Successful patient care after vaccination

well a warm welcome to this talk and a warm welcome back to uh Dr Michael Cohen Dr Cohen thank you very much for coming back it's uh really good to talk to you again lovely to see you again John thank you um now we want to talk about individualization of care really on this on this episode that a lot of patients present with symptoms that don't fit into a neat diagnostic category now some do and they just meet they take every box in in the in the medical textbook but others it's all it's always a bit vague and we you know they don't quite fit into a category and they need an individualized assessment which very often to be quite honest isn't done very thoroughly and and today I think we want to give an example of of a lady middle-aged lady that you've been looking after um now she has had a covered vaccine and symptoms did occur after this that's not saying the vaccine caused the symptoms of course but whatever caused the symptoms basically there was a vague collection of symptoms and by treating the patient as an individual you are basically able to make a substantially better if not cure her I think is basically the the the the story we've got so what what symptoms did you present with so first of all um she's in her um early 40s um I don't know if that's middle-aged or not but uh and she's a lady of course so you know never mentioned a lady's age um but uh she presented um she's someone who's actually extremely fit always been very healthy and I mean fit to the point that she does Sports every day a very uh active mother um and she came to see me having been really frustrated about a month after her second dose of a covid vaccine and I want to stress here that I do think that for some people the vaccines were and are appropriate I just don't think that everybody needed vaccination and I think that the evidence is now bearing that out and as the risk benefit ratio changes with the different strains of the virus it also matters but the point of this talk is not just about that it's very much about when people present with things and what are we doing to improve their immune systems basically and how do we allow them to heal on their own because we don't always find a diagnosis and even if we find a diagnosis it's still important to think well hold on a second what should we be thinking about for this person how do we how do we go about assessing them and how do we go about [Music] um maximizing optimizing their immune system so we're not trying to suppress their immune system which is for example what a drug like a steroid would do we're not trying to overtly stimulate the immune system we're just trying to optimize how the body functions that's it and then allow the person to get better now this doesn't mean that they will never need any other treatments and I also want to stress obviously this is not something there's something very individualized I'm not telling anyone to do this that or the other this is not something that you should do alone this is something that should be done with medical guidance um to come back to this lady so about a month after her second covert vaccine she developed a very sudden onset of um of marked fatigue pain in her forehead fainting episodes she'd had a whole raft of tests before she came to see me by other doctors she'd had a CT of her brain which was normal her blood pressure was normal her ECG the electrocardiogram of the heart was normal and she was really suffering she had extreme weakness in her legs her heart rate was very high she was feeling generally lousy and she said that she'd never experienced anything like it before in her life there was no fever there was not much to find other than these things like the heart rate being high her feeling just awful um and at the time I saw her did some blood tests and I suggested a few different vitamins I didn't give her any standard medications because there wasn't anything clear to treat and um she um I I started her on some vitamin B3 which was otherwise known as niacin um and don't take that without making sure it's a particular type which is called flush free but either way don't do it without a doctor I started her on some vitamin D to optimize her levels and I also gave her coenzyme Q10 which is otherwise known as ubiquinol or ubiquinone um there wasn't any significant Improvement anytime immediate so these things anyway take time to work but she this this story went on she was having Tremors she was having leg numbness she'd been seen by Specialists nobody found anything very thick and that's not to say that there wasn't anything wrong she's not unlike a number of other people that I've seen in other doctors I know of who've seen and we spoke about this in a previous video that we did recently we were speaking about pot syndrome and certainly her symptoms were at least in part very much aligned with POT Syndrome and POT Syndrome is not something that you get any very specific results there are very few tests that you can use but it's a basically a clinical diagnosis and the treatment is is clinical for a lot of people um she wasn't sleeping she had muscle stiffness she was getting contractions in her neck and her hip and she said that even holding up her head in front of her own computer was difficult at times so she was basically started on uh I started her on various vitamins I'm not going to go into too many details because I don't want people to take it as though this is what you should do in such a situation but they were all supplements that that there were suggestions that they may not be at optimal levels and I decided to try them because they are very very safe and because I knew the doses of these vitamins that are considered safe and because I was able to monitor them so to repeat blood tests a few weeks later and see where she was at and see what the levels of these vitamins were as well um there were a couple of vitamins which I'll mention now she she had me I gave her some thiamine and alpha lipoic acid and she noticed that the numbness in her legs and the muscle twitching helped was helped dramatically by these uh by these but a lot of her other symptoms remained um there she felt that her symptoms were starting to improve but in a non-linear fashion um but um over the ensuing weeks and even months there were improvements but then there would be flare-ups of symptoms in between um her her heart rate which was very high went back to normal so it went back to 50 to 60 sort of level um uh her insomnia settled down completely um she had been having breathing difficulties which I didn't mention earlier specifically but that's something that she had and that improved as well quite dramatically um and this went on for a few months so she was actually doing a lot better but she was still having intermittent very significant flare-ups and around this time so it's a few months later now I decided to test her for her levels of Omega-3 and omega-3 is a um it's a very important fatty acid it originally comes from certain types of seaweed fishy the seaweed we eat fish or we don't eat fish but that's where omega-3 comes in in good quantities and good forms um and um so I sent off a blood test her levels and her levels were quite low now I then supplemented her with a specific type of Omega-3 and literally within days she came back to herself um she you know it was it was really quite dramatic how quickly and it was very clear that this was let's just say it was the the last button that needed to be pressed but probably a very significant button um and that that that was that's her story and she's she's doing very well now she's doing absolutely fine um and if you were to ask me well what do I think caused her problem or what um you know you know which of these things was responsible for her for her recovery it's not so clear to say it's not like I can say uh if you do X Y and Z then you will get better but it's about trying to do the things that make sense what works for an individual person according to their response according to their levels and of course making sure that they don't have a significant medical problem that's being missed um and therefore you're treating them incorrectly full stop um but many of these supplements can be used in addition to doing other normal Medical tests and treatments if necessary so it's not it's not this or that I wanted to ask about that actually it's like a medical safety netting I mean you mentioned the the uh the the postural tachycardic syndrome the the POT Syndrome where the heart rate increases dramatically I mean up to very high numbers when the patient stands up and can make them feel pretty bad presumably pretty dizzy and yeah yeah yeah yeah yeah I mean I mean one thing surely tachycardia is often caused by anxiety um it can be caused by anxiety it's one of the causes tachycardia meaning a very fast heart rate above 100 some people say even lower levels but classically at least 100 plus um so yes anxiety is one of the causes of tachycardia and certainly a person who's feeling all these symptoms one of the elements to their symptoms could become anxiety in itself [Music] if you're asking about safety netting it's very important that you safety net throughout doing any any kind of treatment Full Stop in medicine irrespective of whether it's with vitamins or with regular medications and she was pretty well safety netted so I kept a close eye on her checks her Bloods saw her fairly regularly um yeah the reason the reason I mentioned that was being slightly mischievous there that I've talked to so many people who have had symptoms like this that don't quite fit into into a category they know there's something biologically wrong with them and so often because doctors don't know what's wrong with them they say this is a psychological problem and it's just it adds to the frustration and the annoyance so so if we take that postural tachycardic syndrome if you're anxious your heart rate will be fast when you're sitting as well as when you're standing you know it's an obvious change isn't it and um do you think that it's a fundamental error that doctors can fall into that they misattribute an organic physical disease process for something which is psychological psychogenic psychiatric in nature I think I think it's complicated in the sense that you can certainly number one someone could first of all just have a psychological problem and those could be some of their symptoms um I think that you're right that POT Syndrome uh of course it the tachycardia does get worse when you stand up or when you exercise in general when you change posture so that should be a clue to not treat this as only anxiety but you can also obviously get a physical illness or you can get a mix of the two one causing the physical illness causing anxiety or anxiety eventually causing a physical illness so it's it's a bit difficult to separate sometimes and um and I think that very often with the amount of time that doctors have with their patients it can become frustrating for the doctor and at some point the doctor says well I can't find anything therefore it's possibly psychological and you should get some counseling or take a medication that's based on the psychological premise now um however big however I do think that very often we have the opportunity to check things that we don't typically check and which certainly in my experience have paid off very well for the patients that that you could find a an underlying let's say either an underlying medical problem or a concomitant medical problem so someone's has also got something else going on and the approach that I'm talking about is really trying to take everything into account so it's not saying that there's no psychological element it's not saying that there's no physical element it's trying to say what are all the possible elements here and how can we treat this person in the safest way possible with safety netting making sure that we don't miss something and making sure that the person is actually getting better and that's that's that's the approach that I'm talking about I really like the interventions that you carried out in this case because there were very low risk interventions so some drugs that we give you mentioned steroids that are associated with a lot of potential really quite dangerous side effects where I was correcting nutritional deficiencies is is a very we we would never say anything safe but it's just it's probably about as safe as an intervention as we would uh as we would carry out and uh you know the idea of trying something even if it doesn't work out if it's something safe to try then that's just a very attractive approach to me not doing harm it's a humble way to work I think that's the yeah I think you know I mean the Hippocratic Oath that says it um uh it says first Do no harm actually it doesn't quite say it that way if you read it but it's uh there's the classic interpretation of the Hippocratic Gophers first Do no harm and I think that it's a good way to practice in general that we first aim not to harm and then afterwards we aim to do good and that might not be so intuitive to everybody you would think that the job of a doctor is first do good and then do not do harm but what the problem with that is that sometimes we can think that we're doing good but we haven't considered the harms first so I think it's important first to to consider the harms and then first do no net harm would be a more accurate way of saying it um I was interested that the the this lady improved dramatically with the omega-3 but that doesn't necessarily mean it was the omega-3 because it already corrected some other deficiencies so it could have been that right she needed three or four deficiencies corrected and then when you put that last correction in all of a sudden you know everything was in place and the body was able to to heal itself absolute absolutely and um again this is just we're just talking about really low risk interventions um and I could have just told her to eat fish every day but that also had some risks believe it or not um so uh um the the the point being that um I was going to say Omega-3 supplements are available in vegetarian form as well from Marine phytoplankton yo yeah they are actually and the one that I gave her actually you know I can't remember the one that I gave her I mean there are two forms that I know of um where I live where they're high quality purified um from sustainable populations of fish as well one of them is is a fish form and one is actually a vegan form it comes from seaweed not not from the fish at all um um if you look up some of the literature also about um covid and I'm not saying that hers was due to covert I actually my impression was that in her case it may have been due to the vaccine but it really doesn't matter covered vaccine or any other cause um in in the literature it talks about neuroinflammation and we know this I've spoken to a number of my neurology colleagues who have described various um effects of both the virus and of Co and of the vaccine and also other viruses and other reasons why people may have what's called neuroinflammation which basically means inflammation inflammatory changes seen in the brain and so and and omega-3 potentially is something that could help with that and yes it could have been the final um the final buttons press as I mentioned earlier after having corrected various other deficiencies um that this was the thing that made the difference you know this is a bit of speculation here but this lady's symptoms so um could to me be explained largely by Central or peripheral nervous system inflammation as you've said um so the leg weakness that could be explained by peripheral nervous system problems difficulty walking and standing leg numbness tremor the the postural hypertension again could be an autonomic um dysregulation the fainting the insomnia the muscle stiffness the head pressure that comes and goes unable to function out of the house all of that and and the idea that the way she was feeling was qualitatively different from how she felt before all of that potentially we wouldn't know without a fairly sophisticated tests but all of that could have been potentially a neuro-inflammatory um and if or potentially neuro-inflammatory manifestations I mean I think that these were neuroinflammatory manifestations um on the subject just to go back a moment to what you were asking earlier when you were talking about the anxiety element um the thing you know when I asked her Afters what do you think is along the way I was asking her what do you think is helping is this helping is it not helping and um one thing that she thought was actually important was just knowing that somebody believed that her symptoms were not psychological and I think it's important that we give people the benefit of the doubt whenever possible unless something is floridably obvious in front of your face that something is very much psychological very often people have symptoms that we can't explain and that's difficult for us as doctors okay we grow up in a system that that divides the mind and body quite a lot and with time over the years we all learn to see more and more clearly the connection between the two so I think I would encourage more doctors around the world to do nutritional screening profiles to identify potential um deficiencies of simple nutrients that people people might be suffering from it and then to correct those with with really quite simple very low cost interventions I I would tend to agree with you but that's my own personal experience um yeah I can't really add anything to that yeah and and this lady now um she's quite a bit better she's doing great she's doing great she's back to normal she was back to normal months after this started and this went on this was a little while back that this all started I think the only other point I'd like to bring out is that you were trying something reassessing modifying reassessing it's it was a cyclical process a sort of spiral process of improvement but um very much very much a process well it's very much a process I mean as all medicine should be it should we should not be you know we we need to engage our thinking in medicine all the time and just because someone's on even if they're on three different medications for diabetes high blood pressure um and cholesterol let's say our aim shouldn't be to keep them on them our aim should always be to challenge them to to to prod them to encourage them to try and get off things and to to do more exercise to stop smoking whatever it be um and all of these things should be an ongoing assessment as you know nothing should be automatic um the pressures of of day-to-day practice can make things that way but making things less automatic also makes medicine far more interesting engaging um rewarding both for patients and for doctors and you're also treating the root cause rather than giving symptomatic treatments which is another very attractive uh feature to me or of your approach to this particular patient well that that is the reward that is the reward actually knowing that there are many times that we can actually get people better rather than um just dampening down their symptoms or hiding a problem as it were indeed Dr Cohen fascinating thank you very much always great to have a success story and uh I'm sure we'll get a lot of interesting comments on that uh on that video and keep an eye on my channel and Dr Cohen's Channel because I think there might be more to come but for now Dr Karen thank you very much for that thank you John take care you too

Channel: Dr. John Campbell

Views: 259,276

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

Id: 4N7wQrcxO7k

Length: 23min 47sec (1427 seconds)

Published: Mon Jan 30 2023