Management after vaccination with Dr. Cohen

well a warm welcome to this talk and I'm delighted to welcome back Dr Michael Cohen Dr Cohen welcome and thank you for coming back thank you thank you for having me John now you've seen a a shall we say um a small cohort of patients over the last year or two presenting in in a slightly unusual way things that are inconsistent with what you've seen presumably over your other met medical life what sort of things have you been seeing and uh how many patients are we talking about okay well I have a um a clinic which sees I look after about a thousand plus local patients in this clinic and I also uh every year something like two thousand to three thousand other patients come through that's not the um um it's a pretty significant number of people to see let's say and um I would say that during covid and since uh I saw quite a lot of people with very similar types of diverse symptoms um and very often these were neurological symptoms some of them were cardiac symptoms so neurological meaning brain symptoms cardiac meaning heart symptoms and they these were symptoms that varied from severe pain in the limb numbness tingling but really disturbing things not not just a mild tingling to the point of being unable to walk at times when this happened in the acute setting um cardiac symptoms where people had racing Hearts extreme fatigue breathlessness um and the a lot of the time the interesting thing was there wasn't much to find when we would send people for tests and I'd send people for quite extensive tests whether it be an MRI of the brain it could have been uh stress echocardiogram of the heart which is an ultrasound of the heart done under exercise conditions um you had to rely not just on the history but also on the examination but you could see there was evidence of these things happening people having heart rates of 150 at rest being unable to um do a very minor exercise when they're usually fit athletes so these These are the kind of symptoms that I've seen uh quite commonly in these last couple of years and I can say again these are not things that I can prove but I can say that I saw a lot of people who had symptoms like this either after covid or after a vaccination of covid and I've seen people also had a vaccination they had these symptoms they've been told by a number of people well this is it's not the vaccine and or it's in your head and then they'd gone and had a second vaccine and the same symptoms occurred very soon afterwards um maybe as severely less severely a little bit more severely and it's very hard to ignore stuff like that and just say well oh this is this is in your head or it's stress or something like that so that that's what I've seen so we are talking about temporal correlations here that's about as far as we can say from the uh The Family Doctor perspective yeah I I can't I can't I can't prove more than that um but these again it's a little bit like if I go back to vitamin D um two years two three years ago um that was there was some kind of weird Association there that wasn't so weird but there was an association there and we try it and it seemed to have worked and only later a year two years later we're seeing all of these studies showing that vitamin D was actually incredibly important it could have saved millions of lives and this is something that you almost derived intuitively from your own practice pretty much it didn't you'd have to be um it's not rocket science honestly it's just looking and seeing what's going on around you plenty of other people worked it out as well it wasn't that hard to work out I think what was more concerning was that it was so hard to publicize without being ostracized for it absolutely we won't go down that track at the moment so but suffice it to say you're seeing it sounds like you're seeing extreme tachycardia which I mean a heart rate of 150 at rest you know if we're talking about someone who's normally fit a heart rate of around about 60 to 70 is probably what we would expect and it sounds like you're seeing peripheral nervous system and central nervous system symptoms from the way you're describing it so what we're seeing really substantial pathological clinical features here yeah um if you want to talk about cardiac stuff for a moment I saw someone fairly recently she very fit lady um does Sports on a regular basis on a daily basis I would say um and [Music] um she had these uh tachycardias at rest and stuff and and I think what happened with her I I can't remember actually in her case right now if it was possibly due to covid or the vaccine but I'm pretty sure it was one or the other um because it started soon after one or the other and she had um she had something called POT Syndrome and POT Syndrome means postural orthostatic tachycardic syndrome which is um a bit of a mouthful but basically it means that the autonomic nervous system uh so you have the um the central nervous system which is in the brain you have the uh peripheral nervous system which is all the nerves that come out of it and that divides up into both the autonomic which is part of the system which we are not aware of and then the conscious nervous system which is when I want to move a finger I can just tell my finger to do that the autonomic is is less in our conscious control but even that is impartial conscious control where you can actually slow down your heart rate or raise your heart rate that's a CIS that's a system that's moving along all the time it has its own rhythms and rates and um and one of these syndrome called pots there's definitely seen a lot of it during covid due to the illness or due to the vaccine can't always say but I've seen a lot of it and it's a syndrome that hardly anyone ever mentioned before covid and it has a lot of different features including fatigue including low blood pressure um but that that's something that I've seen a lot of and as you'll see we'll talk about a case I think of somebody who I saw going back two years now and I think that a lot of the things that she presented with do match up with a pots type diagnosis now one of the reasons I'm delighted you're on the channel is your approach where you consider basic things first it's like think of the simple things first and it's the main things of the plain things and the plain things are often the main things what are the sort of basic things you look at really in any patient before you get down to what we might call more sort of sophisticated medicine so if we're talking about um I assume you're talking more about treatment right now rather than diagnosis and in general common things are common so yeah yeah the things about looking at you know good nutrition and things like that what's your sort of approach there right so okay fine so if we're talking about um uh the the basics I think for everybody the basics are good nutrition um which is not always obvious as to what good nutrition is and it varies a little bit from person to person for sure um sleep having enough sleep and having good quality sleep keeping stressed to a healthy level I don't say don't be stressed I think that's ridiculous we all have stresses and it's it's really about there's there's a certain level of stress that's good for us and that that is useful for us and it's important for us to have and then there's too much stress and probably too little stress um so in addition to sleep and nutrition there's exercise exercise is something something that should be being done every day virtually in various forms it doesn't mean that you have to run a marathon but it does mean that you should be active on a daily basis and certainly should be doing some kind of sports both for physical and mental well-being um these are the these are the things that really do matter and one other thing that's perhaps less obvious is having good relationships so good social networks I would add to it living meaningfully so having something that gives a person meaning in their life I think that's incredibly important you need you need whatever it is it doesn't it you know everyone's different but you need something like that to keep healthy minded and also healthy in your body so any of these things that are deficient that can lead to a patient coming to see you and it could turn out to be something as simple as one of these basic components absolutely I mean nutrition is the obvious one but obviously sleep is incredibly important so people who a lot of people don't sleep well or have very disturbed sleep and that leads to illness there's no question about it both physical illness and mental illness um in addition to that if I was to think in the realm of nutrition there are certain vitamins and minerals in the body um which are commonly deficient and which we only really need to look a little bit harder for one of them very commonly is iron and we've spoken about that a while ago about a year ago I think and another one is vitamin D um I could go through others as vitamin B12 there's magnesium which is very hard to detect to know if it's deficient in the first place because the blood test doesn't really pick up a deficiency it can show if you've got excess magnesium it can show if you've got too little magnesium but if your level of magnesium on a blood test is normal because it's uh what's called an intracellular ion it means it's mostly stored inside the cells the blood test which looks at the plasma which is outside of the cells doesn't show well what the actual level of magnesium is in a person and so and and there are reasons to think why there's a significant amount of magnesium deficiency around the world today um but yes so you're looking at deficiencies but you're also looking at optimal levels so I could say um a vitamin D considered a normal level of vitamin D today is supposed to be 32 nanograms per milliliter uh if you times that by 2.5 you get it in millimoles per liter however all the studies for covid to date have shown that you need to have a level above 50 to give adequate and good protection not just from developing severe illness in the first place but also from probably preventing ongoing secretly ongoing complications long covered it's important to keep that level up uh and most people will not get anywhere near that level and people are varying in body sizes as well so if you are on the chubbier side you are not easily going to have a good vitamin D level um same thing with iron we measure ferritin ferritin is um it's uh it's a protein that's bound to iron and it's in and so we measure the ferritin level the lab results say your ferritin is normal if it's 13 or above in reality in clinical practice if I don't see patients if I see patients who've got a ferritin less than 50 on a regular basis on a chronic basis they're much more likely to get unwell um and we'll have recurrent illnesses or not to recover so well or to be chronically fatigued um those are two examples and magnesium of course we now know there's data on that that's magnesium itself is very important for sleep it is it's important for sleep it's important for hundreds of chemical reactions in the body it's important also for vitamin D so if you don't have good magnesium levels your activity of vitamin D may be impaired somewhat um magnesium has other functions as well which we won't get into right now but it's an interesting one for deficiencies because a lot of modern soils which use a lot of fertilizers have become depleted magnesium absolutely magnesium is found in in awful um like hearts and blood vessels which we tend not to eat yeah um but the fact that a lot of magnesium is found in the heart and blood vessels to me indicates it's probably important for my heart and blood vessels sorry sir it's well it's not there you can make that Improvement I don't know the science on that to be it's not you may be absolutely correct but I I I don't know for sure about that but I imagine that there's a lot in there yes and I think iodine's probably another one as well though you live fairly close to the city so maybe that's a problem so yeah I'm sure there's quite a bit of thyroid disease that's I'm sure there's quite a bit of thyroid disease as a result of iodine deficiency and again the test for iodine is not so simple you have to do a 24-hour urine collection and that's not going to happen on a on a mass scale so patients come to you and you're able to like screen them really for these these potential deficiencies and if you find a deficiency do you then what do you do if you find a particular deficiency well the first thing obviously is to think why would someone be deficient right are they not getting it in in the first place are they not getting enough let's say B12 in because they're vegetarian or because they're vegan um are they using up a lot of iron because they're breastfeeding because they're pregnant because they have heavy periods because they have uh helicobacter which is an infection of the stomach by a very well-known bacteria that causes an inflammation of the stomach and it affects the absorption of both iron B12 and folic acid um it's about first of all thinking why is there a deficiency here does someone do a lot of sports so they become iron deficient even though they're eating a reasonable amount of meat their body needs to use it so the first thing is you find out why do you think they've got the deficiency in the first place and then the second thing is if is there a problem that really needs treating meaning you know someone could have a cancer for example you can't just treat someone with iron and assume that there's no reason for it most people won't have a cancer but you have to be in bear in mind that it could be that or it could be something else it could be celiac disease it could be pernicious anemia which is when the body has antibodies against basically against the um the ability to bring in B12 into the body in the first place and um and that can also affect iron so all of these things need to be considered and once you've considered that then you can also say well in the context of this person's symptoms what do I need to do to uh to treat them do I need to do anything or not um and as long as your acting safely so you're using safe Doses and you're monitoring the patient to see well is this treatment actually working for them you can often see very clearly when something works and to come to a broader point about this um because we've mentioned in the past when we've spoken about penicillin for example in the 1940s how it was um this was seen we found a Target to treat so medicine went from being very much looking at the whole person to saying okay we now know that there is this bacteria strep for example and Streptococcus bacteria responds to penicillin and we are now going to Target that and that is gonna that's gonna treat various diseases which we know that it does it treated rheumatic fever it treats streptococcal sore throat and the potential complications but it also got us thinking in a way of okay everything is targetable right if I have an illness like cancer I just need to find the target cells and treat them which is great it's all good the only problem is that the body is so complicated and we need to be looking at what is the milieu of the cells around the cancer cells for example or what what does the body need to function best to to um to deal with an infection let's say and um this is this is the issue when things like vitamins nutrition come in sleep all of these things if you can ensure that a person is generally in the best position to be healthy then you're already off to a winning start in trying to treat them for something and very often you know you may have someone who gets recurrent infections just recurrent sore throat sore throats or bronchitis or whatever it is and so each time they become ill we say okay well we're going to give you a course of antibiotics or not it might be a virus we might just say go home and rest but we need to think about what's going on underneath that what are the best contributors to them having a healthy working immune system and what should we not be doing in terms of obviously we don't want to harm right the first thing is we want to improve somebody's health and not harm them so all of our interventions have to be have to be safe as a first as a first point and that that's the basics of of treating somebody uh sometimes when we don't we may know the diagnosis um or we're not 100 certain what the diagnosis is but we know that it's nothing too terrible we can treat with these other things in addition to let's say a typical drug that might be being used for that condition get in these basic things right will optimize the body in order to respond to a treatment and hopefully prevent the severity of future illness or indeed prevent illness um yeah it was caused by these particular deficiencies absolutely sorry go ahead yeah I just think no I was going to say I'd encourage more doctors around the world to order these basic uh diagnostic tests because I know in the UK at the moment it's pretty hard to get the function isn't it I think it's a little bit of a shame because right well I mean I think you know if you even if you start looking at things from a cost effective point of view if if you can just get people to have good nutrition through whatever means necessary meaning either through social policy um or through um making sure that it's possible to do some basic cheap tests um I I see little room for harm there and a lot of potential good I agree completely so so that's looking at the basic approach that should be really applied to every patient in the context of what we've seen over the past few years or you've seen over the past couple of years and in terms of uh promoting health and uh Family Medicine in general so um plenty more to come from Dr Cohen uh that's all we're going to do for now but do look out for the next video and Dr Kern thank you very much and if you choose to come back to do some more we'd love to have you again I look forward to thank you thank you

Channel: Dr. John Campbell

Views: 473,727

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: Wrd7sjIKp7k

Length: 21min 12sec (1272 seconds)

Published: Tue Jan 24 2023