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functional medicine and practical pain management


Ronald Grisanti  

“It’s fairly easy to identify much of the quackery that complementary and alternative medicine practitioners and woo-friendly physicians have ‘integrated’ into integrative medicine.   The problem with ‘functional medicine’ is that at its core it is close to being as nonsensical as the more ‘obvious’ forms of quackery.  It just hides it better, given the number of fancy-sounding laboratory tests. It’s also incredibly difficult to pin down just what the heck it even is…  

The very first principle is FM’s ‘get out of jail free’ card for basically anything its practitioners want to do. They can always find ways to justify any form of treatment, be it science-based or quackery, simply by invoking the ‘biochemical individuality’ of each human being.” The ever-vitriolic DAVID GORSKI from an April edition of his blog, Science Based Medicine (Functional Medicine: The Ultimate Misnomer in the World of Integrative Medicine). 

The question we are going to answer today is whether or not Dr. Gorski is correct in his assessment.  By the way, one of his “obvious forms of quackery” would be what I do.

When it comes to icebergs, any 3rd grade science text will tell you that less than 10% of their mass resides above the surface of the water, meaning that 90% remains hidden below.  I absolutely love the picture above.  It shows some of the numerous CHRONIC INFLAMMATORY DEGENERATIVE and AUTOIMMUNE DISEASES that the medical community fixates on, mainly because it’s what they can document via PHYSICAL EXAMINATIONS and tests such as MRI’S.  However……

When you look at the causal factors lying hidden below the surface, you start to get an idea of how badly the boat is being missed when it comes to treating these diseases (HERE is an example using diabetes).  Medicine’s number one weapon in the war against sickness and disease (the things above the water’s surface)?  It’s a no-brainer — DRUGS, DRUGS, AND STILL MORE DRUGS.  Unfortunately we know that while drugs can at least on some level cover symptoms of said diseases, they don’t do anything to change the underlying physiology (HERE).  Enter something called “Functional Medicine”.

According to the Institute for Functional Medicine (About Functional Medicine) FM practitioners are all about discovering, “the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, Functional Medicine addresses the whole person, not just an isolated set of symptoms.  In this way, Functional Medicine supports the unique expression of health and vitality for each individual.”  In essence, the focus of FM moves from covering symptoms to discovering causes.  What are some of the underlying causes of disease as indicated by the picture at the top of the page?  Let’s list them.

  • INFLAMMATION:  I just showed you in an earlier link that INFLAMMATION is the root of just about every single health-related problem you care to mention — even those that are largely (and erroneously) labeled as “GENETIC“.  Inflammation is also the known cause of Scar Tissue and Fibrosis that I deal with in my clinic all day, every day (more to come on this point shortly).
  • TOXICITY:  Although there are about a jillion things that can cause the body to become toxic, first and foremost is a CRAPPY DIET.  Plus, the worse a person’s diet, THE MORE ADDICTED THEY ARE TO IT.  The cool thing is that while this is one of the most common of the points to see (as well as being the most causal to all the others), it is usually the easiest to address and quickest to respond.  However, it can also be one of the more difficult bullets to address on your own if your body is having trouble in the “BIOTRANSFORMATION / DETOX” arena.
  • MITOCHONDRIAL DYSFUNCTION:  Along with the P-450 CYTOCHROME SYSTEM that reverses oxidative stress and damage from FREE RADICALS, mitochondrial dysfunction is a huge factor in all sorts of problems.  This is because your MITOCHONDRIA create the cellular energy your body uses in the form of a compound called ATP.  No ATP, and your body will malfunction in an almost endless variety of ways.  This is one of the areas, along with the P-450 CYP I already mentioned, where genetic testing could prove beneficial (can anyone say MTHFR?).
  • IMBALANCES OF THE IMMUNE SYSTEM, THE DIGESTIVE SYSTEM, & GUT:  I combined two of the bullets because 80% of your Immune System is found in the Gut (HERE).   Furthermore, the combination of problems with your MICROBIOME (often referred to as “DYSBIOSIS“) and something known as “THE LEAKIES” is arguably the number one factor in your ill health other than your cruddy diet (actually, it’s probably being at least partially caused by your cruddy diet).  Much of this has to do with decades of our national fascination with antibiotics (HERE).  And to top it all off, many of us are dealing with this whole mess simply because we are not making enough stomach acid — true even though we have been endlessly told that the problem is just the opposite (HERE).  This is also the best bullet to put issues like GLUTEN INTOLERANCE as it is intimately related to both inflammation and autoimmunity (HERE).
  • EXPOSURE TO TOXIC CHEMICALS:  Although I touched on this point earlier, be aware that POLLUTION is now said to be the number one cause of death and disease worldwide and that one of the most common ways we are exposed to said pollution is via VACCINES.  Unfortunately, even infants whose parents understand the value of things like NATURAL BIRTHING and MOTHER’S MILK are assaulted from the day they are born by a variety of toxic chemicals (HERE), usually in the form of ALUMINUM and MERCURY.
  • TOXIC EMOTIONS:  The Scriptures tell us that as a man thinketh in his heart, so is he.  Thoughts are real folks.  They have power.  If you live in a constant state of stress, worry, hatred, bitterness, criticism, anxiety, DEPRESSION, fear, insecurity, worthlessness, indifference, invalidation, or CHRONIC PAIN, they will undoubtedly take a toll on your health.  This is not news, as science has told us for decades that 2/3 of all illness is directly related to stress.  This might be a great place to add ADDICTIONS as well (not necessarily sugar addiction, which I already discussed).  A huge result of toxic emotions is Sympathetic Dominance (HERE).

The most current issue of Practical Pain Management carried an article published by two doctors called Incorporating Functional Medicine Into Chronic Pain Care.  Their premise was that all of these issues above can be addressed in four distinct visits.  This is critical because not only is our nation broke, but our screwed up healthcare system is arguably the thing that is doing the biggest amount of “breaking”. 

The authors went as far as saying that with spending on chronic illnesses being so out of control, estimates say that our spending on healthcare will soon be, “$4.153 trillion dollars — the equivalent of four Iraq wars in a single year“.  Think that might be a problem?  It’s exactly why I’ve frequently referred to the current trajectory of our healthcare system as “UNSUSTAINABLE“.  What might ease some of this burden?  Functional Medicine at least provides a glimmer of hope, when compared to our current system.

Unfortunately, what the bassackwardsly-named Affordable Care Act did for American healthcare was take a failing system and instead of even attempting to fix it, expand it.  Not surprisingly, we have a much larger medical bureaucracy than we did just eight short years ago (HERE, HERE, and HERE are some examples), and cost overruns that are out of the stratosphere.  And when I recently asked MY BROTHER, an Emergency Room Physician, whether any (even one) of the myriad of the current barrage of healthcare mandates would / could / might improve patient care, he looked at me as though I were on drugs. 

Without a different approach, sooner or later (probably the former) our healthcare system will totally implode.  The problem is, integrating a system like this into the mainstream is a huge challenge.  Mostly because it requires patients to team up with their doctors.  In other words, it will require patients to actually do something.  They will have to get off the sidelines, and actually help their doctors by taking personal responsibility for their own health.  And doctors will have to become more than glorified PILL PUSHERS, shilling for BIG PHARMA.

“Science has lent support to what may be known intuitively—how we live, the quality of our relationships, the food we eat, and how we use our bodies, have a much larger impact than genetics ever will. In other words, FM treats chronic pain by addressing these poor habits. This is also a fundamental principle of sustainable health. Implemented correctly, FM can help practitioners to prevent, treat, and often cure chronic conditions more effectively and at lower cost than the conventional medical paradigm.  The onus is placed on the patient’s self-care to process this information and to determine what specific healthy behaviors are best for their cells. This process is not easy for most; it takes determination, focus, and dedication.”

Unfortunately, if you ask the average physician how much “onus” their average patient has, the answer will probably be, ‘not very darn much’.  After all, we are the “Easy Button” society.  We don’t want to take an active role in our own health; we want someone else to do it for us.  And by golly, we want someone else to pay for it too.  The problem is, despite what America’s industrial medical complex tells us, our current system has proved an abject failure in almost every measurable way.  The solution?  These authors offered up a four-visit system to turn things around — a system that incorporates several things I write about on at least a semi-regular basis.  

  • VISIT ONE:  This is where patients are taught how to do an ELIMINATION DIET.  I have been preaching the Elimination Diet for years, and when done correctly, I am of the opinion that it is far more accurate than ELISA testing.  It’s also far less costly and can be done without the supervision of a physician (HERE).  In other words, you can do this on your own.  Although most people tend to think of this bullet in terms of their weight (HERE), honestly, overweight is nothing more than a symptom — the part of the iceberg that sits above the waterline that you can actually see (HERE is a great example).
  • VISIT TWO:  Physical exercise is the focus of this visit.  What is my opinion about physical exercise?  Although it’s certainly important, it’s not anywhere near as important as an ANTI-INFLAMMATORY DIET is.  I am a monster fan of RESISTANCE TRAINING, but for those of you who can do almost nothing without stirring everything up, simple BALL EXERCISESWHOLE BODY VIBRATION, or even YOGA is the ticket.
  • VISIT THREE:  The focus on this visit is “sleep hygiene and stress management“.  Honestly, trying to accomplish this point without understanding SYMPATHETIC DOMINANCE could easily prove to be an exercise in futility.
  • VISIT FOUR:  This visit is all about reviewing progress.   I’m all about seeing if we are accomplishing anything beneficial, but honestly, it seems like it’s a bit too soon for this point.  It’s definitely too early to redo any labs or blood work, and you know better than the doctor how you feel or if you are CHEATING or not.  And as far as WEIGHT LOSS, who really cares anyway.  A mirror (or better yet, a picture) will tell you more than any scale ever did.

My take?  Fantastic when compared to DIABETES DRUGS, CHOLESTEROL DRUGS, HIGH BLOOD PRESSURE DRUGS, ACID BLOCKERS, OSTEOPOROSIS DRUGS, ANTIDEPRESSANTS, PAIN MEDS, and the mountain of other pharmaceuticals being foisted on the American public.  It’s certainly a step in the right direction (be aware that these four visits are in a group setting).  However, I think that this protocol stops short of being all it could be — far short.  Honestly, it’s more like “FM-lite”.   Want something better?  Here’s my gift to you in the form of a couple of (whisper, whisper)….secrets.

Firstly, most of you don’t need to go through “Functional Testing” to get started taking your health back (HERE).  Secondly, I don’t charge you one red cent for a protocol that leaves the one above in the dust. And thirdly (and even better), for the most part, my basic protocol is DIY (HERE).  How much easier do you want it to be?  Just do me a favor and share our site with those people you love and care about and could benefit from this information.  The best way to do this? FACEBOOK, of course!


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