Tag Archives: disease

Change vs. Transformation

It has certainly been a while since the last post!  Rest assured, I have not abandoned this blog.  Many ideas have been swimming around in my mind, and today I feel compelled to share with you one of the most important of those ideas.

I want to have a serious conversation with you about how to approach the Journey we call Healing…

One of my main goals for our patients is to be successful on this Journey and reach their potential for optimum health.  “Optimum health” means different things to different people, and each person has his or her own potential, limited only by factors we can’t control, such as some genetics, some lifelong diseases, and some environmental impurities.  However, even if you DO live in toxic surroundings, carry some “bad” genes, or have been diagnosed with a lifelong disease, that doesn’t mean that you can’t reach YOUR potential.  We just have to find out what that potential is.  You may have never experienced it (yet).

During this journey toward optimum health, we undergo a healing process.  It’s important to know that “healing” is not the same as a “cure”.  Conventional medical school teaches that a “cure” is defined as an “infinite remission” of a disease.  Understandably, that becomes their main goal.

That sounds good and noble.  But is conventional medicine good at curing disease?  Recent statistics indicate that 7 out of 10 deaths are due to chronic disease, the major ones being:

  1. Cardiovascular Disease (heart disease, heart attack, stroke, and others)
  2. Cancer (all types, quickly overtaking Cardiovascular Disease as the #1 cause of death)
  3. Diabetes (especially Type 2, which is exploding, although we are seeing many more adults develop Type 1 than before)
  4. Autoimmune disease (Multiple Sclerosis, Celiac Disease, Rheumatoid Arthritis, Hashimoto’s Thyroiditis, alopecia areata, Parkinson’s Disease, Sjogren’s Disease, Lupus/SLE, and many others)
  5. Neurodegenerative and cognitive disorders (such as Alzheimer’s and other forms of dementia, as well as other types of neurological problems like neuropathies and seizures)

Another staggering statistic is, one out of every two adults had at least one chronic illness.

Verdict: conventional medicine doesn’t have a great track record of curing.  This is not to say that they don’t save lives, especially in emergency or advanced situations–there is definitely a time and place where conventional medicine is exactly the right approach–but its principles don’t hold up so well when applied to treating chronic disease.

We must think instead in terms of healing.  A Functional Medicine doctor must know who the person is in order to help make them whole.  (This is one of the reasons we ask so many questions on our intake forms!)

Each person has several layers of being

  • Our parts – our body and brain – these constitute the “material” layer
  • Our mind, thoughts and psychological status – these make up the “awareness” layer
  • Our meaning, values, and things we deem important to us – these form the “non-conceptual awareness” layer
  • Our transpersonal relationships and spiritual paths – these help us to “transcend”

When we talk about healing, we’re not talking about eradicating a disease.  We’re talking about healing a person, a person with dreams, thoughts, desires, wishes, secrets, aches and pains, losses, regrets, hurt, headaches, digestion issues, mobility problems, excess weight, high blood sugar, short-term memory problems, sadness, and many other aspects.  We are multidimensional beings.

We are also interpersonal beings, and we identify with our associations, which often include our family, our marriages, our circles of friends, our careers, our communities, and more.

Next, I want to make a bold statement:  Illness is a gift.  That statement might cause some resistance, to put it mildly–in fact, it might make you angry, but please read on, because I’ll explain.  (In fact, despite the tough battle I must fight regarding my own autoimmune diseases–yes, plural–I had arrived at this conclusion myself, for the same reasons I’m about to discuss.)

Illness is a gift in that it presents for the person a HUGE opportunity for growth and transformation.  That doesn’t mean that this is always a happy or pleasant journey.  In fact, it’s a very challenging path, with many potholes, ravines, unstable rocks, roadblocks, and steep cliffs along the way.  Hippocrates, known as the Father of Medicine (the same one who said, “let thy food be thy medicine”, taught us that one can learn how to gain from our illness by one’s own thought.

This means that healing is a journey.  When you’re first dealing with your illness, you may experience denial and anger.  Eventually, this may evolve into acceptance and benefit and if it does, this is the stage at which you can begin to heal.

A colleague told a story about another friend/colleague of his that developed cancer.  His friend became angry, frustrated, and resentful, blaming it on an office issue in which he had a staffing issue with someone he hired.  His cancer required a lot of his attention and a lot of time spent away from the office, and he could not allow this issue to continue in his absence.  So, he dealt with that issue once and for all and resolved it completely.  This was a major stressor that had affected his whole life for years, and the development of the cancer forced him to resolve the issue.  Had he not developed it, he might have allowed this issue to continue, dragging him down for the rest of his working life.  As it stands, I believe his cancer is in remission, and his office is solid and peaceful.

My own autoimmune disease was a gift as well.  If someone had said that to me early on, I would have thought they were crazy.  However, I slowly realized as time went on, and I fruitlessly searched and searched for a doctor who could really help me and would take the time to try and solve my mystery, that such a doctor would not be made available to me anytime soon, and that I would have to become that doctor myself, to make sure that no one else went through what I did.  So, I went through school and although this cost me dearly (my disease got worse and progressed into multiple diseases), I emerged, tattered and broken, yet alive, and resolute: no one in my care was going to suffer or walk alone.  Had I not developed that disease, I would not have found my calling to serve, and I would not have sat here before you.  My disease(s) ARE indeed a gift.

That doesn’t mean the journey was easy.  It required transformation.  Transformation is not the same as change.  Change is what it takes to be different, in which State “A” is different than State “B”.  Change involves small alterations, Baby Steps that can be taken quickly, such as vowing to take 3 deep breaths every 20 minutes, in order to relieve stress at work.

Transformation happens on a grander scale in which you begin to identify or connect with something else and ingrain into your core being so that it becomes part of you.  An example of this might be the discovery of yoga or Nia for that stress relief, in which you experience a “wow!” moment.  When you hit a “wow!” or “a-ha!” moment, you’ve just undergone a transformation.

Another sign you’ve undergone transformation is when you begin to “do a 180” from your previous opinion and believe the opposite of what you believed before.  One of my patients, always the skeptic and always one to do what he was going to do and never put much stock into my gluten-avoidance advice, read a particular book, “Wheat Belly”.  Not several months later, this man is not only gluten-free but GRAIN-free, realizing that corn (something he once consumed rather freely) isn’t so great, either.  Every chance he gets, he strikes up conversations with visitors or even some regular patients in our front lobby, professing the evils of the grain family, especially wheat (“that stuff is killing us!”)  I smile and laugh inside.  Transformations are beautiful and fun to watch.  Witnessing someone go through transformation, as painful and confusing it can be for the patient (and the doctor–we don’t want to see you suffer either!) is one of the greatest rewards for me in practice.

All transformation involves change (lots of change), but not all change is transformation.  Almost anyone can go on a crash diet and lose 10 pounds in two weeks to fit into that bikini during Spring Break.  Anyone can eliminate gluten for a week.  However, some people are so hooked on the adrenaline rush of the evening news cast or political AM radio talk shows that despite the fact that these stimuli are causing subtle, low-grade stress reactions that slowly eat the person alive, they can’t bring themselves to stop watching or listening.  Or they can’t simply leave that toxic ex-significant other alone.  If these people were to take those steps, they would surely have “wow!” moments…and undergo important, potentially life-saving transformation.

On a grand scale, there have been some pretty famous transformers that not only experienced personal evolution, but shared this with the world; examples include people like Mother Theresa, Gandhi, Martin Luther King Jr…you get the idea.  You don’t have to be the next Gandhi, but it might not be a bad idea to use his level of commitment and vision as a role model for your own personal journey.

Sometimes, transformation occurs through the resolution of dissonance.  Dissonance is the difference between what you want (more energy, less weight, cancer remission, a sharper mind, fertility, clear skin, better lab test results) and what you’re currently doing (are you eating salads or sodas for lunch? Are you walking or watching violent movies at night?)  Sometimes, all it takes is to be AWARE of the dissonance; that alone can motivate people to make changes.  Other times, it takes an event that really hits home (such as a heart attack, or a conventional doctor’s mention of an insulin or statin drug trial).

My job as a Functional Medicine doctor is to help YOU facilitate that change, and to walk with you as a guide through your journey, holding your hand in support every step of the way, so that you do not ever feel alone.  My patients come to me ready to do something; most aren’t sure what, but they know they can’t keep doing what they’ve been doing and expect different results.

It’s also my job to understand that most patients will likely take steps backward in their journey.  This is normal, and it is not a sign of failure.  To give up completely and drop out of care without another idea in mind would be failing; to keep going, even if you’ve veered off the path, is not failure.  The path to healing is not linear; it spirals and curves, twisting and turning.  Sometimes you fall.  You don’t need to hide it and you don’t need to be ashamed.  You just need to get back up and keep trying.

Spirituality can bring about massive transformation, and even help alleviate some chronic diseases.  Some people find God, while others begin to question the religious framework in which they were raised.  Still others try out spiritual paths for themselves, dabbling in one philosophy or another, as if trying on clothing to see if it fits.  (There is NO problem with that!  If you feel drawn to do this, then by all means, please do.)  Some people merely get in touch with nature and that provides a spiritual springboard for them.  Others seek counseling or cut toxic drama-prone people from their lives.  These trials and excisions may cause a little (or a lot of) pain, but they bring about healing.

Every good healthcare professional (Functional Medicine and otherwise) should make Compassion their top priority.  Compassion can be eloquently defined as, “where love meets suffering.”  It is our job to love our patients for who they are, wherever they are in their lives and on their journeys, leaving no room for judgment or condemnation.  If we doctors are to call ourselves healers, this is an absolute requirement…

…because healing is MORE than a cure.  Chemotherapy cures cancer, but it does not HEAL the person.  Chemo may be necessary in many cases, but that person must also work to heal from the inside and undergo a true transformation.

Let’s walk. 🙂

“My lab tests are normal” (…or are they?)

Cindy* sits across my small round table during our first visit together.  She has hit a brick wall.  Last week, she submitted to my office her intake forms and previous medical records, which consist of lab test after lab test.  These are isolated individual tests, taken on different days (or even months), never all at the same time.  Some of the tests are repeated several times.

Cindy shrugs, throwing her hands in the air.  “I don’t know what to do.  They look at me like I’m crazy.  They tell me my labs are normal.  And yet–well, you’ve seen my questionnaires.  I’m a mess!”

So her lab tests were “normal”, eh?  Let’s see about that….

First, let’s talk about the blood test process.  After the doctor or nurse takes your blood, they send it to a lab, telling that lab to run various tests on it.  The lab analyzes the blood sample and determines the results of the tests ordered.  These test results are reported back to the doctor in the form of a number.  Some of those numbers are familiar–for example, a cholesterol of 183, triglycerides of 132, or a blood sugar/blood glucose of 94.  If you have a thyroid issue, you may also know your TSH level.  The lab will compare your number results with what is called a “reference range” – a “normal” range.

Next, it’s important to understand what “normal” means.  The conventional medical system only recognizes two states of health: either you have a disease or you don’t.  If they can’t establish the presence of a disease, the doctor tells you you’re “normal” or “fine”.

The problem is, the regular definition of “normal” (and the “normal range” used by the labs to determine whether you’re sick or not) isn’t based on good health or healthy function.  It’s based on that “normal range” we talked about earlier.  How are those ranges determined?

By statistics.  The large national lab companies are responsible for setting their own reference ranges.  To do this, they compile the test results of the samples submitted, established an average, and compare the results to the corresponding patients. Every so often, as the general health of the population shifts and the average number values change, these laboratories will adjust their average ranges accordingly.

Look around you; 60% of the population is overweight and 20% of the population has developed diabetes.  About 73% of the population is taking at least one medication.  Cholesterol problems, hormone imbalances, and digestive issues abound.  Alzheimer’s Disease and autoimmune disorders are skyrocketing.

Do you really want to be compared to those around you?
Do you really want your “normal” range to be based on those people?

Also, it’s important to understand that these labs do this on a regional basis.  This means that a patient in South Carolina and a patient in Utah may have the same fasting blood sugar levels, but get labeled “normal” in South Carolina, while the lab in Utah would “flag” the result as abnormal.  The South Carolina patient’s doctor would tell that patient he or she is “fine”, while the Utah patient’s doctor will make recommendations for preventing diabetes.

One huge problem is that in gathering these statistics, labs fail to take prescription drugs into account when establishing normal ranges.  Medications, by definition, artificially manipulate the body’s function, altering its chemistry.  Because of this, it’s important to consider their effects when determining what’s “normal” and what’s not and yet, this is not done.  As a result, people undergoing thyroid testing get lumped in with people taking thyroid medications, and people undergoing a blood sugar screening get lumped in with those taking insulin.

Do you want to be lumped in with people taking loads of medications?  Do you think that these “normal” ranges can be fully trusted?

Now…when most doctors get these results back, they scan them, looking for abnormal results.  If any test result falls out of range, the lab highlights it, usually in bold, stating “high” or “low” off to the side.  Most doctors, lacking the time to fully investigate these results, quickly scan each line item.  Anything not flagged in “pathological” (disease) range is passed over without a second thought.

So, back to Cindy.  When she hands me the printouts from her previous lab tests, I, too, scan for the lab’s flags.  However, that’s just the tip of the iceberg; I usually find many more abnormal results that lie outside of healthy range, but not yet far enough advanced for the lab to flag the result as “abnormal”.  It’s not that I run different tests, it’s that I use “functional ranges”, which are much tighter and designed for healthy function.

For example, a good healthy functional range for fasting blood sugar is about 85-100.  The lab’s established reference range is often 65-110. If Cindy has a fasting blood sugar of 77 , she begins to lose optimal function, and yet most doctors will tell her she’s “fine” because the lab won’t highlight her result as “abnormal” until she reaches 64.  By the time her blood sugar falls that far, she has lost a lot of function!  She probably started feeling dizzy and lightheaded around 79.

Is Cindy hypoglycemic at 77?  Nope, she’s what we call “functionally hypoglycemic”, because she falls below the lower functional blood sugar limit of 85.  When she gets to 64, we can officially call it true hypoglycemia.  But why wait until then?  Someone with blood sugar in the 70s can certainly have hypoglycemic symptoms and can still benefit from a blood sugar stabilizing plan.

That’s what Functional Medicine is all about, folks: good function.  It’s about catching health issues early, identifying breakdowns in proper function before they become established diseases.

Of course, once they do, it’s not impossible to turn it around.  But if you’ve got a train starting to travel in the wrong direction, picking up speed second by second, isn’t it easier to get it stopped and turned around before it reaches full speed?  True health works exactly the same way. 🙂

*real patient, but not her real name

Does my health insurance cover Functional Medicine?

That’s a great question.  In fact, that’s one of the first and most common questions people ask.  This is understandable; after all, chances are you’re paying good money for your premiums, not to mention deductibles and co-pays.  Your employer has no doubt touted the benefits of each plan, which seems generous at the time.

So where does Functional Medicine fit in?  The short answer is, I recommend that you first carefully review your policy, checking for any reference to “preventive” services, or possibly “nutritional counseling”.  When in doubt, it’s best call your insurance company directly and ask them if any of these types of service are covered under your plan.

To understand the long answer, we must first make an introductory foray into the world of so-called “health” insurance.  The first thing that you should know about health insurance is that the term is a misnomer; your health insurance company (be it Blue Cross Blue Shield, Aetna, Cigna, Humana, or worse, United Healthcare) has not made your health their top priority.  How can this be?

Well, let’s do a little research (I love research).  Quick Google searches show that the first Blue Cross plan was introduced in 1939.  Humana was founded in 1961.  United Healthcare is the new kid on the block, formed in 1977.  And the elder of the insurance companies?  Aetna has been around since 1853.

Since insurance companies are private corporations, this may go without saying, but it’s worth highlighting here: in order to survive, health insurance companies must turn a profit.  This is true of any company, family/household, or individual.  You must make more than you spend.  By definition, this means that they must take in (revenue) more than they pay out (expenses).  This means that their customers (that’s you) must pay more in premiums (as well as deductibles and co-pays) than they pay back out on your behalf (in the form of benefits, or covered services).

Functional Medicine itself requires the doctor to spend an enormous amount of energy behind the scenes between your appointments.  This time spent on your behalf includes deeply interpreting lab results and putting them together, attempting to find the underlying common cause or causes of the problem.  This may also take research and review of the newest published studies as they come hot off the presses.  No other healthcare discipline goes this far or invests this amount of time on each patient.

Since these doctors only have so many hours in a day, they’d rather devote that time to your case, (researching and reviewing your case, preparing information and treatment plans, and answering your questions), than wrangling with insurance bureaucrats, none of whom have any medical training themselves and thus lack the understanding that Functional Medicine doctors have.  Most Functional Medicine doctors would love to provide the convenience and assistance of filing insurance for their patients, but with the time and energy constraints, they find that they can’t do both well.  The bad news is, they don’t file your insurance for you and they furnish you with the receipt to submit instead.  The good news, though, is the most important: they’re not bound by their arbitrary rules, and their time can be spent where it counts–devoted to YOU.

So, about that receipt I just mentioned… Yes, most Functional Medicine doctors will provide a descriptive receipt upon request.  Depending on your insurance company, they may accept that receipt and perhaps reimburse you for part of the out-of-pocket investment you made.  I can never guarantee this, as insurance companies are like water, always changing and tough to get a firm grasp of.  Sometimes they will want codes, and this is where things get sticky…

The codes the insurance company likes to have essentially reduce you to a Dewey Decimal-like system of numbers.  Every established disease (official diagnosis) has a 4- or 5-digit number, in the form of “123.45”.  Each recognized type of treatment has a 5-digit code, too, in the form of 12345.  Although the two numbering systems are different, each recognized disease corresponds with its appropriate avenues of treatment, and vice versa.

So what’s the problem?  The difficulty arises in that these coding systems are old and outdated.  They fail to consider dysfunction (i.e. breakdowns in healthy functions or processes, the earliest signs of disease) and they also usually neglect to include contemporary health issues.  In other words, there is a language barrier between Functional Medicine and health insurance, especially considering that health insurance is actually structured around–and oriented toward–conventional medicine, which intervenes only when the dysfunction has advanced for years to decades, resulting in a blatantly recognizable, established disease condition.

The common scenario is this: you start to feel that something’s not quite right.  You visit your conventional/regular doctor, who runs the blood tests and, after scanning them quickly, says “everything is normal”.  You know that it’s not, but now they’re hinting that it’s all in your head.  Meanwhile, your health does slide further and further away from healthy ranges, toward the outlying borders of “normal” and eventually it does cross into “abnormal” territory.  This may be years later, and by then it may or may not be too late to effectively use natural methods.  But the insurance company now has a number it can assign you, a little numeric box it can neatly put you into.  They’re happy, they’ve been satisfied.  But what about you?

That’s where Functional Medicine comes in, and hopefully you’ll be able to see a Functionally-oriented doctor before you reach the disease point.  With any luck, your insurance company will cover at least part of the tab.  If they do, look at it as a secondary bonus, and if they don’t, simply consider it part of the cost of living.  After all, when owning a vehicle, we understand that if we don’t invest in maintenance, the car breaks down and stops working.  We must pay for regular oil changes, state-mandated vehicle inspections, license plate tags/stickers, brake pads (which are actually designed to wear out!), tires, and many more.  Why give your body any less?  Make your health your top priority, even if it’s not your insurance company’s.  Why?  Because you only have one body, and it only treats you as well as you have treated it.  We’re a product of the decisions we have made every day.  Up until now, people have relied on their insurance coverage for any kind of medical care.  But if we want a different result, we may have to consider a different approach…whether an out-of-touch insurance company thinks it’s medically necessary or not 🙂

How Functional Medicine works – the nuts & bolts

Practiced properly, true Functional Medicine orders a LOT of diagnostic testing because each test gives another piece of information, much like putting together a puzzle.  Basic testing only gives you part of the puzzle picture; you’re never really sure what the rest is supposed to say, and you’re forced to guess.  I don’t like putting my patients’ health at that kind of risk; it’s too important.  So the testing is non-negotiable – and why wouldn’t it be?  The human body is quite complex and there’s a lot to evaluate.

Actually, a good evaluation starts before testing is ordered:

  • Lifestyle habits
  • Dietary analysis
  • Trauma and illness history
  • Thorough symptom and metabolic questionnaires
  • Complete medical history
  • Vaccination schedule
  • Medication and supplement regimen
  • Cognitive evaluation
  • Motivation assessment

An important concept in Functional Medicine is that the testing conventional doctors order is not nearly enough.  It barely scratches the surface, because the current healthcare system is driven by insurance companies who do not see the merit in prevention; they are in the business of screening for advanced, established disease and then patching the symptoms with medication when they get further out of hand.

Once we uncover and identify dysfunctions, the doctor takes a secondary, supportive role in the patient’s care as the spotlight begins to shine on patient him- or herself.  The patient’s participation and initiative become crucial for a successful outcome.  He or she may be asked/required to do any of the following:

  • Dietary changes – short-term, long-term, or permanent
  • Specific supplementation – short-term, long-term, or lifelong
  • Specific exercises – these can include eye movements, walking, stretches, arm circles, strength training, interval training, or yoga positions
  • Homecare instructions – these can include doing math or art, reading, prayer or meditation, or utilizing the senses such as listening to music or smelling various scents
  • Other modalities and specialties – acupuncture, massage therapy, aromatherapy, talk therapy, thermography, colon hydrotherapy, homeopathy, physical therapy, brain-based therapy, conventional medical intervention, and more
  • Other lifestyle modifications – TV or computer limitations, activity modification, sleep-wake schedules, work environment, and others

It’s a challenge, and each person must decide for themselves whether or not they’re ready to take the plunge.  Commitment is key.  Motivation is key.  The effort is worth it; one of these days I’ll share some of my patients’ success stories–real cases (while protecting privacy), to demonstrate the power and miraculous relief that Functional Medicine can bring when conventional medicine, traditional alternative medicine, and self-treatment via the web have ALL failed.  It’s truly amazing!