evolved and meeting you um a few years ago and having our conversations I’ve learned a lot about that and I’ve come to appreciate you know not only pelvic floor um as being an issue um but but
Even other things I mean I think it may not be a coincidence that women have a stronger predisposition towards migraine you know and particularly women in their 40s seem to have a lot of trouble you know these are women who have often had children already pelvic floor dysfunction and then everything is
Connected you know and so then it’s just Downstream consequences you know physically you know you know with the with the pelvic floor leading to to you know core instability leading to neck and shoulder instability leading to headaches I think we don’t appreciate that and I I’ve even had you know aside
From pelvic floor patients tell me oh I had an ankle injury a few years ago and then they’ve developed headaches after that so I think we we take for granted how our bodies are connected the various parts of our bodies are connected and things Downstream really can make an
Impact and we’re compensating you know like that ankle injury might mean that you favor your other leg which leads to you know your your hips being misaligned which means then everything above becomes misaligned and think the same thing can happen with P pelvic floor and stability I’m I’m certain of that now we
Need to make sure it’s strong and well balanced um in order to make sure everything else is too yeah I think the ankle thing is spot on I mean every time I’ve seen somebody like maybe they come in post off and they’re in a boot or they’re they tore something and they’re
In a boot the almost it’s like the opposite side so if it’s the right foot I see chronic pain in the left low back and then the right shoulder it kind of like bounces and we’re not understanding that hey if we don’t look at all of this
And I just treat this ankle and then you know you’re just treating the neck and then somebody’s just treating that other you know it’s like well what are we looking at as like a whole because it’s it’s those imbalances over time and then that compounds to overwhelming the nervous system right
Right and so then and where is the base of our nervous system in our brain right and then you know and kind of understanding it from a level of that because then people can start putting pieces together and learning about their bodies and thinking like oh my gosh like
I had no idea all this stuff was interconnected I mean even in PT school and even being a PT for years I didn’t realize it to the degree that I have in just the past few years and just dealing with my own health stuff um and then really diving more into pelvic 4
Physical therapy and just my mind has just been blown in just how lifestyle and lifestyle can even just be like just daytoday stuff you know I think people think well I eat fine and I exercise right that’s you know well are you doing that’s a part of it it’s a part of it
Are you sleeping are you doing things you don’t like are you people pleasing right you know like you were saying like a lot of women get it and I don’t think that’s a coincidence either no because we’re we tend to be quieter we tend to be more people Pleasers right and we’ve
Kind of been conditioned to stay small right and that’s Chang in Flex forward don’t show our breasts because be modest you know even though we probably need to be a little more in extension than in that flexion yeah lots of lots of layers so so many so many and you know I could
Go on and on about that stuff and I actually talked about some of this in a previous podcast just kind of like an overall understanding of like chronic conditions and in general and how things that you know even just years ago I was like why I’m healthy like I eat right I
Exercise like great and then looking back it’s like well if you’re like having road rage or you’re just like irritated at the little things we’re not looking at well what else is really going on deep down like why is it that you’re feeling on edge or whatever that may be but that takes
A lot of inner work too and therapy or introspection and you know all the all the things well yeah and in migraine you know we s also sort of see this feedback loop right where even migraine in and of itself causes mood issues so a person may have migraine and not have an
Underlying anxiety disorder migraine actually might Trier cause anxiety to happen and when you treat migraine it gets better um but it can be kind of a chicken or the egg situation too or just a vicious cycle of feedback loop because pain and you know that anxiety of when
You’re going to get the pain just leads to more pain which leads to more anxiety and then it’s never ending until you really harness it and get it under control so yeah and sometimes it has to get to a point where people are almost
Like sit down to force to look at it yes you know cuz it’s it’s easier to kind of not have to into some of that stuff if like oh I get a headache every now and again whatever but if it’s like I am debilitated it’s stopping me from
Traveling I don’t even want to do XYZ and it’s drastically changing your life that’s when we have to look at it you know as much as those times are horrible and they’re not fun it’s like you know you learn you learn a lot more but at
The same time it’s still not fun to kind of go through that whole process right and yeah the whole lifestyle it’s it’s crazy how all of that can affect everything like even just thinking about I’ve had patients with like chronic headaches and even like some of
Your patients as well and just even like talking about like hey when you feel tense like what where do you feel like what do you feel like happening and and they’ll talk about something really tense and I’m like hey look at your shoulders you know and they’re like oh
My God have you really was doing that we folding in punched over you know like gripping your hands like cling your jaw like just even bringing awareness to it can be a game changer you know but you know I know you’re talking about that with your patients I guess it was more
Of like in general when I have people with like headaches and stuff I’m like s sort of like a neuromuscular R trining too of like okay that that body awareness so that you’re not clenching it almost a fake it till you make it type of thing to just avoid that
Feedback loop from happening with the brain yeah and I tell people I’m like if you’re squeezing your butt you’re probably squeezing your jaw and you’re probably hiking your shoulders so some of that is even fascinating to just even observe you know and like when you’re having especially I see even like with
Women in like stressful executive jobs maybe in like male dominated Industries or just like in really intense Industries where productivity is like above all else right and there’s a lot of internal pressures that can happen and just even noticing when you’re in meetings or you’re you’re in difficult
Conversations what is your body doing and how can you kind of reset that afterwards you know because we’re always going to have stress it’s more of like how do we get out of that Loop of stress and regulate yeah regulate some of that y feel like we could talk forever I know
So let’s let’s kind of so I think one of the things that a lot of people get confused on is headaches versus migraines so would you be able to kind of yeah break that down a bit so people can understand that a bit more so I’m a headache specialist um which means that
I special specialize in a variety of headache disorders um so headache is sort of like the umbrella term and you know migraine is one of the diagnoses that follows under fall falls under that umbrella so you know migraine is a diagnosis that’s part of you know the headache field so cluster headache
Tension type headache hinia Contin etc etc there’s many many many different kinds of headache syndromes that answers your question it does so can you touch on just maybe like the most common a few and just like a brief kind of explanation of cluster headache tension headache and migraines and how
Those may be different from each other sure so the most common headache syndrome is tension type headache it is actually the second most common Affliction on the planet the third yes according to the World Health Organization wow okay I didn’t know that the third most common Affliction on the
Planet is is migraine actually so both tension type and migraine are really common um and mostly underdiagnosed in case you were wondering number one is cavities it’s very common oh okay fun fact fun fact so um very very common syndromes largely underdiagnosed undertreated cluster headache is rarer and mostly uh
Predominantly male 2:1 ratio and a different uh manifestations so I don’t know if you want me to get into what each of the types look like um I think that would help people so they can kind of understand because they may not have you know if they’re in Austin they’ll
Have access to you or Texas but some people are like I was looking at my stats some there’s people in Germany and Europe and different parts of the world that listen to this too and it’s like what what are yeah what are some things that they could look for just in general
Just to kind of be aware yeah so symptom wise right so tension type headache basically involves muscular tension associated with headache and that muscular tension could be around the head and neck and shoulders migraine is distinguished from tension type headache even though tension can also be a component of migraine yeah I’ve seen
That um it’s very common actually but the main distinguishing factors is that a migraine has to be associated with sensitivity to light sensitivity to noise or both and or nausea and vomiting um so you have to have a component of those things going on in order for it to
Technically be a migraine what about auras does that matter so migraine can present with or without auras um and auras most Aura is visual but there are other kinds of auras as well um that often go underappreciated so there are actually motor auras where a person can
Get weak on one side of the body there are are sensory auras where they can be numb or tingly uh um on parts of the body they can they can also have vertigo as an aura so dizziness um spinning shifting they can have difficulty speaking as part as an aura I bet the
First time they have that they’re probably like am I having a stroke yes almost uniformly gosh that must be so scary for people very scary and so I think people under appreciate how powerful migraine can be it is you don’t understand it until you have one correct
Correct you know it is not just a headache it is a it is truly a syndrome it’s a brain syndrome it’s it’s not a pain disorder it’s a brain disorder and it’s very powerful because it causes a lot of different symptoms another thing that migraine research has shown over
The past 10 15 20 years um is the presence of a prodrome so which is the first sign sign that a migraine is occurring and it can happen hours to even days before the onset of pain which um can be things as subtle as feeling fatigued or irritable or urinating
Frequently or feeling thirsty or hungry or Cravings things like that people used to think for example of chocolate as being a trigger for migraines now we’re wondering if it’s actually a craving and that you already have triggered the migraine that you’re actually already in it and then it’s really good information
It’s it turns out because the sooner you treat a migraine the easier it is to get ahead of it so if you can start to appreciate some of these non-headache signs of migraine as being your warning sign and acting on that it actually really really helps people so tension
Too can also like include jaw too right can you explain whereare on the face and head that people get tension headaches so it it technically could happen any part of the head a lot of times when people are experiencing jaw tension they’re getting temporal headaches cuz when you clench your jaw
You also clench the temporalis muscle which is the muscle that’s on the side of the sides of your head they those are what we call the muscles of mastication they help us chew and so you don’t just clench one of them you kind of clench
All of them at the same time and so unfortunately there’s bundles of nerves um that go underneath that tempor Alis muscle and they Supply the sensation to the temples and to the face and so people will tend when they’re clenchers they tend to get headaches kind of in
That jaw temporal frontal area yeah that like kind of see the ram horns pattern or whatever or horn well so that’s that’s different the Rams Horn’s different because it it usually originates from the back of the head um from the ox the occipital muscles so and that pattern of tension
Can happen from the neck and shoulders and then affecting the occipitalis muscle in the back and then it will sometimes wrap forward another pattern that we’ll sometimes see is shoulder tension that actually R radiates from the shoulder into the anterior neck muscles the sternal clom mastoid which
Then also will feed into the temporalis and into the jaw so we see a number of different distributions of of headache based on where those muscular SK patterns occur and and it can be different you know from person to person so again even like eye pain too eye pain
Yes so eye pain can can come from the Jaw eye pain can also refer from the occipital area so and and there can be like specific parts of the eye that are affected so we look out for things like that too yeah and that you know from like a physical therapy perspective you
Know we’re working on we can you know dry needle part of the face the upper trap the jaw um the jaw the temporalis the upper cervical spine and then you know strength conditioning working those inner neck muscles and things like that but from your standpoint what are some things
Some of the lifestyle stuff that we’ve talked about yeah so I think you know making sure that the muscular skeletal system is in good check is really important um again I think it just depends on what pattern of muscular skeletal um you know referral patterns
You have so it might be that maybe you need to work on your neck and shoulders maybe or maybe you need to work on your jaw or maybe you need to work on the anterior angle of your neck you know so it just kind of depends on the person
And what’s going on Downstream like we talked about before ergonomics is huge in our modern society so we just are too attached to our devices um we’re not we’re too sedentary we’re not not up and about like we should be and you know when you spend 8 hours in front of a
Computer or spend you know hours at a time looking at a a you know a tablet or a phone um it really takes its toll because you’re in flexion for a long periods of time so sustain positions we we need to count find the time in our busy schedules to counterbalance that
Flexion um so we need to get up we need to take breaks we need to walk more you know I think getting that 10,000 steps a day actually there’s a lot to that because we’re sort of forced to be out of flexion when we’re up and walking and
You know I mean you can do other things too to improve your ergonomic your workstation you know things like that too so that it’s not as impactful for sure yeah you I feel like you know we do some ergonomic stuff too but it’s more of like if you you can have the perfect
Ergonomic setup and if you’re not moving like it doesn’t like you’re saying you have to move and we’re our bodies are meant for movement and that’s also how we regulate our nervous systems right you know which can you know if those are just regular trigger headaches and all
That stuff so right um from and so now for kind of like the migraines and stuff like what are some things that you do for treatment there for medication management you mean so we um we generally have a three armed approach for medication management so um there’s prevention um there’s acute medication
And then there’s rescue medication um so for prevention that’s basically something that’s in your system at all times to calm the brain down um to make it less likely to trigger make you less likely to reach your threshold it kind of raises the threshold higher so it’s harder to reach
It and I think of that particular arm as being where you can go more conservative versus more aggressive so some of the most conservative um but effective things that people can do are some supplements so really really big one is magnesium it has the most evidence of of
All the supplements that have been studied in migraine and most migraine patients have a relative deficiency their blood levels can be normal but they still have a higher requirement from magnesium than the general population um and magnesiums a really great tool cuz it’s a natural muscle relaxer it helps with sleep it helps
With stress anxiety it hits a lot of those important you know comorbidities those those triggering things for migraine there are other supplements like riboflavin coenzyme Q10 and um and then we’ll look at things like vitamin D deficiency so huge it is you know vitamin D actually helps magnesium absorb so you if you’re
Deficient in D you can be deficient in magnesium I didn’t know that yeah it’s a there’s a really important connection there okay um so yeah so and there are other supplements out there that have less evidence but might be you know interesting areas of research in the
Future um so so I would say that’s kind of more on the conservative side and then we have a number of pharmaceuticals that we’ll prescribe um as well if for whatever reason the you know supplements aren’t enough and we need to add something else in there um and even even
There you know some of the the older School things that we used to use um have some efficacy we also have newer Generation Um medications and injectables that we use for um prevention a lot of people think of Botox for example as being used only in the Cosmetic world but we actually use
It in the medical world for a whole host of reasons and one of them is for chronic migraine um and can be really helpful for a lot of people yeah I mean it it helps to kind of relax mus which again tension is an important component of migraine it works on various pain
Chemicals and then um we also have some newer generation medications that work on a migraine causing molecule called cgrp so um those are injectable monoclonal antibodies like amig mgal ajovi and vipd and then there are also some what we call Gant medications um that are oral medic that also work on
Cgrp so those are uh ntech and cipta what’s cgrp again uh calcitonin Gene related peptide what does that mean in English like translate that to non- neurology people right well so I think the way to think about it again migraine being this brain syndrome so the brain is very complicated right there’s lots
Lots of chemicals occurring in the brain that are up regulating and down ulating cgrp is one of the chemicals in the Cascade of events that leads to migraine so you you you trigger a migraine cgrp levels go up you treat with migraine medicine cgrp levels go down so it’s a
Very it’s it’s just a very important part of that process and um it’s kind of become a designer drug so to speak for specifically for migraine which is those started coming out in about 2018 um and now there’s multiple meds on the market for that it’s been very exciting
Um for our our field yeah that’s huge yeah for anybody that’s ever had a migraine I mean I never wish that pain on anybody it is yeah pretty awful yeah and so for cluster headaches then you said those tend to happen more in men yes yeah um so those tend to follow a
Circadian pattern so meaning um they tend to have happen kind of the same time of day every single day for a period of time and they also happen seasonally so they usually happen with um like the changing of the seasons so like in the fall and in the spring that
Those are kind of super common times some people get them more often than others and basically you’ll have that seasonal change and you’ll have this a a daily headache for a few weeks to even a few months and the problem with cluster headache is that they are the most
Debilitating form of headache they are far far worse than migraine even though migraine’s pretty bad migraine’s considered a moderate to severe headache cluster headaches are uniformly severe when they occur they’re shorter in duration about a Max of about 20 minutes to an hour whereas migraine is usually a
Minimum of 4 hours but that you know 20 minutes to an hour is or a couple hours is is very intense yeah um so and then there are a number of medications that can be used to treat cluster headache the options are less but they do exist um in fact cgrp is
Also involved in cluster headache melatonin is a natural treatment really yes and then and then actually there’s a lot of for many years there’s there’s an organization called cluster Busters where if you have cluster headache there’s a website that you can visit and they have a whole wealth of information
About cluster headache um but for many years cluster Busters has touted the use of silos cybin um for cluster headache I think I can’t wait till we start legalizing more of that because it’s just there’s a lot of interesting research out there in fact Yale’s doing
A study right now on siloc cybin and cluster lowd do siloc cybin for those people that don’t know it’s the magic mushrooms that’s right but no I mean there’s stuff coming out on PTSD and all all these things and it can be lifechanging for a lot of people I’m
Just really excited for a lot of this stuff to come out because of its effects on the brain I mean it’s fascinating right um and and what do those headaches look like do they present in a certain way yes so they are um unilateral um so
That means one side yes one side sorry it’s okay I’m just translating yes thank you is and um they are associated what with what we call autonomic symptoms so meaning um so it’s a one-sided headache and on the same side of the headache um you will have autonomic
Symptoms like tearing or redness of the eye congestion just on the same side um runny nose just on the same side flushing just on the same side and then another um component can be agitation um so um whereas like the migraine patient tends to want to go lay down in a dark
Room and be quiet the cluster patient generally gets really animated and agitated and paces and sometimes bangs their head against the wall even so it can be really really awful um even just that that sort of Behavioral component of it do they have physical pain yes severe physical pain okay like and
That’s just kind of anywhere it’s just on one side of the head it’s usually in the eye frontal temporal area but that mimics so much the tension headache yes so how do you determine again I think the the main distinguishing Factor are the autonomic features oh I see okay so intention type
Headache you won’t have those autonomic symptoms okay and so you said like R like irritation in the eye redness tearing maybe sweating sweating flushing um yeah cuz autonomic for you guys is more of like a change in your nervous system so you know if your heart rate increases and
Stuff and you get flushed more on one side sweating on that side anything that would basically occur if your heart rate increased right or no right potentially yeah I mean I’m trying to like break down autonomic but I don’t know that’s like the best way to describe it meaning
More like the involuntary nervous system because the nervous system you know kind of has these these things that it controls and that you don’t have control over like volitionally right yeah like your heart rate automatically yeah your heart automatically beats you don’t have to tell it too right correct but yeah is
There you know we we talked a lot about lifestyle was there anything kind of so we talked on like three kind of major headaches or forms of headaches um and we talked a bit more on lifestyle prior and so kind of jumping back to to that
Is there anything that we did not chat about lifestyle wise that yeah so I think you know in migraine intention type headache in particular my my top three maybe I’ll say my top four lifestyle recommendations would be manage your sleep make sure you’re getting you know adequate you know
Restorative sleep um every night manage your stress and manage your muscular skeletal system and then so those were kind of my top three for years and years and then probably in the past couple of years I’ve I’ve added a fourth which is alcohol avoidance um because alcohol and
Unfortunately causes a lot of problems it it it’s it’s inflammatory um it messes with your sleep um it increases your risk of cancer um there’s lots of negatives to alcohol and so more and more I’m telling my patients to avoid it I think there’s actually like a big shift especially in
Like the younger Generations like the genz years yes to avoid alcohol like I I mean I don’t drink I mean I might have one drink every few months or something just don’t respond well to it but it’s it’s fascinating to kind of see this shift at least in different Generations
Right like yeah the newer recommendation is like if you’ve never had any alcohol don’t start yeah uh because it’s it’s just better for your body to not be exposed to those cancer causing well I think we’ve just normalized it so much that the fact to take it out just seems
So like insane to people but you know it’s one of those things where I’ll go out and I’m just like I think people don’t know what to do cuz they like are you not drinking I’m like no I don’t really drink it’s just like wait what
Why I know I’m like no like this I’m not judging you if you want to have some drinks but I also I get inflammatory I get tired I get puffy I just like and then I think it’s hard it’s been a part of our society for Millennia I mean how
Do we get away from you know something that’s so ingrained in our social fiber you know especially around the holidays when you’re with family right maybe that’s what yeah but no I think then people can start looking at it realizing it I didn’t even realize this too and but there’s more and more
Like there’s a couple places in Austin that are like sober bars you know just fun cocktails and just going out and I think that sometimes people think oh my gosh well if alcohol’s out well I have a social life and you can get there yeah I mean I’ve gotten to the point where
People are like are you drunk I’m like no this is my personality I’m just weird you know e alcohol to make me aware exactly cool is there anything else that you wanted to touch on before I can’t think of anything right now oh my gosh I just love all of this information I
Think it’s great so well thank you so much for coming we will tag her information below and yeah I’m really excited to share this with people and give them information that they didn’t necessarily have before awesome thanks for coming thank You