Beyond the Pain with Dr. Gary Kaplan: A Journey into Integrative Medicine

Are you tired of enduring chronic pain, battling with unyielding fatigue, or wrestling with relentless depression? I know I was, but there is hope, my friends. I invite you to join me and our guest, the renowned Dr. Gary Kaplan, as we navigate the perplexing world of chronic illnesses. Dr. Kaplan brings his groundbreaking insights on chronic conditions and a unique neuroinflammatory approach to treatment that might just change the way we understand and manage these persistent foes.

We discuss the pitfalls of our medical system, including the unscrupulous dealings of pharmaceutical and insurance companies, and the lack of resources available to emergency doctors. These realities are frustrating, but we face them head-on, sharing personal experiences like Dr. Kaplan's journey with his father's medical challenges. The riveting conversation also unveils the psychological and environmental factors that play a crucial role in diagnosing and treating chronic illnesses.

We wrap up by delving into the latest advancements in immune dysfunction research and the role of cross-disciplinary collaboration in propelling this field forward. We explore promising treatments for long COVID, the importance of early testing, and the potential implications of different COVID variants. Brace yourselves as we reveal the secrets of supercharging your immune system and effective anti-aging methods. So, buckle up and join us on this enlightening journey that dares to challenge traditional perspectives on chronic illness, shining a light on the power of integrative medicine.

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Episode Transcript

Speaker 1 (00:07):
Hello everybody and welcome to the Off White Code
podcast.
I'm your host, jordan Amney,and today I'm joined by the
founder and medical director atKaplan Center for Integrated
Medicine.
He's a clinical associateprofessor at Georgetown
University, the author of whyAre you Still Sick, how
Infections Can Break your ImmuneSystem and how you Can Recover,
and he also specializes infinding solutions for chronic

(00:31):
illnesses such as long COVID,chronic fatigue, fibromyalgia
and many more.
He is one of only 19 physiciansin the whole country to be
board certified in familymedicine and pain medicine.
So, everybody, it is mypleasure to introduce you all to
Dr Gary Kaplan.
Hello, dr Kaplan, it's nice tomeet you.

Speaker 2 (00:51):
Jordan, pleasure to meet you and thank you for
having me on the show.

Speaker 1 (00:54):
Of course, and so for everybody that doesn't know you
or the things that you'reworking on, could you please
like give us a little breakdownof your medical journey and what
led you to where you are now?

Speaker 2 (01:05):
So the medical journey is a bit long, but
basically the shorthand versionof it is my boards of family
medicine and pain medicine andthere's not a lot of me that
will board it that way.
I focus on people with chronicpain and chronic illness and I
see a lot of people this wholetower of babble right of letters
that are of people that I see.

(01:26):
So I see people with PAN, pan,pediatric autoimmune acute onset
, the neuropsychiatric syndromeof origin of strep and other
infections.
I see people withpost-treatment Lyme syndrome.
I see people with post-COVIDsyndrome.
I see people with chronicdepressive syndromes that are
non-responsive to treatment.
I see people with chronic pain.

(01:46):
So the interesting thing was,years ago we were looking at
this stuff as chronic fatiguesyndrome.
These are all things that we'vecome to name by the description
of what it is, not thepathophysiology.
So we're calling things name,as in you have a bloody nose,

(02:06):
well, that's good, but what'sthe origin of that bloody nose?
You're bleeding from somewhere.
Where's it coming?
Antirably, posteriorly, right?
We need to be specific aboutthat because of fractures.
So we need to look at that.
One thing that I do with a lotof my students is we talk about
congestive heart failure.
Congestive heart failure.
Is pump failure right?
So what do you do to treatcongestive heart failure?

(02:28):
Well, the first thing theystart doing is diuretics.
They'll do something to thatIron or trope in order to
increase the beating of theheart.
However, maybe the first thingyou want to do is how come?
Why did the pump fail?
Is it because they had an heartattack, coronary artery disease
?
Is it because they gotcardiomyopathy?
Is it because, you know, fellin the blank?

(02:49):
And so, as you back up and youwant to talk more about cause
and not the symptoms, and toomany times we get focused on the
symptoms, and so one of thethings that happened was we were
focused on all of thesesymptoms going on, and in
particular, by Academy, theAcademy of Pain Medicine,
thought it would be very spiffyto start giving opioids to

(03:10):
people who had chronic pain.
As a white paper back in thelate nineties, and it sounded
like a good idea.
With the help Extrapolation ofresearch from terminal cancer
patients spiffily changed thename of things from addiction to
dependent on opioids.
So it would sound more polite,and off we went.
Well, the consequences of thatare brutally apparent today.

(03:34):
Right, one in twenty thousandpeople dying a year from opioid
overdoses, a horrible behavioron the part of some of the drug
companies, not horrible behaviorof the part of a large number
of physicians as well.
You know, at one point therewere more scripts being written
in the state of West Virginiathan there was a population in
West Virginia, and you know it'sjust the amount of damage we

(03:56):
did.
Our first thing we take in theHippocratic Oath is first, do no
harm.
And here we were, not a largenumber of physicians but
nevertheless a group ofphysicians.
So we're just exploiting thesystem to the end degree and it
was absolutely horrific andcontinues to be so.
So we've done a huge amount ofdamage by doing that.
But we had backed up in theearly 2000s and we were looking

(04:18):
at.
The fact is, we started usingthe oil because we watched our
patients see side back and forthbetween depression and chronic
pain and stop back up and what'sthat going on about?
So I was fortunate to be able toconvince a group of colleagues
to sit down and start exploringwhat was going on with chronic
pain and what was going on withdepression.

(04:40):
And who's a pood from NIMH wasone of our people at, mike
Lumpkin, who's from Georgetownin neurophysiology, and so we
had.
They had a really excellentgroup of people some other
psychiatrists, some otherphysiologists and we had an
excellent group of people whosat down and looked at the
literature, and we'd meet once amonth, every other month, to

(05:01):
talk about this.
And what happened is, over time, we began to understand that
what we were looking at wassymptoms of inflammation in the
brain, and so that began ourunderstanding of chronic pain,
of chronic fatigue and a numberof other disease conditions
being a result of an inflamedbrain on fire.

(05:23):
And that led to my first book,which was Total Recovery,
talking about specifically theinnate side of this, looking at
microglia's activity in thecentral nervous system and
because that's really the mainmicroglia astrocytes and I can
talk shop here.
This is lovely.
Microglia astrocytes and mastcells are the innate side of the

(05:44):
immune system in the centralnervous system.
So we started looking moredeeply into that as to what that
was about, and as I developed aneuroinflammatory model of
thinking about these conditions,a couple of really astonishing
things happened.
So I had one patient come insuicidally depressed a
17-year-old kid and he'd beennon-responsive to any of a

(06:08):
number of treatment programs.
He'd been hospitalized.
They sent him to me becausewhat the hell Kaplan's thinking
about this neuroinflammatorystuff?
See what he thinks.
Well, I examined him, ran abunch of tests on him, and one
of the things we found was hehad celiac disease.

Speaker 1 (06:22):
Okay.

Speaker 2 (06:23):
About 5% of celiacs will present with no
gastrointestinal symptoms andonly neurologic symptoms.
Okay, so he indeed had nogastrointestinal symptoms.
So, but blatantly celiac, nodebates about it.
We took him off gluten, we didsome other stuff to clean up his
gut and a year later he is offall antidepressants.

(06:46):
He is 100%, and he's been nowthat way for the last five years
that I followed him.
So you know, if you thinkdifferently, if you think about
what's going on here, you end upwith a different answer.
I want to give you anotherexample of a young woman that I
saw.
This is a young lady who, whenshe's 10 years old, she develops
obsessive compulsive disorder.

(07:07):
Okay, out of the blue Developsobsessive compulsive disorder,
and the next thing that happensis she starts getting depressed,
she starts developing cuttingbehavior and she ends up
hospitalized for suicidalideation, self harm, medicated,
released, again, goes throughthis process of doing better for

(07:28):
a little while, but againregresses another psychiatric
hospitalization for attemptedsuicide.
We're back and forth, and nowI'm saying when she's 16 years
old.
So what do you think the harmthat's been done to this poor
young woman since she's 10 yearsold?
She's been told she's broken.
She's been told she's crazy.

Speaker 1 (07:47):
Right.

Speaker 2 (07:49):
And the psychiatric guys who are looking at her got
an aga is a treatment-resistantissue.
So I take a look at her from aneuroinflammatory standpoint.
What we found on her where shehad Lyme disease she had CDC
positive Lyme disease, nodebates about it, and she had
autoimmune antibodies to thelimbic system and central
nervous system.
So this poor young lady hasbeen sick now for six years, has

(08:14):
been told she's crazy.
And who was crazy is us.
We missed the diagnosis.
We told her that she was crazybecause we didn't think about
looking at this differently.
The end result of which is I'venow got a kid who is not just
struggling with a brain that'sall lit up, but who's also been

(08:34):
traumatized by the medicalprofession, the self-esteem
that's been done, harm that'sbeen done to her by virtue of
psychiatric hospitalizations.
She is not broken, she is sick.
And we screwed up the diagnosis.
And when I went to tell herpsychiatrist about this, her
psychiatrist read me the RyanAct.
She said no, you're wrong.

(08:56):
She doesn't have Lyme disease,she doesn't have PANS.
This is completely you know,you're completely wrong in your
diagnosis and just went off therails on me.
Now this is the resistance thatI run into in the profession
from time to time when wesuggest to them that maybe we
need to think about differently.
And so this is the work thatwe've been doing is trying to

(09:17):
educate the profession, tryingto educate our medical students
to think differently about thisstuff and understand that when
we're not listening to patients,when we're not because if you
went back and, by the way, gotthe history on her, there was a
tick bite, there was an erythema, migraine's rash, I got it yeah
.
Okay, got treated for two weeks,which is an adequate treatment

(09:40):
time, and then all this otherstuff evolved out.
So the reality of the matter iswe have to think differently
about these people, because aslong as we keep focused on their
symptoms and not on the cause,we're not going to get anybody
better.
We're just going to leave themstuck in a loop and do a lot of
damage in the process of it.

Speaker 1 (10:01):
Yeah, it's very interesting because the body
works kind of as a whole andthese inflammatory diseases we
really when you see psychiatricdisorders it almost feels like
you know they say with medicalschool and everything, like
you're drinking from a fossilbut drinking from a hose and
there's just so much going onand there's so many things to

(10:22):
consider.
But it's very interestingbecause there's been a lot of
conditions, like evenAlzheimer's and other things,
that they're linking now to justinflammation in the brain and
then we're finding out that ifwe can reduce that inflammation
we can really treat things.
And, to your point, if anybodydoesn't really understand Lyme

(10:43):
disease as well, like the, youhave this migratory arthritis
and all this inflammationbuilding up throughout the whole
body.
And I guess one of my questionsis how did, how were you able
to determine?
Were you just determining fromthe history or were there like
some kind of titers that werepositive, that allowed you to
suspect that it would be Lymedisease in her case?

Speaker 2 (11:06):
So all of the above.
So there is.
I know I know we do thisabbreviated, but the reality of
the matter is history, history,history.
My intake histories are an hourand a half Okay.
Before I touch a patient, doanything with them, I sit and
I'm listening to them and I'mtrying to understand the

(11:26):
evolution of the disease intheir body.
Because the other thing, andthen the other answer to your
question, is yes, there'sabsolutely a laboratory analysis
that gets done, testing thatgets done in order for us to be
able to arrive at the diagnosis.
So it's a combination ofhistory.
The history helps guide thetesting that we do and that we
put all that together and comeup with a treatment plan for

(11:47):
them.
The other thing we do which isdifferent is because, again, why
do people go on a long COVID?
20% of people go on a longCOVID, the other 80% don't.
What's different about that 20%?
And so the question is what'sthe setup?
Clearly, genetics is a piece ofthis, no question, and we have

(12:11):
much to understand in that area.
There's also epigenetics, andintegrated medicine is about
paying attention to theepigenetic profile as well.
So epigenetic profile is anumber of things we're looking
at.
Have you been poisoned Right?
Do you have heavy metals inyour system, lead out of the
water supply, mercury out ofeating too much fish, especially

(12:34):
the high-end fish?
I had a young woman who,12-year-old, who severe problems
again, with kind of a pandaspresentation, except that her
problem is mercury toxicity.
She was eating tuna fish everysingle day.
The FDA says maybe we shouldn'tdo that.
The FDA says if you're pregnant, don't eat that more than twice

(12:55):
a week.
Well, what about the rest of us?
So we got rid of the mercury inher and she became fixed, all
done.
So it takes a standing back andgoing.
What else is going on?
So, looking at toxins beingexposed to mold-ridden buildings
, where you're getting moldtoxins, all the plasticized that

(13:17):
we get exposed to in otherenvironmental toxins.
Looking at adverse events ofchildhood.
Now, if you're coming in andsomebody comes into the
emergency room and they've got aheart attack, I actually don't
care what their familybackground is.
I do care about gettinglitigated and getting the proper

(13:39):
lines into them and bringingthem back to life.
First things first.
If they're dead, the rest isirrelevant.
So first thing you do is you dowhat you need to do to address
the emergent needs, but then youneed to step back and go.
Okay, how do we get here andwhat can we do?
And I have a chronic illnessproblem.

(14:00):
So we want to look at what wasit like growing up?
Was it a safe environment orwasn't a safe environment?
Adverse events of childhood,which is an incredibly benign
way of saying child abuse.
If you've had grown up in anenvironment which was
particularly difficult, painful,traumatic, your odds of

(14:22):
developing an autoimmune diseaseare about 15% higher than the
rest of the population.
Your odds of developing heartdisease, obesity, diabetes is
25% higher than the rest of thepopulation.
These events have long lastingphysiologic effects on the
individual and they manifest ina way that can shorten their

(14:43):
lives, and so we want to makesure we understand the totality
of the individual who's come into see us so that we can get the
best possible treatment out forthem.
And if it's acute appendicitis,I don't care.
What I care about is gettingthat appendix out and getting
the infection under control.
But if I've got chronic fatiguesyndrome, if I got chronic

(15:07):
depression and I've got chronicanything that's going on chronic
fibromyalgia and, by the way,in most of my patients it's a
little bit of all of the above,so we're not so much a little
bit.
I have patients who havechronic pain, chronic fatigue,
chronic daily headaches, sleepdisturbances, so it's a little
bit of all of the stuff thatwe're looking at and thus we
need a very comprehensivehistory in the process of

(15:29):
understanding all of the areasthat are under siege, if you
will, that have been disrupted.
So we want to get a verycomprehensive history.
We want to think in terms ofthe epigenetic issues.
That's part of our history aswe're taking these, asking these
questions and we're then we'relooking for infections that may
have come into play.
Do you have problems with any ofthe tick-borne disease?

(15:50):
Are there problems with chronicstrep?
Are there problems withtoxoplasmosis?
I just had a kid who came intosee me history of hallucinations
, visual and auditory.
He was at a very good school,overseas, very smart guy.
Suddenly in the last two yearshe's got severe depression and
he's got problems withhallucinations.
He's medicated.
The things were marginallyunder control.

(16:12):
I worked him up.
He had toxoplasmosis and he hadBartonella.
We've been treating those andfor the last two months he said
no further hallucinations of anykind.
He's gone away to send a to himor pack off him with the
medications in order to do that,because I'm treating the
underlying cause.
So that's the kind of stuff wewant to work on.

Speaker 1 (16:33):
I think that is one of the most interesting things
too is and you kind of spoke onit is that you, when you see,
let's say, just a regularpsychiatric patient, they
usually especially if they'reyoung or there's something on it
there's usually not just onething going on, there's multiple
things, and you're trying totreat all of these things going

(16:56):
on and if you don't hit thebasis of it then you're just,
you're essentially just shootingfrom the hip, just doing
whatever.
I'm interested in the fact thatbecause when you were talking
about how autoimmune disordersor if you have like a rough
childhood, you can have anincrease in the chances of

(17:17):
getting an autoimmune disorderDo you think that that and you
may not have, we might not haveinsight on any of this yet but
do you think it's due to thedrastic increase in like
cortisol, which typically canlower your immune system to
begin with, and then that stickswith you, or do we even have an

(17:37):
I think, unquestionably, that'sa piece of the problem.

Speaker 2 (17:40):
Okay, we know that the endocrine soup that your
brain is now coming up and isdistorted by virtue of being in
a very high stress, threateningenvironment.
The specifics we still havework to do on, but one of the
things we have, one of thethings that will be at this
conference we have a conferenceon chronic disease in November

(18:00):
and one of the speakers is goingto be talking specifically
about that of what happens withall of these psychological
stressors that set us up fordamage to the immune system and
so we're trying to create aholistic conference to educate
our colleagues about the fullrange, inclusive of the gut
microbiome, inclusive of thepsychological issues, inclusive

(18:23):
of the other epidemic issues, sothat we have, we give them a
roadmap, if you will, in orderto be able to have to think
about these problems and how tofix them.
If somebody comes into you withchronic fatigue syndrome right,
and your model is, I don't knowwe, we first of all, does it
exist?
Do we believe them?

(18:43):
I was on the advisory committeefor health and human services on
MACSF for four years and thestories I heard were absolutely
horrific People who weredismissed, people were told they
were malignant people who werecalled that they were lying.
And these are people who arefrequently really crippled.
I mean they're homebound, someof them bedbound, and being

(19:05):
totally dismissed by theprofession on top of everything
else they have to deal with isactually horrendous.
So the first thing I wouldencourage all my students to do,
and all my colleagues do, isbelieve your patient, listen to
them, try and understand what'sgoing on with them and then
don't just write them off.
I will also encourage all of youto read a book by a friend of

(19:28):
mine, sarah Remi, r-a-m-e.
Why the Book is Women aMysterious Illness.
This is a book that talks aboutthe journey Sarah's, in
particular, going through themedical profession being
dismissed.
It's a particular problem towomen, more so than men, because
women's complaints arefrequently, more frequently

(19:48):
dismissed than taken seriously,especially when they're soft
symptoms, soft being tired.
Well, you have four kids, yougot whatever.
So we write you off as opposedto going now.
Wait a minute.
What do you mean by you'retired?
What does it mean to be tiredand trying to understand what

(20:09):
that experience is like forsomebody?
Is it different than it was ayear ago?
Is it different than it will betwo months from now?
So what's changed?
What's happened in there thathas caused what's going on with
you?
I'll give the example of myfather.
This is the upper end of thespectrum.
My father is 94.
My father is a vigorous,healthy 94.

(20:33):
Six couple of miles a day.
I was doing great.
In November he had some kind ofan episode that they didn't
quite figure out.
What happened?
Okay, hospitalized, worked himup, nothing.
He's now down in Florida andhe's telling me he's good.
So I go down.
He just saw the cardiologist,so I go down there to see him

(20:55):
and we go off for a walk.
He gets maybe 100 feet, he'sout of breath and his heart's
pounding and I said let usdiscuss the meaning of the word
okay.
So no, you're not.
Okay, I'm going to call thecardiologist.
So I call the cardiologist andthe cardiologist's first
statement to me is well, he's 94.

(21:16):
Okay, I call bullshit.

Speaker 1 (21:20):
Yeah.

Speaker 2 (21:21):
All right, and I'm a doc, I'm an academic doc, and so
I can carry a little more heftand get a little more deference
when I say let's start thisconversation over, and I'll have
you know, by the way, I makesure if I have to go to the
hospital for me or I'm with myfamily, people know I'm a
physician, okay, and people knowI'm an academic physician.

(21:44):
And it's not because of beingan asshole, it's because as soon
as somebody, our colleagues,hear that stuff, we get treated
differently.
We are treated completelydifferently than anybody else
who walks in that ear or walksin that hospital.
It shouldn't be, but it is.

Speaker 1 (22:02):
Yes sir, that's very accurate.
I'm saying it myself.

Speaker 2 (22:07):
So now we're having a different conversation.
He says, well, okay, let me,let me put a, send him home for
a loop.
Okay, so that we're, we'llmonitor him for a couple of
weeks.
Well, they put the loop on himand the next thing you know,
they're calling off saying how'dyou like to come in the
hospital Cause he's got thirddegree heart block?
Fine, so they put the pacemakerin him.

(22:31):
My sister's down there and he'snot doing well.
After the pacemaker, still sameproblem.
And I said, okay, first off,why does he have third degree
heart block?
Didn't have it before.
Now he has it Right circumflex.
Perhaps we've had anothercardiac event, but it doesn't
show up on the KG.
So there, as far as theirconcern didn't happen, I'm going
this is new.

(22:53):
But what changed?
What's new?
So I said to Lynn, stress them,tell cardiologists, I want them
stressed.
So they go to stress test thema couple of weeks after putting
the pacemaker in, he's on thetreadmill, maybe about a minute,
and done heart rates about 120.
Okay.
So then they say, okay, well,we'll do cardiac cath.

(23:16):
But they're really reluctant todo so because it's 94 years old
.
I know he's got coronary arterydisease because we've already
put a stent in his LAD.
So I go down there to see thecalf and I get a call when they
put him in the hospital andthey've done the blood work on
him, saying your dad's a littleanemic and we're going to have
to give him a transfusion.

(23:36):
I said really how anemic.
They said, well, thehemoglobin's about 7.9, 6.9, 6.9
.
That's half a tank.
You run a car and half a tank,you can't run a person.
So I said okay, and they said,well, we're going to transfuse
the unit.
And I said why don't you do twowhile we're at it?

(23:58):
And so they fought me on it,but I finally prevailed and we
gave him two units and meanwhileI'm flying down there.
I get down there in the morningand the cardiologist has pulled
him down to the cath lab andthey got ready to do the cath
and I go in and the cardiologistsays, oh, we're going to have
to cancel the cath.
I said, okay, what's going on?

(24:19):
He said well, the hematologistdidn't clear for me, really Okay
.
I said any idea why he's anemic?
He says no Interesting.
I said can we get agastroenterologist to look at
him?
He says well, if you want a GIto look at him, we'll do that.
He said fine.
So we sent him back up to thefloor.

(24:40):
The hematologist comes in andthe hematologist looks at dad
and says, oh, it's probablyavian malformations.
If the hematologist was in theroom for four minutes, he was in
the room for a very long time.
I mean, he was out and I wouldhave a chance to say bless the
thing.
So, okay, fine.
So he takes off thegastroenterologist much nicer

(25:02):
guy comes in and he says I'llscope him tomorrow.
So he scopes dad in the morningand dad's got two tumors in his
colon.
He's got a four-sonometer and asix-sonometer tumor.
Might be a reason for the bloodloss.
Yes, yeah, so okay.
And, as luck would have it, oldpeople get old tumors and so

(25:23):
he's got one node, nothing elsegoing on on scans, and so went
in and did partial collect meand now he's back up to walk in
a couple of miles a day anddoing well.
Thank you very much.
Now are we going to do chemo andother stuff on him?
No, we're not going to do that.
Not the conversation.
That's his decision and Irespect that.
But the reality of the matteris they were perfectly ready to

(25:48):
simply write him off becausehe's 94.
And there was no reason towrite him off.
He's got a bunch of qualityyears ahead of him.
The other part of the problem isthat everybody's so freaking,
subspecialized, no one lookingat the whole picture.
So the cardiologist iscompletely focused on the pump.
Meanwhile there's a series ofblood tests they've done where
he's clearly getting anemic.

(26:09):
But fluids aren't his thing,pumps are his thing, so he
doesn't pay any attention to thefluids, even though they're
documenting a progressive anemiaon him.
So we got to step back and payattention to our patients at the
most basic level and make surethat we're doing good medicine.

(26:30):
That's bottom line and it'sbeen very frustrating.
My father is just, from mystandpoint, run-of-the-mill
stuff that you should be doingright.
No magic to it.
My patients much morecomplicated and require a lot
more thinking outside the box inorder to be able to address
their concerns.

Speaker 1 (26:50):
But if we can't do the basics.

Speaker 2 (26:52):
How are we going to take care of these far more
complex people?

Speaker 1 (26:56):
Exactly yes, and so first, when they corrected the
tumor and the anemia, did the AVmalformation and all the did
all that clear up with?

Speaker 2 (27:07):
There are no AV malformations.
Okay, that was just theassumption of the part of the
hematologist.

Speaker 1 (27:13):
There are no AV malformations, okay.

Speaker 2 (27:15):
So the AV malformation, the AV
malformation is going to be anaffirmation.
We demonstrate that, as opposedto just assume that.

Speaker 1 (27:20):
Yeah, yeah.
I think that some of the issuesand you were kind of harping on
it is that when people come inand they say, oh, I'm 94,
they're like, oh, okay, there'sreally nothing I can do, and it
actually really displays itselflike in emergency medicine,
which I'm going into when peoplecome in for chronic pain,

(27:43):
frequently the same person comesin over and over and over again
.
Let's say, they havefibromyalgia, which is a
condition where you have a lotof pain consistently.
It's a chronic condition thatyou have a lot of specialty in.
But coming from like I'vedefinitely seen it happen where
it can be very frustratingbecause whether they don't have

(28:03):
the time because you know in anemergency room you don't have
time to take a full long historyand really give a lot of
thought to some things, butinstead of figuring out maybe a
better plan, like it can be veryquick or very easy to get very
frustrated at the fact that theperson keeps showing up and then

(28:25):
they get worse treatment andworse treatment.
And then it's like, oh my gosh,why this person's here again
for their pain?
That doesn't exist, because yousent them to some specialist
and then that specialist didn'tactually specialize in whatever
actually was going on, and thenthey get written off and then
you see them again, and so thenit's very frustrating on one end

(28:46):
of the spectrum because you'rethe gatekeeper and you don't
have the time.
But you realize that it's not.
I think that instead of gettingfrustrated, I think the key is
to kind of maybe becauseobviously as an ER your scope
can't be everything, but if theycan get them to somebody like
you or something where they canactually get it, the whole

(29:09):
picture, looked at, it would beway better than because
essentially, you admit them oryou don't admit, you give them
the, you refer them to somespecialist, you don't know who,
some pain person, and if theydon't see, or they give them
drugs and then nothing's solvedand then they just come back and
then they just come back andthen it's frustrating because
you can't help them.

(29:30):
So it's just a human response tobe frustrated at something that
you can't help, and so it'salmost like a dual led short or
a constant circle of not gettingthe right things done.
So I really actually applaudfor one you're thinking, but the
fact that you were able tostart this medical center that

(29:50):
really looks at chronic pain andlike the full scope because
it's almost it feels impossible,because the rule of medicine is
everything gets morespecialized every year.
It's like you're saying so ifyou with more specialties,
nobody's looking at the fullscope and you really you have to
trust your family physician todo that.

(30:10):
But it can be very, verydifficult to if they're not
seeing the family physicianregularly or whatever.
And so it's a really a greatthing that you've built and the
like, the concept behind it alland trying to get down to the
nitty gritty of why everythingis happening.
So for one, I'm glad that yourfather is healthier and

(30:33):
everything, but now I'm actuallyglad for all the other patients
that you see as well.

Speaker 2 (30:38):
Thank you.
I think you know we have a realproblem in medicine.
We're in a real crisis inmedicine.
One of the problems is, youknow, ers are treat in street
right.

Speaker 1 (30:48):
Yeah, you can't do that, that's your job, but
that's your job, that's fine.

Speaker 2 (30:53):
So, and the problem becomes increasingly, people are
using the ERs as their primarycare physician.
So either we're going to changethe model of the ER, and maybe
we need to do that.
But the other part of theproblem is we've got, we're
dictated to by insurance whichsays your time is not worth any

(31:14):
money.
Okay, so you've got six toeight minutes to see a patient,
because if you see him for nineminutes you're losing money.
And so you end up on thistreadmill where you're
constantly being dictated towhat amount of care you can
provide to a patient by what theinsurance has decided your time

(31:35):
is worth.
The other part of the problemis EMR, because EMR now a good
chunk of your visit is spentfilling out the EMR to be able
to get the insurance toreimburse you for what it is
you've done Right.
So I'm assuming you guys stillhave Scribes.

Speaker 1 (31:51):
Yeah, I mean for the most part, like most ERs do.
I don't believe that my place.
But you know, with residentsand everything, you've got to be
used to making the charts tobegin with.
But for most ERs they haveadopted that haven't helped the
ones that don't, because it canbe very chaotic without one.

Speaker 2 (32:09):
Right, so but.
But there's another cost.

Speaker 1 (32:14):
Yes, yeah, you got to pay the Scribes.

Speaker 2 (32:16):
You got to pay the Scribes.
So EMR added another cost, theinsurance added another cost.
In our office which ishappening increasingly around
the country I write a script,send it off to the pharmacy.
The pharmacist says to thepatient that'll be $1,200.
Patient calls me back and says,excuse me, I can't afford this.

(32:38):
And then we begin with gettingpre-authorization and I have one
person one entire person in myoffice devoted to doing nothing
more than gettingpre-authorizations for
prescriptions and imagines thatwe order.
Now the amount of money I makeon a prescription and an order
for an MRI or a CT scan orwhatever is zero.

(32:58):
So the insurance companies arenow adding to the cost of our
clinic by one full-timeindividual in order to be able
to get the patients theprescriptions that they're
entitled to be getting.
All right, this is happeningthroughout the system.
Several years ago, clevelandClinic put out a study that

(33:20):
showed they were spending $10million a year on
pre-authorization.
So we have to pay attention tothe damage that the insurance
companies and the pharmaceuticalcompanies are doing to us in
terms of being able to get ourpatients access to care, and
that has horribly corrupted theprofession and we're going to

(33:44):
have to fight back against it.
I mean, unfortunately, the waywe fight back against it.
We're fee-for-service practice.
We do not accept insurancebecause I can't spend the time
and do what I do with mypatients.
If I were on an insurance basis, I would be bankrupt.

Speaker 1 (33:59):
Yeah, lord, help the lady or whoever is having to
speak to insurance people allday.
I mean even just to dedicateone person that has to do that,
like I know.
I've worked with many because Iwas a scribe at once and I
remember working withcardiologists and he would
prescribe some medication andthen he would get a call from
the insurance company and they'dbe like, oh, you can't

(34:21):
prescribe this medication tothis person.
And he's like, well, yes, I can.
This is literally what thisperson needs.
And you have to have this fullfive to 10 minute discussion
while you have patients waitingand then for one you're now 10
minutes late, patients upset.
You're upset because you justhad to talk to somebody about
you know it's like getting aprank call or something.

(34:42):
You're like what is going on?
And then you go in there.
So now you've got two peoplefrustrated and now you're
supposed to get to the bottom oftheir cardiac disease.
It's not helpful in theslightest towards the actual
goal, which is treating people.

Speaker 2 (34:58):
It's a very broken system and unfortunately it's
going to get worse before itgets better, if you ever tried
to access the system which youfind.
First off, trying to get aphysician's office to call you
back is almost impossible.
Secondly, frequently you can'tget to the dock.
You get to the PA or you get tothe nurse practitioner.
And being able to actually see aphysician becomes an

(35:20):
increasingly rare event, and infact there was a study looking
in Mississippi where they hadnurse practitioners instead of
family physicians and what theyfound was the cost actually went
up to the insurance companiesto have the nurse practitioners
doing it because they wereordering more tests.
But there's a reason we spendfour years in medical school and

(35:45):
then another fill on the blanknumber of years in our residency
and our fellowship training,right.
And we are not going to get thesame product in a four-year
program.
That's four years.
That may be a nursing program,maybe a year or two after that
if you're doing nursepractitioner, but you're not

(36:06):
getting the same product.
What doesn't mean there's not agood place in the necessity for
nurse practitioners and PAsthere absolutely is, but we
haven't figured out the propermix at this point in time.
And what's more, responding toinstead is the insurance company
saying, okay, we're only payingfor this.
So somebody has administratorsdecided well, that their nurse
practitioner is doing thisbecause we can't afford to have
a full doc doing this and thedoc will only do this.

(36:29):
And you know there was a debatea little bit ago in one of the
states how many nursepractitioners could a physician
supervise?
Specifically, it was regardingto CVS, and CVS was arguing that
you should have one physician,one physician, supervising 100
nurse practitioners, thatthey're many clinics.

Speaker 1 (36:51):
I don't even know if you could manage a hundred
employees at a gas station orsomething.

Speaker 2 (37:00):
So it's a massive problem and so we have.
You know, we've wanted to theweeds, the politics, a bit of
medicine, but I'm verydiscouraged by what I'm seeing.
There are areas where we'rereally excelling, we do some
really spectacular work, andthere are areas in terms of
day-to-day care of patients.
Well, we're getting really poorcare because patients can't get

(37:23):
access to the time that theyneed in order to be heard, to be
seen, in order to be listenedto, and especially my chronic
patients.
The other thing I would tellyour audience, and very
important in working withchronic patients, it's extremely
important that you constantlyreassess, whether or not you're,
what's happening to you, what'shappening to them in terms of

(37:46):
their treatment program.
Are they getting better?
Are they responding to it?
Because what happens is theyend up with an accumulation of
drugs that aren't necessarilystill working.
They may end up missing a moresignificant issue that comes up
medically, because you wereassuming was just more the same.
So, if you're going to payattention to your other care for
a chronically ill population,it's a constant reassessment and

(38:09):
making sure that you didn'tmiss anything and making sure
that things haven't devolved ina direction that suggests some
other illness or diagnosis thatyou originally missed.

Speaker 1 (38:20):
That's good advice.
I'm very interested in now howI'm going to structure you know,
not only my thought process butwhat I can do to help in any
way.
And I guess I'm curious too,because the like we were just
talking about, like nursepractitioners, and the one

(38:41):
unfortunate thing about being aphysician, is the consistent
test and the continuing yourmedical education that you have
to.
Just, I mean, you don't justbecome a doctor and then they
let you go and do whatever youwant.
You know you have to.
You're constantly having tostudy and educate yourself, and
that's too.
And that leads me to like Ithink it's in November, whatever

(39:03):
you're actually doing Aninternational conference on,
like the developing of or thedevelopments in like this
chronic illnesses.
I guess you know that's theextra thing.
Like you're saying, like you'regonna get a little bit more
because you're constantly.
You have these people that wereso programmed to continually
keep learning more and more andmore.

(39:24):
And I'm glad for one thatyou're actually going to be
speaking at this conference.
And I guess I'm just interested, like where is it going to be
held at?

Speaker 2 (39:35):
Conference will be physically held in Washington DC
at the Marriott.
It's co-sponsored by Georgetownand Foundation for Total
Recovery, which is a foundationI created after I wrote my first
book, so I took some of theproceeds from that book to see
that foundation.
It's an education and researchfoundation and so this will have
some of the top people aroundthe country.

(39:55):
We've got people from NIH DrNath, who'll be speaking on
ME-CSF, and Pans Pandas.
We have Frankovic from Stanfordtalking about Pans Pandas.
We have people from Cornell andColumbia and from the UK
talking about autoimmune diseaseand chronic pain, autoimmune
disease and post treatment Lymesyndrome.

(40:16):
We have some very interestingMustafa Maglevio, coming out of
Wayne State, is doing somereally fascinating work with
stem cells and autoimmunity andso looking at how he's been able
to actually reverse a couple ofcases this has got ends of one,
we have more work to do on thisbut where he's been able to

(40:37):
actually put people who haverheumatoid arthritis,
scleroderma, in remission.
Okay, okay, ain't nobody doingthat.

Speaker 1 (40:47):
No.

Speaker 2 (40:49):
So we've got a lot of cutting edge stuff.
We're going to be talking aboutIVIG treatments for this stuff.
So we've got a really topfaculty all cleared for CME.
So you can attend it, either inperson and there are reduced
rates for the students,obviously or you can attend it
virtually because we want asmany people.
Last year's conference we hadover 900 people, so in the room

(41:11):
only physicians and in the roomresearchers, and in the room
were limited to about 300 people, so otherwise everybody can
attend virtually.
So that's November 8, 9, 10.
And we've gotten good reviewsfrom the programs we've run.
So really would encourage youraudience to attend and anybody
who has loved ones who arestruggling with any of these
conditions.
What's the latest research?

(41:33):
Where are we going?
What are we doing?
Because there's a lot of stuffbreaking very fast in these
fields and a lot of excitingthings happening.
So November 8, 9, 10,washington DC and they can go
through.
I have to look at the websitemedstarhealthorg.
Forward slash N-D-U-C-I-2023.

Speaker 1 (41:55):
Okay, and what's?

Speaker 2 (41:56):
the name of the conference Like the full
developments in understandingchronic illness, the role of
immune dysfunction andinfections.
Okay, perfect, yeah, 8, 9, 10.

Speaker 1 (42:07):
That's exciting.
I love that they allow thevirtual ones as well, because
it's better to be in person,because you just retain a lot
more.
But for some people they justcan't do it.
You live in California and yourshift is the day before and you
can't get over there to be atthe conference.
The ability of allowing thevirtual ones allow and even just

(42:30):
people that aren't physicians,like you were just saying, that
would be interested in like thenewest research and everything.
That's how we learn asphysicians.
What's the newest thing and thefunny thing about medicine is
it's more of a practice thanjust a science, so you have to
continually keep learning andsome things change, and so I

(42:51):
think that's also a great thing.
How is it co-hosting theseconferences?
Is it very stressful or they'recertainly challenging.

Speaker 2 (43:01):
I mean, basically the first thing is what do you want
to cover right and who do youwant to be your faculty?
So that requires a fairly deepdive into the literature in
terms of what you want to belooking at and who you want to
invite.
And then we've been veryfortunate because of the
reputation we have.
Pretty much all of our A-listcrew says yes to us, so that

(43:21):
part makes it easier.
And then once we've got thatset up, we have lots of other
people have a research assistantwho's doing the groundwork here
.
But we've got organizations thatwe work with that put on the
conference.
They're very expensive to puton.
They're a great big deal to puton it runs almost $400,000,
rustible as conference off, notso cheap.

(43:43):
But we also want to keep theprice to a level where people
can find it accessible.
And there's also a difference,by the way, of being in the room
during the conference and beingvirtual.
When you're in the room there'sa lot of sidebar conversations
that can be had with a lot ofpeople and a lot is a lot of
chemistry that occurs just byvirtue of this is a very diverse

(44:06):
group of people.
A lot of conferences.
It's the same people over andover and over again, okay, and
they all know each other.
This is a group of people wherewe've got neurologist and
pediatricians andgastroenterologist and
nutritionist and stem cellspecialist, rheumatologist,
family physicians, painspecialists, so there's a whole

(44:27):
diversity of people thatnormally are not in the same
room with each other.
And now there's a lot of crossfertilization occur.
Lime specialist is psychiatrist, so we've got a lot of
opportunity for crossfertilization to occur amongst
all of these differentpractitioners and so it gets
quite exciting and there's a lotof interesting follow up,

(44:49):
research and opportunities tocollaborate that come out of
these meetings and that'sperhaps even more important than
the meeting itself.

Speaker 1 (44:57):
I love that.
Yeah, that's the beautiful thingabout having, like the most,
like all the brilliant minds inthe subject coming together is
that for one.
You know one, if you hear apresentation, most of it's, all
you know, preplanned and you'rehoping to get your message out,
but once you can actually sitdown and start speaking to
people like that's where you'regetting this education from too,

(45:19):
because other people havedifferent ways of looking at
things, and I'm sure you knowlike we were even just talking
about with the Lyme disease andstuff like that, like pure
psychiatrists that see similarsymptoms.
After that, you may be moreinclined to think, oh well, yeah
, you know, I wonder if it isthe Lyme, you know, instead of
rejecting immediately, you'd belike oh, I bet it is something

(45:42):
similar, because I've heardabout this before, and so, yeah,
I think that's.
The conferences are great, youknow you can learn so much, and
so I think when you, when you'reco hosting it though do you
have to are you coming up withthe guest list and like are they
putting all that expendituresand everything on your plate, or

(46:05):
is it more of like it's kind ofall figured out and then you
just have to come up with theguest list?

Speaker 2 (46:12):
No.
So we so myself and my co chair, craig Shibasaki sit down and
decide who we want to invite andwe create the faculty.
So we create the faculty, weinvite the faculty and that's
the conference.
And after that there's allkinds of people who put
everything else together andthen during the conference
itself, we're hosting right.

(46:33):
So I've got my own lecture topresent, but I also spend a day
where I'm introducing people andfacilitating panel discussions
and that kind of stuff.

Speaker 1 (46:44):
So there's a lot of work that goes on.

Speaker 2 (46:46):
And then I got lots of people that I get to meet
face to face that I've only evertalked to over over zoom and
that's kind of fun also.

Speaker 1 (46:55):
Yeah, well, hopefully I'll be able to attend.
Well, maybe not with theschedule I'm about to get, but
if not this one, maybe the nextone.
Then we'll get to meet face toface, I'll be there.

Speaker 2 (47:05):
That would be great.

Speaker 1 (47:06):
Yeah, of course, and so that I mean that's great,
that's how people are going toget their education.
I know that you're a busy manand everything, and so I want to
get to kind of the the nittygritty, because I know we've
been kind of talking shop.
But since you are a specialistin chronic conditions and
everything, I really am veryinterested for one on like what

(47:30):
condition you find like the mostinteresting to treat and maybe
like what is the condition thatyou find the like most difficult
to treat?

Speaker 2 (47:40):
So hands down.
The most difficult to treat iscomplex regional pain syndrome.

Speaker 1 (47:44):
Okay.

Speaker 2 (47:44):
That is hands down.
It's a complex regional painsyndrome.
It's fortunately a relativelyrare bird.
You'll have people who havepain on denting pain things that
shouldn't cause pain cause pain.
Just brushing against the skinit will cause excruciating pain
for these people, and so thoseare some of the toughest pain
conditions to treat.

(48:06):
As far as the other things areconcerned, if you know, again,
it's having a lot of tools inyour box.
So I'm originally trained as anosteopath, so I do manual
therapy.
I'm also trained as anacupuncturist.
I was trained at UCLA efficienttraining program, and so we've
got lots of tools to be able todo things.
We do things like prolotherapyand there are various injection

(48:30):
techniques that we can use inorder to treat some of the pain
problems, and so it's combiningall this stuff and I have a team
around me.
So I have a team, apsychologist, I have a
nutritionist, I've got anacupuncturist, herbalist, I've
got physical therapist, and soand nurses, and it's this team
approach that allows us toreally be able to accomplish
things that we would never beable to accomplish as a solo

(48:52):
practitioner.
And I have other colleagues.
I have not going to leave thelong field.
That's one of my colleagueshere we have a nurse
practitioner, herpete, who isalso working in our team, and
another doc who just joined usrecently.
So it's about having this teamapproach.
The synergy of this actuallyallows us to accomplish a great
deal more.
Also, I think, havingreimagined all of these things

(49:16):
not as separate diseases so much, but as different phenotypic
expressions of an underlyingneuroinflammatory disease, and
when I look at it like that,there's a unity to all of these
things that allows us, okay,came out expressed differently
in this individual for this, butthe underlying problems the
same.
So now we're looking at thepathophysiology of it and by

(49:36):
virtue of the more I understandthe pathophysiology, the better
I'm able to be in terms ofdiagnosing and treating these
individuals.
So that's the key Get away fromthe symptoms, get down the
pathophysiology.

Speaker 1 (49:47):
Just saying pathophysiology, I'm sure all
the medical students just lovebeing there as the, because that
was like one of the toughestparts, but that is that's
essentially medical school,where you're breaking all of
that down and trying to get towhy certain things happen.
And I definitely find that themost interesting is also one of
the most difficult aspects istrying to figure out what

(50:11):
everything is going on,especially like in a situation
you were talking about, likewith complex regional pain
syndrome.
I can imagine that it may evenbe difficult getting labs,
depending on where they havepain.
You can't just stick themanywhere if they're having this
excruciating pain just a touch.
And so I mean I think it's very, it's very like, interesting,

(50:33):
but I could see where it couldbe just super difficult because,
yeah, it's neuroinflammatorypain, but people are going to
present very differently eachtime.
Yeah, it's definitely a toughtask that you've taken upon
yourself, but I know that a lotof people can really benefit
from it.

Speaker 2 (50:52):
We can do better, we have to do better.
You keep asking questions andyou get better.

Speaker 1 (50:56):
Yep, yeah, I think it's awesome.
I'm curious too, because youhad mentioned, like long COVID
and that 20% of people get it.
Have you figured out or, more,discovered any way of maybe
trying to prevent it?

Speaker 2 (51:13):
Yeah.
I mean, it looks like if you getthe vaccinations, the number of
people going into the longCOVID is significantly decreased
, probably about 15%.
If you treat it.
Paxilovid also looks like it'llreduce the number of long COVID
.
Treating also with metforminoriginally kind of sideline than

(51:35):
gain back.
We know that early on we wereseeing that diabetics who were
being treated with metformin hada much higher survival rate
than those that did not, and sometformin dampens the it's an
mTOR, so when it does is itdampens the over-response of the
immune system with cytokinestorms, and so that which is

(51:56):
what was killing people.
So, that also seems to bebeneficial.
And then past that, usinglow-dose naltraxon, which
modulates the microglialactivity, the central nervous
system.
Low-dose naltraxon high doseobviously is used for treatment
of drug overdoses, also used interms of alcoholics to prevent
recidivism, but in low dose,anywhere from about 1.25 to 4.25

(52:20):
, it actually down-regulates themicroglia and so it doesn't
stop it from reacting, it juststops it from over-reacting, and
so those things can be veryuseful.
Cytokine profiles BrucePatterson will be speaking at
the conference has identifiedsome cytokine profiles that are
consistent with long-haul COVID,and we have a treatment

(52:41):
protocol in order to be able toaddress that High percentage of
those people, respond to it andget better.
And then the other thing aboutlong-haul COVID is sometimes
what's happened is it's just theend result of a longer process.
So these people again you haveto go back.
What's the nutrition status,what's their status of whether
or not they've had environmentaltoxins, what other things that

(53:01):
potentially set them up in orderfor them to go on to this?
And then you're going to goback and treat that.
Well, we do all of that.
We've got a pretty good successrate in treating this
individual linoleum back.

Speaker 1 (53:11):
That's awesome.
So Metformin still continues tobe the wonder drug that
everybody has always chalked itup to be, but I definitely did
not know about naltrexone which,like you just mentioned, is
I've only seen it really, andeven in the medical school and
everything really just mentionedas a way of preventing alcohol,

(53:36):
more like alcohol abuse andeverything like that, and so
it's more naltrexone, metforminand the vaccinations that are
our best defense against it.

Speaker 2 (53:48):
Yeah, and Paxilovid, if you happen to get it.
Paxilovid also cuts down theincidence of long-haul COVID.
So we have tools now, which wehad done before.
The other thing is the bug hasevolved.
Delta, unquestionably, was theworst of the worst.
The Omicrons seem to be a bitmore benign and COVID is not a

(54:09):
benign disease to begin withbecause of these long-haul
problems.
But now things are looking andby the way you can get these,
flu can set off a chronicillness, chronic fatigue
syndrome, chronic pain symptoms,because all of these bacteria
and viruses are capable of doingthis, depending upon the immune
system's predisposition.

(54:29):
So we see the same thing inlong-haul COVID with COVID, but
we're seeing.
It looks like it were.
Data were not there yet, butthe data is suggesting that the
Omicron variants don't tend toproduce long-haul issues as much
as the earlier variants did.
We'll see.
That remains to be seen.

Speaker 1 (54:46):
Yeah, yeah, hopefully not, at least until more
research happens.
But is there a prime treatmentwindow?

Speaker 2 (54:54):
Because I mean not so big Paxilovid you want to be
treating within the first 72hours.

Speaker 1 (54:59):
Okay.

Speaker 2 (55:00):
In order to get that to work, metformin likewise the
earlier started the better.
So same thing withLottoestotraxin.
Now Lottoestotraxin has to becompounded.
It's not available off theshelf, so you have to prescribe
it, and it's a dose-dependentresponse, right?
So low dose under 4.25 or undermilligrams.
That helps modulate themicroglial system, as metformin

(55:23):
helps modulate the acquired, theB-cell system.
So you want to get in as fast asyou can in order to address
these things, and I want toemphasize this over and over and
over again.
I just I talked to a patient ofmine who's a New York young
woman.
She has an internship and shegot sick.
She gets a cold right.

(55:45):
Basically, all upperrespiratory infections should be
assumed to be covered untilproven otherwise.
So she gets a cold and she'sstill going to work and she's
young, she's healthy, otherwiseshe's getting through all this
stuff.
And I'm talking to her and I'mgoing now we're a week into this
and I said did you test forCOVID?
She said I don't know if COVID.
I said did you test for COVID?

(56:05):
And so I said you have to testfor COVID.
So she tested for it.
She in fact has COVID Now.
It's lovely that she's got amild case of it, okay, but she's
now out infecting everybodyelse.
We need to be responsible foreach other.
We need to do this testing anddetermine whether or not we have

(56:26):
the disease so that we don'tspread it to everybody else.

Speaker 1 (56:30):
Exactly.
I think that it is maybe themedia and how everything was
spun.
Whenever it happened, I willsay that there was some weird
kind of we were not as informedgoing in.
So it kind of set up this thingwhere we everybody doesn't want
to admit that they have it.
And I remember specificallythat if you had the vaccine you

(56:51):
weren't supposed to get it oryou weren't supposed to be able
to pass it on.
And then if you had COVID once,you weren't going to get it
again.
And I remember in my situation Ihad COVID, and two weeks after
that, because I was a student,they had to make us wait to get
the vaccine.
I get COVID right before.
And then I was like I wastrying to tell them you know,

(57:14):
essentially, but as a studentyou'll do whatever.
And so I get the vaccine twoweeks after I get COVID.
And then you know, fast forwardthree to four months, my wife
she has, and she had COVID too.
She had COVID, had the vaccine,everything Fast forward three
or four months.
And then she had a cold and Iwas like, did you get tested?

(57:36):
And because I work, you know,in the hospital, we had to.
We essentially just got hertested anyway, and but she for
like a week was like there's noway I can have COVID.
There's just not, it's notpossible.
We've already had it and we'vebeen vaccinated, it's just not.
Every all the media is tellingus one thing, then, lo and

(57:57):
behold, she has it.
And then right after that westart to find out that it can be
, you know, caught again.
And so that one was more of aweird spin on the fact that,
like you, if you're primed tothink that you can't get it
again, you're just going toassume that you can't, it can't
be that, yeah.
So it started off more of as ataboo, and then that led to

(58:20):
people being more skeptical andbeing like, oh, I don't want to
have to lose my job just becauseof COVID checks, and I think
that's really good, especiallyas students too, because they
get we get so nervous that we'regoing to have to miss time and
do certain things, and so that'sdefinitely a smart thing to
just go get tested, because youwere also talking about long

(58:43):
COVID and some of that and thequicker you get in there to
treat it, the better.
Well, a lot of people, if it'slong COVID and all it is is
fatigue and your smell is gone.
You could say that it was justthe cold for almost a month,
before you start to actuallystart to think that there's
something going on.
And then you've already.
You're missing your time.

(59:04):
You're missing your 72 hours.

Speaker 2 (59:07):
You missed a diagnosis because at that point
in time, unless we're doingblood testing, the testing won't
, the nasal swabs won't tell youanything at all.
Exactly, Exactly.
So COVID there's a lot aboutCOVID.
I mean, COVID, from my opinion,was the greatest national
security failure in the historyof this country, but it was a
novel virus.
We had no idea what the hell wewere dealing with.

(59:29):
Originally we were using theventilators all wrong because we
had assumed it was onepresentation when it was in fact
another, and the government wasdoing doing us no good in terms
of getting a legitimate pieceof information out to us on a
regular basis, and so we had ourback channels where we're
communicating in order to beable to share information with

(59:50):
each other to get the properdata out, and it created nothing
but chaos with the public'smind.
And it was a terrifying bug.
To begin with, I mean, we hadno idea what was going on.
It was killing people, lots ofthem.
We lost over a million peoplein this country to that bug.
So very bad bug and nolegitimate government

(01:00:10):
coordination of what was goingon and not enough lead time,
which we should have had interms of what was going on.
So we could have prepped better, we could have held our
estimates.
Sorry, there's certainly aquarter million less people that
could have should have died ifwe had done this properly.
So really a massive failure.

(01:00:32):
We're in a different situationnow.
You know everybody got upsetabout those vaccines.
The messenger RNA vaccinesdidn't just materialize on a
magic.
Those vaccines were originallydeveloped looking at Ebola and
so they had been on the shelffor 10 years because nobody
wanted the vaccine for a walla,because it just wasn't a market
for it.
But the development had alreadybeen done on those vaccines 10

(01:00:54):
years earlier.
That's where they pulled themfrom.
That eventually they did theresearch and found there to be
useful here and we have now awhole new technology for doing
vaccinations.
Are there side effects of thevaccines?
Yes, there are.
There are side effects for theflu vaccine.
We see a number.
We see any of a number ofthings.
But if you look at thepotential side effects of the
vaccine versus the consequencesof the bug, no contest, no

(01:01:18):
contest.
Do you see cardiomyopathy in apercentage of people because of
the vaccine?
Yes, you do.
The stats, I think, aresomething in the order of one
per 100,000 versus 200 per100,000 if you get the bug.
So you know if you put it side.
Yes, there are side effects ofthe vaccine.
There are risks always, but thebug is so much more deadly and

(01:01:43):
damaging than the vaccine?
I don't think it's a contest.
Vaccines do not guarantee youwill not get the bug, but they
mitigate the severity of thedisease when you get it.

Speaker 1 (01:01:54):
I agree with you and I think that that kind of
transparency is.
I'm glad you even said all ofthat, because I think that kind
of transparency is what we wouldhave made the country and
everybody community way moreaccepting of everything.
And I think that, like you said, it was just a mishandling of
we want people to take this.
Even if it's good for yourhealth, we're gonna act like

(01:02:17):
there's nothing that can everhappen and there's a consequence
to every single thing, thatevery action has an opposite
reaction, like it's just a youcan't hope, you can't do
anything without there being aside effect, and so I mean just,
but it's the risks andeverything that you have to

(01:02:38):
weigh.
And then I knew that I wasgoing to be in the hospital.
I wanted to help people orprotect people as much as I
could, and that's the reason Idid it.
And I don't know, I mean it'syeah, I think the transparency
is exactly and I'm glad that yousaid I mean, even if there is a
chance of cardiomyopathy, likethe last thing you want is for

(01:02:58):
it to be, I mean, there's stilla chance of cardiomyopathy with
the other, with the actual bucks.
So Much higher, yeah, muchhigher.
So yeah, it's really about thetransparency and we've I mean,
unfortunately, in medicine.
Anybody that worked in ahospital during COVID time knew
the severity of it, buteverybody on the outside was,

(01:03:20):
you know, there was quarantine.
So you, you, that just breedsskepticism to begin with, and I
mean we could probably go on forhours about the misuse or even
the benefits and the good thingsthat were done during that time
.
One good thing I will say isthe student loans.

(01:03:40):
I hate that they're gonna haveto bring those back.

Speaker 2 (01:03:45):
Yeah, I can certainly understand that.
I was like bring in anotherround.

Speaker 1 (01:03:48):
Now, I'm just kidding .

Speaker 2 (01:03:49):
I'm kidding, but the other thing that's come out of
this is the people who havechronic fatigue syndrome
suddenly got believed.
Yes, two million people whichwere being dismissed and written
off.
All of a sudden, covid comesalong and people are developing
long-term fatigue as a result ofCOVID and you're going.
Ha, maybe this is a real thingand indeed now these people are

(01:04:12):
getting the attention that theydeserve and the research dollars
that they deserve.
When I first got involved withME-CSF and HHS, our NIH budget
for ME-CSF was five million ayear.
Now five million is a goodamount of money to you and I.
However, in a research arena,it's a joke, it's a tip.
It's the fastest way to endyour career because there's not

(01:04:34):
enough funding to supportongoing research.
So five million a year was nota useful number for them to be
spending on long-haul COVID.
And if you made a comparisonbetween the money being spent on
ME-CSF, we had about twomillion people struggling with
the disease versus people whowere struggling with multiple
sclerosis, where about threequarters of a million people

(01:04:56):
have multiple sclerosis in thiscountry.
That budget was $140 million.
Ok, but it was about notbelieving the disease existed
and so you couldn't get a groupof people behind it to do the
funding that was appropriate inorder to treat the research that
we needed.
That's now happening andbecause that's happening, this

(01:05:20):
whole business ofneuroinflammatory disease is
getting a lot more funding and alot more attention, so we'll
end up with better answers forpeople in the relatively near
future.

Speaker 1 (01:05:28):
I did want to ask you one more question if you have
time, because we've been talkingabout the immune system and I
heard that you have like threehidden secrets that could
supercharge your immune systemand I was very interested to
hear that going on ourdiscussion.

Speaker 2 (01:05:44):
So the not so hidden secrets are sleep, exercise and
nutrition.
Ok, pure and simple.
Those things are essential fora normal.
The best anti-inflammatoryessential nervous system is
exercise, both weights andcardiovascular.
Ok, sleep, getting eight hoursto sleep at night, seven hours
to sleep at night, is absolutelyessential.
Sleep is when we detoxify ourbrains.

(01:06:07):
Right.
Lymphatic system is most activeduring slow-wired sleep.
But otherwise, the other thingyou want to look at is low-dose
naltrexone.
So low-dose naltrexone isprobably going to turn out to be
one of the better anti-agingdrugs.
And again metformin, which willalso be another one of the
anti-aging drugs and in fact, isbeing investigated now as an

(01:06:28):
anti-aging drug.
So those are the two big ones.
The third one that looks verypromising, well, let me back it
up.
So the other one that's muchmore accessible and easier is
NMN.
Ok, nmn is the precursor to NADand precursor, ultimately, to
creation in the mitochondrialcycle, for creation of ADPs, so

(01:06:51):
NMADH.
So supplementing with NAD, nmm,rather, I think, does a lot in
terms of maintaining your energy, especially your age, and going
forward, and so we want to makesure that we're doing those
things.
So those would be the three bigthings.
The other thing sitting off inthe background is rapamycin
low-dose, so rapamycin, anotherM-tor, but using one to six

(01:07:14):
milligrams a week.
There are some studiessuggesting that it may actually
be very effective slowing theaging process.
But the easily accessible ones.
Nmm Signal is the brand we use.
No economic connection withIsarium, which is the company
that produces it, but I thinkit's the highest grade NMM on
the market at the moment.

(01:07:34):
Davidson-claris doing someresearch on it that they're
going to be producing apharmaceutical grade NMM.
And then low-dose naltrexonehas to be by a script, so you
can do that as this metformin.
But I think those three areprobably all anti-aging and
actually lead to.

(01:07:55):
The other thing I wouldactually make sure is make sure
your vitamin D levels are goodVitamin.
D levels norm is listed at 30nanogram per deciliter.
It should be 50 to 80.
D is a hormone.
D is necessary for a healthyfunctioning in the end system.
We know that the people whosuffer worse in COVID had low
vitamin D levels and higherprobability of developing a

(01:08:16):
low-haul again with low vitaminD levels.
So vitamin D somewhere betweenI'll supplement myself 3,000 to
5,000, international units a day.
But you can also get lots ofvitamin D going out in the sun.
20 minutes arms, legs, chest aday will do that for you.
But checking vitamin D shouldbe part of a normal physical
Checking vitamin D levels, seewhat they are and treat a

(01:08:40):
cordial end.

Speaker 1 (01:08:41):
I agree, the problem with today's society, with it
being very technologicallyadvanced, is the fact that we
don't get this whole vitamin Dthat we used to.
I mean, that's one of the mainthings is you would be outside I
mean, if you're looking at itfrom an evolutionary standpoint,

(01:09:01):
that's the whole reason formelanin and the different skin
tones, to begin with, is justyour absorption of vitamin D and
where you exist in theenvironment, and I know a lot of
people.
I was doing my rotations andeverything in New Jersey and New
York and a lot of people sufferfrom vitamin D exposure because
also vitamin D deficiency,because the clouds and the

(01:09:26):
exposure to the direct sunlightis drastically decreased.
So, especially if you live in amajor city and things like that
and hemperbidur inside, you'renot going to get what your
ancestors or what your body isprogrammed to regularly receive,

(01:09:46):
and it's so cheap.
As far as the cycle, there's alot of other things out there
that people will tell you totake, and vitamin D is a gods
and I think that's one of thebenefits from COVID.
I hate to say that there'sbenefits from a virus, but
people were actually concernedabout their vitamin D levels and

(01:10:07):
then realizing that there was,I think, and I would butcher the
statistics but there was adrastic amount of people in New
York all had very severely lowvitamin D levels, and nobody
would have even thought to checkthat.
If people go, oh, I've steppedoutside every now and then I've
mowed the grass before wearinglong sleeves, and they don't

(01:10:30):
realize that you need direct sunexposure to those areas.
And now, right now, it's almostimpossible to walk outside in
Mississippi with your shirt offwithout getting a sunburn or
getting destroyed by mosquitoes.
So you've got to find some wayto supplement it, and so I'm
glad that you brought that up.

Speaker 2 (01:10:49):
The other thing that you want to keep in mind is use
of sunscreen.
I know we're psychotic aboutgetting sun exposure because of
basal cells and melanomas orwhatever, but the reality of the
matter is sunscreen blocksvitamin D production 100%.

Speaker 1 (01:11:02):
I've heard that.

Speaker 2 (01:11:03):
We need direct sun exposure on our skins, but
dosing 15, 20 minutes a day, notmore than that.
Then you can put it all insunscreen you want.

Speaker 1 (01:11:11):
I agree and actually I like what you, just because I
looked up.
The other day I went into thepharmacy I think there's 25, 50,
milli equivalents or whatevervitamin D for the pills, and
then there was the 200 orwhatever, and I remember looking
and I was like, oh, I wonderwhat I should get.

(01:11:31):
And I looked up the dailydosage and I think it was 30,
like you had said, and I justfelt like it was so low of full
supplementation and I had heardduring COVID times about some
people taking like 500.
And I didn't know specificallywhat.
And so I agree to what you weresaying is that it probably

(01:11:51):
should be a little bit higher.
Especially if you are a personlistening to this now and you
don't get a lot of sun exposure,you need to consider that.
On top of it, if you've gotdarker skin complexion, anything
like that, like you're going toneed more vitamin D than the
regular, then just what theaverage.

Speaker 2 (01:12:10):
Get your blood levels checked.

Speaker 1 (01:12:12):
Yes, don't guess.

Speaker 2 (01:12:13):
Get your blood levels checked.
It's easy.

Speaker 1 (01:12:16):
And I also.
I was looking up the signal foryour in-and-in supplement and
because those can actually berelatively pricey I don't know
if you can find them at apharmacy or like a vitamin store
cheaper, but the signal one isrelatively the cheapest one that
I've seen so far.
And do you have a recommendeddosage?
For how much somebody?

Speaker 2 (01:12:36):
should be 5,000 to 1,000 milligrams a day, so two
to four pills of the signal aday.

Speaker 1 (01:12:43):
Yeah.
I think that is because I knowthe importance from medical
school.
You know the whole NAD pathwayand where the hydrogens and the
pluses are going, but you don'tever think about having to
supplement it because it's alljust known in this obscure
pathway that you're just havingto only think about when you're

(01:13:05):
getting tested.
And so I think that that's atleast something that I'm going
to look into getting for one,because getting around 30, you
know I'm like whew, the age isstarting to kick in, so I need
as much anti-aging as possible.

Speaker 2 (01:13:19):
The reality of the matter is as you age that's the
other thing, right as you age,by the time you're 50, 60, your
NMN stores are pretty depleted,and so we want to build them now
so that we have good storehouses that continue on
throughout life.
So now is the time for you tobe planning to live, to be 100,
120, right, we want you vital,we want you strong.

(01:13:42):
And you know, the longevitydata says we should easily be
able to get to 120 to 160 ingood vitality.
It's not just a matter ofnumbers, it's a matter of having
quality years.
And basically the demographicdata says look, everybody born
after 1995, average lifespanwill be 100.

Speaker 1 (01:14:04):
We can only hope.

Speaker 2 (01:14:06):
Well, there's no reason not to as long as we take
proper care of ourselves.
We know we can do this.
We know the body's capable ofliving that long, but we have to
take care of it.
So I have had a pleasure beinghere with you today.

Speaker 1 (01:14:22):
I was about to say yeah, I don't want to keep you
too long, but I have drasticallyenjoyed speaking to you.
I've learned a lot even myself.
So you do a lot of great work,and it was a pleasure to speak
to you.
And I would just like for you Idon't know if you had said it
before, but please let anybodyknow where they can reach out to
you, or so.

Speaker 2 (01:14:43):
CatholicCliniccom.
K-a-p-l-e-n cliniccom is ourwebsite and we can be contacted
through that.
And the book is why You'reStill Sick, how infections break
our immune system and how youcan recover.
That's available on Amazon, asis total recovery, so I would
encourage you to look at it.
And again, Sarah Remy's bookI'll put it in a plug for Women

(01:15:03):
of Mysterious Illness, I thinkshould be required reading by
every medical student, Brian,book that you wrote.

Speaker 1 (01:15:11):
OK, yeah, Everybody, go check them out and go sign up
for your conference the newdevelopments and understanding
chronic illnesses.
And Sarah, it was so great.
I'm going to check out the book.

Speaker 2 (01:15:22):
Great, all right Jordan.
Thank you very, very much.
A complete pleasure.
Thank you very much for theshow.

Speaker 1 (01:15:27):
Of course, thank you, and thank you very much for
listening.