Well I Ever Get Better? (Chronic Illness & Healing Discussion With Dr. A)

So again, as to the question of, I have a chronic problem, will, you know, will I ever get better? I'm getting frustrated. Number one, it's very common. Number two, it's frustrating for everybody involved, you, your loved ones, healthcare providers, et cetera. But number three, there is an answer to the question. It just has to do with your particular case, how wide and how deep of a problem and how long it's been there. And then the other part of the equation is, You have to build a healthcare team around you that will help you to deal with all of those underlying problems. And even if it takes a long time to push you towards health. When you either are a person who has a chronic illness or you are a healthcare provider working with people who have chronic illnesses, this is a very, very common question that comes up. And even if the question isn't verbalized, It's always implicit in the dynamics between, you know, the provider and the patient. And it's also something that people live with in their lives. So if you're the patient, it's something that's always in the back or the front of your mind, but also your family and loved ones and everybody else. One of the more difficult parts about this particular question is it's not a linear answer. It's not the same for everybody because chronic illness Chronic illness is a large group of problems that are on a lot of different levels. And so while they may be lumped into the world of chronic illness and triggers and pathologies of chronic illness, there's a lot of different ways that chronic illness can manifest. What do we mean by that and how can that help us in answering the question? Well, the first thing is there are chronic problems that may be extremely unpleasant and have a lot of pathology associated, But they affect a particular area. Now, that doesn't make it better or worse. It's just that they're more limited to a particular area. For example, there are chronic disorders that may affect your eye and your vision, things like macular degeneration, certain other retinal problems, things of that nature. Those might be associated with body-wide problems, but they're really focusing on your visual system. There are types of arthritis that arthritis is affecting of the joints. So you're going to have joint problems in maybe, maybe one joint, maybe a lot of joints, maybe all your joints at times. Then there are other chronic illnesses. For example, if you have Crohn's disease and it's affecting your digestive tract and specifically a lot of your small intestine, Well, then that's gonna not only create inflammatory activity in your digestive tract, so certainly it's affecting one organ system, but that inflammatory activity can affect the way that you absorb nutrients. It can affect the immune system in the digestive tract, affect a lot of things that then have a spillover effect to the rest of your body. Another one that probably has some of the most spillover effect to many parts of the body, which is a chronic illness, would be diabetes. So you take type 2 diabetes, for example, And you not only have the problem with blood sugar management and getting, you know, the sugar into your cells, but you now also have all of the downstream problems that poor blood sugar management gives you. That can be problems in your nervous system, problem in your eyes and your vision, problems with your sensory nerve apparatus, problems in, uh, you know, your body weight and your body's metabolism, inflammatory triggers, all kinds of things that can go on. Then you can get into areas that are multi-system, multifactorial. Now, over the years, I've worked with a lot of people with a lot of chronic illnesses, and let's say it's not something that's as easily identified as, say, type 2 diabetes or Crohn's disease or one of the eye conditions or whatever else it is, but it's something where somebody comes in and they have chronic fatigue syndrome, fibromyalgia, maybe they've been diagnosed with Lyme disease or complex infectious problem. Well, often when you get to those sorts of diagnoses, even something where you're told, well, you have chronic Lyme disease, there's a lot of things like that might be the tip of the iceberg, but there's a lot underneath. And having I've been involved in not only research with chronic fatigue and fibromyalgia patients, but also treating them for a long time in large numbers. What we see in chronic fatigue fibromyalgia is usually there's a lot of underlying disease states that may or may not have been picked up yet. And so when you get to those, whether it's say chronic Lyme or chronic fatigue syndrome, fibromyalgia, et cetera, then you don't have one organ involved. You pretty much have sometimes all of your organs involved, and you might have diseases that are triggering in your hormone area, uh, in your musculoskeletal area, in your digestive areas, you know, all, all around your body. When you're looking at that, then you kind of can see with chronic illnesses, you may have like a lot of you affected. You may have a medium amount affected, and you might have, you know, one organ system affected. None of them are great, and they're not normal function, they're an illness. But it's a little easier to prognosticate about a single, maybe, organ system as opposed to something that's got a lot of downstream effect. Now, what's another thing? And this is something that comes up a lot in training physicians and talking to them about this process of chronic illness. Because so when we say chronic illness, acute illness is what we normally go to the doctor and get treated for. You break your arm, uh, you get a strep throat, you have a cold, you get influenza, whatever. Those are usually acute things and you treat them and then you go on about your life. Chronic illness means that you don't have something you can make go away, at least easily. So in chronic illness, there is an underlying truth really that runs throughout all chronic illness, and it just is a tenet of Pathology. Pathology is the study of disease. And the tenet— and this is something that often you can overlook as a healthcare provider because you learn about this tenet of pathology usually in your second year of medical school, so it's a long time ago— but it's really important, and that is the difference between damage that can go on in the body. In pathology, when you divide damage up in the body, you can look at Reversible and irreversible damage processes to make it simpler. They're just what they say. An irreversible damage or injury in the body means it's a— think of a scar, right? You can do things to scars to make them less, make them look better, but there's always gonna be some scar tissue there. Well, you can also get scarring in areas such as your, your eyes. your visual system, you have macular degeneration, you can get irreversible scarring that's never going to go away. So when it hits the point of being irreversible, yes, that's going to be a deficit in your life wherever that is. But then there's something called reversible damage. Now usually they're on a continuum, but they don't have to be. In an area though where you have damage, you have irreversible damage such as say irreversible scarring or damage due to macular degeneration in your eye, you're never going to get the vision back where it's irreversibly damaged. But normally, all around it are reversible damage areas. So they're damaged and they're on the way to being irreversible. The idea of reversible is if you stop the triggers for the damage, you can walk it back and regain some of the function. So to keep with the eye, it's an easy example with the eye. We would have people where they would have macular degeneration and they would be discovered. It's getting discovered younger and younger now, which is very, very good. And we would do therapies with them that were aimed at not the irreversibly damaged part, but stopping the reversible damage. And if we could do that and kind of walk that back and repair things, Then they might have lost some of their vision, but they wouldn't continue. So the same thing would go for if you have an arthritic condition, something affecting your joints that's chronic. If you have irreversible damage in a joint, it's unlikely that's ever going to go away. So even at your best, you're going to have to live with some of that. But the reversible damage that's going on, if you can calm down the trigger for the damage in the first place, then you may not get any more and you might even heal up some of the reversible damage area. So as a healthcare provider, when you're thinking about the question of, I'm chronically ill, when will I ever get better? I'm getting frustrated. You have to look at, is this a small, medium, or large problem? Is it affecting, you know, one or a few or multiple organ systems? And then you have to look at how much damage in the body is irreversible. Versus reversible. Then the next question is, what can I do about the reversible damage part? So in the case of, you know, something that's a little more focal, focused, like, you know, macular degeneration or something, you can go after the damage. And certainly if there's underlying problems, you go after those. When you get to something that's bigger, like say chronic fatigue syndrome, fibromyalgia, chronic Lyme disease, Then you have to really step back and you have to look at what are the underlying areas of illness in this person, and can I set up a protocol to not only test and find these problems, but to also kind of shepherd them along through treatment? And one of the problems with the broader chronic illness areas, which is, you think about chronic fatigue, fibromyalgia, chronic Lyme, chronic infectious disease syndrome, et cetera, You've got potentially many organ systems involved that are dysfunctional. Then the next problem that you have to think about with a patient like that, and if you're the patient, you know this sort of on the back end, is, is this something that's been a problem for 3 or 4 or 5 years, or is it something that's been a problem for 20 or 30 or 40 years? I've had lots of patients on both ends of the time spectrum, and what generally— now, not always, but Generally, what, what you see is the shorter amount of time you've been chronically ill, the faster you can get towards healing. If you unfortunately have been dealing with this for 20 or 30, 40 years, you can still heal. It's just there's a lot more to heal. It's going to take a lot more time. When I said at the top of the video, this is one of those very difficult things because the answer is not simple. It's not sort of like, you know, okay, I broke my ankle. Or put in a cast, doc. Thanks. I'm going to be in a boot or I'm going to be on crutches or whatever. It's not that simple with chronic illness. Let's say you have chronic illness that is largely due to one underlying problem. So I mentioned that, say, diabetes, type 2 diabetes, can have lots of downstream effects. The only upside of that, because it's not an upside to have a lot of downstream effects, but the upside of that is if you can get the diabetes Type 2 diabetes under control and manage it and then feed your body in a way that starts to heal the damage, you can affect all the downstream areas with one group of intervention. Or if your problem is stemming from high blood pressure and there's a lot of downstream damage and you get the blood pressure under control, you're treating one thing that affects many very positively. When you get to the other disease states, such as something like chronic fatigue, fibromyalgia, chronic infectious disease syndrome, chronic Lyme, or any of those other ones, then you actually have a constellation of problems, and you can never treat one thing or even two things and affect all of the problems. Because in those states, you not only maybe have some infectious immune problems, you probably have some digestive system problems. You probably have some hormone endocrine system problems. You probably have inhibitory problems, meaning immune balance issues, etc. And you probably have a number of other things that go on in the body that have just all decompensated. So instead of treating one thing like the diabetes and having it affect a lot of stuff, now you have to treat all of these things over time. You usually can't treat them And this is one of the things that you see, say, with chronic Lyme or chronic infectious disease problems. People, rightly so, will get focused on killing whatever bug is there, but by the time it becomes chronic, it's not just about the bug. It's about what the bug's done to your immune system, what the bugs have messed up with your hormones. Have they lowered your resistance so toxins are affecting you? Are there other toxic things like mycotoxins affecting your body? And in that case, then, Yeah. Then you just have to treat everything. So then the answer is a bit different. So if it's a person with uncontrolled type 2 diabetes, the answer can be, it might take us a while, but we're going to change your diet. We might do medication, may do other things, but it's all after getting your blood sugar under control. And when we can do that, your body will start to heal downstream. All those other problems will start to get better. On the other hand, if it's a chronic infectious disease— picture chronic fibromyalgia, we have to identify all these things first, and then we have to kind of play this chess match of treating all of them over time to get them better. And normally what happens with those more complex illnesses, instead of you kind of getting better like in a straight upward line, it's sort of like a roller coaster. What I would always tell patients is the roller coaster may go up and down, but over time the trend is up. But what happens is as you remove some of the underlying problems, the body readjusts and gets a little bit more energy to fight back against the other problems going on. And that can actually be a little bit of a dip. And then the healthcare practitioner has to back up and say, maybe we are— we've got enough effort going into the hormonal issues and now we can work on the immune problems or the toxicity or whatever. Or maybe we kind of got a handle on the mold exposure and all of that, and now we can go work on the inflammatory things that are downstream. So the answer is I have never seen a patient who didn't get better to some degree, and the differences are how much time does it take and how much better can they get. The more complex the illness, the longer it usually takes. The longer you've had the illness, the longer it usually takes. The more underlying problems you have, the longer it usually takes. And so The important thing to think of if you're the patient in this equation is, what do I have underneath? Are we working on everything as much as we can? And then am I able to communicate with my healthcare providers or my team and say, you know, these things did get better, but now I'm experiencing these new, seemingly new symptoms or exacerbations of symptoms? That's a time then when the healthcare team needs to kind of step back and say, okay, well, we maybe have done enough in this one area. Let's move on and treat the other areas. So you will continue to march forward in your healing, but it's going to be a process. You know, when it comes to chronic problems, I've seen people who develop, say, chronic fatigue syndrome, and we found underlying conditions that were there for maybe 1 or 2 years. I've seen them get better. Completely in the span of a year. People that have had 5, 10, 15, 20 years, especially with a lot of misdiagnosis and other things that didn't go right, I've seen that person get better, but incrementally over a number of years. So you have to be real about it and you have to understand that you're healing a lot of things underneath. I've had people with type 2 diabetes they just discovered and it was just starting to give them downstream effects. And they really went after diet change and got their blood sugar under control. Maybe a little medication or a little bit of natural intervention, blood sugar got back under control, A1C came down, and in 6 months most of the downstream things were gone. And I've seen people that have really uncontrolled sugar problems over time, and the downstream things are a lot more to treat. So again, as to the question of I have a chronic problem, will You know, will I ever get better? I'm getting frustrated. Number one, it's very common. Number two, it's frustrating for everybody involved— you, your loved ones, healthcare providers, et cetera. But number three, there is an answer to the question. It just has to do with your particular case, how wide and how deep of a problem and how long it's been there. And then the other part of the equation is you have to build a healthcare team around you. that will help you to deal with all of those underlying problems. And even if it takes a long time to push you towards health. All right, I'm Dr. Paul Anderson. Thank you for listening. Thank you for subscribing, liking, sharing, commenting, notification bell, all those good things. Really, uh, very, uh, pleased with all the new subscribers and the questions. So keep them coming. Thank you very much.