Video about functional medicine so good

[Sallysblooms]

This is good, I hope all doctors will understand this some day. I have been blessed to find good doctors that work with me because I do know about POTS, supplements etc. Takes a special person to work hard and know more than a regular doctor. There are great ones out there and all doctors need to know more!


http://www.youtube.com/watch?v=IhkLcpJTV9M

 

[medfeb]

Hi Sallysblooms

Thanks for providing this. Well worth watching!

 

[Esther12]

To be honest, that talk reminded me of a lot of the things I dislike about 'biopsychosocial' medicine and it's promoters, even if it might not be as bad for patients as a lot of the CFS BPS stuff, and is in some ways the opposite.

Possibly there's something to it that I did not understand, or was not clearly explained - the emphasis on 'mechanisms' could be sensible, but I'm not sure if he's saying anything that helps us move forward here. Actually, as the video goes on I ended up feeling even more suspicious of what's been claimed.

There were some broad points he made that I agree with, but felt sceptical about him as someone providing treatments. He seemed to be talking about an understanding of medical problems and approach to solving them that cannot currently be supported by our limited understanding of biology. Maybe I'm wrong though.

 

[Enid]

Thanks Sallysblooms - very impressive to watch - I must have been an idiot thinking this was what medicine was all about anyway - how wrong can one be.

 

[alex3619]

Thanks Sally, its a very good video. I have been interested in systems approaches since the 80s. I embraced them in the 90s. I tried to apply them to CFS but my knowledge was lacking (late 90s) yet my approach was not hugely different from what is discussed in this video, I just didn't have the tools.

Now on causation, diagnoses and mechanisms I agree with the speaker (Mark Hyman). Its how I think about it myself, which of course makes me biased.

However, I do recognize the concerns raised by Esther12. BPS arose out of an attempt to apply systems theory to medicine. It failed. Its still failing us. This arose, in my view, because they tried to tack existing medical paradigms onto the BPS model, rather than applying the BPS model to improve existing paradigms. To get advances here takes time, research and communication. It will not, it cannot, happen overnight. Its a process not an algorithm, and this distinction has been lost along the way.

So functional medicine is still in its infancy. However, I do agree this is the way forward, particularly in dealing with chronic disease. Treating symptoms of a patient because some patients with those symptoms improve on a particular treatment is statistical medicine: to put it another way its Russian Roulette. Identifying causes (with appropriate testing) and treating causes has to be better. Treating systems of causes is better again. I do see this as the future of medicine, even the future of psychiatry.

This is a roadmap, a diagram for medicine. Here is the analogy I was going to develop in my book, and now I think I need to look more closely at functional medicine, because its their analogy too. Conventional medicine, especially psychiatry, is based on heuristic algorithms. Patient presents with lack of activity and drive ... ergo its depression: thats an algorithm. Its an if-then presumption. However, looking holistically at the patient (which is what BPS is supposed to do but fails) we would have to look at diet, biochemistry, social factors, psychology, the whole system of issues. This includes pathogens, immune problems, etc. The problem is this is complex, and complex in a way that most doctors are not trained to reason about. Their entire paradigm is algorithmic and statistical.

Put it another way. You need to get to a village called Wellness. One doc looks up a book that says turn left in 3 klicks, turn right after the big tree, go under the bridge and turn left, proceed 20 klicks and .... you get the idea. The next doc says, hey, wait a minute, I will generate a map, and then we can navigate a path to the destination.

One has instructions. If anything goes wrong along the way, you wind up lost. Next thing you know you will be blamed for not following instructions.

The other has a map. If you get lost you simply create an updated map, and renavigate.

Bye, Alex

 

[Sallysblooms]

My doctors are integrative and use all ways to heal. We do this together. I have always known reg. doctors do just what they learn, write scripts. Scripts rarely heal. All people and problems are different of course, there should be no rules about how to help people. The sky is the limit if your mind is not closed. It is important for all doctors not to just go by what they learned in school. They must keep learning. They have to travel and read constantly to keep up with the newest ideas, supplements, treatments, etc.

 

[xchocoholic]

Thanks Sally,

That was good but I thought he skipped over the testing (Metametrix,etc)
used by functional doctors too quickly. The tests show what they're looking for and this is a little different in everyone. Things like food antibodies, nutritional deficiencies, good and bad bacteria, parasites, hormonal imbalances, etc etc ..

Maybe, since I knew about the testing already, I was looking for that tho ... A newbie might not look at it that way ...

tc ... X

PS. Dr. Wahls says the same thing he does in different words ...She found help at the functional medicine institute too ... From what I can tell this is what the DAN (Defeat Autism Now) or ARI (Autism Research Institute) community has been doing for decades.

 

[ahimsa]

I think this idea is great in theory. It's always good to take a holistic approach to the patient--don't just look at one organ, or even one system, but how they interact. For example, before I was diagnosed with Orthostatic Intolerance, I got heart tests (EKG and echocardiogram) that showed my heart was fine. But what was wrong, in my case, was the interaction between my brain and my heart while standing (an oversimplification of NMH, but you get the idea). The tilt table test is what revealed this problem. So, yeah, I'm a big fan of looking at the whole body as a system, not only looking at individual body parts.

But although the general theory sounds good I do wonder how much these integrative doctors actually know yet about how the underlying abnormalities contribute to various symptoms. I think a lot more research needs to be done.

I also wonder, why focus only on chronic illness? Assuming that a doctor could fully understand the bodily mechanisms that are "broken" (for lack of a better word) in a patient with a chronic illness, then wouldn't this same approach work just as well in a patient with a progressive (getting worse) or terminal illness? Why aren't integrative doctors testing and treating these patients? If they know how the body works, and how to fix it, then why not start on the patients in the ICU wards?

If an illness fluctuates *even without treatment* then it may not be the best illness to use to validate whether a new treatment is working. I'd rather see them do work on illnesses that usually get worse and then show that a large number of patients on this new treatment either don't get worse or get better.

I'm not trying to be sarcastic. I really do want to understand why this approach is used only on patients with certain categories of disease. There may be something I'm missing.

 

[xchocoholic]

IMHO, The problem appears to be that the FDA is interferring in allowing doctors to help us ... this is just one example.

http://www.terrywahls.com/

The FDA has not evaluated any of the statements on my website, in my books or lectures, or made by me. Nor are any of these statements intended to diagnose, treat or cure any disease. Only an FDA-approved drug, diet or device can legally make such claims in the U.S.

I understand that insurance companies restrict the type of testing and treatments patient's receive too. Medicare has paid for most of my testing but not any of the supplements required.

These doctors look for the obvious possible causes first because in some people eliminating these will allow that person's body to heal on it's own. Things like food intolerances (gluten, soy and casein are normally problems), bad bacteria, nutritional deficiencies, parasites, etc etc ..

After the patient has addressed those, then they look for less likely causes. It appears that testing for nutrients isn't as reliable as it could be so these are harder to pinpoint.

Sadly, in some cases, the patient can't be healed. There can be permanent damage to any organ.

tc ... x

 

[alex3619]

Hi ahimsa, let me give you one example. A failure in function can give rise to a weakened immune system, poor DNA repair and high rates of DNA mutation. At this point a functional approach may restore health. However once a cancer develops and proliferates, its a whole other game. Restoring the immune system only improves the odds, its not a cure at this point. That requires something else.

Let me put this another way. Functional medicine can restore the balance that led to a crisis like cancer or a heart attack. It cannot by itself cure the cancer or heart damage. That will require a different kind of intervention.

Most chronic diseases are of the kind that functional medicine can help. Many can be cured, potentially. We still have to learn how to do that. Many people do not appreciate the issues that complexity raise, including doctors. Functional medicine is more complex than regular medicine and this slows both its teaching and its research. Its hard. Its also a way to get to the underlying problems and fix them ... don't just put a band-aid on a splinter, actually find and remove the splinter.

Functional medicine also cannot cure fundamentally genetic diseases. What it can do however is provide strategies to modify the risk factors from genetic disease.

Bye, Alex