How to Use a Functional Medicine Practitioner

I have visited this subject in previous blogs but I have just read a very interesting case study of two patients with horrible fibromyalgia issues and I think the subject must be broached again and again. If you or anyone you know suffers from the wracking pain of fibromyalgia and the resulting exhaustion of the accompanying chronic fatigue you, too, would feel my fervor regarding the subject of functional medicine/integrative medicine. However, everyone or better said anyone with medical issues such as autoimmune disorders, cardiac issues, infertility, cancer, etc. can benefit from seeing a functional medicine practitioner, a licensed MD who specializes in functional/integrative medicine and will from here on out be referred to as a FMP.

Typically when a person visits their general practitioner or even a nurse practitioner the medical person will look at a brief medical history of the patient they see before them. They will have been given no more than 15 minutes to visit with this person and provide a diagnosis and I am told sometimes the doctor never takes their hand off the door knob. How much thinking or caring goes in to a diagnosis given on the run? The easiest path is always the path of least resistance and hardly anyone will or can resist taking a miraculous little pill, so guess what? This medical person will reach in to their pocket and pull out a pad of paper, scratch some words on it, sign it, give it to you with instructions to take it to your pharmacy of choice and send you on your way.

Do you know (or have you experienced it personally) that some people end up taking pharmaceutical products that actually counteract each other? Or that they end up with a cupboard full of pharmacy products that are costing them (or us) a bomb but they haven’t even addressed the medical issue? The case study I just read was depressing as these two women had been put on psychiatric medicines, pain medicines, acid reflux medicines, etc. (and I am not exaggerating about the etc.) and still their symptoms did not abate and both cases got much worse. They both thought they were losing their minds and the medical people they saw corroborated their suspicions instead of doing the right thing.

This is the point where you as the patient have to have done your homework. You have to understand that this physician means well but medicine is a big business now and there are bills to be paid and equipment to be used to pay those bills, so they want to use them be it in a surgical setting or elsewhere. They don’t or won’t take time to thoroughly examine your situation and if and when you start asking questions (because you have done your homework) they will get irritated and downright rude. I have heard that people are told “you aren’t a doctor” or “do not mention that name again in this office” if they ask questions or mention people like Joe Mercola. If this ever happens to you, excuse yourself, grab your clothes and leave. Go home, turn on your computer, Google “Functional Medicine Practioners” and make an appointment with the one nearest to your location.

Why? You will instantly see the difference because the first thing you will do is fill out a health history like no other you have ever filled out. I seem to remember that Dr. Rob Bruley’s was 24 pages long and included questions like “Do you clear your throat often?” or “Have you experienced any major life changes recently?” right down to the number of daily bowel movements you experience. These questions will be carefully examined by your FMP before you are even seen in the office and a course of action will only take place after you have also had at least one hour and a half appointment in their office, face to face. Don’t be taken aback by the offer of a glass of water, or even a tissue to wipe away your tears of relief. Someone is finally listening to you and they don’t even have their fingers on the door knob.

Next the FMP will try to make things better as soon as possible but this may not be an overnight solution. They may prescribe pharmaceutical products to temporarily alleviate your anxiety or pain, after all they are MDs, so they do understand that once in awhile a pill really does help. What they will do that your GP doesn’t do is try to find the underlying problem not just apply a bandaid that will eventually fail and leave you with a gaping hole again filled with aches and pains that will require one more pill with all of its side effects and conditions. You will most likely have a full blood panel ordered, a 4 stage stool test, mucosal barrier tests and heavy metal tests. You may also need an Estronex test or Cortisal/DHEA test or even an Iodine loading test. The tests requested by the FMP will depend on how you filled out that lengthy questionaire and what tests they feel will peel off the layers and expose the underlying cause of your problem. Your insurance may or may not pay for all the tests but if you are seriously ill the cost of the tests is nothing when compared to giving in and losing this battle altogether. Don’t forget there are a plethora of case studies out there where people have sought treatment, been given treatment at great expense, the treatment fails and they go bankrupt trying to pay for failed allopahtic care. Bite the bullet and pay for the tests you need it will be cheaper in the long run.

Once the tests results are back your FMP will schedule up to 3 hours of time to thoroughly discuss a plan of action. You will walk out of the office feeling drained (admittedly of money as well as emotions) but positive. Someone has listened to you, taken action and hope reigns anew. In the case of these two women in the study I read they had both suffered for years with paralyzing pain, dizziness and anxiety. They both were on some of the strongest pain meds you can take and neither one got relief without increasing the strength or adding this pill or that pill and those just exacerbated other issues. When they finally found a FMP and followed through with recommended tests they found that they were both taking zero pharmaceutical products, their pain was gone and their future rosy. Just in case you are interested, one had undiagnosed autoimmune thyroiditis and the other had a bacteria that was harbored in the mucosal lining of her intestinal tract. Both patients were treated in very different ways despite having the same issue of fibromyalgia and both had successful outcomes.

When considering this recommendation remember I am a lay person just like you, I am not a doctor. I have health concerns much the same as you do and I see a FMP because he was the only one who understood that I understood and would listen to me and work with me. He was never threatening or condescending and I can honestly say I have never seen his fingers touch a door knob for anything except to keep  our discussion private and to allow me to leave when I feel all questions have been addressed.

Boning Up on the Facts

I hope my friend Carla won’t mind if I take a cue from her for today’s blog but she was pondering osteoporosis and its affects on her aging mother. I have osteopenia which means when I had my Dexa scan done there was some thinning of my bone but not enough for my functional medicine doctor to concern himself with. To quote him ” it is a normal thinning of bone”. My mother had osteoporosis and this was evidenced by the change in her general height. That said, she really never did break a bone until she was 90, and she fell more than any other person I know. When she did tumble from her walker at the nursing home she fell right on her left elbow and it did break. It was surgically corrected, and once they took the darned pin out it healed and she acted like she had never had a break. Mother started taking one of the Pharma drugs in her 80’s and it may have helped but it also may have contributed to some wasting in her jaw bone that caused her to lose some teeth. I guess we will never know and that is what the Pharma world counts on. I am left pondering my mother’s osteoporosis thanks to Carla and here are my ruminations.

I believe that my osteopenia and my mother’s osteoporosis were primarily caused by undiagnosed Celiac’s disease. We were a family of bread eaters and cereals, you name it there wasn’t a grain that wasn’t eaten at our house all in the name of healthy eating. Mother had the ability to clear her colon in seconds as her doctor told her “with any kind of stress”. I think we would now call that IBS and mother had it her entire life but not one person thought to alter her diet. I think of all the nutrients she didn’t absorb and I am no longer in wonder at her osteoporosis or for that matter her dementia. I have blamed my similar issues on anything and everything, that is until I started reading and then took to heart everything that Joe Mercola and others were putting out there about grain consumption. Once I eliminated grain from my diet, allowing for the occasional treat, my digestive issues all but disappeared.

Calcium is supposed to build strong bones. Well milk was huge at our house and mother dutifully drank her glass of milk at almost every meal ostensibly “for her bones”. Mother also took her tums. Pasteurized milk is truly useless and that “healthy” drink, skim milk, is just pure sugar and does little more than cause insulin resistance in the individuals who drink it (my father drank gallons of the stuff but ate no sweets and little bread and died with undiagnosed diabetes). In other words, calcium is not the only answer and most of us get plenty of calcium in our diet from various vegetables and if not lactose intolerant from cheese, cottage cheese, etc. What is often is missing is Magnesium to balance the calcium intake and Ionic Fizz and Peter Gilham’s Calm both easily add magnesium to your diet. I love my raw milk kefir and have some most mornings in my smoothie. By the way, there is no pasteurized milk in my house if I can help it but that is a recent revelation (last 10 years) and pasteurized skim milk used to be a constant in our refrigerator and I, too, took Tums regularly.

Mother exercised in her fifties but only then and it was always walking. She worked harder than anyone I know and had more energy than anyone I know but she didn’t actually do weight lifting or any kind of exercise that would cause percussion of the bone and a pulling of muscle on the bones. Lesson learned is exercise your muscles and pound a little on your bones with exercise like running, walking, climbing stairs, etc. T-Tapp actually does it all and also improves your mirror image.

Mom ate a lot of fish especially in her later years as they lived on the shores of Lake Superior but fish is notoriously high in mercury and she was still eating her oatmeal and bread, so whatever goodness she was supposed to get from her fish was washed down the loo. Omega 3 oils are vital to healthy bones and the best kind of fish oil I know of is Vital Choice Salmon Oil. It is a deep orange it is so rich in astaxanthan from krill, has a pure taste and is undistilled and has undetectable levels of mercury.  Omega 6 oils need to be minimized at least in the summer (we may have increased need for some if we live in the northern climes).

Mother judiciously avoided sunshine. She slathered on sunscreen, put a large brimmed hat on her head and covered every inch of her body with thick fabric. In her last years she was seldom exposed to sunshine and when she was she squinted and asked to go back inside. I never had her Vitamin D levels checked but I wish I would have as it is easy to do and is so important. Vitamin D levels should be at least 50-60 ng/ml and even higher if you have any health challenges like cancer or even a virus. My functional medicine doctor ordered the test for me originally but now you can order your own online at the Vitamin D Council site. It is so cool that at my local Healtheast hospital (Woodwinds) you can walk in to the hospital lab and ask for a Vitamin D3 test without doctor’s orders and for $40 find out for yourself. It may be true of a lab near you and it pays to ask. Once you know your D3 levels you may need massive amounts of D3 to get your levels up (up to 50,000 mg temporarily) but you might just need daily exposure to midday sunshine. Sunshine prescription: 15-20 minutes midday sun on as much exposed naked skin as you can decently manage. In the north our sunshine is only effective from May-September unless you live at high altitude so another option is the Sunsplash from Mercola not only will it help your body produce its own Vitamin D all year you will also walk around with a healthy glow.

Lastly, Mom took a daily multiple vitamin but we know now those really aren’t adequate and with her digestive issues it was mostly a waste of her time and money. What she really needed were a host of minerals and vitamins that would have helped her keep her bones strong. Vitamin K2 is vital, selenium, boron, copper, zinc and B12 (a vitamin many of us have unhealthily low levels of) are all necessary to build and keep bone strong. Recently, I found quite by accident a product developed by Jonathon Wright called ProBone-O by Life Enhancement. It has no fillers or magnesium stearate and is easy to use as you just drop it in the vestibule of your mouth, let it sit 20 seconds and then swallow, even the digestively challenged will absorb the nutrients.

I can’t change things for my mom as she died in March at the age of 91 but maybe my ruminations can help you or someone you love. All of the experts I mention have numerous articles about bone health on their websites and they have all proven to be quite reliable. It really is up to you to bone up on your health.

PACE with Kathy Smith

I have had Kathy Smith’s DVD called Functionally Fit Peak Fat Burning (FFPFB) for sometime and enjoy working out to it immensely. It had occurred to me sometime ago that it fit very nicely in to the Progressively Accelerated exercise program that Al Sears devised and I thought it was worth a mention to those who like PACE.

Kathy Smith does it with a bit of humor as she does occasionally make mistakes that are not edited out but I enjoy a smile when I am exercising, so that is alright with me. She takes you through a stretch and warm up and then in to the exercise itself quite effortlessly. The exercises are accelerated for 2 minutes at a time for 6 different segments and following each accelleration there is a cool down that she uses to work your lower body. The total workout is 45 minutes ( longer than Al Sears suggests you need) but it flies by and you feel energized when you are done.  At the very end you can do her stretch or your own stretch. I happen to like the stretch she does on her DVD titled Power Walk for Weight Loss, so I choose to do that when I am done.

I do FFPFB every other day and mix it up with the Power Walk because she works your upper body in that program and it is shorter for those days when you don’t want to spend lots of time getting fit. It also does have you work out at different levels but it is not a PACE type of exercise.

If you  mix this exercise with 5 minutes in front of your Vitamin D sunlamp three times a week and 20 minutes in your Sunlight FIR sauna almost every day you have done everything a body needs to be healthy and you will feel fighting fit.

Functional Medicine:Do It Or Die?

I realized the other day that I haven’t been using my blog and I have been accumulating various random thoughts that are clogging my precious file space, so it is time to put it in writing and refill my gray matter with more ruminations.

People constantly ask me health questions because they know I have a keen interest in health related subjects and research topics regularly. As a result I have learned that most people really don’t get adequate care at their local medical clinic. I have a very personal case in point that I would like to share and I hope no one will feel violated as this is within my nuclear family as I would never discuss in this forum any of my clients health matters. I would especially like to appeal to the doubters among you.

Let’s call this patient Surrey (because it is fun to name characters when you are writing). Surrey cannot get pregnant and it is clearly her problem, so she recently went to her local medical clinic and was seen by a very “compassionate” and “thorough” health care professional. Surrey had the normal exams that every woman endures and she was sent to the lab for routine blood tests because she had some specific concerns that she and I had discussed, so she specifically requested that some issues be checked.

The tests came back and she was told all was normal, normal as defined by the AMA or some other esteemed group of people like the employees of your insurance company. As I mentioned Surrey is infertile and heartbroken, so rather than pursue the normal prohibitively expensive infertility treatments I asked her to see a functional medicine doctor, Dr. Rob Bruley, in Linden Hills Minnesota to see if he could do anything to just get her body working on its own.

Dr. Bruley requested more blood work. These are not weird or unnecessary blood tests but tests that should be run on each and every one of us but unless you request it or see someone more responsible like a functional medicine doctor you will never have these tests done despite their lifesaving qualities. She had thyroid tests run again, Vitamin D3 tests to check her Vitamin D levels, she had a fasting insulin and a non fasting insulin test and a more complete test of her blood cells even Celiacs disease was on the lengthy list. None of these tests were earth shattering but the news that followed certainly rocked Surrey’s world.

Remember now that she had been told her thyroid was fine just a few weeks prior to this time but after a more careful examination was complete she was found to not just have an underproductive thyroid but she has autoimmune thyroiditis sometimes called Hashimoto’s Disease. Even Dr. Bruley was taken aback by this discovery. It is unfortunately a major contributor to infertility in females.

She was also found to be very insulin resistant which is a precursor to Diabetes 2. Insulin resistance is being looked at as a number 1 contributor to infertility in young women not to mention a plethora of other health issues that plague our population at the moment. The previous blood tests had revealed no hint of this rather major health issue.

Lastly, she was diagnosed as being anemic. As I understand it her red blood cells are not readily absorbing available iron for some reason. Again this is a big problem for women who want to have offspring as it interferes with a woman’s ability to be fertile.

What is that saying to do with baseball, three strikes and you are out? Well I would say our public health care is out, out of touch, out of treatments that don’t involve a pharmaceutical product, out of the business of taking care of people’s health. And if that doesn’t scare you Minnesota’s health care has a reputation for being some of the best in the country.

Surrey still isn’t pregnant and her biological clock is ticking so loud I can hear it and I am 30 miles away. She may pursue conventional infertility treatments and I can’t blame her for that but the care she received in the office of a doctor that calls himself a functional medicine doctor (Google the word) may have extended her life. Whether she spends those extra years with children or not only time will tell.

If you still doubt the message I am trying to share on this blog site I guess I can say no more than “doubter beware” and you are in my prayers.