Functional Medicine Versus Dysfunctional Medicine
Easy choice right? Who wants dysfunctional medicine? By definition it does not work. Then what makes a medical model functional? If only the answer was so simple. Wait, it is that simple in a way…Functional medicine works in getting its patients back to living a healthier more abundant life through the best of natural and western medicine while treating the patient as an interconnected whole.
Let’s walk through what my imaginary, yet average patient, Jill experiences in the conventional and dysfunctional world. Fill is a 40 year old fatigued patient, tired of not only her chronic stomach issues, but the way she is treated by the 10 doctors she has seen without a diagnosis or any hope for relief. All the standard tests, even a stomach scope just don’t lead to any improvement. 8 years into it and she begins to add some weight around the hips along with some menstrual cramping that she never had before. Another series of specialist ensues. They can only agree on two things. They don’t know what is wrong and that the gut and other issues are not connected.
Jill runs out of conventional specialists and decides to take a different approach with a functional medicine MD. She is a little nervous that he doesn’t take insurance but is assured that most labs can be run through her insurance. The pre-visit questionnaire strikes her as so different. She had filled past medical forms out before listing meds, allergies, past diagnoses, drinking habits, and family history, but this went much further. She dutifully answered questions about her diet concerning how much wheat and dairy she eats. She thoughtfully answered questions about how many courses of antibiotics she could remember taking. She went so far as to call her mom and double check whether she was a C-section baby and whether her mom breast fed her for the questionnaire. This whole experience was becoming rather surreal. This functional MD would know a lot of information about her before they even met.
The appointment day finally came, none too soon. She arrives early for her 90 minute initial visit, wondering what they would talk about for 90 whole minutes. Normally, she would try to get her top two or three concerns out in the allotted 15 minutes, but now she had all this time. Oddly the waiting room was not filled with a crowd of people checking their watches. The nurse brought her back to an exam room for some final informational review and the standard vital signs. This was another reminder of the 10 extra pounds she had collected in the preceding 6 months. So far, this seems pretty standard.
After the nurse leaves, Jill glances around for the usual pharmaceutical propaganda promising the magic cures from the latest pill. Nothing catches her attention and then the door knock startles her. Dr. Functional enters and introduces himself. After a short description of the visit plan, Dr. Functional asks Jill to start at the beginning with her story. With a few questions by the doctor, Jill spends 30 or 40 minutes describing her symptoms, what she had tried, what tests she had done, and how she had fared with all the therapies.
Dr. Functional continues the dialogue with a review of that long and detailed pre-visit questionnaire. As he walks through her life story, he explains that birth by C-section alters a patients gut bacteria later in life. He continues with how multiple rounds of antibiotics for ear infections and strep throat in the childhood years can further disrupt gut bacterial balance. He turns to dietary habits and explains how her low fiber diet with lots of dairy and sugar almost guarantees gut problems by this time in her life. Dr. Functional definitely has her attention as her understanding of how her body functions deepens. Finishing the story of her health, Dr. Functional hints that the connections of her gut and changing hormones will surprise her even more after the physical exam.
Dr. Functional asks Jill to sit on the exam table to run over a few physical findings in search of more clues. She expects the usual quick heart, lungs, and belly exam. Interestingly, Dr. Functional methodically works down from her eyes, through a detailed exam of her mouth and teeth, then her thyroid, skin stretch, fingernails, joints, skin moisture, a detailed neurologic exam including a tuning form buzzing her joints. Of course the heart, lung and abdomen received their due attention, but this was definitely more detailed than the usual.
They return to their seats and Dr Functional begins. Thank you Mrs. Smith for that thorough description and for this opportunity to be a part of your healing journey. Let’s discuss how I see your body is and is not functioning correctly. First, your early life between a C section and antibiotics set your gut up for imbalances and maybe yeast overgrowth. By the time your diet of inflammatory foods without much fiber had a few years to make this even worse, you were in your 30’s. The stress of motherhood, fast food, and little time for exercise took a toll on your body. Your defenses against the gut inflammation and imbalance began opening the walls of your intestines for both food proteins and bacterial chemicals to cross the threshold leading to inflammation. The unhappy intestinal lining and surrounding muscles responded with many of the expected symptoms, pain, bloating, occasional nausea, and diarrhea. The changes in your gut cannot be seen with scopes, so that was normal in the past. We have some advanced tests that help us confirm this situation and guide how to treat it. They look at how leaky your gut wall really is and whether food sensitivities, parasites, or yeast may be contributing.
Earlier I mentioned that I would surprise you with another connection to your female problems. Women with leaky gut and bacterial imbalances called dysbiosis often experience hormone imbalances. These may be simple cramps and irregular cycles, or polycystic ovaries, fibroids, and infertility. Basically the inflammation from the gut spills over and bathes the ovaries with inflammation hormones. This means that your gut issues are causing your hormones issues. Let’s take this two steps further. First, these hormones and the inflammation in the gut trigger weight gain through affecting other hormones. Depending on whether the inflammation or the hormones are stronger, the weight may settle in the belly or the hips respectively. Second, inflammation and hormones also combine forces to affect energy levels. Inflammation triggers higher cortisol from your adrenal glands which when they remain elevated drain energy.
So, what I am saying is this. Your symptoms have a cause rooted in your life both present and past. By recognizing this root cause in your gut, we can target therapies that have far reaching benefits. We will start with a few tests and when you come back for your next visit, we will discuss how these tests impact your treatment program. The treatment program will address nutrition and other lifestyle factors as well as supplements that will restore proper functioning to your GI and hormonal systems. My last question is “ Are you ready to move towards a healthier more abundant life?”
Jill gets a twinkle in her eye and a flutter in her chest as she says yes. In the coming months, she works hard to clean up her daily nutrition and follow the program. Month by month, progress builds. It seems slow at first and she wants to doubt, but she keeps pressing. As the changes take hold, so does her hope. At first, she is not sure. But then, she wakes one morning and say “yes” I am beating this. Functional Medicine has helped me to function again, to live a healthier life.