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Walk and Talk in Austin: Activity, Weather, and Fibromyalgia Insights

Dr. Michael Lenz records a walk along the Lady Bird Lake trail in Austin, Texas, including views of downtown and the Congress Avenue “bat bridge,” explaining how bats congregate there in summer but are gone by mid-November. He reflects on staying active with chronic pain and fibromyalgia, noting many patients were previously very active and may grieve lost abilities, and recommends starting low and gradually increasing movement. He discusses how weather affects symptoms, with many doing better in warm summers and worse in dark winters, while others struggle more in heat due to dysautonomia, temperature regulation issues, POTS, or autism; he shares a patient who felt significantly better while hiking in Central America. He notes nature and activities like kayaking can reduce perceived pain and closes with channel and podcast information and his medical background.

00:00 Walk and Talk Intro
00:33 Austin Bat Bridge
01:55 Staying Active With Fibromyalgia
04:47 Weather and Symptom Flares
07:24 Music or Silence on Walks
10:09 Colorado River and Lady Bird Lake
11:59 Nature Therapy and Kayaking
12:48 Downtown Views and Trail Life
13:57 Wrap Up and About Dr Lenz

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...

Text Dr. Lenz any feedback or questions

Cohort Study Links ADHD to Earlier and More Severe Perimenopausal Symptoms

The episode reviews a population-based cohort study using the Icelandic SAGA cohort (women aged 35–55; n=5,392) examining perimenopausal symptom severity in women with versus without self-reported ADHD (9.9%). Using the Menopause Rating Scale (MRS), Adult ADHD Self-Report Scale v1.1, and PHQ-15, researchers found higher overall perimenopausal symptom burden in women with ADHD (mean MRS 18 vs 13) across psychological, somatic, and urogenital domains, and higher prevalence of severe symptoms (overall PR 1.8; somatic PR 2.2; psychological PR 1.63; urogenital PR 1.57) plus severe general symptoms (PR 1.94). Symptoms peaked earlier in ADHD (ages 35–39 vs 45–49), suggesting onset up to 10 years earlier. Adjustments for sociodemographics, smoking, binge drinking, and PTSD (more common in ADHD) did not remove associations. Limitations include cross-sectional measures, self-reported ADHD, symptom overlap, and lack of treatment data; the script calls for tailored guidelines for perimenopausal women with ADHD.

00:00 ADHD Meets Perimenopause
00:23 Study Purpose And Rationale
01:16 Cohort And Measurement Tools
02:33 Menopause Rating Scale Breakdown
03:17 Overall Symptom Burden Results
04:11 Severe Symptoms And Ratios
05:26 Earlier Onset By Age
06:23 Confounders And PTSD Analysis
07:38 Clinical Takeaways And Guidance
08:39 Limitations And Future Research
10:00 Wrap Up And Call To Action

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...

Text Dr. Lenz any feedback or questions

Trigeminal Neuralgia Beyond Nerve Pain: Marsha’s Racing, Menopause, and Advocacy Story

The episode explores trigeminal neuralgia as more complex than a simple nerve injury, often overlapping with nociplastic chronic pain features like widespread pain, fatigue, insomnia, and brain fog. Marsha, a longtime off-road racer, recounts an eight-year path to diagnosis after severe electric-shock facial and scalp pain, repeated ER visits, normal imaging, and feeling dismissed as drug-seeking. She describes TN as “torture,” worse than childbirth, and details treatments including carbamazepine, gabapentin, nerve blocks, and gamma knife, which provided about a year of relief but left facial numbness and corneal damage with vision loss. She also has Sjögren’s syndrome, concussion history, anxiety/depression, and discusses perimenopause/menopause timing, hormone therapy trials, and possible ADHD. Racing helps her cope mentally, though symptoms worsen after removing her helmet, and she emphasizes support groups, self-advocacy, and not giving up.

00:00 Trigeminal Neuralgia Beyond Nerves
05:05 Marsha’s First Symptoms
07:26 ER Visits and Misdiagnosis
08:35 Finally Getting a Diagnosis
09:38 Becoming an Advocate
13:49 What TN Feels Like
15:58 Neuropathic vs Nociplastic Pain
17:14 Treatments and Gamma Knife
23:13 Concussions and Early Clues
28:14 Hormones Menopause Connection
36:38 Racing as Therapy
39:23 Daily Management and Race Day Routine
41:42 Racing as Flow State
44:29 Adrenaline and Desert Races
46:46 TN Community and Daily Struggles
48:37 Fatigue Meds and Survival
52:13 Living Without a Cure
55:02 Faith and Being There
56:38 High School Trauma and Isolation

Click here for the YouTube channel

International Conference on ADHD in November 2025 where Dr. Lenz will be one of the speakers.

Joy Lenz

Fibromyalgia 101. A list of fibromyalgia podcast episodes that are great if you are new and don't know where to start.

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...