Master Chef Christine Ha on Adapting to Life with NMO

Episode Transcript

Dr. Correa:
Welcome back to the Brain & Life podcast by the American Academy of Neurology. This week, we have Christine Ha from MasterChef.

Dr. Nath:
Whoa, Houston celebrity.

Dr. Correa:
Wow. Yeah, I'm so want to make it down there and go and check out Xin Chao and Blind Goat. Oh, I've heard so much about the food and I'm already hungry thinking about it.

Dr. Nath:
Easily those two restaurants are in my top 10 Houston restaurants and they're incredible, she just puts flavors together so well, and Asian flavors and other flavors. And as we all know, she is blind. And something that I didn't realize before looking into this is her vision loss came from a condition called neuromyelitis optica or NMO, which is an autoimmune condition, and I really want to hear what she tells you about this.

Dr. Correa:
I'm really excited that we all got a chance to speak with her and you'll get a chance to listen more about her story, how she really worked her way up to become a chef despite dealing with the vision loss that comes with NMO, and the challenges of even getting the diagnosis. And then we get a chance to talk with our medical expert about how it's different and in some ways similar to MS and other immune conditions that attack the brain.

Dr. Nath:
Absolutely. I think that a lot of people don't know about NMO and I'm so glad that she's sharing her story.

Dr. Correa:
And then this week is our last guest for the season, and next week will be our final episode for Season 1. It'll be a holiday week fan favorite. We're going to be selecting some of your favorite episodes, and then along with some of Audrey's and my favorite episodes, we'll share some clips and talk about this season, what we've learned, and those experiences that we've had.

Dr. Nath:
Happy holidays, everybody.

Dr. Correa:
Welcome back to the Brain & Life podcast. Our guest today is an author James Beard nominated-chef and advocate that is sometimes referred to as the Blind Chef. Many food enthusiasts and MasterChef fans saw her burst onto the scene during the third season of the show where she even wowed Chef Ramsey and spoiler alert, won it all. During her run on the show, she shared not only her ability to harness Vietnamese flavors, but how she excelled despite living with neuromyelitis optica or NMO, an inflammatory condition that can damage the nerve of her eyes. Next time you're in Houston, Texas, make sure to check out the variety of Vietnamese, Viet-Cajun, Viet-Tex restaurants, including her local restaurants, Xin Chao and Blind Goat. Chef Ha, thank you for taking the time from the restaurants to talk with us on the Brain & Life podcast.

Christine Ha:
You're very welcome. Thanks For having me.

Dr. Correa:
You've lived with NMO for over 20 years. Were you already into cooking and food before you even had symptoms?

Christine Ha:
I would say that it started around the same time, very coincidentally. I started cooking when I was in my second year in college, and it was initially out of a means of survival because I'd moved out of the dorms after my freshman year and I moved into an apartment and had to learn how to cook. So it was at that point I realized I missed my mom's cooking growing up, I ate a lot of really good home-cooked Vietnamese comfort food. And she actually died when I was 14 and left no recipes, never taught me how to cook, so it was really my mission at that part of my life to try to recreate a lot of her dishes from memory. So I initially just got recipes and cookbooks and read them, and then I started excelling at cooking and started really enjoying it because there was something very satisfying about being able to cook something and then feeding it to my friends and my roommates and having them enjoy my own creations.
And it was at the same time, actually my third year in college when I was 20, that I experienced my first symptom of NMO, which was optic neuritis or inflammation of the optic nerve. And that was a gradual process throughout my 20s of dealing with the vision loss. And of as many NMO patients are, I was initially misdiagnosed with MS or multiple sclerosis. And it wasn't until a few years after that that I was correctly diagnosed with NMO. And the vision loss just continued to happen gradually throughout my 20s at the same time as I was enjoying cooking more and more and I felt like I had to go back to square one and teach myself again how to cook from the beginning each time I lost more and more vision.

Dr. Correa:
Not only were you just adapting to the regular world around you, having the changes within your vision and losing vision over time, but on top of that, it sounds like the passion and the things that you were working towards, I'm sure you were having to reframe your approach for it and when something changed with your condition.

Christine Ha:
Exactly, it was starting over again and felt like I had to just keep picking myself up and teaching myself the same things over and over again with less and less of my eyesight.

Dr. Correa:
And at that time already, just in your 20s, how did you deal with the uncertainty of the condition and what was coming and the diagnosis when you got it?

Christine Ha:
It was very scary because at that age, when you're a young adult and you're in college, you're just coming out of it and starting your first job, you don't ever think that you'll be dealing necessarily with a chronic disease that will change your life forever. So, for me, I felt very alone and it was isolating. I didn't know anyone else that had NMO. Of course, it was, and it still is quite a rare disease, so I had never heard of it before, I was searching online and only found like two resource groups. One was in San Francisco, one was in London, and didn't know anyone with conditions like mine. So it was difficult and challenging not only physically, but also mentally and emotionally.
I think eventually I was able to move forward because the proper time to grieve the loss of my vision, grieve the loss of some independence. And then the next step I realized was that the world would keep on turning regardless of whether I did something in this world or not. So I figured I needed to realign what my mission was in life and figure out my new purpose now and just adapt and figure out how do I contribute back to the community or society or to this world in spite of the challenges I was dealing with.

Dr. Correa:
NMO damaged the nerves to your eyes and your vision and you were adjusting and adapting to that all along. But for many people, it can also affect the brain and the spinal cord. Have you had other complications from the condition?

Christine Ha:
Yes, I did have some severe inflammation of my spinal cord. Fortunately, it never affected my brain, but obviously it affected my optic nerves because over time my optic nerves atrophy and that's how I lost my vision, and then I've had a few attacks as well where it greatly inflamed my spinal cord. So I recall one of the worst attacks was over a period of four days, I went from having normal sensory and motor skills to being paralyzed from the neck down. And I remember I started with not being able to relieve my bladder, so I was suffering from a form of incontinence. And naturally I thought, "Oh, I'll just keep drinking water eventually it'll force its way out." And I never experienced anything like this before, and so eventually my neurologist was like, "You have to go to the ER." And then I was given a course of very high dose corticosteroids, at that point. I was in a lot of pain, so they had given me morphine as well in the hospital.
And that was a very long recovery process because over four days I lost complete use of everything below my neck. And then I believe that recovery process took about nine months of physical and occupational therapy and a lot of different drug therapies to calm the inflammation in my spinal cord so that I could finally walk again, sit up again, use my hands and my fingers, and regain all the feeling back in all of my limbs and my fingers and my toes.

Dr. Correa:
And where were you at that stage already in the career path that you were working on?

Christine Ha:
This was when I was actually working in the corporate world. So my undergraduate degree was actually in business and I was working your typical corporate desk job, and then I had to leave the job when I had this attack. First, we thought it would just be a short-term thing and I would come back to work in a month or two. And eventually we realized that it was a much longer recovery process, and this was when I felt like I was floundering in life and trying to figure out what my next step would be. Because even though I was regaining use of my body again, I was still losing my vision at the same time. And I felt like life, I realized, was short and you have to do what you can to enjoy it. And truth be told, I wasn't enjoying what I was doing in the corporate world that much, so I decided to go back to school for creative writing, and that's when I pursued a master's in creative writing in Houston.
And while I was experiencing this spinal cord inflammation and the optic nerve inflammation, the only thing that really got me through it was listening to audiobooks and it rekindled my love for literature. So when I got better, I wanted to go back to school and explore that side of what I love to do, which was writing, and I hope to eventually write stories and share my own story through the form of creative writing. And so, I was really going down a different path again, creative, but still not culinary. And it wasn't until my last semester in grad school when I decided to audition for MasterChef just for the experience of it and to hope to write a good story about it. Not expecting to go as far as I did, but then having won that season, that's really what launched the culinary side of my career, and then I ran with that.

Dr. Correa:
The rehabilitation process you talked about, not only with the changes in your eyesight over time, but then after all those spinal cord injuries, did your perspective of both your life and the world change through that process?

Christine Ha:
It definitely did. I would say I learned more about reprioritizing things in my life. I feel like maybe before I was more caught up in some of the superficial things in life, when you're stripped of everything that you thought once was important of you, you really are forced to focus on the very core of things that are important to you. And then not only that, something I do value out of those very challenging experiences I had was it has really taught me to become a much more compassionate person, whether a person is experiencing NMO or vision loss, but also just natural human challenges that a lot of people go through, whether it's failed relationships, death of a loved one, loss of a job, depression, all of these things. I feel like I've been in a low spot in my life, so I've able to understand what it feels like for other people to also feel like they're lost or sad or upset, but to recognize that, in the end, we as humans are all very similar in that we feel pain in very similar ways, it manifests emotionally and physically.

Dr. Correa:
To speak to that, beyond the loss of eyesight and then the injuries that you had to your spinal cord that you recovered from, what are some of the other invisible challenges that you've had to deal with?

Christine Ha:
I think a huge challenge that a lot of people in the NMO community or blind and low vision community, or actually anyone in the community that deals with the disability is really the stigma that comes with it from abled people or from the rest of the world or the community, I think a lot of it stems from not understanding what it is like to live with a disability. And so people, I think, treat us differently as if we were a lesser person. For example, I might be with my husband or my friends or will be somewhere and then somebody would like to take a picture but they don't ask me, they'll ask my friends or my husband if it's okay to talk to me or okay to take a picture with me. And my husband's response is always like, "She's her own self, you can ask her yourself."
And I think that happens a lot to people in the community that deal with disabilities is feeling like we're being treated as a lesser person. And so, I think that is a huge thing that we have to deal with that's not normally visible for a lot of people in this world, and it's dealing with also having to educate people on how to treat people with various disabilities. And I wouldn't say it is easy because everyone's thresholds is different, everyone's needs and wants and desires are different. And so it is a very nuanced thing and you have to learn how different people as an individual operate. But I think it's people in society tend to be taught like brush these things under the rug, like you're not supposed to acknowledge someone's disability because you're pointing to it or you're making people pay attention to it. But I always say that questions are always welcome because that's how you learn, and I think it's completely okay to ask questions and learn more and figure out how to deal with people with various disabilities down the road in a healthier and better way for everybody.

Dr. Correa:
By age 28, you had lost all of your vision, and despite this, you were able to launch your career after MasterChef while using braille to read and using a walking cane, you hosted pop-ups and cooking demos and went on TV. You wrote your first book, Recipes From My Home Kitchen, which is published in 2013, and then you opened your first restaurant Blind Goat. What have you found most helpful to adapt to your environment and in a world not optimized for access to differentlyabled people?

Christine Ha:
I think that resilience is really important. I think finding a good support network, whether that's a good staff, good management, good friends, family, counselors, therapists, doctors, medical team, I think relationships are really what makes all of us function. And no matter where you are or what challenges you go through or what sort of missions you're on or goals you have, I think finding the right people to surround yourself with and to bounce ideas off are very important regardless if it's for career or for trying to figure out your recovery path or your diagnosis or whatever it is. I think life will always be challenging with all sorts of different things, but I think my advice is always find the right people, people that are smarter than you, and really work off that dynamic, I think, to help you live a better life yourself, if that makes sense.

Dr. Correa:
The restaurant kitchen is intense and incredibly demanding environment, but with your vision loss, how have you adapted to using knives, the stove, all the different tools that are required for your cooking?

Christine Ha:
Well, that stuff, I feel like, over the years, it's become second nature because of how much experience I've had in my own home kitchen. The restaurant kitchen, I will say, is a very different thing. It is very busy during service. There's a lot of people in there working trying to just pump out food and dishes in a timely manner. I will say that fortunately now I have both restaurants up and running with really good staff that I can trust. At the beginning when we first open a restaurant, I am there trying to teach the staff how to do the dishes. Of course, oftentimes with the restaurant industry, as many have heard during the pandemic, we've been short staffed, so I will have to be there doing prep, I'll be having to wash dishes.
But since then, I now mostly do the menu development, teach my sous-chefs how to do the dishes, and it's their job to teach the rest of the team. I've taught my staff when I'm in the kitchen to not move anything on my station like my knives without telling me. Of course, in a commercial kitchen, everyone is already very vocal when they talk about walking around with a knife or if they're turning a corner or if they're carrying a pot of hot water. People have already learned to be very audible and loud in the kitchen, so that is helpful, but they know that they have to communicate everything to me because I am visually impaired.

Dr. Correa:
So let's talk more about going farther together. You've worked on a lot of adaptations for yourself, but as a business owner and leader, you've been an advocate towards expanding access within the business environment, but also in the restaurant community for different abled people. What are some things that you would recommend that other business owners and leaders consider when it comes to people with disabilities?

Christine Ha:
That is a tough one because I can understand from a business owner's perspective, oftentimes your businesses are running on very small margins, and sometimes you think hiring someone with perhaps additional needs or certain disabilities, you automatically, I think, as a business owner, you would think, "Okay, I have to spend more time perhaps training this person, or I have to spend more money to adapt something for them." But there are studies out there that show that there's a large portion of our population who live with disabilities. Many of them are unemployed even though they can be fully employed but it's because so many of us have been marginalized or ignored by the workforce or people who hire or people who own companies. I think if we make this initial investment in employing, in making adaptations for people with disabilities, I think that there will be a larger workforce pool to choose from, and I think competition is always healthy.
And I think you will find that some of these people with disabilities will often be the most loyal employees. And we all know, as business owners, that turnover can be very costly for company. So if someone with a disability finds that you can grant adaptations and are willing to listen to them and help them meet their needs and succeed in their job, they will stick around for a long time because it is not easy, they know to get into that position or get a job like that. These are some of the initial stigmas that people need to get over and realize that in the long-term, it will be more beneficial for everybody, whether it's the company, you as a business owner or the employee.

Dr. Correa:
Christine, you've been doing some work with the NMO advocacy organizations. What brings you hope for the people living with NMO and other inflammatory and autoimmune brain conditions?

Christine Ha:
Continue to research, people should participate in case studies or any sort of research going on, I think these are important. And I just hope that to continue to raise awareness, about NMO is the most important because that leads to more correct diagnoses that leads to more doctors or medical staff or scientists being interested in the disease. I think it is important to be involved in the advocacy work to continue to raise awareness and educate people about NMO. And then subsequently, that'll garner more interest from pharmaceutical companies, from doctors, from scientists, and help improve the lives of those living with NMO.

Dr. Correa:
And what's next for Chef Christine Ha, you or your family? Maybe it's a vacation, which is probably well-deserved.

Christine Ha:
I'm working on moving the Blind Goat into its own space. I'm actually working on a third restaurant concept, but we're R&Ding for that menu, and we're in the process of working on a new concept that will be completely different from the first two restaurants I've done. I've been on and off working on my memoir since my grad school days, my memoir was actually my thesis for graduating with the MFA in creative writing. My hope is still to continue to work on that and get that published eventually. And then for the past several years, been the subject of a documentary that is unfolding my life's story and showing the progress of being the daughter of Vietnamese refugees, how I grew up in America, and then dealt with the death of my mom at a young age, and then the vision loss, and the NMO diagnosis later in life, and then in spite of that, I guess, still being able to find a vocation for myself. It's still an independent project right now, so hopefully we will find some funding for it and find it a home in the near future.

Dr. Correa:
Wow. We look forward to many of those inspirational stories with the documentary, your memoir and writing. I'm really looking forward to the next time I can get out to Houston and try out some of your food. Thank you so much, Christine, for taking the time and joining us today.
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Dr. Correa:
Welcome back to the Brain & Life podcast. Today I'm honored to welcome Dr. Fiona Costello. She's a professor and neuro-ophthalmologist at University of Calgary and a researcher at the Hotchkiss Brain Institute in Canada. In Calgary, Canada, she also has a clinical practice that serves the needs of patients with conditions that involve the vision pathways in the brain and the brain. In her research, she also uses the conditions that affect the eye as a window into the many different brain disorders, including MS, neuromyelitis optica and tumors. We're glad you can join us, Fiona.

Dr. Costello:
I'm delighted to be here. Thank you.

Dr. Correa:
So I was just wondering, in your past trips to the US, have you ever been to Houston by chance?

Dr. Costello:
I've been to Houston many times, and actually one of my former mentors lives in Houston.

Dr. Correa:
Oh, okay. I've never been, but we just finished a great discussion with Chef Christine Ha. I don't know if on your trips to Houston, if you had a chance to visit Xin Chao or The Blind Goat, one of her two restaurants.

Dr. Costello:
No, but I know what I'm doing the next time I'm there.

Dr. Correa:
Exactly. It's on my list. So she talked with us about her path to cooking and despite living with NMO and attacks that resulted in vision loss, how she was able to move forward with a career in that passion. So I would love to hear some more from you a little about what is NMO and understanding that condition.

Dr. Costello:
That's a great starting point. Neuromyelitis optica or neuromyelitis optica spectrum disorders, and I'll abbreviate it, NMO for the obvious tongue-tying reasons, it's somewhat of an enigma. It's not that common, but it used to be considered a severe form of multiple sclerosis. We now recognize it as its own thing. It's an inflammatory disorder of the brain and spinal cord predominantly, and it will often cause very severe relentless vision loss, and for some, significant weakness because of attacks on the spinal cord. It's technically speaking in autoimmune astrocytopathy, but suffice to say it's an immune-mediated, meaning your own immune-mediated attack on your own brain and spinal cord with a tendency to involve vision and motor function.

Dr. Correa:
As you get to the discussion that you would have with someone, for Chef Ha, NMO entered her life very early. For some other young men and women like her, NMO can be a diagnosis that occurs earlier in life. How do you start that initial discussion with them about the diagnosis and what their outlook is?

Dr. Costello:
It's important. I mean, I see these patients often when something devastating has happened to them, so they've lost vision. And I get a few clues based on sometimes the patient or sometimes the way they lost vision, that I'm not dealing with a more garden variety version of a common problem. As a neuro-ophthalmologist, I see people who present with vision loss in one or both eyes. If I'm worried about NMO, and if I were in this conversation, I would say it upfront that I'm very concerned about the nature of the problem, and I wouldn't oversell the likelihood that the vision was going to get better, that separates optic neuritis or attacks on the cable that connects the back of the eye to the brain in NMO from other conditions. So I would be cautious about not promising that patient, first and foremost, that the recovery or prognosis is going to be great because it often isn't. So that's tough.
I also will want to impress upon someone the need for follow-up because people have busy lives, it's difficult to get to appointments. Treatment is no fun. And when the news is intimidating, at least when I'm a patient, I don't like to hear it. So I really, really have to make it not in a way that scares someone, but really impress upon the person in front of me how important it is that we're in this together and that they follow-up with me, let me know what's changing, let me know if something affects, for example, the other eye or if they have a new symptom and to trust me that they're not going to necessarily like the treatment, but my goal is to salvage what they have, and if possible, improve upon what's happened with their vision.

Dr. Correa:
With these categories of autoimmune and neuroinflammatory conditions, people, as you said, can come in with vision loss or this sudden debilitating new symptom and you're talking about how to manage and diagnose what's going on now, but how do you bring up the possibility that there are the chances for it to attack other areas of their central nervous system or the brain and spinal cord and nerves and that the symptoms might not always be what they came in the first time with?

Dr. Costello:
Such an important question because most people who present with vision loss don't think it's something severe that's going to blind them, they think it's a contact lens problem where they scratch their cornea. See, what starts as an eye problem becomes a life problem, and that's a weighty conversation, but it's an important one to have because with NMO, the stair to disability is untreated relapses. So I really, really have to talk earnestly and honestly to someone I'm worried has NMO about relapses. So I tell them what to look for. And one of the more kind of cryptic presentations that often gets overlooked is something called area postrema syndrome where patients will experience nausea, vomiting, sometimes hiccups. Many of my patients have actually had that happen to them before they present with blindness in one or both eyes.
I don't promise that they're going to get better from the problem that they're sitting in front of me with. So if someone has vision loss in the right eye, I don't promise that's going to get better. I say I'm trying to save what I can and protect the left eye, but I talk to them about what NMO gets up to and it can present with an ascending numbness and tingling that quickly progresses to paralysis in the limbs with bladder and bowel dysfunction. And people don't need to be told that's a problem, but they need to know why I'm treating them so aggressively for the vision issue is to prevent exactly that. But it's a lot to get your head around as a young person that you went from being perfectly well the same as all of your friends the day before, and now you have this condition that like a minefield can come out of nowhere and take a piece from you. And I think that's what actually what NMO patients live in fear about the most and find one of the more distressing aspects of the diagnosis.

Dr. Correa:
And at the beginning, you mentioned that initially in the past, our understanding of the condition we're describing as NMO as being a kind of variant or a type of multiple sclerosis, but we understand that very differently now, and this is a process that happens often with medical conditions. What is it that we know now that really distinguishes that NMO is its own condition that's separate from multiple sclerosis?

Dr. Costello:
Yeah, so important. It used to be considered a really severe form of MS. And when I look back on my early training, I realize I saw cases of NMO that were mislabeled MS and the patients had very severe courses and were often wheelchair-bound in five years. So first, NMO has a different pathology, it has different treatments, and in fact, the treatments we use for MS can worsen the course for a person living with NMO. But really importantly, the lessons that we've learned from, say, optic neuritis and MS don't extend to NMO, so they don't have the same hopeful prognosis for recovery. Many patients with optic neuritis, in fact, well over 90%, who either have a diagnosis of MS or will develop it, their prognosis is very good, like they're going to get vision back to 2040 or better off a reading chart within a year of presentation.
But what's really, really difficult is that the outcome or forecast for the animal patient is firm or bleak. And it isn't a decision to treat or not treat based on the patient's willingness to take on the risk factors of high dose corticosteroid therapy to hasten recovery, you have to treat to salvage what you can, but importantly to patient from suffering another devastating relapse before you see that person again. So I think what I say to my NMO patients is that they don't have the wiggle room of a patient with MS, they have a different condition mediated by different aspects of your immune system, and they have a different course with a different treatment plan.

Dr. Correa:
So there's a different kind of urgency with NMO in terms of picking treatment and moving forward with it and preventing further attack and injury degeneration of the brain, spinal cord and eyes.

Dr. Costello:
It's a much more, I would say, high-stakes, high-risk circumstance, and I think that's the most important thing that I need to usually convey in the first appointment because, like I say, nobody wants to go see their doctor multiple times in a given month or so. It can threaten a person's livelihood if they don't have coverage from work. But I don't want them to suffer a significant attack on their spinal cord that puts them in a wheelchair because I didn't really make it clear what the risks were to not getting this right and not treating this aggressively from the beginning.

Dr. Correa:
It sounds like it's particularly one of those conditions that if possible someone should try to seek out the opportunity to see either a specialist in inflammatory disorders of the brain and spinal cord and/or neuro-ophthalmologist like yourself to really help navigate the complexity of what's going on and help them manage both treatments and the possibilities of what may occur in the future.

Dr. Costello:
Oh, absolutely. I think the management of an NMO patient is 100% a team sport. My time is very much filled talking solely about vision because vision dictates so much of our independence and so much of our quality of life. And it's very, very fearful for patients or people living with NMO to worry about going blind in both eyes, as you can well imagine.

Dr. Correa:
We set up and talked about how significant of an early diagnosis it is and has a different course, and we set a lot of heavy things to start, but I wanted to get a sense from you, where are we with treatments? Because you talked about how in the past without treatment it can progress very significantly, but there's been a lot of new changes in treatment development and a lot of the neurologic conditions. How much do we have to look at in the direction for hope when people are started on the right treatments in early on?

Dr. Costello:
I think that's really important, and I don't mean to be a heavy heart at gal. I will say that I think radically changed what NMO patients can expect in terms of their lifetime and experience with this diagnosis. It starts with recognizing, first and foremost, that it's not MS and not to treat people with the wrong things that we know can make life more difficult for them. We now have treatments that target different parts of the immune cascade, and what I mean by that is like the launched attack, the friendly fire that our own immune system is launched on our brain and spinal cord. So by very selectively taking out parts of that arsenal or parts of that attack front, we can disarm the foe of NMO and prevent relapses, which we know are, as I say, the steps or the stairway that brings a patient to permanent neurological problems that they would otherwise not live with.
And I think that, with the new therapies, we're radically changing relapse rates that previous patients with NMO would've suffered. So we're also rewriting those books in terms of where folks are going to be five years after diagnosis, 10 years after diagnosis. And so, the world really is full of bright possibilities in the era of new therapies. We still have tried and true off-label therapies that we've used, so people shouldn't feel that they're getting shortchanged if they're not on one of these newer agents. But I think we also, as a group, collectively have to make newer agents more affordable to all people who have NMO as a diagnosis. Because right now, that's simply not the case. Any new therapy is initially quite expensive and people in different parts of the world do not have the same access. You have to also be seropositive, meaning you have to have that antibody to qualify for these newer agents. I think everybody is their own case with NMO, and each person should be very optimistic with the right team that they're going to get the right treatment.

Dr. Correa:
I wanted to lastly tap into your expertise about understanding vision in the brain. And Chef Christine Ha referred to after being on TV as the Blind Chef. So she had all of her vision up until her college years and had some experience cooking before losing her vision, yet she's still able to both cook and access things in the kitchen, tap into her sense of feel and understanding things, and then can even plate using her memory of vision and can do fine looking cuisine and plating of food. How is it that her brain allows her to do that without vision?

Dr. Costello:
Well, I think this speaks to the remarkable resilience of Christine. I think too, that the brain is remarkable in its own way. So we're very dependent on site as mammals, humans, we like to be able to see things because we're not going to outfight or outrun most of our foe, it's probably an evolutionary thing. A lot of people will be able to compensate for loss of peripheral vision or loss of central vision, especially if it's somewhat different in each eye. So the hole will be greater than the sum of its parts. But I can tell you that every day I see people who astound me in their ability make the most sight out of the light that they get.
I think a lot of it has to do with knowing your environment and being able to adapt to that, giving yourself little breaks. I think if any of us are suffering loss in vision, whether it be vision or strength, we have to pace ourselves a little bit. Our brains will do what needs to be done to compensate for something we're unable to do. So we rely upon our other senses, touch, smell, hearing, and I think that's a really positive lesson in resilience for all of us too.

Dr. Correa:
Gets back to the billions of connections in the brain and its ability to adapt and change. And Christine is a perfect example of that and probably doesn't hurt the thousands of hours of time that she's dedicated to her work and practice. So Dr. Costello, it's been such a pleasure speaking to you. We thank you for your work and advocacy for the community living with NMO and with vision-impaired conditions. I really appreciate hearing from you and sharing the time with you on the podcast.
Thank you again for joining us today on the Brain & Life podcast. Follow and subscribe this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life Magazine for free at brainandlife.org.

Dr. Nath:
Also, for each episode, you can find out how to connect with us and our guests along with great resources in our show notes. You can also reach out by email at BLpodcast@brainandlife.org, and you can call in any time and record a question at 612-928-6206.

Dr. Correa:
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Dr. Nath:
Special thanks to the Brain & Life team, including...

Dr. Correa:
Nicole Lussier, our Public Engagement Program Manager.

Dr. Nath:
Twin Cities Sound, our audio editing team.

Dr. Correa:
And Andrea Weiss, our Executive Editor for Education and News Publications.

Dr. Nath:
We are your hosts...

Dr. Correa:
Daniel Correa, joining you from New York City and online @NeuroDrCorrea.

Dr. Nath:
And Audrey Nath beaming in from Texas and on Twitter at AudreyNathMDPhD.

Dr. Correa:
Thank you to our community members that trust us with their health and everyone living with neurologic conditions. We hope, together, we can take steps to better brain health and each thrive with our own abilities every day.

Dr. Nath:
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Dr. Correa:
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Dr. Nath:
Thank you.

Dr. Correa:
This helps others find the Brain & Life podcast. Thanks again. See you next week.

Master Chef Christine Ha on Adapting to Life with NMO

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