by Paul Wynn, Pain-Free Living Magazine, September 2017
THE FOUNDER OF AN INTEGRATIVE-MEDICINE CLINIC EXPLAINS WHY CHRONIC PAIN SHOULD BE TREATED AS AN INFLAMMATORY DISEASE
Imagine talking to your doctor and finding out that chronic pain is actually an inflammatory disease. It’s an unconventional idea that surprises many people, but it’s slowly gaining traction thanks to the work of Gary Kaplan, D.O., a clinical associate professor at Georgetown University in Washington D.C. (Click here or on the image below to continue reading this article.)
If you’ve never heard of functional medicine (FM) before or don’t know how it differs from conventional medicine, you’re not alone. Behind functional medicine is a wonderfully simple philosophy that treats the body as a whole, interconnected system which looks at mind, body, and spirit as contributing elements to a person’s overall state of health. Functional medicine is evidence-basedmedicine and seeks to identify the root cause of disease by probing into the unique history of a patient’s life and genetics, as well as environmental and lifestyle factors.
In contrast, conventional medicine can be one dimensional and often results in treatment by medication. In acute cases, this may be very appropriate, but because we are not one-dimensional beings in most cases there is much more to the story. When it comes to complex, chronic disease, many physicians are, unfortunately, not adequately trained – and often don’t have time – to assess what may be the underlying cause(s) and apply diet, nutritional supplementation, exercise, and awareness of lifestyle stressors that are contributing to their patient’s illness.
As FM practitioners, we look upstream to assess the interactions of the patient’s history, physiology, lifestyle, unique genetic makeup, and mind-body-spirit that affect the function of the body as a whole.
What does this look like in an initial evaluation?
As a functional medicine practitioner, I start by asking what their story is and often that story starts with “I was fine until…” This is when we need to put on our detective hats and go back in time to reveal clues that may typically be overlooked; sometimes even going as far back as the time of mom’s pregnancy! For example: What was your mom’s pregnancy like? Was there a Caesarean section or vaginal birth? Were you breast or bottle-fed? Were there a lot of antibiotics used in childhood? The answers to these questions may indicate alterations of the microbiome in the gut (the bacteria that support our immune system). This is immensely important as research is uncovering a multitude of new data that shows how deeply interconnected our immune system is with the gut.
Other questions may include: Were there traumatic events in childhood or later? Was there ever exposure to environmental toxins like mold in the living or working environment? Were there ever infectious exposures or injuries? What are the patient’s diet, exercise regimen, sleep and emotional support system like? Is there ongoing stress at work or in personal life? Every answer peels away another layer of the mystery.
Fortunately, medicine as a whole is moving in the direction of functional medicine, but this approach takes time and a commitment in partnership between a patient and their physician.
Lyme disease and other tick-borne illnesses shouldn’t prevent you from enjoying the outdoors, but you should absolutely be aware of how to best protect yourself and what to do if you think you may have been bitten by a tick.
Lyme disease and other tick-borne illnesses (babesoisis, ehrlichiosis, anaplasmosis, bartonella, and Rocky Mountain Spotted Fever) can cause skin, heart, joint and nervous system problems. Early symptoms may be fatigue, chills, fever, headache, muscle and joint aches and swollen lymph nodes. With the chances of getting a tick bite higher than usual this year, precautions should be taken to minimize your risk. This includes using an effective repellent*, wearing long pants and sleeves whenever possible, incorporating a tick-check into your evening routine, and most importantly, staying educated on signs, symptoms, and treatments.
* Choose a repellent that contains one of the following: Picaridin (20%), IR3535 (20%), DEET (20-30%) or Oil of Lemon Eucalyptus (30-40%)
Below you’ll find some myths and truths about tick bites, and what to do if you think you may have Lyme, by Jane Marke, M.D., Integrative and Holistic Psychiatry
Tick Bite Care
What to do if you get a tick bite? There are some myths, but there’s good science busting them.
Tick attachment time is irrelevant. If a tick is sick enough, Lyme bugs are in their saliva, and they transmit the disease immediately. If the tick is less infected, they have to send bugs from their stomach to mouth, and that takes longer. But do you really want to count on how sick the tick is? Don’t let anybody tell you that because the tick wasn’t attached for 24-36 hours you’re ok.
One double-dose of doxycycline is not sufficient. The guidelines that are on the government guideline website, www.guidelines.gov advise 21 days. (That’s a federal government Institute of Medicine website and it’s high quality). No other Lyme guidelines exist. (CDC is not in charge of guidelines; the Institute of Medicine is.) The problem with the study of one single-dose of doxy is that it looked for the bull’s eye rash; it did not look to see if people got sick later. It reduced the rash incidence by 87%. That’s something; but not enough, and it tells us nothing about whether those without rash got sick later. There is no reason to not follow the government guidelines and to risk your health or that of your child because somebody only wants to give you one “double dose” of doxy. There are mice studies of this treatment, and they look abysmal
If you missed the tick bite and have the bull’s eye rash you are lucky inasmuch as you have incontrovertible evidence of being infected with Lyme. You HAVE Lyme. You can still get “early Lyme” treatment, but it’s not the same as treatment for a tick bite. You can find recommendations for treatment on the www.guidelines.gov website. Here’s a direct link to the Lyme Guidelines: http://bit.ly/2tqnaGU. These are government endorsed guidelines, the best we have at this point in time.
Tick-testing is controversial.Don’t wait for the testing to get treated. Negative tick tests give you no useful information; we have no idea how reliable tick testing is vs human testing. But if a tick is positive for a co-infection, something other than Lyme, you might consider getting prophylactic treatment. That’s your call, made with your doctor, but it’s a real consideration. So if you send the tick for testing, make sure the lab tests for co-infections, as well as several species of Lyme.
Jane Marke, MD Integrative and Holistic Psychiatry
Urgent Tickbite Care
80 East 11 Street, Suite 214
New York, NY 10003
Break the Cycle of Chronic Pain
/in Inflammation, News/by Kaplan CenterBreaking the Cycle of Pain
by Paul Wynn, Pain-Free Living Magazine, September 2017
THE FOUNDER OF AN INTEGRATIVE-MEDICINE CLINIC EXPLAINS WHY CHRONIC PAIN SHOULD BE TREATED AS AN INFLAMMATORY DISEASE
Imagine talking to your doctor and finding out that chronic pain is actually an inflammatory disease. It’s an unconventional idea that surprises many people, but it’s slowly gaining traction thanks to the work of Gary Kaplan, D.O., a clinical associate professor at Georgetown University in Washington D.C. (Click here or on the image below to continue reading this article.)
Functional Medicine: Evidence-Based Medicine With A Whole Body Approach
/in Treatments, Wellness/by Lisa Lilienfield, MDWhen your doctor becomes a detective.
If you’ve never heard of functional medicine (FM) before or don’t know how it differs from conventional medicine, you’re not alone. Behind functional medicine is a wonderfully simple philosophy that treats the body as a whole, interconnected system which looks at mind, body, and spirit as contributing elements to a person’s overall state of health. Functional medicine is evidence-based medicine and seeks to identify the root cause of disease by probing into the unique history of a patient’s life and genetics, as well as environmental and lifestyle factors.
In contrast, conventional medicine can be one dimensional and often results in treatment by medication. In acute cases, this may be very appropriate, but because we are not one-dimensional beings in most cases there is much more to the story. When it comes to complex, chronic disease, many physicians are, unfortunately, not adequately trained – and often don’t have time – to assess what may be the underlying cause(s) and apply diet, nutritional supplementation, exercise, and awareness of lifestyle stressors that are contributing to their patient’s illness.
As FM practitioners, we look upstream to assess the interactions of the patient’s history, physiology, lifestyle, unique genetic makeup, and mind-body-spirit that affect the function of the body as a whole.
What does this look like in an initial evaluation?
As a functional medicine practitioner, I start by asking what their story is and often that story starts with “I was fine until…” This is when we need to put on our detective hats and go back in time to reveal clues that may typically be overlooked; sometimes even going as far back as the time of mom’s pregnancy! For example: What was your mom’s pregnancy like? Was there a Caesarean section or vaginal birth? Were you breast or bottle-fed? Were there a lot of antibiotics used in childhood? The answers to these questions may indicate alterations of the microbiome in the gut (the bacteria that support our immune system). This is immensely important as research is uncovering a multitude of new data that shows how deeply interconnected our immune system is with the gut.
Other questions may include: Were there traumatic events in childhood or later? Was there ever exposure to environmental toxins like mold in the living or working environment? Were there ever infectious exposures or injuries? What are the patient’s diet, exercise regimen, sleep and emotional support system like? Is there ongoing stress at work or in personal life? Every answer peels away another layer of the mystery.
Besides a comprehensive history, there are a number of functional medicine diagnostic tests that may be necessary. This could include a sleep study, digestive testing (stool, urine, breath), saliva testing to assess cortisol (which can indicate stress or inflammation), thyroid and other hormone testing, nutritional testing, mold, heavy metals, and infections like Lyme or Epstein Barr. A consultation with our dietitian, psychotherapist, meditation instructor, or treatments such as acupuncture, herbal therapy, massage therapy, physical therapy or injection therapy may also be appropriate.
Fortunately, medicine as a whole is moving in the direction of functional medicine, but this approach takes time and a commitment in partnership between a patient and their physician.
Tick Bites: What You Should (And Shouldn’t) Do If You Get One
/in Treatments/by Kaplan CenterLyme disease and other tick-borne illnesses shouldn’t prevent you from enjoying the outdoors, but you should absolutely be aware of how to best protect yourself and what to do if you think you may have been bitten by a tick.
Lyme disease and other tick-borne illnesses (babesoisis, ehrlichiosis, anaplasmosis, bartonella, and Rocky Mountain Spotted Fever) can cause skin, heart, joint and nervous system problems. Early symptoms may be fatigue, chills, fever, headache, muscle and joint aches and swollen lymph nodes. With the chances of getting a tick bite higher than usual this year, precautions should be taken to minimize your risk. This includes using an effective repellent*, wearing long pants and sleeves whenever possible, incorporating a tick-check into your evening routine, and most importantly, staying educated on signs, symptoms, and treatments.
* Choose a repellent that contains one of the following: Picaridin (20%), IR3535 (20%), DEET (20-30%) or Oil of Lemon Eucalyptus (30-40%)
Below you’ll find some myths and truths about tick bites, and what to do if you think you may have Lyme, by Jane Marke, M.D., Integrative and Holistic Psychiatry
Tick Bite Care
What to do if you get a tick bite? There are some myths, but there’s good science busting them.
Jane Marke, MD
Integrative and Holistic Psychiatry
Urgent Tickbite Care
80 East 11 Street, Suite 214
New York, NY 10003
Additional resources:
Horowitz Lyme-MSIDS Questionnaire