| | Published May 9th, 2012
| Michelle Simi - A Doctor who Makes House Calls Despite Chronic Pain
| | By Sophie Braccini |  | | Michelle Simi (right) with her assistant, Kyle Lyall Photo Sophie Braccini
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A beautiful blonde with caring blue eyes, Doctor Michelle Simi of Moraga comes across with both warmth and reserve. But beneath her smile is a level of pain she does not show, pain triggered by a rare auto-immune disease called Behcet's Syndrome.
 When Simi was first diagnosed with Behcet's nine years ago, she had to abandon her full-time medical practice. But now, after finding a mix of treatment that helped stabilize her condition, she is back practicing medicine the way she wants to, taking the time to see patients as long as needed, and accepting only a limited number of them so she can take care of her family, her health, and her professional life without burning out.
Behcet's is an auto-immune disease like Lupus, but is quite rare. The name Behcet comes from the Turkish physician who first described it, explains Simi, and there are only about 2,000 cases in the United States. The range of the symptoms includes joint pain, fatigue, headaches, night sweats, mouth sores, and even stroke. "There are periods of flare ups and relapses," she explains, "so doctors can just dismiss it or think it is something else."
Simi believes being a physician helped her get a diagnosis relatively quickly, within one and a half years. "I know the system, I knew who to go see and when to push to get more answers," she says. She underwent six months of aggressive chemotherapy for her condition, and is currently on a less toxic infusion treatment. "It is still an immune suppressant, but not as horrible as the first round of chemo," she says.
One of the turning points for Simi was getting in touch with San Francisco-based physician Mark Renneker who does a lot of research on what she calls "oddly sick people." Renneker referred her to Petaluma-based physician Brian Bouch who specializes in integrative medicine.
"Dr. Bouch had me tested for gluten allergies," she says. "I tested positive and removed it from my diet. Then I wanted to have a full spectrum done and found out I was also allergic to dairy and salmon, among other things." She says changing her diet has made a huge difference. "That's something I'm trying to stress through the American Autoimmune Related Diseases Association," she says. "Food allergies are a huge contributor to inflammation in the body that may trigger or stimulate the primary disease." After changing her diet Simi dropped 40 lbs, one medication, reduced her Prednisone medication, and has not been to the hospital since.
Simi strongly believes in communicating with associations and getting the word out to the community. "I've also learned to ask for help," she says. "My husband Todd has been a pillar during all this, and I can always call my parents who live in Alameda."
The Moraga community has been very supportive as well.
"When I had chemotherapy and I was so sick, the parents at my children's school, Los Perales, took turns bringing us dinners." During that time, her son, who was a fifth-grader, made a presentation about the disease to his classmates during Health Week and his teacher, Julie Rudolf, wore the Behcet's Association wrist band.
Now at Joaquin Moraga Intermediate, her older son's core teacher, Robin Anderson, said she would help the family promote a Walk for Behcet's that Simi is planning this September.
For now, Simi's remaining symptom is chronic pain. Besides the medication that she cannot completely avoid, she practices meditation to alleviate the pain. "I practice what is called mindfulness meditation," she says. "It is a focused technique where you get in touch with the pain and blow it out as you exhale. Another way to meditate is to imagine parts of your body and visualize cells getting healthy. The brain recognizes the healthiness."
Simi says that this biofeedback method has been tested with control groups and has shown to be effective. She practices it with some of her patients who suffer from other forms of chronic pain, such as arthritis. "Looking into integrative medicine helped me get my life back," she says. "I'm still sick, but I have good days."
Simi has been able to return to work as a physician, but in a different way: She makes house calls and is taking patients from the three Lamorinda communities.
"I want to do this on my own terms, taking the time to see the patients in their home," she says.
Behcet's Awareness Day is May 20. For more information about Behcet's go to www.Behcets.com.
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Lamorinda Weekly, Moraga CA