Saturday, November 10, 2018

We Have Stories to Tell

As a holistic minded Family Physician, I notice a lot about the human condition in the context of health care, mostly in the office practice of Family Medicine.  The plight of humanity is still a fascinating work in progress.  We have an infinite array of response repertoires to our lives, many of which are unpredictable.  We have stories to tell.

I love to hear the stories and listen for the health related components that are misaligned with the dreams of the patients.  

I also enjoy reading blog posts and often have reviewed them on my Blog Talk Radio Show of the same name as this blog.  Medical Mojave, who used to call her blog Pissed Off Patient, is one I've followed for a few years.  She has been off line for a while and just reappeared with a couple blog posts and a comment on my last blog post.  Here is my response to her comment with more:

Thanks for your comment. Your blog, Medical Mojave is a Blog that I always read and used to comment about on my Blog Talk Radio Show. It points out the tensions between patient and physician from the patient side of a rare condition. A good book about thinking limitations in scientific and medical professionals that reaffirms the patient perspective that the physician could reflect a bit deeper on the patient story/ plight is The Limits of Scientific Reasoning by Faust 1984 U of Minnesota. From the preface: "human judgment is far more limited than we have typically believed and that all individuals, scientists included, have a surprisingly restricted capacity to manage or interpret complex information."
We have to work to process the complex information/situations better. The current Electronic Medical Record seems to have set back decision making considerably for physicians due to excessive administrivia and less time for patient care and clinical decision making.

I still believe that the patient's story is the most important part of the patient-physician encounter, in the context of an effective relationship between patient and physician.  It tells us us who the patient is and where they have been and where they are headed and more.  At the same time it resonates with who the physician is and where they have been and where they are headed.  The patient-physician dyad is powerful if allowed to be powerful.

Wednesday, October 3, 2018

Breakfast Chat with Dr. Pat: Talking with Doctors

Dr. Jonas, your host for the Dr. Synonymous Show will discuss strategies that may enable patients to be better heard by their physicians.  Physicians seem to have less and less time to engage patients.  This may be detrimental to quality in healthcare.  How might we get around this?  Dr. Jonas will engage those present about ways to get their story heard.  This will include some information about how doctors think and make decisions. 
We will talk about some common problems and at least one rare disease- Ehlers Danlos Syndrome.  The EDS patients get rejected a lot by physicians before they finally get a diagnosis.  How can we get beyond these rejections in this era of opiate abuse and dependency in which patients with pain struggle to get it treated adequately?  The EDS patients might be the poster children for this quandary between pain and opiates.
Click below to listen to the podcast on Blog Talk Radio.

Thursday, September 27, 2018

The Brain Nutrients and Depression: Presentation by A. Patrick Jonas, MD


The Brain, Nutrients and Depression.         A. Patrick Jonas, MD
Institute of Holistic Leadership September 27, 2018

Outline

The Brain. The last frontier?  Nutrient Power by William Walsh, PhD
Nutrients:  Food, supplements, vitamins, minerals, phytonutrients= nutraceuticals
Depression:  Definition(s)
           6 types: Undermethylation, Folate Deficiency, Copper Overload, Pyrrole Disorder, Toxic, Other
Neurons- cells that process signals at 200 mph.  100 B in the brain
           4-100 microns diameter.  Up to 4 inches in length. Act as tiny battery cells
           Long axon transmit electrochemical signal across synapse to other cell.
           1000 hair-like dendrites branching from the cell body, receiving chemical messages
           100 T receptors in average brain
Neurotransmitters: are made, packaged into vesicles, release into synapse, interact w/adjacent cell,      reuptake, death
Most psychiatric meds alter neurotransmitter activity at synapses.  e.g., SSRI’s disable transporters
Nutrients
           Top six biochemical imbalances in brain disorders
           Copper overload, Vitamin B-6 Deficiency, Zinc deficiency, Methyl/folate imbalances, Oxidative stress overload, Amino acid imbalances
Methylation Pathway Model by Amy Yasko, PhD - See Handout
Spectracell Depression Wheel --See Handout
Epigenetics:  DNA wraps around histones which have “tails”, where chemicals may adhere.   Methyl groups- tighten DNA wrap around histone and decrease expression of genes
           Delivered by SAMe to histones
Acetyl groups- loosen DNA wrap around histone and increase gene expression
           Delivered by acetyl coenzyme A to histones, delivers hi energy acetyl groups to mitochondria for processing in the citric acid cycle.
Neurotransmitter Transporter Proteins.  Methyl vs Acetyl for histone tails.  Gene expression of serotonin, dopamine and norepinephrine transporters dependent on M vs. A competition.  E.g.,histone methylation promoters are natural SSRI’s
Nutrient therapy and epigenetics:  Methionine and SAMe, Folic Acid, Niacin (B-3), other nutrients.
Epigenetic disorders:  Autism, Depression, Schizoaffective Disorder, Paranoid Schizophrenia, OCD, ASPD, Anorexia, OCP
Transgenerational Epigenetic Inheritance
The Clinical Process hx and pe, labs, diagnosis, treatment, aftercare
Nutrients and Neurotransmitters
                                 Increased Activity                                 Decreased Activity
Serotonin
Dopamine
Norepinephrine
NMDA
GABA

Response times vary
           Pyrrole Disorder
           Zinc Deficiency
           Copper Overload
Overmethylation
Undermethylation
Toxic Metal Overload
Depression:  Undermethylation, folate deficiency, copper overload, pyrrole disorder, toxic, other
Schizophrenia:   overmethylated, undermethylated, pyrrole disorder
Autism:  Zinc deficiency, copper overload, B-6 Deficiency, Elevated toxic metals, oxidative stress, undermethylation
Behavioral Disorders and ADHD (94% with chemical imbalances):  Abnormal copper and zinc levels in violent persons, copper and zinc and Vitamin B-6

Tuesday, September 25, 2018

Crooked Trails: Interview and Discussion with Author Sandra Miller, MD

Sandra Miller, MD has created another medical adventure novel featuring Abigail Willmore, MD.  The second novel in this series (number 3 is almost complete) continues the story of Dr Willmore, who was successful at the Grand Canyon Clinic in Only Rock is Real, the inaugural book for Dr. Miller.  Read my post about the first novel by clicking here.  (including a link to the interview recording on the Dr. Synonymous Show).

Now we find Abby (Dr. Willmore) agreeing to practice in the expanding Yellowstone National Park Clinic for the summer.  Dr Miller's vocabulary is up to the task of writing about the breathtaking scenery, from the heavens to the glaciers and volcanoes to the sunrises and sunsets to the tattoo of a snake, which she calls "Bitey", on the arm of the clinic nurse.  As a retired Family Physician and educator, her medical vocabulary adds to the sizzle when she describes human relationships, illness, bleeding, nausea, infection, immunizations, medical office processes, delusion, stalking, sexuality, professionalism and sexual assault.

If you also are curious about Yellowstone National Park and dinosaurs in Montana, showcased in a medical thriller, get this book.  If you also want to hear the author discuss how she creates her work, listen to this and the previous interview on her first book.

We'll discuss many of these aspects of her book and her general writing style in the interview which will be broadcast on the internet on The Dr. Synonymous Show on Blogtalk Radio Monday October 1, 2018 at 9:30 PM Eastern.  At that time and for years thereafter you can:

Click here for interview on The Dr. Synonymous Show

Sunday, September 23, 2018

Malaise

Malaise is defined as "a condition of general bodily weakness or discomfort, often marking the onset of a disease. a vague or unfocused feeling of mental uneasiness, lethargy, or discomfort."

I love the word.  I even appreciate experiencing it every year or two for 34 - 48 hours.  I have it now.
With myalgias - muscle pain.  Everywhere.  Similar to the first day of the flu.  But without the mucous in the head and lungs with the intense cough of the flu, fortunately.

The feelings of malaise and myalgias are caused by the white blood cells bursting and allowing interferon to float through the circulation.  Maybe it's part of the grand design to keep us away from other people when we're infected, to minimize the spread of contagious microbes.

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