Denise (00:03):
Myth magic medicine and everything in between two doctors talking
Denise (00:11):
Welcome to myth magic medicine today. My guest today is Dr. Judy Wright, who graduated from SUNY, did family medicine residency at St Joseph's and then worked at Mount Sinai and Richmond Community Health before moving out of clinical medicine to continue advocating for equitable access to healthcare and food allergy education. Welcome Judy, how are you today?
Judy (00:36):
I'm well, thank you. Thank you for inviting me here. My pleasure.
Denise (00:41):
Why don't you, why don't we back up a little bit? Did you, did you get involved in advocacy when you were still working as a clinician? Did it start there and that's why you moved out
Judy (00:52):
So I would, I would, I was always an advocate. It, you know, I always consider myself a health advocate. I was a sociology major when I was in college. So it, for me, it was always going back into the community and really helping people in communities, such as what I grew up in, because, sometimes, it becomes a trust factor when they see someone that looks like them understands, you know, collectively some of the background, you can get them to talk more, you can help them more. And as a family physician, I'm totally body ,mind, you know.
Denise (01:33):
The everything specialty
Judy (01:36):
Exactly. You know, to understand you, to help you the best way I can. So I've always seen myself as an advocate. Yeah.
Denise (01:43):
Good. All right. So what made you first interested in food allergies. You've told me a little bit, but it's for the, for the listeners, just back it up a bit
Judy (01:56):
I would say that it was my children that made me really interested in being an advocate for food allergies, but my children brought back some of my own stuff, because I also had some food allergies, not as many as they did as they do, but I also had food allergies, um, that I didn't even realize while I was,
Denise (02:21):
That was what I was going to ask. Did you realize you had them? Because a lot of the symptoms are very sensitive,
Judy (02:26):
Right? I, knew I had eczema that I knew, I knew I had regular seasonal allergies. I knew I had, I didn't have tthe triad, I didn't have any asthma, but what I didn't realize is that I had food allergies and it wasn't until I turned 15 and two weekends in a row, we had class trips, one to the ice skating ring and one to the bowling alley. And both times I got frozen pizza and both times I broke out severely by the next day, just welts everywhere where I'm itching, like crazy I'm even scratching under my feet. And you know, you can't get that itch at all. And then probably two days, the second time it happened because now it's going to happen faster. Right? The second time it happened the second weekend in a row, two days later, my lips blew up to three times the size. Right. And my mom took me to the emergency room. So itthat's kinda ,that's when I started allergies,
Denise (03:30):
We, this might be a little bit out of order, but since the title of my podcast is myth magic and medicine, I think there's a little bit of myth about all allergies, Actually to be allergic doesn't mean full blown, anaphylactic. There's a whole range of things. Can you speak a little bit about the kinds of things that you might see, with children in particular
Judy (03:50):
Babies? Oh, absolutely. Sometimes it's minor. They itch a little bit like, you know, their skin feels a little itchy. They feel a little uncomfortable, but that's it, for some of them they get itchy and they get a rash. And if they have eczema, it may really become, you know, aggravated that may, you know, cause, that eczema to be exacerbated. And it could be as simple as that. And people could go on like that, like I did for years it could be a scratchy throat, but nothing else, not aanaphylaxis, just your throat or under your tongue gets a little itch. Or it can, you can start to go on where you're just breakout, something starts to swell, but it's not an actual anaphylactic reaction. And then sometimes it can become where your throat swells up, your tongue swells up now suddenly you can't breathe, you know? And a lot of people think, well, that's what it is. No, it's not always that.
Denise (04:57):
No, it could be. But of course it could always become that. Which is why I think why the EpiPens are so important, regardless of whether you've actually had ...
Judy (05:09):
Yes, and you could have aan allergy that's just an itch or even a breakout for years. And then suddenly one day, just like that, you have an reaction. It also can go in the other direction. Like I was allergic to melons
Judy (05:28):
I realized as a teenager and I stopped eating that and then about, I don't know, about seven or so years ago, my husband was eating a watermelon. It was hot day and I was like, " I want that" Nothing. like no itch, nothing. So sometimes if, if it's long enough, you might grow out of it, but you should be prepared.
Denise (05:56):
Yeah. You said somebody else got EpiPen handy in case you.... Do this under the advice of your physician
Judy (06:02):
Exactly.
Denise (06:06):
So it was really finding out that your kids had issues. That was the, the clincher. That was what brought you into this.
Judy (06:14):
I mean, isn't that always the way we'll advocate for our kids harder than we.
Denise (06:18):
Absolutely.
Judy (06:19):
Right. And so that, that's what it became. And like my, my mother, she took it, she took it seriously right off the bat because that was me. Right. But some of the people you had to really get them to try to understand, no, this is not just, oh, you know, we're making a big deal. This is not, no, no, this is real stuff here. Right. Um, and even with restaurants, I'll tell you one thing. I went to one of the pizza chains. I will not mention the name. I went to one of the pizza chains in our town.
Judy (06:59):
Um, and actually we called it in and my husband was on his way from work. So he picked it up and he didn't look. And he got here and I opened it up and it was a pizza with cheese. I never get pizza with cheese. They can't have the dairy. I always get the gluten free, no cheese, bacon. And I called them. And, they, you know, they were like, but we have it here. I said, no, you gave me the wrong thing. And so they asked me to bring it back, which was upsetting because I never went to get it in the first place -my husband did. So I brought it back and I was explaining to the manager what happened. And a couple of the people that make the pizza in the back started to giggle. Well, the back is open so I could see everything. And I was like, "is something funny?" And I gave them an entire, just as calm as can be lecture on the seriousness of food allergies. And they all were standing there. And the manager said, "thank you so much. I'm so sorry. We we'll make sure that this [doesn't happen again]," I said it doesn't even have to be my kids. It could be anybody. Right. And for any reason, when somebody tells you they don't want something on there, make sure you don't have it on there.
Denise (08:08):
No, you're not, you're not asking a pizza chef to not serve cheese. You're just saying, please make sure it doesn't get on my kids' pizza.
Judy (08:14):
Exactly, exactly. I don't go there anymore. but you know, I felt it was, I could have easily just gotten, he had it ready for me. I felt the need to educate, not just for my children, but for other people, you know, you may think it's not a big deal, but it can be a really big deal.
Denise (08:34):
I think a bigger issue, 'cos you could always choose not to go to a particular shop, what about schools?
Judy (08:42):
I have always made the lunches for my children. They actually have them at a separate table, which I know some people are like, "Oh I don't". Cause I've seen it. "Oh, I don't want my child to be separated" and I get it. but wouldn't you rather your child be safe. The way I look at it is that's just an opportunity for my children to interact with other children that are not even in their class. Yeah. So now they have more people to interact with. Right. Because they're at a table that is an allergen free table, you know,
Denise (09:15):
Allows the other kids to be respectful of that because they haven't got to [figure out], was it you or was it you ?
Judy (09:22):
Yeah, exactly.
Denise (09:22):
That's that's good. Did the school ban any particular food there was certainly a big push recently. My kids haven't been in school for a long time. They're old, butfor a while, you know, no peanuts but there are so many things that you can be allergic to. Certainly peanuts is very common, but there are so many things, you can't ban everything.
Judy (09:41):
You can't, you have to teach, I say that too. You can't ban everything. I mean, you know, they talk about the top eight food allergens, but there's an emerging ninth, you know? So, and the emerging ninth is Sesame, which by the way, my son, just, my son just got diagnosed now, with the Sesame allergy, like in the last month and a half. Right. So, so it's just, that's the emerging ninth top food. You can't ban anything,
Denise (10:14):
Would you mind?
Judy (10:15):
Yes. Sure.
Denise (10:16):
Would you, would you mind just listing those eight for the listeners not in order, but so...
Judy (10:23):
Wheat, eggs, dairy ,fish, shellfish, peanuts, and treenuts. Cause a lot of people don't realize that peanuts
Denise (10:40):
And tree nuts, separate,
Judy (10:42):
You know, peanuts are not, they're legumes they're not even nuts and I'm missing one. What is the one I
Denise (10:50):
Missing gluten maybe because gluten is separate from people tend to think, oh, you're gluten, you're gluten, right? No, I'm allergic to wheat. I can take gluten from rye. I can take it from barley, but I can't take it from wheat. So
Judy (11:03):
You can't take it from wheat. I, it's something else, but if I remember it, uh I'll I'll let you know. And then,
Denise (11:09):
Oh, well, you've got selfish. Strawberries used to be pretty high on the list. I think that was quite,
Judy (11:15):
It used to be. I remember it. I I'll tell you, but, but the emerging is, seseme
Denise (11:23):
The biggest problem are the things that sneak into stuff. So the dairy stuff tends to be in things, soy,
Judy (11:32):
Soy
Denise (11:34):
Yeah. soy and it's in a lot of things. And especially, you know, like sugar. Yes. And it's things it doesn't need to be in, but it's in there, like sugar and salt. just in the seasoning
Judy (11:49):
Yeah. So, you know, just, um, it's it's you can't, you can't blame everything it's in things. And then there's cross reactivities to different, you know, you could have a dairy allergy and some people with dairy allergy also have a cross reactivity to soy so you know,
Denise (12:11):
And gluten and quinoa, which doesn't have gluten but it's similar. Yeah,
Judy (12:16):
Exactly. And, and, as I said, those are just the top eight, nine. Yeah. There are other things that people become allergic to. So you can't ban everything You cannot have nuts and peanuts right. Because most, most of the food, the, biggest food allergy in the world is peanuts. Right? Like, that's the biggest, right. But, you cannot, you can't have nuts and peanuts. anything And actually our, our school system in my town at this point, you know, like how you used to be able to, for Halloween or for, Valentine's day,
Denise (12:59):
You could bring, make your own
Judy (13:00):
[For] friends and stuff. Little baggies. No, the baggies can have pencils, little tiny pads. Like non-edible, they don't even like, really want that stuff. So there's no bringing birthday cakes. None of that stuff. We, they don't do that. So,
Denise (13:17):
Yeah, kind of sad. But I think speaking as the parent who had other children over to my house and I had to keep track of who has what the really important thing is for the child, that's he, him or herself to be educated to look out for themselves. Obviously that cannot start as a baby, but by the time they hit school, they've got to look out for themselves.
Judy (13:38):
Oh. And, and my son, once he got it, he was well versed. Like would tell anybody, they're like, there's no way we're going to mess them up. He will tell anybody all of his food allergies. And he knew them probably within a month of the diagnosis. He was just like on it, and the other thing is, like you said, it's hard for other people to remember sometimes. So I was always very diligent. Like I didn't want him to, for lack of saying, for lack of another way of saying, I didn't want him to be a burden to anybody else. So for instance, what I mean is, let's say somebody's having a birthday party and they invited him. I wanted him to feel comfortable, inviting him. Sure. I would send him with something to eat a vegan wheat,-ree cupcake from this wonderful vegan bakery in another town away from me.So that when they're cutting and eating cake, he had a cupcake,
Denise (14:44):
Can be part of it. Yeah.
Judy (14:45):
He can be part of it, you know?
Denise (14:46):
And I, and I think the majority of, hostesses, usually women, would want that, or, you know, want the information. It's just, if you've got 20 kids in your house, you, do you remember which one's got what name, never mind, which allergy , it's pretty difficult. Yeah. And it's a learning curve.
Judy (15:06):
It is a learning curve. And I feel like my son learned it a lot easier, a lot easier than my daughter and what I attribute that to is before she became really bad, we had her diagnosed, but with him, he knew what it felt like he knew the discomfort, he knew all of that. So it's like, I don't want to be like that anymore. You know? So he became very well versed in what his allergies were.
Denise (15:34):
Yeah. So this, do you have to say about schools in regard to having their EpiPens available to kids? There was, now way back in the day, when I was practicing in emergency medicine and pediatrics, we had schools that, well, "you can have an EpiPen, but it has to be locked up in the school nurses office", which wasn't terribly useful if there was a crisis. Has that improved
Judy (16:04):
It's, for us, it's still in the nurse's office, but I will say this, my, sister lives in another state and my sister lives in New York actually. And so she's a school nurse and she actually, I actually helped her put together something to teach the teachers how to give the EpiPen, because they actually came to her and asked her about it. Because they wanted the EpiPens in the classroom when the child was in the classroom. Yeah, and she still could come and administer it. But if, for some reason, say another child came into right with an asthma attack, the teacher needs to know what to do.
Denise (16:51):
Yeah.
Judy (16:51):
And so, because of that, and I, helped to put together this entire presentation that she didn't really want to have to give, but I'm like, no, this is a good
Denise (17:04):
Thing.
Judy (17:05):
You know, and she gave it and she taught the teachers how to use an EpiPen. And I thought that was wonderful, you know, to be able to say, okay, it's going to be there just in case anything happens. You know, the teacher actually brings it with them during recess, things of that nature. So Yep.
Denise (17:25):
So has it restricted your kids in their social lives? Do you get nervous if they go to them? I don't know how old your children are? Don't think they're old to be going off to the mall by themselves or other places where danger might lurk.
Judy (17:38):
Not yet, but I will. So the, so I will say this, my son became very well versed, but my son is getting older and older children can rebel So now he's on the, if there's something he sees my daughter eating, he's just
Judy (17:55):
Like, which is the, that's not fair. Not everybody has this. Not everybody in a family will have the same allergy. Right. Which can make it complicated. They share most of the same ones.
Judy (18:04):
They share most of the same allergies, but he has an allergyto wheat. She does not. Okay. And so there are certain, certain dishes
Judy (18:13):
She can have cupcake. He can have cupcakes that aren't made by. They have to be vegan.
Judy (18:17):
She can have a vegan cupcake, but it can have wheat in it. Yeah, and so we have certain cultural dishes, that he remembers eating as a kid that he can no longer have. And he's just like, that's not fair. you know, and then he sees other things that I may be eating and he's just like, that's not fair. So he's like, he's beginning to be a little rebellious about it. Like one day I went and I saw the top, you know, the peak of a cupcake, like the peak of a muffin was gone. And it was just myself and my children in the house and she's like, I didn't do that. My daughter's like, I didn't do that. So I had to call my son and he's like, yes, I was curious to how it taste. I'm like, you can't, you
Denise (19:01):
Can't,
Judy (19:01):
You can't do that. And then I didn't even know that you did it so you could be somewhere having a reaction, you know? Um, and so, yeah.
Denise (19:10):
And of course, you know, although he remembers some of the symptoms, it with time, these things [memories] do fade, so he's going to need to
Judy (19:18):
Yeah. Yeah.
Denise (19:19):
Will you, do you think you'll advise him to get retested in a while to see what else he might be able to reintroduce?
Judy (19:25):
So actually, um, they just got tested again about two months ago.
Denise (19:31):
Mm-hmm
Judy (19:32):
and that he, he that's when he was diagnosed with the sesame allergy.
Denise (19:36):
Oh, they added one instead. Okay.
Judy (19:39):
Added one. But they did say that it looks like his egg allergy may have gone down. So they want me to start doing stuff with baked eggs, like, you know, like cupcakes with baked eggs, actually, both of them, their egg allergy is way down. So they want me to start. Yeah. But very slowly start with things that you bake that has eggs in it. So yeah. They did add one for him and added one for her completely off the cuff and was like, "What do you can't have peaches?" So, you know,
Denise (20:19):
And you live in Jersey, where they grow'em?
Judy (20:22):
Right, exactly. You know? Yeah. But you know, it's give and take. And, and so if we we'll probably test them again in another year.
Denise (20:33):
Okay.
Judy (20:34):
Yeah.
Denise (20:35):
So what, what do you do outside of advocating for your own children? What kind of work in advocacy for, other kids, obviously through your sister? Because she's got a school full of kids.
Judy (20:51):
Thing is, like advocate, to advocate for themselves to advocate, always that if you're done, if you see your physician, or if you see a nurse practitioner or whoever you see, you see them for a point in time, some of us only see our physicians once a year. Some of us don't even see them that often. Right.
Denise (21:20):
And appointments are shorter and shorter.
Judy (21:22):
So exactly. So you see them for a point in time, but you're with yourself 24 hours a day. So I ask people to really get aware of their own bodies so that if something doesn't feel right, right off the bat, and we shouldn't ignore that, I also educate people to become more health literate. Don't don't, you know, try to understand certain things that are going on. And if you are speaking to your doctor and it sounds like a whole 'nother language to you, stop them, ask them what it means. I think people get, they become really nervous about doing those things. They, they, you know, it's hard for them, you know, they get shy about it. They feel like I, who am I to question the doctor and I still see that going on, which is shocking to me because people seem so it's shocking me, that people still, , have problems asking their physicians.
Judy (22:27):
What is it that that means to you? Can you explain to me in a way that I understand it and if they don't do that, they're not really, they're not helping themselves. No. And they're certainly not helping the physician because when they don't understand, they're not going to give the physician an answer that the physician can understand tobest help them. Right. So I want them to feel comfortable in questioning things, question, symptoms that you have, question diagnoses that you get question the physician themselves. And if you don't feel comfortable with them, get a physician you feel comfortable with, not, I'm not saying that's the easiest thing but there are ways to do that, to get references, to get, you know, just it's, it's very important to me because I feel like, especially with the health disparities that we see in this country and the health inequity that we see in this country, there's a lot of people being left behind.
Judy (23:20):
And I truly feel that this is one of the inalienable rights that you get good healthcare in this country and healthcare in this country is expensive, but it doesn't mean you don't have a right to it. Yep. And so that, that's very big for me. I like to speak in a way that people can understand. And even when I was a senior resident, I used to tell the, you know, junior residents, why are you writing the, discharge instructions like that? You know, you know, the symbols for two tabs and then two tabs PO
Denise (23:57):
What is "sig"?.
Judy (23:59):
Writing that for, exactly. Are they supposed to understand that? Yeah. You know? So yeah, I'm, I'm very big on educating on that. And, in fact, as a co-host of Queens on Call podcast, I'm the co-host with two other women who are nurses, that's our goal -to educate people, but, make it fun and talk about, talk about it, using words that people can understand. We're not here to talk over people's heads or be the smartest people in the room. That's not our goal because we want you to understand what's going on and understand how to advocate for yourself and your children, which falls right back into my whole thing with the food allergies as well.
Denise (24:44):
So hopefully I, although everybody is welcome to be listening to this, hopefully we have a large percentage of physicians listening. How would you advise a physician who doesn't know that much about food allergies to increase their knowledge?
Judy (25:01):
So it's funny, you can learn a lot from your patients themselves, about what's going on, but they have one, look, I'm a physician who walks into something when it comes to my children. I said, early on I don't want to be my children's doctor.
Denise (25:18):
Yeah.
Judy (25:18):
I want to be their mother so please do not pay attention to the MD after my name, when I come in with my kids, I need you to explain everything to me. There's a wonderful website, uh, named FARE which is, food allergy research and education, has wonderful information on there about food allergies and understanding food allergies And as you and I were talking about how allergens can be in things you don't even think allergens are in, or even when you're looking at the ingredients, I'll give you an example. You can see eggs, you can see egg whites. You probably say to yourself, that makes sense. That's still egg. You can see lecithin and not realize that might actually
Denise (26:07):
be
Judy (26:08):
exactly. So, you know, all kinds of wonderful things. And I think the allergist, , she had a printout she had from FARE is one of the first things that she gave to me, when we came back to see her. So that I would say, do that first. Obviously there are other publications and things that you can look at, but it, the first thing I would do is, is go to FARE and, and understand how best to help, your, your patients or if you think somebody has some something.
Denise (26:44):
Well that's really what I'm thinking of. It's not so much, "Hi, I have a food allergy." No, it's "Hi. I've got this funny sort of thing that happens here ."and, and it's, it's takes a lot of teasing out. So it has to be somewhere in your mind has to be that link.
Judy (26:59):
It absolutely does. And a lot of times you'll look at other things first. You will look at other things that, you may run other tests, and then you say, you know what? A history is a great thing. And that's why I tell patients be honest, because if you can get a good history and it may not be the first go, it may be the second go. It may be the third go. It may be, you said, here's a journal, every time this happens, I want you to write it down, write down a date, write down what was happening before that.
Denise (27:32):
Andwhat happened for half a day before
Judy (27:34):
What exactly. Yeah. Yeah. So, you know, it, I know people, sometimes they get impatient, but sometimes it really takes teasing out and several visits for someone to figure out what is going on. And it may even take them if they don't think they are figuring it out. Right. They may refer you to a specialist you know? So yeah, those, that would be the best way to go.
Denise (28:01):
Good. Thank you. Anything else you wanna say?
Denise (28:07):
You say anything you like and change your mind afterwards?
Judy (28:12):
Yeah, for me, it's just about really, really paying attention to your own health. We have to be honestly our own physicians to a certain extent, because we are with ourselves 24/7 And so, I know a lot of people, we're so busy with our lives and we go about our day and we ignore things too. We ignore pain and we ignore stuff that's happening. I really, really want people to pay attention to what's going on with them, going on with their loved ones, especially the loved ones who cannot talk for themselves. You know, I'm in what they call the sandwich generation, you know, older parents, very young children you know? And so it's very important to me to advocate for everybody involved, not just because I'm a physician and I want people to know that you don't have to be a healthcare worker to be able to advocate for yourself. If I can say anything, that's what you need to know. You have what it takes to advocate for yourself. You do not need to be a healthcare worker to do it.
Denise (29:16):
Good. Thank you. And of course food is medicine. So just make sure you eat the right medicine for,
Judy (29:26):
eating too much too.
Denise (29:32):
Yes. We're all working on that. I think COVID did a bit of a number on us. Yeah. Nowhere near as much exercise as usual.
Judy (29:39):
absolutely.
Denise (29:42):
So thank you very much, Judy. It was extremely nice getting to know you a bit better and I look forward to seeing you again soon. Oh, before you go, could you just clearly say the name of your podcast? You'll definitely be in the show notes, but
Judy (29:58):
Yes. The name of the podcast is Queens on Call , and it's in the major places that people listen to podcasts, Google, Apple, Spotify -it's there. So it's usually where people, wherever people listen to their podcast, they can find it.
Denise (30:15):
How long have you been doing that?
Judy (30:18):
We started playing around with it in 2020, and we get more into it every year. We get a little bit more serious. Okay. Now we need to do more marketing. Now we need to do this. So yeah.
Denise (30:30):
How often do you release a new episode?
Judy (30:33):
Usually every week, like every Monday is usually when we do that, we release one, it's one's not going to be released this Monday because life happens, but it's usually every Monday.
Denise (30:44):
Okay, good. So people can look for one soon. And do you have any other ways that people might wish to contact you for educational purposes or just to say hi,
Judy (30:55):
So, yeah they can just to say hi, we have a one Queens on Call, on Instagram and also I can be found at Doctor underscore Judy underscore right on Instagram as well.
Denise (31:11):
Great. Thank you very much. It was lovely, and I will talk to you in the near future.
Judy (31:18):
Thanks
Denise (31:22):
Thank you for joining us at Myth, Magic, Medicine. If you have found this episode useful, you can apply for free CME credit in this link. https://earnc.me/qFW7mo If you're not a medical professional, please remember while we're physicians, we're not your physicians. So please consult with your own healthcare professional, if you think something you have heard might apply to you or a loved one. Until next time, bye
