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Diagnostic Medicine: It Takes Time to Understanding the Big Picture
In today’s world of high healthcare costs, short office visits, mid-level providers and impersonal service, a critical element that has disappeared is the time required for the patient and physician to discuss the patient’s medical condition at length. Listening, asking questions, following up with a physical examination and occasional testing are all critical to correctly diagnose a patient’s medical problems.
Time allows a physician to build the context within which the symptoms are placed. How long did they last? A week? A year? Are they increasing or staying the same? Does anything make the symptoms better or worse. The answers to these kinds of questions help to include or exclude different potential diagnoses as the cause of the patient’s symptoms.
There is no substitute for time. Checklists and boilerplate intake forms are impersonal and often confusing. Medical histories taken by less experienced personal are often too superficial to be useful. Other than the simplest medical problems, it’s impossible to diagnosis ailments with any degree of accuracy without time. Ample time for the patient and the physician to discuss the patient’s problems is an irreplaceable component of diagnostic medicine.
Understanding the Body as a Whole
Another critical aspect of accurate diagnosis and effective treatment is learning to view the body as a whole, interrelated unit. Symptoms from one area of the body may hold some significance to symptoms from other parts of the body which can get lost in the over-specialized type of medicine we see today. I look for all of the pieces to the diagnostic and treatment puzzle.
A frequent example is when a patient has heartburn, a tendency to urinate frequently and occasional lightheadedness when standing up quickly. These symptoms often result in referrals to a gastroenterologist, a urologist, and a cardiologist. As separate and distinct as these three symptoms may seem, they are all closely related and are commonly caused by a single, treatable condition.
In order to better understand how the body functions, I first focus on the autonomic nervous system (ANS). The autonomic nervous system is the portion of our brain that coordinates how our organs (heart, circulation, lungs, intestines, bladder, kidneys and liver) function, how intensely we react emotionally, how our hormones are regulated and how our immune system functions. Understanding if the autonomic system is functioning correctly is often the key to many medical puzzles.
Autonomic Nervous System
The ANS is often referred to as the “automatic” nervous system in that its functions are not under voluntary control. And with such a major influence over the body, an imbalance in autonomic function is quit frequently a component of many chronic symptoms or illnesses. A good review of the autonomic nervous system as well as associated symptoms can be found here.
Over the last decade, I have developed particular expertise in monitoring and treating imbalances of the autonomic nervous system by using an advanced, FDA-approved technique called spectral analysis (see www.ans-hrv.com for more information, photo below). I have been fortunate to study autonomic testing and analysis in Lisbon, Portugal at one of the top autonomic training programs in the world.
This program is sponsored by the European Federation of Autonomic Societies and is lead by some of the world’s top experts in autonomic conditions that lead to heartburn, fatigue, headaches and bladder dysfunction.
Spectral analysis is as simple as having a few electrodes on your chest (similar to an EKG) and blood pressure cuff on your arm; it takes only fifteen minutes while sitting in a chair. There are no uncomfortable shocks or painful needles.
Simply put, spectral analysis accurately evaluates the health of your autonomic nervous system by measuring how well the different components function under different conditions. Imbalance of your autonomic nervous system makes it difficult for your body to adapt to the wide array of physical and emotional stressors you encounter on a day-to-day basis.
Whether you are become overheated by the sun, overweight from excessive carbohydrate consumption, psychologically stressed from work pressures or weakened by an infection, a healthy and well-balanced autonomic nervous system is required to allow your body to compensate for these stressors.
And surprisingly, damage to the brain can occur from either physical or emotional trauma (i.e. dying of a broken heart), excessive nutrient consumptions (overnutrition), LPS leakage from bacterial overgrowth (small intestinal bacterial overgrowth or SIBO), omega-3 fatty acid deficiency, metabolic inflammation or toxin exposure (chronic alcoholism, heavy metal exposure, pollutants) and can lead to imbalance or permanent damage to the autonomic nervous system.
Symptoms and Illnesses Associated with Autonomic Nervous System Imbalance
The Autonomic Nervous System has 2 main components known as the Sympathetic (S) and Parasympathetic (P) Nervous Systems. Think of these as a right and left hand that work together in unison. Research has demonstrated for many years that autonomic nervous system balance between the S and P arms is required for the maintenance of overall health. Autonomic Nervous System imbalance tends to destabilize a patient’s response to disease or illness, making it difficult to fully or quickly recover. Over time, the imbalance itself will often lead to overt symptoms.
Symptoms and Illnesses Associated with Autonomic Nervous System Imbalance
Autonomic imbalance is commonly a result of excessive sympathetic input (i.e., sympathetic dominance) and inadequate parasympathetic input.
Many people who feel “normal” often live with the subtle effects of autonomic imbalance while many others have severe imbalance to such a degree that it causes significant symptoms on a daily basis. Common symptoms associated with autonomic nervous system imbalance are:
If you have any of these symptoms, the chances are your autonomic system is out of balance and is not operating correctly.
Additionally, this form of autonomic imbalance is now understood to be one of the earliest mechanisms that triggers a the pathological cascade resulting to a wide variety of teh common medication listed below.
Diagnosing and treating the underlying imbalance in addition to certain changes in diet and nutritional supplements changes will dramatically improve and even completely reverse these conditions.
Treatment of Autonomic Nervous System Imbalance
Treatment involves determining the type and degree of autonomic imbalance and utilizing certain treatment modalities (exercise, nutrition, medications) to restore the balance at the level of the hypothalamus.
For many individuals, treatment is required for only 3-6 months and can be tapered off leaving the ANS in balance while other individuals, especially those with severe symptoms initially, may require chronic therapy to maintain autonomic balance.
After the system is rebalanced, patients (or their family members) often will often report marked improvement of not only the targeted symptom or condition but also of a wide variety of subtle symptoms initially thought to be either “normal for someone of their age” or so unimportant they were not worth mentioning.