In this episode of Functional Medicine Back to Basics Dr. Rutherford discusses the importance of doing a thorough patient history before any exams or testing are done.
Note: The following is the output of a transcription from the video above. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.
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Actually, the technically the first part of the series was a presentation that we did called Wacom all medicine versus functional medicine and that kind of summarizes where the whole series is going. And then we did an intro video, another intro video.
To summarize why we were going to do this and the reason that we’re doing this? Is there’s, a lot of people out there doing functional medicine there’s, a lot of people out there. There’s, a lot of stuff online.
There there’s just and and and we have at this office, we have put over six or seven hour, 100 hours online, more or less hardcore scientific data relative to the different types of chronic conditions that are out there and the kind of conditions That we treat the fibromyalgia, peripheral, neuropathy, chronic fatigue, dizziness vertigo, balance, quite irritable, bowel syndrome and and it’s, all it’s, all got power, health, talking, calm and and and from those we got a lot of a tremendous amount of Positive feedback, but we also got a lot of.
Why can’t? You tell me, then how to fix me why you’re holding back on me, you’re, not telling me, you know. Well, I don’t, have my supplement line to sell to you that probably isn’t going to help a lot of you and and and there’s.
A reason for that, and and we can’t – tell you, and so that was the genesis of this series. Functional medicine was perceived to be a very very my first seminar I went to the the doctor was teaching. It said this is not.
This is complex. This is not easy. If you’re looking online and you’re, getting supplements for people for for your or they’re, getting supplements for themselves. You’re still playing whack-a-mole. You’re, still giving a supplement for a symptom that’s for people, a hundred six hundred you know 100 years ago, or sixty years ago we there’s.
A new patient population and autoimmunity is what’s, defined that patient population, chronic stress responses. We’re, going to talk about a little bit today, define that patient population and that’s.
The chronic pain patient or the chronic condition patient and we need to go back to old school. This was the initial seminar I went to and we need to learn how to diagnose, and we need to learn how to assess our patients and, and so that is what the that’s.
What generated this whole series today? We’re, going to talk about the history we ‘ Ve talked about functional medicine in general, we’ve talked about last week. We talked about obstacles secure and the vast majority of the obstacles to cure that we talked about.
Last week we’re, not that you have a none curable disease, but they were more about things relative to maybe a person’s, ability to even embrace this type of a protocol, but I urge you to to watch it.
We talked about things like sleep apnea not being addressed, and so there’s, a number of things there that are obstacles to cure, meaning meaning no matter what you do. No matter what you get on the diet.
You do your brain or you have exercises you do yoga. You do acupuncture you do whatever you’re doing and it’s, not working because you haven’t done those obstacles to cure. I could actually account not doing a good history as an obstacle to cure for the doctor.
Okay. So this week we’re doing history. I’m walking you through this week by week. Eventually, we’re going to get to treatment. It’s, probably gonna be like it a month or two out before we get to that, and I’m just gonna walk you through a functional medicine, as it should be classically, and – and this should answer a lot of Your questions – maybe some of you – will pick things up along the way that you will use that that will help you and I’m.
I’m totally good with that. I think half the country has chronic pain right now. So I don’t think there was enough doctors to fix everybody, so so history is so important. Now I come from a time before there was MRIs before there was cat-scans.
I come from a time before you know there was nerve conduction, velocity tests and – and I come from a time before the what I call the dark ages of diagnosis. When we suddenly got chronic pain, we started to become a problem: chronic fatigue, immunodeficiency disease, lyme disease.
These types of things mold and suddenly I come from that time where there was no testing. So now there’s. There was an explosion of alternative testing, a lot of which maybe isn’t, totally accurate and and and but yet doctors were basing their and still are basing their entire protocols on these.
So one of the things that that we had to do back then before all of this was occurring before MRIs and cat scans, and all these all these alternative tests and came about was we had to do a history and we had to do an exam.
I know when I was in clinic, if I did, if I came out of it. If I came out of the exam room in less than an hour, my clinic director would tell me to go back in. I must have missed something that was fairly standard back then.
It says just so much an hour you need to for for chronic pain conditions. You need to take a good history and I’m gonna go through a history, and I’m gonna and I’m gonna and you think you’re gonna see.
Why? Maybe if you’re, calling some up on a phone and they’re, sending you a three page standard history form and then it goes back and they do kind of a couple standard tests. And then they start. They give you the Paleo diet and throw a bunch of supplements at you.
Maybe that’s, not functional medicine or at least not for chronic conditions. Okay and and and so we’re gonna walk through a history and what it should look like, but still a little bit more background on history fast forward from when I was younger and and doing an hour history and an hour exam was Like standard procedure, I remember my first exposure to functional medicine was listening to a lecture by Jeff plant Jeff LAN is the coined the word functional medicine.
He’s. I think he he taught at Bastyr University for years and and more than that, he he was also he. I think he still may be involved with creating formulas for supplements, but he was really a big genesis of functional medicine and he understood that you had to take a history in for a chronic condition that started literally from birth.
And now we’re. Finding out, maybe even before you know and and I’m – not just talking genetics but like the state of the mom, and so so they and I think they still have there’s, a couple of different lines of functional medicine.
I think they still have a group that dr. bland runs and and they teach functional medicine the doctors and I think they still have their template and it was a and it was a. It was a. It was a sheet of paper and it was a timeline from the time that the person was born and you would take their history from the time they were born.
Where did you have a c-section? Is that is that matter? Yes, it matters because if you didn’t, if you were c-section as a child, you didn’t, get the meconium from your mother’s, vagina, going as you were going through, and that alters immune function and we and We now know it was your mother, where’s, your mother stressed when, when, when you were born during the period of time as she carried you, oh my god, she was going through.
Well, we now know stress hormones can cross the placenta and that person who has anxiety and panic attacks literally since they were born the mother says, should they’ve been that way since they were born, it may actually go back that far to the Fact that that there are that there were stress enzymes coming from all the way back that far and dr.
bland put, that was the first one I saw that put this together and and then you would look every step along the way he would take the you Would take the particularly pertinent information from every step along the way, and you would put it on this template this chart and then you would use that to compare the persons present day, symptoms and problems, and you would start to use that to make a diagnosis.
I Got News for you, I mean this is the way we used to have to do. When I was kids when we were young, when we were young doctors, you had to figure it out from an exam and a history, and you had to come up with three differential diagnoses that were probably going to be.
What was wrong with the person and there was no backup. Well, I mean we barely had x-rays at that point in time, but we didn’t have MRIs cat-scans and all the other things I said, and I think we were better diagnosticians fact.
I’m, absolutely certain. We were better diagnosticians. Then today’s, just divert to the test, whether it’s, an alternative test or whether it’s, a blood test or whether it’s. An MRI or a cat scan it’s telling you you’re normal there’s.
This you walk in it’s. Eight minutes. You know it’s. Ten minutes you can’t get a good history. You divert to the test. You treat what the test says that’s, not the way you do functional medicine, it wasn’t.
The way we used to do standard medicine. So let me let me kind of use my case. Okay, most of you have watched. I was found out last week how many people watch these things. I was like in shock, so thank you for watching and I try to bring real content to you and here’s, real content, I’ll.
Give you my case. Okay, I watch this know. I have a lot of these issues, so I’m just going to share this with you, I was going to give you the Cliff Notes, version. Okay. So, basically you know I was born to a very stressful mom.
Hmm that may or may not have had any issues. I do remember being stressed from the time I was a young man. I had had my first gut surgery when I was five weeks old, and so I had a prologue stenosis and I had a gut surgery to open that up.
So in other words, food wasn’t going through me. Is that important you had? You know you had your gut opened up another foods going through where’s, the problem with that. We now know that, once you cut somebody’s intestines, you probably have a permanent leaky gut.
If you’re, taking a history for a chronic pain patient knowing if they have a leaky gut and ultimately food sensitivities, is very important to know and knowing that maybe they’ve had it their whole. Life is important to know fast forward.
I’m at very, very nervous young man. I’m continually having to go to the restroom in third grade. Fourth grade fifth grade there’s, nothing wrong with me. I’m vomiting stuff up, so I was under a lot of stress.
We are our. If any of my relatives, let’s, see this. They he’ll, go yep. He was under a lot of stress and it was very stressful. When I see someone here who is a young man, let’s say that they’re 15, 16.
20, the mother, well, 15. Let’s, say 15 and the mothers brought brought the child in and they and and and I asked how are you when you’re, a kid and they say? Oh, I’ve, had gut problems when I kid, but they checked everything and everything was normal.
I know that if there’s, no pathology there, that young man was our young lady was under a lot of stress and that that was may become, causing the gut problems that they’re sitting there in front of me, because brain Causes gut problems so so for me I, when I look back yes, I was stressed.
I also had bad bowels at that point in time my mom was Italian. I lived in a little Italian neighborhood in Trenton New Jersey, a wonderful place to grow up just outside of a place called the burg in Trenton New Jersey.
For those of you from back there, you ‘ Ll know what I’m. Talking about and an Italian neighborhood, so what am i eating? I’m eating pasta. I’m eating bread. I’m eating. I’m eating pizza every Friday night.
I I had bad bowels my whole life and and in retrospect, when I do my history, it’s, entirely pasta and I have celiac. I know that now it’s entirely possible. I’d celiac from that time. That’s important for my doctor to know, because it tells me how long the person has had that problem and it caught.
It gives me a better idea of how long it’s, going to take them to get better or gives me incentive insightful. I’m sana saying it gives me insight on other things relative through their history. I go fast-forward a little bit more.
Actually, I actually had ulcers. You know what, in my teen years ulcers, you know they’re kind of. Like you’re stressed you’re stressed you’re stressed you’re stressed you’re stress emotional trauma.
We may touch on that a little bit in the history, but emotional trauma is significant. In chronic pain and seeing it now, I’m, seeing it I’m, seeing it everywhere yeah. When we first started talking about emotional traumas, we kind of got a lot of being part of chronic conditions and chronic pain and fibromyalgia, and a lot of the gut problems and things like that.
Yeah we got a lot of flack, but the data is there and now I’m starting to see psychologists and psychiatrists, doing brain rehab exercises, functional, neurologists and and functional psychiatrist using 5-htp and Sami, and things like that for their post-traumatic stress syndrome, emotionally Traumatic patients, so you seem to divert when I say that, but I’m.
Not this is what you start to initially grab from the history. When I say you can make it an exam, 21 years old, fast forward, 21 years old, I get mononucleosis. Okay, probably I’m kissing too many girls right, the kissing disease.
So I get really sick. I mean really sick. I mean I lose like 35 pounds hi. I’m that big guy. To begin with right, I lose like 35 pounds. I go from like 150 to 123, I’m, laying in bed I develop strep throat, I can’t eat sweats, just the whole thing was awful and it’ll.
Last for months and and and finally I got through it and then the fatigue from it lasted for over a year. In fact I played I was playing sports at that time in college. I missed the whole season because I could I couldn’t.
I couldn’t even get on a treadmill for like ten minutes. We now know. We now know that if you, if you have mononucleosis and and which is caused by epstein-barr virus and and if you have the symptoms, the acute symptoms for more than four to six weeks, like three months and fatigue for twelve to fourteen months, that you probably developed Hashimoto’s, an immune attack against your thyroid, and why is that important? To my case, years and years and years and years and years later, I developed more Hashima, I developed a more severe type of Hashimoto’s, and – and it goes although – and it goes all the way back to that point when I was 21 – and I’m gonna hit that in a minute, so so fast forward from there all of a sudden I get better, but I’m a little fatigued and I start fighting my way.
I’m figuring. Well, I’m 22 now, so this must be old age. I have to fight my way so I get through that. You know and that and we go on with that for the next years and then poor diet and and stress and all that type of stuff and then and then I get to almost 50 and and I go through a stressful event in life.
I end up getting. I ended up getting pneumonia and the next thing you know that triggered what ultimately was full-blown Hashimoto’s, full-blown celiac fatigue, chronic fatigue. I started to get eczema and seborrheic dermatitis at that point in time, anyways a flat fibromyalgia sensitivity.
I just tell my wife every fiber of my being hurts when I try to get out of bed and then it’s. Some small fiber neuropathy, I’ve, also had along the way for my history. Okay, I’ve. Also had a lot of concussions all right, and so from sports and a couple of car accidents and stuff like that.
So so now let’s say I’m 51 years old, 50 or 59 or 49 somewhere around there and let’s say I now I show up in the doctor’s office and and there you Go like what’s going on, and I – and this is what happened same thing.
You know I I said well, you know I’m sick. I I I’m tired. I can’t get out of bed. I heard everywhere I’ve got all this stuff happening. I’m starting to put on weight. I know it and the doctor tells me, after you know five minutes of giving me one little sheet devices you’re depressed here.
Take this thing that take this depression thing that’s; kind of how it still is. You know in a lot of ways and and in a lot of functional medicine practices its expanded, but the reality is is: is that that whole past history? I could literally look at that history today in a patient coming in here and almost tell them what’s wrong with them? Okay, because my epstein-barr virus, that probably was what exploded to cause my particular Hashimoto’s and there’s, other things that cause it.
Okay, probably started back when I was 21 it’s. Probably the reason that I couldn’t lose the way it’s. Probably the reason that I that went up and down that I just struggle with it that I was always more tired than I thought I should be the ulcers you go back.
You look at the history there I had ulcers. Clearly I’ve. Had stress my whole life, there was emotional trauma there that you can look at our videos on on PTSD and chronic pain. If you want to look those up, and and now you can look back and see how that was there, you’re gonna, go all the way back to my birth and and today.
Today. If somebody came in to me – and I do get these people and they have anxiety and panic attacks – and I’ve – been nervous, my whole life and and I throw up before sports events and no matter what I do is I can’t get it under control, maybe it actually came from their mom.
Maybe there’s, actually stress hormones that cross the placenta that actually helps you to be able to address that person’s case. So you take my case. You get up to that point in time. Finally, miraculously I run into, and in my research and stuff I run into some people who are just starting functional medicine, and I that’s.
Why, when you hear me talk, I say I think it’s. I think it’s fair. For me to say I was one of the original functional medicine group doctors and I was – and this is the way that they taught it. They taught that you need to do the history and you need to do the exam.
I was just at a recent functional medicine practitioner, a regional functional medicine seminar and the great thing about this seminar was the teacher was also in practice and he indicated to the whole group that was sitting there and there’s.
Maybe 50 people sitting there that he does an exam that’s, three hours, long, a history and an exam that’s, history and exam. It’s. Three hours on there was a collective groan from the group which leads me to believe a lot of functional medicine practitioners.
Maybe aren’t, delving into the cases the way that they should be because it can add just so on. Add yesterday, in one of the papers here’s, my template for functional medicine – you can just do this, and in and in 20 minutes you can no, we threw out the person and you can get this computer program and if you improve your program, You just put the blood panels in there and the blood panels are going to tell me what what supplements they give them.
You put them on this diet and you can treat everything I can tell you from personal experience. You are looking for trouble, treating people that way and and and there are there, some people they’re, going to get better doing that.
Yes, but when you have, when you have people, when you have people coming in to your practice and your functional medicine practitioner eventually, you start getting some very difficult cases, because patients are now.
I’m, not just starting the good it like people. Now are not just going to medical doctors before they come to us, but they’re going to other alternative practitioners before they come to us, and the things that I’m talking to you about over this year are the things that Are missing when that person comes to us and they’ve, been to another functional medicine, doctor okay, who maybe didn’t even take a history.
Maybe just said: oh, you have this. So let me give you these supplements. I practice functional medicine so so for me, the history was extremely important for the doctors that helped me to help understand myself and and to to figure out what was wrong with me and to be able to start dealing with it and get to the point.
Where now I’m 66, I’m here. I’m. Doing this, and and and you know, I’m working pretty hard, and I believe me when this thing hit me back then I couldn’t work at all I mean I was flat down. I was in bed for the first year.
I couldn’t, get on a treadmill. History has a lot to do with helping them to say you have. You have gluten sensitivity. We found out later I’d seal, that you have a permanent leaky gut. You’re, probably gonna have food sensitivities we found out, I had a leaky gut and and and so this is so – these are the important things there’s.
The elements that should be in a good history. I’m gonna walk through all now. We’re like a see five page history when we started this was years ago, and the reason for that was I go back to the what I call the dark ages of also of alternative medicine.
There was this period of time, where suddenly we have all these chronic pains, developing chronic pain patients device. This is an I miss my 39th and he’s, my forty or fortieth year in practice and and so so back then we were treated.
We were treating a different patient population. Now we’re, treating now people are sicker now than they were then, and in chiropractic. I’m a chiropractor and and in chiropractic people. Don’t respond as well to chiropractic today or physical therapy.
Today is eased too because of all the things that we’re talking about because of autoimmunity because of chronic emotional trauma because of leaky guts because of food sensitivities. Environmental factors, which are a little bit overplayed, but still environmental factors are, can be a can, definitely be a player, and so we had to try to figure out how to how to get people well and a lot of doctors started using a lot of these alternative Tests and the alternative tests were kind of iffy, but they were the only thing people had and it started going from.
We stopped taking histories again and we went to and we and we started doing almost no exam, and then we went to the alternative test. So so what we’re gonna do now is we’re gonna walk through history and help you to understand what the pertinent subah history should be, what you should be getting asked if you’re going into Your alternative doctor, if you’re, not getting satisfaction.
Maybe some of these are the things that that are missed, and here’s. Why, okay, what I was gonna say is: we went from 56 pages now it’s. Down to 18, because over a period of time we sifted out what was pertinent.
It is it all parasites there’s, the all parasite group and then or is it, are you know or is it all mold and there’s? The all mold ruber, or is it all heavy metals and there’s? All the heavy metals group and lime is another whole thing.
You can look at our thing there, you could look at our presentation online and and and so we had to sift through all that and we sift it through it and it’s about it.’s about 18 pages. There is there’s.
A food diary here, I think most everybody is on board now with food, can be a big problem in flaring up joint issues and immune responses and allergy responses. So we put a food, we ‘ Ve put it.
We actually have people fill out a food diary before they come in to give it to us so that we can see what they’re eating and we it can tell okay. If we tell this guy, he ‘ S got to get off a gluten, this could be a big challenge and and and it tells us if it’s – not know this person – or it tells us this person’s already off gluten.
This person’s already off all grains. This person’s already eating better than 99 % of the population, and here they are sitting in front of you. The bad guy food sensitivities, reactions, fibromyalgia, brain fog, vertigo balance, and what’s going on so they should always.
They should always know what your food is, that it’s, so big we’ve, been spending the last. I don’t know six months around here. Finally, you know fine-tuning what we feel is one of the better allergy elimination procedures that there is because it’s, so important to get a person’s, allergies down so foods.
Huge food is just enormous: it should that person should before they ever start with going along with you. They should know what your food is, what you’re eating and what they need to get rid of medications.
Okay, there’s. A lot of reasons, people don’t need to know what your medications are and when people look at your medications, it’s. It’s like look after three medications. They have a term for it. It’s called polypharmacy, and that means you’re, taking too many medications, and I wasn’t made up by the alternative field that was made up by the medical field.
Basically, what they’re saying is, by the time you get to the fourth drug. It’s, causing some of your problems or it’s, interacting poorly with the other drugs I’ll. Give you one example of why that people doctors need to know what your drugs are, particularly in the alternative field since thyroid Hashimoto’s thyroiditis.
These conditions are so prevalent today and they’re so prevalent in in in evaluating chronic pain. Yeah, almost every drug that you take alters thyroid function in some way. Some of it alters the way the thyroid works.
Some of the way you you actually make the hormone some of the way in which the hormone actually goes to from being inactive to active. Some part of the part of it and how it’s being absorbed. If you’re trying to fix these, I read and you’re, taking all those medications.
You need to know that you there’s. Waste there’s, ways to deal with it and so on and so forth, but you need to know that that’s, just one example. Certainly you need to know what medications they’re there.
If you’re, going to start using a lot of different types of herbs and botanicals to help that patient and you have to know what’s going to sync. And what’s not going to sing? But also, if you know what medications a person is taking – and this goes for what supplements are taking, then you should ask that person which of those seem to help you in which don’t, if you, if you’re taking.
If you have a depression and you’re, taking a benzodiazepine better that you may know as xanax, that’s called and that’s, a GABA enhancer. You may use something that increases a person’s GABA, because you know that that’ll, give you a hint that’s now how to treat that person.
If you’re, if you’re using another type of a drug like a valium, I think it’s. A serotonin reuptake inhibitor, you’ll, know that maybe you 5-htp white might might be helpful for that person at the very least.
Ultimately, if, if you can work with that person’s doctor to get them off of the drugs knowing your drugs and knowing your supplements obvious, hugely important, knowing what the person’s taking is important, knowing what their allergies are, you can Get so much from their allergies, because if they’re allergic to everything, they either a leaky gut or they got a histamine response more than likely.
Okay, you don’t need to take an allergy test for 175 different things because you fixed their gut. You fix her out histamine response and all sudden they’re, not allergic to one or 57 different things.
So you want to know that you want to. You want to know that you want to know in general. You want to know the general person’s. Past history. Do they have autoimmunity in their past history? Do they have autoimmunity and their family if they have thyroid? Does her mother have it to their grandmother habit? Does their sister have it there? If it’s like that, you can automatically know they probably have Hashimoto’s.
Okay, you want to know you want to know, do they have other autoimmunity in their family? They’re apparently have Crohn’s disease or they have all sort of like whatever. If the person has autoimmunity in their family already there’s, a good chance, you’re.
Looking at autoimmunity, you want to know the normal stuff that they have hypertension, irritable bowel syndrome. Somebody checks, irritable, bowel syndrome in the functional medicine world. You should already be thinking that the person is in chronic stress response, because now today we know irritable, bowel syndrome causes.
I’m. Sorry irritable. They’re, calling irritable, bowel syndrome, irritable brain syndrome. Did they have money nucleosis did they have they have ulcers like I had? Did they have surgeries that when we get to the surgeries here and the surgeries are hugely important, did they have a hysterectomy that they have a complete hysterectomy when you’re? Trying to fix female physiology or physiology in general.
Obviously this is going to color what’s going on with you, but but for me it was simply. I had a number of intestinal surgery, and so so basically that tells the person. Okay. We have a violated intestines there’s a place.
Does the patient have their their stomach, replace? Does it that’ll, tell us a lot about their leaky gut or the fact that they’ve developed, maybe a malabsorption syndrome. I’m just walking through how much you can tell from a from from looking at a history here.
So the surgeries again, if you look in and somebody’s got a cholecystectomy. They’ve, had their gallbladder taken out, which is not uncommon at all, and they got all kinds of gallbladder symptoms but and there you go, but my gallbladder is out yeah and, and I’m, not eating fatty foods.
It may tell you what you that you have to do something to take the place of that gallbladder being yeah, or it may tell you that they have if they’re, having female problems and and and and the menstrual problems, and they’re having hot flashes and they’re, having periods that are heavy short too short, too long.
All those types of things it could be that their gallbladders back and stuff up into the liver because it’s, not there. The livers back and the livers over overproducing are not able to clear enough, and then next thing you know what you’ve got is, is you have you have hormones backing up in there like estrogen and progesterone stuff, like yeah next thing, you know They’re, trying to put you on hormone replacement therapy.
You take something for the gallbladder, you take something for the liver. You clean that out and all sudden you’re, having periods for the first time in three years, something we just had happen here just a week ago, so this is functional medicine, and this is why, if you’re doctors, if your Functional medicine, doctors, aren’t like grilling you on on all of your surgeries and and your past.
If you got high blood pressure, but you don’t have a kidney problem and you know have a heart problem. You should know that the person ‘ S probably got a chronic stress, fight/flight response. This is the day where this comes from the days where this is how we used to diagnose.
You would walk into a doctor. They would they wouldn’t sit you down when I was. I’m 66. So let’s say when I was like young, let’s say when I was like, like 21 or less, and you asked how does that doctor and – and they were that doctor, he’s.
Just amazing. She’s, just amazing. There weren’t too many. She’s back that, okay and so, and so basically they would come on and say they listen to me and they asked me a lot of questions and they spent like an hour with me.
Well, that was standard back then, because you didn’t have the luxury of oh. Let’s, go and do this test, let’s, just do the test and and and and and that and then what went and then we’ll. Treat from that.
Most of you know from listening to that or from experiencing that that and those people not listening and doing that instead, that that’s, not a good way to go about things: family history, we already talked a little briefly about family history.
You like to know that we particularly do dizziness and vertigo and balance. So we asked an entire series of questions. Dizzy’s, you go to the doctor, they say dizziness! Okay, I’m gonna. Send you through that you I’m gonna look check your blood pressure.
I want to make sure you’d, have a stroke, and I’m, going to send you to the ear, nose and throat doctor there’s. There’s 18 different causes of dizziness 18 15 of them have to do with something called your cerebellum, so we have quite so yeah.
So if a person specialises a certain area, they should have an entire section of a specific diagnostic questions. That’ll, lead them to where it should be. Now I didn’t make this up. I talked, I told you, no, I talked to you about dr.
, bland and, and he had the whole history timeline. I learned primarily from dr. cross Ian from those of you. Don’t know who he is. He’s a reason. Yet you’ve ever heard of the term Hashimoto’s. I give him credit the more than anybody else for exploding functional medicine, and this is what he was doing.
Okay, because he said, if you’re, going to do this type of work and you’re, not going to take enough time on the side to take a history and look at the person’s. History. In other words, to get there to get their data from the hospital I got, I should grab it right there there’s.
I just have a stack right here for a patient who ‘ S got neuropathy, and I’m kind of concerned that, yes, something that’s, pretty severe that is gonna need really possibly some pretty aggressive medical attention.
I think it may be beyond functional medicine, something called Lou Gehrig’s disease, possibly I have a whole stack there and that’s. How I that’s? How I understood it, because when that person came – and she’d, already been to all these doctors, but what we, but we put time on the side so that we can read the entire history of that person.
Past and look in their beak and say I think they’re. I think they’re missing, something you’ve. You have this and you have that you have this and and and then of course, what does the patient say? You know I’ve looked online and that’s.
What I thought and I get that a lot, because they you’re gonna, do the research? Okay! If anybody’s going to do the research you’re gonna, do the research! Well, frankly, that’s, not what you’re, paying your doc for your paying your doctor to do that job, to figure out what’s wrong with you right.
One of the uniqueness is of functional medicine. Is that you’re working with systems? Okay, you’re, not really working with every little pain and every little abnormality you’re working with systems, so we practice functional medicine here and we practice functional neurology.
Those are two separate disciplines that we have munched together, because so much of what happens so much of what we get in our office is heavily influenced by. If a person has anxiety, depression, panic attacks, the vast majority of our patients have had emotional trauma.
Maybe they’re in some level of post-traumatic stress syndrome. So we have to be attentive to that, because if you watch some of our other videos, you ‘ Ll see that the flooding, your system, which stress hormones all day long, is not a good thing and it will sabotage a lot of the things that a functional medicine practitioner is doing so so we check both.
The point is that I’m going to make yours is in the and in functional medicine. The whole protocol was to do a systems-based approach find the mechanism. If the person has a hot flashes, you just throw estrogen Adam, or do you find out if their hypothalamus, which is determining if you have enough estrogen in your body, it’s, talking to your pituitary gland, to tell them to give a signal to Your adrenals, which is then going to tell you, which is then going to make some certain chemicals that are going to ultimately tell your ovaries to make estrogen functional medicine, is finding out if that pathway is broken down, and instead of giving hormone replacement therapy for the Ovaries, it might be that the person is really stressed out of their mind or that they’re, taking medications or something like that – that’s, causing their pituitary gland to not talk to them.
You fix this all sudden. The hot flashes go away that’s, functional medicine. Now how do you in now? I I see patients over a period of months, and I make an estimate as to how that’s. Gon na take, and every day the patient comes in here, they’re, usually see somebody for every time they come in.
They’re, usually see three three doctors actually and – and I spend about 20 minutes with them going over an assessment for him that I had them fill out every week and the assessment form is it’s about four pages? Long.
Three pages long, you think I would know by now – and essentially it looks like this. Okay – and many of you may recognize this, because this is a very popular assessment form. This assessment form is kind of the update of what most practitioners are being taught to use.
The update of that time line that I talked about for and here’s. The reason look, how many questions are on this thing? I don’t know how I don ‘ T know how well you actually see this, but that’s brain this is this.
Is this? Is gut small intestines, large intestines, gallbladder leaky, gut liver blood, sugar, a variety of things, and then there’s. There’s adrenals and there’s, and then there’s electrolytes and thyroid and high thyroid symptoms and low thyroid symptoms of female symptoms and male symptoms, and so there’s.
Hundreds there’s. There’s, a couple hundred questions on here: okay, it just checks sheets, my patient fills it out every week and they come in and they put it in front of me – and I can look at that and I can immediately see what’s going on this is part of history.
Taking who’s gonna, remember, to tell me everything that’s wrong with them that week, no nobody who and I’m, not gonna know to ask those questions. So the doctor walks up the insistent goes so tell me about what’s happening this week, and maybe the person goes.
Oh, you know. I got more constipation this week and maybe I got a little bit more diarrhea and I’m. Not sleeping as well, okay, so then, so then the practitioner goes: let’s, handle that let’s. Yeah except except functional medicine is systems.
Okay and each one of these areas represents a system, and what will happen is sometimes you might look at somebody’s case and say you know what, after doing all that history and after doing all that exam, which we’re, going To talk about more briefly about the next week, but we’re gonna talk about that and you’ll, see how it syncs together.
You might look at this as a practitioner and say you know what this person’s had emotional trauma since or a kid. Their blood sugar is way low. We talked about obstacles to cure last week and and we talked about blood sugar there and we’re gonna talk about it again and and and their guts, bad and and and and then they have a ton of other things going on.
Like the whole sheet is marked up, but we’re gonna go with those three and we might go with those three and after two or three weeks this entire page might disappear. All of these systems may synchronize, because you’re.
Treating a couple of systems you’re, not treating a a symptom, and this is where the history becomes radically important and nobody’s, going to sit there for an hour and ask you these questions every week.
So they ask a couple. Questions and then they morph back into kind of like the the medical approach and I’m, not anti medicine. I’m just saying the medical model of tonight. It’s. Eight minutes ten minutes sit there.
You know get your symptom, give you a drug, see in six months or whatever, or we’ll. Send you for this, that’s, not functional medicine. This is functional, medicine, okay, no matter how the person is doing it.
If they’re, not if they’re, not completely screening all of your systems and working one or two major systems at a time and then and then allowing the other systems to synchronize and maybe regulate so that you don’t need to address those symptoms, that is functional medicine and you can’t.
Do it with without these tools, I would contend. I don’t know how you would do it without these tools. That was our functional medicine questionnaire. This is our initial functional brain questioning, okay, so this is.
This is all about brain function, and this is all about brain chemistry, so you can tell from looking at this. If the prisons got you, probably you can take a good good, strong impression as to whether they got good circulation in there through they have inflammation.
Do they eat something and have in place? There is zero chance that you can know a person’s. Entire physiology, which I will argue you have to know if you are treating chronic pain unless you are, you are utilizing tools that allow you to to be able to do that.
We also, and and and – and so I think, that kind of, like kind of like gives the overview of why a history is important. The facts that that that chronic pain can can can basically not be dealt with in the model of the eight minutes going on out there today, the ten minutes, the fifteen minutes come in.
Give you supplement, give you the Paleo diet. Okay, here’s, your Paleo diet over lot online. Here you know, and and and here’s, your blood test and let’s, throw that out there. You can see how this is just a fraction just a fraction of the data that you can pull out of a history before I see a patient to go in for an exam.
I want. Oh, you can get this. I want to see their history. This is the history. This is half of the history. This is half. I got a bad look from the behind the camera there. This is half of the history because it ‘
S got the name on top that I was just talking about for the lady that we think we mapped the reefer for for co-managing a very serious problem, and I will look at all that and there will be answers in there.
Some people will come to me. Go why I went to the Mayo Clinic and then and they couldn’t, find anything and I’ll go so, do you have the records and they’ll, say yeah. I want to see them and you cannot imagine how many times the answer to that problem is in their records before we even walk into the room to examine them, because the medical profession looks at things differently than the alternative profession.
But but this is gathering the type of data that you need to gather to be able to assess a functional medicine case properly, and the last thing I do do on these is, I actually have people fill out. Some other forms now this.
This is me personally. Okay, this is nothing. This is maybe not something that a lot of doctors would do, but I do have people fill out a little bit of a questionnaire to find out. You know what their expectations are, because if a person comes in here – and they have an awful lot of things we can help.
But by helping that we’re not going to be able to meet their expectations because they want to go from being a bedridden and, having you know, fibromyalgia and peripheral, neuropathy and chronic fatigue.
And I didn’t even mention the cerebellar problem, and you want to go from that to you know, being an Olympic athlete and climbing Mount Everest and stuff like that. That’s, probably not a realistic expectation, and, and so you need to know that about your patient before you start treating them, and you need to know that about yourself that if you’re going online, somehow you know you you need To somehow learn how to evaluate what these doctors are telling you online, because a lot of lot will make it sound like you can be cured and and and most of our patients cannot be cured.
Even though last week we talked about obstacles to cure its obstacles. To um stopping your downward progress, reverting it and and getting as well as you can and learning how to manage it and then learning what your true metabolic capacity is, so that you know you know what you need to do to stay better and, and so you Can you can tell all that you can you you, you won’t ultimately know all of that until you treat the person and you see how they respond, but you can go an awful long way by gathering all of the data by gathering.
All of the past data actually going through and it takes some time and it takes some time to do that, and you can learn so much from that, and I will argue that you can probably diagnose the person 97 % of the time properly, particularly functionally.
If, if you go through this whole, if you go through this whole procedure, if I go into a doctor’s office and I’m sitting there and it’s, a 10 or 15 minute interview and they’re taking all my history down and then I don’t care.
What the medical doctor or I don’t care. What’s, an alternative practitioner and the next thing I do is I get a list of like you know five or ten thousand dollars worth of tests that I got to do and now we’re gonna treat from that.
I I’m looking for another doctor, okay, because this this big piece here is missing there’s, just an enormous amount of data that you can gather from a history too, to start a case right there, but but truly to probably