In my first post, I talked broadly about the benefit an integrative approach can have on people. Today, I want to share a story that hits a little closer to home.
Scientific studies on the growth of Integrative Medicine are expanding daily. We're seeing a steadily increasing trend of improved health outcomes with lower systemic costs.
But populations studies and systemic costs don't matter to the individual sitting in an office with me. The specific cases - and the flexibility I have to make each protocol tailored to each patient - that is where the power of Integrative Neurology really shows up.
Patient "Jane"
A couple of years ago a patient came to see me, her health and life spiraling out of control. Once upon a time, she was a happy young woman. The slide was slow at first, then picked up speed. By the time she walked into my office, the woman was morbidly obese, chronically fatigued and experiencing extreme fibromyalgia pain. All of that pain consolidated somewhere inside her temples as daily migraines superimposed on idiopathic intracranial hypertension.
After seeing specialists for years - many of them neurologists and headache doctors at prestigious universities - my patient had collected a binder full of failed treatment plans. Nothing was making her symptoms budge. Hopeless and exhausted, she found fleeting relief in her daily routine of Tramadol and anti-depressants.
Fortunately, this patient had a good friend who convinced her to see "just one more neurologist. A different kind. See an Integrative Neurologist." The patient was extremely skeptical about my approach, but at this point "had no other choice." The headaches were just too unbearable.
Relationships Matter
My patient's friend was right. Integrative Neurology is a different, and better, way to treat people. Why? We are trained to look at the relationships between systems. So we understand that when one part of you breaks, it can put strain on many other systems. Strain any system long enough and it will eventually break as well. This will compound the stresses and shift them to still other systems - creating a domino effect.
As an example: gut health influences the immune system, endocrine system (hormones), nervous system and others. So an improperly-working gut will lead to improper hormone levels. Improper hormone levels will impact, amongst other things, sleep patterns and your ability to deal with life's stresses. Circularly, sleep and stress impact your gut's ability to function properly.
When it all fits together, it's a virtuous cycle that can create health. But start pulling or pressing on any system (whether through lifestyle or pathogens) and your body can be knocked out of whack quickly. Disrupted hormones, toxins, allergens, and infections can play significant roles in chronic illness, whether manifesting in the heart, brain, skin, gut, or frankly any organ system.
Understanding not only what system is broken, but what other systems are getting stressed because of the break is essential to unraveling the problem.
More relationships that matter...
In our era of specialists and sub-specialists, it is getting easier and easier for doctors to miss the relationships between systems - focusing only on the set of symptoms-based solutions that have defined their careers.
It's nearly impossible in today's conventional medical system to consolidate all the sub-specialists into a complete picture of a patient.
That's where I come in.
I proudly wear the term "super-generalist" to describe my medicine. It took some re-educating on my part to get out of the “stuck in the neurology silo” approach and cast a much wider net. By being open to all forms of medicine, and looking across all systems, I can view my patients from a much wider lens, and I have access to a much larger toolbox to treat patients with.
The impact is nothing short of life-changing.
Gut Dys...what?
Back to my extremely skeptical and extremely sick patient. As you might be guessing, every one of her systems was misfiring. During our first visit, we identified some food intolerances, digestive issues and a strong likelihood of methylation (biochemical process) imbalances and hormone issues such as adrenal fatigue.
The treatment plan was multi-pronged, but it began with lifestyle.
She initiated a quick but strict elimination diet to start the gut reset process, then followed it with a modified ketogenic diet and a few basic supplements like fish oil, vitamin D and magnesium (see my recommendations here).
We addressed her need to work on stress in her life, so she started working on strategies to build up her resilience for stress. She was not yet able to start exercising, but we did our best to get her moving as much as possible. She worked on improving her sleep.
And she started cleaning up her environment to rid herself of common toxicants in products she used.
Bringing It All Together
After 6 weeks she came back to see me. For the first time in years, she was feeling more energized. Her chronic fibromyalgia started waning, but her headaches continued on.
Digging deeper into the toolkit, we did some targeted Functional Medicine tests and discovered severe gut dysbiosis, DNA issues, some targeted nutritional insufficiencies, and high inflammation and stress markers.
We added prescription drugs and supplements to her personalized diet to treat both the gut and her nutritional issues. Vitamin B helped normalize her methylation and restore normally functioning DNA. Low dose naltrexone (LDN) as well as powerful supplements to counteract oxidative stress.
Three months later my patient was back as a different person. She had lost 30 pounds. Her energy was returning and her pain was subsiding. She had cut out Tramadol completely. By 6 months, she had lost 70 pounds and weaned herself off the anti-depressant. She was well on her way to reclaiming her health and life goals, and her body was developing the virtuous cycle of all systems working together to create health.
People ask me why I paused a career as a neurologist to go back for MORE school and to switch focus. Stories like the one above, along with the help I've provided to my friends and family, made it an easy decision.
Integrative and Functional Medicine is how medicine should be practiced. It is how doctors should work with patients and with each other. I'm excited to join the team at Case Integrative Health and advance this approach for medicine I look forward to helping you achieve your health goals!
Dr. Rana Mafee