Episode Sixty-Five – When It Doesn't Work

Carolyn McMakin, MA, DC Kim Pittis, LCSP, (PHYS), MT

0:03 Okay to not be okay 8:23 What do you do when it doesn't work 13:17 Tarlov cyst, phantom limb pain 14:37 Rating pain 18:09 Expectations – doctor-patient relationships 26:46 All the tricks in every bag 32:13 Athletes sometimes hurt themselves on purpose 34:24 Listen – becoming an ally 38:14 What interferes with frequencies – the stable state 40:28 Asking good history questions and being realistic 43:49 Concussion and Vagus 45:42 It's not about the frequencies, it's about the big picture 50:39 FSM and lung fibrosis 54:01 Kims quote

Episode Sixty-Five: Video automatically transcribed by Sonix

Episode Sixty-Five: this mp4 video file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Kim Pittis:
And I got the cutest comment the other day. I had quite a few comments the last two weeks asking if I was okay and all these things. I don't know if I looked tired or stressed, but yes, a lot of things have been happening in my bubble, but on Instagram and basically on Instagram, I plan out my social media posts one month ahead of time, just like I plan out my personal Game Changer podcast and our podcast topics.

Dr. Carol:
Which impresses me. It's like, how do you even do that? I'm lucky to get time for breakfast.

Kim Pittis:
Well, so am I. And this is why, if I don't plan as much as I can, then I don't eat. Children don't get fed. Dogs don't get walked. Patients don't get treated. So this is how I function. But anyways, the last four weeks I had highlighted mental health and mental health awareness in my social media posts, and people were very shocked when I said that. I talked to a therapist and I was like, I think I hope everybody has somebody to talk to should they want to. But I love talking to my therapist and yes, I am okay. And it's because I have a therapist and friends and people like you that I am okay.

Dr. Carol:
There have to be times when it's okay to be not okay, at least in response to a situation or something that comes up. It has to be okay to be not okay for a period of time. I have trouble with not okay as a lifestyle choice. I have trouble with that. Yeah. It's like, you're entitled to be bumped. That is an appropriate emotion for you in response to this situation. And then as the person who's listening, this is the reason I'm a terrible therapist, is I'm a fix it guy and I want to fix stuff. When you're a therapist or sometimes just a friend or sometimes a doctor, your job is not to fix it. It's to support the person who's having the response. And letting them be where they are at this so they feel accepted. It's I don't post those moods on social media because there are too many people that worry about me already, so I'm not going to tell people, yeah, having a bad night.

Kim Pittis:
Right. And to each his own. Like I. But I have.

Kim Pittis:
What's that?

Dr. Carol:
I think what you did was wonderful.

Kim Pittis:
Thank you. It felt good. It felt like the right time. I had been like, I have three teenage daughters, and I worry about what social media does to their brains because it's something I didn't grow up with as a teenager. It was hard enough just being a teenager, going to school and hearing about the stuff you missed out on, let alone actually seeing it in your face that you weren't invited to the party or you don't look like that person or blah, blah, blah.

Dr. Carol:
When you or even me, when we were in high school, there was there were always groups and cliques and there was always the mean girls and always girls, I guess there were mean guys, but.

Kim Pittis:
It's just different.

Dr. Carol:
All girls. Yeah. So there was always the main girls, but now the main girls have social media on which to be mean. And so instead of their six or eight or ten closest friends who say mean things to whoever. Now those they've got 150. Yeah. From all over the country or all over the world. Join in at being mean.

Kim Pittis:
Exactly.

Dr. Carol:
And that's.

Kim Pittis:
It's not okay.

Dr. Carol:
No.

Kim Pittis:
And to your to carry over all but the mean girls there's a mean girls with teenagers and then we develop into grown women and there's still mean girls there's still there.

Dr. Carol:
And I know about that.

Kim Pittis:
We know that. So part of the reason why I posted part of why this is going to be a good segue way slash introduction to our sort of topic today that we're going to try to address. Is there is always there is a time to be real. And that's what I value so much about you as a friend and a mentor is you level with people, you're real, and when something works, it works. And when something doesn't, it doesn't and all the stuff in between, it's just real. And so the reason why I posted what I want to post because it's a very real moment I was having and I was looking at my social media history and it looks very nice, right? And that's the whole reason I'm having a professional social media person is there's delicious food, there's smiling faces, there's healthy bodies, there's treatments, there's all the things, happy dogs.

Dr. Carol:
It's all the A sides.

Kim Pittis:
Yeah, but there's. It's the other side that gets us to the A side, right? There's the yucky days that make the great days so great. And so that was my part of just being real this month of there's going to be burnt dinners and dog walks that don't happen and chats with your therapist because that day really sucked.

Kim Pittis:
But, here are some other strategies to get you back on the other side to your point. Having a bad day, bad week, bad month is going to happen. It's how you choose to put those steps in place to. Get back on track again. That's what I value so much about working with athletes is there is always some sort of progressive step for betterment. We can all learn from that.

Dr. Carol:
Yeah, and the being real part for me applies to my relationships with patients and my relationship to myself. I think I talked about last week. A patient that came in was just. She's her presenting emotion is anger. Yeah. She doesn't think of herself as an angry person, but she is angry with the receptionist on the phone. She comes in and she lays in, not at me, but saying, You're going to be mad at me because I'm still doing that thing that makes me worse and you told me not to do. And that's. Wait, you're mad at you. Why would I be mad at you? You're choosing to keep yourself sick. That's a choice. Go for it. And if you want to come in with that kind of attitude and energy, you can leave it in the parking lot. Don't bring it in here with me. It's 2:00 in the afternoon. I don't need it. You don't get to do that to me.

Kim Pittis:
Yeah.

Dr. Carol:
So it was not invalidating her emotion. You can go be angry someplace else. You just can't do it to me. And that's okay as a therapist. Especially with chronic pain patients. They are entitled to be desperate. They're entitled to be frustrated. They're entitled to be angry at the last three guys that either didn't help or make them worse. They're entitled to be angry that they were told this surgery would help and it has crippled them permanently. And they're entitled. And our job, at least my job, the way I approach it, is to validate the emotion, tell them how brave they've been. And tell them we will find a way for you to have a life.

Dr. Carol:
So that's the conversation that was the topic for today that I warned you about last night. Yeah. What do you do when it doesn't work? So I have a patient that flew out here from New York in a chartered jet plane of some sort. She said it wasn't a Gulfstream because she can't sit. She had a surgery on her sacrum that made her much worse than she was before. And she researched the doctor. He's the best in the country for Tarlov's cysts. And that was two, four years. That was four years ago. She hasn't been able to sit. She can't do this. She can't do that. She's in constant pain. And she's been with me two weeks.

Dr. Carol:
FSM always works for nerve pain. Always works for facet generated pain. We've had. One, two, three, four, five, six, seven treatment. And if she's a one or a two when she gets up off the table, it never lasts till she gets to the parking lot. Never lasts overnight. So yesterday was the conversation that, this isn't getting it. We finally had her last MRI reread by somebody that actually looked at the film. And she has a stress fracture as a result of the surgery in her sacrum. Okay. So the radiologist that reread the film said you need new imaging. And she's got a stress fracture that she's had for four years. Okay. I can't fix that I don't think. And yesterday I told her that I said, you're not going to stay another two weeks. I'm not going to waste your time or money. I'm not getting that. If FSM is going to work, especially for nerve pain and bone pain and it lasts at least 24 hours. We're not getting it. But, then I listed the things that she can do. And then I made eye contact and said, You will have a life. It will be different than it was four years ago. But you will have a life. We can try these things. Are there risks? She said. And it's like, of course, always and we work through those.

Kim Pittis:
Yeah.

Dr. Carol:
And yes, you're leaving on Thursday because I'm leaving for San Francisco Thursday night. Yes, you're leaving on Thursday. But we have text message and we have email. And I will hold your hand through this. And she's got tears leaking from her eyes. And you reach out and you give her a hug. It's going to be okay. It'll be different. But it's okay.

Kim Pittis:
And I was thinking about your text so much when I woke up this morning, because that's when I got it. Because I shut my phone off now at 9:30 p.m.. And even with my children, they know unless they have a fever of 106 or on fire or have a bone sticking out, its like you have to leave me alone at bedtime. Got your text. And it was so funny. So many things ran through my mind this morning because first I thought, how spoiled are we that in all the years I've known you and have known FSM and have been practicing with it, we expect so much out of it. And in the very rare instance, it doesn't work. It's a bit of a gut punch. I'm like, What do you mean it didn't work and didn't work with you? I get it when other practitioners, when it doesn't work, but with you. And then I thought, where else is there a practitioner and a method and a tool that is so foolproof that when it does right, so reliable, that when it doesn't work, it's like, wow.

Kim Pittis:
Because there are so many patients that see so many. Best in the world practitioners doing cutting-edge treatments. And it doesn't work. And it's because nothing ever works 100% of the time. So that to me was what we take so much of what we do for granted.

Dr. Carol:
And with nerve pain. If it was something else. So I assume that the pain at her sacrum was the S3 nerve root because there was a centimeter-and-a-half Tarlov cyst. After the surgery to remove the Tarlov cyst. There was still a centimeter and a half Tarlov cyst at S3. So I assumed that the nerve root was just butter. And left heel was numb and hypersensitive. So that's like phantom limb pain, right? So the stuff that always works for phantom limb pain and for fixing the nerve, and she'd get up off the table at a zero. And by the time she got to a parking lot, it was back to a. It's interesting with nerve pain. She came in rating her pain at a six or seven, and then I gave her the verbal descriptions. So we have a pain diagram that has words instead of numbers.

Kim Pittis:
What are some of the words like sharp, bright, prickly?

Dr. Carol:
It's like distressing and I have trouble concentrating on other activities. Slightly bothersome. It's a laminated sheet and I don't know where I got it and I can make a copy of it and put it in the Advanced.

Kim Pittis:
It would be interesting to have for sure.

Dr. Carol:
So she looked at the words and she said, I'm terrible at numbers, but oh, it's a three or four. And I'm thinking, Well, I live at a three or four. If my pain is below a three, it hasn't been in, I don't know, 18 years, but you just keep on. Yeah. It's different for nerve pain. Nerve pain may be a three or four, but there is something visceral about it. There's two parts to pain. One is how much it hurts. The other is how much you mind it. Yeah. So it hurts a three or four, but you mind it, a seven. She's never been athletic. She's never worked outside the home. She raised four children. She had a sheltered and comfortable lifestyle. Her Husband was in finance. So. She's never had to deal with pain before. So to have this be the first thing that hits her. Of course she's going to mind at a seven. No, you're not being a wimp. This is real. Pain levels are three. And nerve pain bothers you a seven. And I've done everything I know. When you can get rid of phantom limb pain for four weeks with one hour of treatment. Hello. So that's where our expectation comes from is just mileage. If she'd walked into a practitioner who's taken the Core and lives in New Jersey and that practitioner had to deal with this complex patient. Okay. You keep trying and get frustrated and say I'm doing something wrong.

Dr. Carol:
For me, I'm still maybe doing something wrong, but I'm doing everything I know. To do that usually works. And that's worked at least 20 to 50 times before. So when it doesn't work, what is your ethical responsibility as a clinician, as a practitioner? As a human. So there's a point at which during the clinical experience where you're the clinician. And then at some point, especially yesterday for me, you encounter the patient as a person with compassion and not false hope, but at least options. She was already devastated because FSM was her last hope. She got on a private plane and came across country. And scheduled herself for four weeks with me. And I'm telling her at the middle of week two or three, they're going home on Thursday. We're done. It's not going to happen. Can't get it done. And. This is what we can do. This is what you can try. And maybe a person can help you once we do these things, once we know what's going on. I need new imaging. I've no idea what's going on inside our sacrum. So that was why the text came in. And it's like I turned my phone off after I sent my last text message at 11:00 at night.

Kim Pittis:
Yeah, I don't know. Again, I was sitting with that because our. Obviously with me dealing with sports, FSM is never the only thing that a patient is doing. There is this plethora, this multitude, this dream team that is behind an athlete. You've consulted on some very high-end cases. They have an entourage. There are multiple factors that go into what's getting this patient better. And when this patient does come back two months early. Yeah, we can all say it was this or it was that. Perhaps it was the sum of all the parts. We don't know what it was. But when you have a chronic pain patient that's in that case of where it is just pointed and so specific on you and the treatment. That is a lot. That is a lot to unpack as a therapist. It's a lot of expectation and hope that the patient has. And like anything, there's a lot of buildup, right? I'm sure she's very excited coming in to see you. Getting to see you. It's the beginning of a season or like New Years. You have all these hopes and then reality creeps in. And like you were saying, you have not just a professional responsibility, but a human to human heart to heart sort of moment where you're like, I'm sorry, but I can still support you. It's it's just it's sad. I guess at the end of the day, it's one of those real and sad sort of moments that we have.

Dr. Carol:
Yeah. And it was really interesting how anxious she was when she came in. So it took a week for her. So four two or three-hour sessions to begin to see me or trust me as a person. So when she first came in. It was the clinician, it was the book, it was the social media, it was the YouTubes, It was all that. And then by week two. It was. You could see her relax. And then. I actually don't remember when our first session was. This was week two or week three. And as you develop a relationship with the patient, especially when they get out of pain, at least for a while, and they find out that you care enough to look for what's wrong. I was the first person out of everybody she's seen in four years that led her through the anatomy, the neurology, what it could be, instead of just throwing drugs at her. They put in a spinal cord stimulator and it didn't work. Wow. Spinal cord stimulates work even for nerve pain. And it didn't work. It's like okay. And at the same time, another new patient showed up at the same time as her. And he was seeing he lives in Oregon, but he went down to California and saw a pelvic floor trigger point specialist. And they've been treating trigger points in his pelvic floor and in his groin, and there was sensitivity in his boy parts.

Dr. Carol:
And I was the first one that went back to, let's do a neuro exam. And there's neurologic hypersensitivity at S2 and S3 three. And he was the one I talked about that he has to have an S2 disc since. Nobody has done lumbar x-rays on him and he's had this for two years. And he's seen that's a good face. So I write it on a piece of paper. Have your GP do lumbar x-rays and his go-to posture is to contract his rectus abdominals. When he gets anxious, he contracts his rectus, which bends his sacrum, which increases his pelvic floor pain. So the other thing we did besides FSM to get rid of the nerve pain, get rid of the trigger points, was put him in the gym and teach him posture and use the Transverse and the obliques and to leave the rectus dominus lengthened and use the Transverse and the obliques to stabilize his lumbar spine. And he's athletic. So there are answers for him. And the treatment is lasting. So on any given day you may have some of each. If we had just done FSM for the nerve, the disc, the little mini hernia, if we just had FSM, it wouldn't have lasted. You had to retrain his posture. Retrain how he uses his body.

Kim Pittis:
That's obviously. That's why I love doing Sports Course so much, because that is what blows my hair back all the time. That's the fun stuff. I want to go back to the patient that left, though, for a second. Have a couple of questions for you for her. So obviously you didn't just do one or two treatments with no success. You saw her. How many times do you think? Seven times.

Dr. Carol:
At least. Yeah. And each session is 2 to 3 hours.

Kim Pittis:
And you're trying different things, obviously. You're going with strategically, statistically would work the best based on history, based on your mileage, based on all the objective findings.

Dr. Carol:
There has to be objective findings when you. You have to look where you start.

Kim Pittis:
Right. That's where the logic and the science behind this originates. And then you have to start going into the creative lateral recesses of your brain when it doesn't work. But when you've exhausted that. So what is it? Why didn't it work?

Dr. Carol:
Leif in the Q&A is saying, why can't you do torn and broken in the bone for the stress fracture? The problem is she has osteoporosis. Her vitamin D levels are 50. It should have healed in four years and it didn't. She needs new imaging focused just on the sacrum to find out what's going on. Then the radiologist that read her film from February of '22 said she also has arachnoiditis. That the radiologist that read it in February didn't mention the stress fracture, didn't mention arachnoiditis, didn't mention… All he mentioned was venous engorgement. Excuse me? In a perfect world if you could immobilize a structure, and if it was in a place where it could heal, it takes six weeks to heal a stress fracture. I'm not going to have her stay here for six weeks and lend her a CustomCare and a convertor to treat the fracture every night. So go home and see if you can figure out whether it really is a stress fracture. Whether when they cut the roof off the sacrum, did they… They use a bone saw. Right? It's a bone saw. What if it zigged when it should have zagged? What if it's not a stress fracture? What if there's a chunk of bone land on the O.R. floor or laying it in the bucket in the O.R.? That just was an oops.

Kim Pittis:
Right.

Dr. Carol:
Stuff happens. It's. Yeah.

Kim Pittis:
I don't you think.

Dr. Carol:
We did roughly the same thing for three days. And then when it became clear that wasn't going to work, I said, let's pretend that you have a torn S.I. joint. Let's pretend that you're SI joints are lax. And so we taped them and she was good for two days. And then when it got worse, she got scared and they took the tape off. Then when I put the tape back on, because it felt different it frightened her. So some of this is her emotional response to the pain. Everything scares her. And running the emotional frequencies is not the thing. It's all 40/89. It's all centralized. So I used all the tricks in the bag every single day that she was there. I had six units on her. She was from neck to feet to treat the cord and the thalamus. Two from back to front to treat the dura, the arachnoid, the fracture once I found out the fracture was there. One to treat torn and broken in the connective tissue in case the joint was torn. And one from sacrum to feet with increased secretions in the nerve, trauma in the nerve. So there were two units just running on 396, two units running on the cord in the midbrain. Two three units. So where am I? Two, four, seven. Yeah. Three units running from the sacrum to the front to treat the arachnoid, the bone. We even did the spinal segments. So S1 segment is to zero. There isn't a frequency for S2, S3, and S4 but I made them up. So yesterday I ran those sacral segments. Didn't do anything. Didn't touch it. Okay, fine. There's just no more rabbits in the hat.

Kim Pittis:
To me, because you had made a dent in the pain though, during the treatment that to me sparks a little bit of hope. But the fact that she can't get to the car is not good.

Dr. Carol:
And there's always the patient that says, it's always better when I lay down anyway.

Kim Pittis:
Yeah, sure.

Dr. Carol:
Okay. Does it go to a zero? No, but it's better when I lay down. So in her head, she's not sure that it's doing anything, so I just. And I leave Thursday, and I don't get back until the following Thursday and. I. Yeah, I don't. I just. Yeah.

Kim Pittis:
Yeah. Like I said, it's a part of being just real and like, you're not expected. There's no possible way you're that good that you could fix the entire planet like we have. You're amazing and you can fix amazing things. But every human, every thing has a limit. And to your point, maybe there's enough emotion behind it that's just not there yet. Right. That's just not ready to be fixed.

Dr. Carol:
I agree. There's a piece of that in there. And that's not something you tell them.

Kim Pittis:
No. And they're not aware of it. But I think once you've been in practice for a long time. I've even seen it with athletes who you would think are chomping at the bit trying to get back faster. There is always a component to certain people that are worried about what that comeback is going to look like.

Dr. Carol:
Yep.

Kim Pittis:
Will it be like that? Is it easier to just stay injured right now?

Dr. Carol:
Yeah, and shes got disability insurance so is this a time to hang it up even though I'm just 28 and I could do two or three more seasons. But. Yeah, No, I get it. And then there was there's the professional golfer that I saw back in the day, and he would. He had facet generated pain. He had SI joint problems. And we gave him exercises. There were things he wasn't supposed to do. We treat him. He'd get better. As long as his manager was out of the office, out of the treatment room. When his manager was gone, he'd say, I've been doing this for 18 years. I'm just ready to retire. The manager is pushing him to get treated because he's the manager. The patient kept doing dumb stuff because he wanted to stop playing golf, and if he was consistently injured enough, then he could retire. It's just.

Kim Pittis:
That's very it's very interesting. Another selfless, selfish plug on the FSM Game Changers podcast that comes on every two weeks. I'm too busy. I talked to you once a week, so I can't possibly talk to other people. I had the honor and privilege of having Andy O'Brien on, so that should be published today or tomorrow. Andy O'Brien is a brilliant exercise scientist. He's worked with the best of the best in all sports all across the planet. And we were talking about generalization versus specialization with athletes, with professions in professional sports. And I've always been in the bubble of jack of all trades, Master of Nothing, has no place in health care or no place in professional sports. The practitioners I've worked with, have all been very good at what they do. At their bubble. I've seen amazing therapists, amazing chiropractors, amazing trainers, FSM practitioners. And they're just very good at what they do. So we were talking about with athletes, there's been this big shift in getting 10,000 reps and to be to have mastery at something. Now I can say now that's a good face. And I get it. To get really good at something, you have to do it. To be a very good dressage rider wasn't rocket science. I had to get on a horse a lot more than I was.

Dr. Carol:
Four times a week for two years and I.

Kim Pittis:
Had the strongest core I had ever had riding as much as I did. But that's a whole other episode. But what we're seeing right now on the healthcare front are teenagers with repetitive strain injuries. And what I was saying, when he's hot and I'm like, no, 20 years ago you would never put teenager and repetitive strain in the same sentence. Like repetitive strain injuries were for old people that did stuff like scanning groceries all the time. So movement patterns have become redundant neurologically and psychologically. And so just to piggyback off of what you're saying, I was seeing a teenager for a while who really wasn't getting better and questioning my methods and I wasn't just doing FSM. There is a ton of manual therapy, exercise therapy where he was working with other people. And the one day the parents weren't in their room and I'm like, How's it going? How's everything going? School, friendships. Talk to me. We've got an hour. I want to hear all about your life. And tears from the kid. Ms. Kim I just don't. I'm just so tired. I just don't want to do this anymore.

Dr. Carol:
Oh. Okay.

Kim Pittis:
And that's what I said. I'm like, All right. I just don't want to get. I just don't want to get better. I just don't want to do anything. I'm just tired. And my heart broke a little bit because the weight of the world was on this kid's shoulders. But what an easy fix.

Dr. Carol:
Yeah.

Kim Pittis:
You get to find something else that brings you joy. Yes. And I'll help you have a conversation with your mom and dad. And I'll help you have a conversation with your coach. Whatever you need me to do. Let me help you.

Kim Pittis:
Because you're not getting better, and that's not cool.

Dr. Carol:
Yeah. So you became his ally in that moment. You turned into a person who would listen to him.

Kim Pittis:
I know we have a lot of patients that listen to the podcast, and we probably have a little bit more practitioners that listen to us. So practitioner to practitioner, don't discount that personal relationship that you develop of not just being the fixit guy. And I get it. We want to just fix everything. But like you said, you become maybe the only person in their corner at times.

Dr. Carol:
That listens to them.

Kim Pittis:
Like really listens.

Dr. Carol:
I can guarantee I am the only one that will take a one or two. My new patients are 3 hours. And if I can do a one-hour history, great. But if the history is tangential, it's nonlinear or it's complicated. You all have histories that go 2 hours and they just go. Nobody's ever asked me that. Well, and you have to get to know all the features. And then because you had so many visits with him, you had a relationship with him. And there's a question from Jane wondering what can interfere with the frequencies with some individuals. The challenge that we have, it says besides interference from other electromagnetic fields, there are there is no other there is no interference from other electromagnetic fields. No. That's not a thing. We work on professional athletes that just never get off their phone. They're watching videos in the training room. Watching videos, talking to their manager, talking to their girlfriend, just because they're used to being effectively a piece of meat. Yes, you can work on me and I'm going to do my thing. So it's not interference from electromagnetic fields. The challenge with FSM is you have to treat the right thing with the right thing. So this kid with the pelvic floor pain. Like they had been using one on as treasonous onto his pelvic floor muscles, all that stuff and trigger points.

Dr. Carol:
Nobody had ever done a sensory exam. Nobody had ever shown him. Thank you. Nobody had ever shown him a picture of the S2 disc. And why did I do that? Because when I measured the sensation in the S3 nerve root right around his body parts. Okay, that's not normal. So why the results don't hold? That's a stable state. I can get rid of nerve pain. I can get rid of all the trigger points in the pelvic floor. Okay. How do you get it to hold? And dealing with the emotional side of him was amazing how sensitive he is, given his background. It's like. He talks about, I want to be able to feel closer to people and I have this resistance. He's the only one in 27 years of doing this where I ran increase secretions in the posterior pituitary because his blood pressure is low. And given circumstances in his early childhood, it's a pretty good chance that he doesn't have much oxytocin. Okay, let's try it. So we did it two days in a row and his is blood pressure stayed normal. He got super stoned. And he said, I feel better. And he bought a CustomCare and a converter. A CustomCare. So it's the person. It's the stable state.

Kim Pittis:
Yes.

Dr. Carol:
Teenagers with repetitive strain injuries, especially if they're playing like baseball. They don't have any testosterone until they're 19. That's another conversation. So you can't put tissue back that's not there.

Kim Pittis:
Yeah.

Dr. Carol:
And you can't make a bicycle into a car. You can't. There's. Yeah.

Kim Pittis:
And it's funny because when we deal with a certain demographic all the time, we just have certain assumptions, certain presentations that these people are going to come in with. And becoming a better listener has helped me really see every individual that is walking in, not just stereotyping, thinking, Oh, this is just another football player, This will be easy. It's no, this is a person with this history, with these emotions at this time. And I've started to ask new questions with my history and with my interview. I definitely don't do a two-hour or three-hour and take I can't I'm not there yet. In my skill set I'm not sure that it's so necessary. I do ask my patients to give me as much information via an email before so I can try to at least ask the right questions when they come in. But I've been asking especially new patients and when I've seen somebody for a while and I recheck. Sometimes you do a longer visit after a while to redo an assessment. So I'll ask them. Tell me about what it looks like when I've helped you rehabilitate from this injury? What is your life going to look like?

Dr. Carol:
Exactly.

Kim Pittis:
And sometimes it's instant joy on their face. I'm going to golf and I'm going to walk my dog more and I'm going to cook dinner all the time. And sometimes there's that flash of panic. Geez, I haven't gotten that far yet. I don't know. I've been in pain for so long. I can't imagine my life without it. And I used to say things like, tell me how I can help you or tell me what you think. That's also been something like, How can I help? I'm not going to fix it. This is a partnership. But how can I help you? And sometimes their feedback is completely unrealistic. I want to go to the Olympic trials. I'm sorry you're 76 years old and that ship has sailed. But let's get you out of the walker first. How about that? Let's get you going to Safeway. Again, going back to the practitioners and going back to being real, asking really good questions and being really realistic with your skill set. Again, I had talked to Andy and we're talking about the importance of having your bubble of practitioners that you can call on a moment's notice and ask a question to. And that's what I value so much about his relationship and my relationship with some of the other trainers that I've had on is I can ask them in a split second, what would you do for this? Or this is what I'm seeing. I never feel stupid when I ask questions to this group because it will come back. They will say, Kim, have you ever seen this? And I never think for a moment this guy is so stupid. He just needs to open up Netters. And he would see that because we all see things with a different lens. And like you were saying, you're neuro centric that you and you've seen so much in your professional history that you just can't unsee certain things for the good or for the bad.

Dr. Carol:
Concussion and Vagus. That's the other thing that gets run on almost everybody. Because the vagus nerve regulates the immune system and reduces inflammation. Anybody that comes in with digestive problems or immune system problems, one of the seven or five machines that's running on them is running concussion and Vagus. And then there are the patients. It's like the problem she came in with that bothered her the most was burning mouth syndrome. And I always thought that was a 12 deficiency sort of thing. But she stuck her tongue out. The tongue was pink, no ridges, not red, not B-12. Her red blood cells were normal, but she had really good testing. And just like you're allergic to gluten. And she's sitting there eating saltine crackers every 3 to 10 minutes. The whole time we're talking. I don't know anything about burning mouth syndrome. So I looked it up and it's. Oh, it's related to food allergies. So. Yeah. I can't help you with burning mouth syndrome until you stop eating gluten. Oh, okay. That's off the table. I can treat your swollen knee. I can treat your left shoulder. I can treat your neck. And we'll turn the Vagus on to get the inflammation turned down. And we can help your leaky gut. That's easy. You are the one that's in charge of burning mouth because you eating gluten every 5 minutes is perpetuating it. Okay, fine.

Dr. Carol:
So sometimes it's not about the frequencies. It's about the big picture. How do you get things to last? One of the questions is how do you get it to last? It's got to be a stable state. Physical, mechanical, Emotional. Immune. Immunological. Neurological. The stable state.

Kim Pittis:
The learning never stops, does it?

Dr. Carol:
No. And I'm sorry.

Kim Pittis:
It's funny, I was talking to my therapist last week and we were talking about something and she said, Kim, there are many steps to success and they never take the line that we think they're going to. And there's been some really neat MEMES that I've seen about zigzagging, and you see a person on a step going, Oh, I only have this far to go. And then you see how far they came, right? And again, try not to compare yourself or your path to somebody else's path. So I think that also is an important step as we're working with these patients that have been through the wringer, that have seen so many things. Sometimes we can get really myopic in our thinking because we're going to see tainted, but we're prejudiced sometimes. And especially yourself. I remember I was up in Portland with you. We were doing one of the pain and injury modules during COVID together, and the patient had come in that we did. Used as a demo. And I think he was about to get a spinal cord stimulator or patch or inject something. And you're like, No, oh, no. And he was like, Oh, but I heard they're so good. And you're like, I'm sorry, I they could work. I've always just seen the ones that have failed or that had all the things. And there was that moment where you're just like, Yeah, I guess it could have a positive outcome, but you don't see those positive outcomes because they never see you if it had a positive outcome.

Dr. Carol:
That's the thing. It's I admit that I have a skewed view. That I only see the failures. The challenges that the surgeons see them at week two and most of the time, with the exception of my hip surgeon, most of the time, the surgeon never sees them one or two years later when the surgery has failed. Surgery has a consistent side effect that is specific to this surgeon. There's one neurosurgeon in this area where my patient had weakness and atrophy and C6 after a disc C-5-6-disc in the waiting room, this patient met five other patients that had exactly the same side effect.

Kim Pittis:
Wow.

Dr. Carol:
And it's. So I only see the failures. That one I admit. So. Radiofrequency ablation of the nerve roots. One of the most validating events of the last five years was last year. In the core. We had a physiotherapist, pain management specialist, psychiatrist who's in his fifties. And I went off about Radio Frequency ablation. So you are off RF a joint. For those of you that don't know. They insert something that creates heat and they kill the nerves in the joint. They also cook the cartilage, cook the capsule, but they kill the nerves. Okay. Now. That typically provides relief and it lasts 6 to 12 months. And when the nerves grow back, it's like trimming a rosebush. You cut one and you get three back. And when they come back there, they have an opinion about what you did. They're sensitized. And this physiologist who used to do RFs until he found out that they didn't work. Sitting there nodding. And I looked at him nodding and said, thank you. And he said, I don't know why they still do them. The research doesn't support it. They know for sure that they're going to have to redo them in six to 12 to 18 months. And they know that after a period of time, they simply won't work. And then you get to insert a spinal cord stimulant above the level. Right. And it's so. There you go.

Kim Pittis:
This podcast went by. This was the fastest podcast we have ever done. Linda has a question. Is FSM beneficial for treating lung fibrosis.

Dr. Carol:
What's it called? Idiopathic pulmonary fibrosis, IPF. We did a research, I did with two chiropractors in the state of Minnesota and a researcher in Minnesota. We did a three-day, four-day research project with eight patients with idiopathic pulmonary fibrosis. Some were very progressed. Most of them were on oxygen. Idiopathic means they don't know where it comes from. This researcher from the university had a model that said that it starts because of mechanical problems at the base of the lungs because it always starts at the bottom in the back and the fibrosis from the bottom up. If it was something they breathed in it would start from the top down. And so we worked based on her model. The psoas. The quadratus lumborum, the pleura and the lung tissue. Didn't make. About 50% of them improved temporarily. Nobody got worse. No change or got a little bit better. And she wanted to do a larger trial. She's not a clinician. And I pointed out to her inclusionary and exclusionary criteria how to design a study and risk assessment. And she had never thought about the placebo group. She had never thought about crossovers. She had never thought about what happens when you treat it. The biggest problem with FSM and idiopathic pulmonary fibrosis is you can't put tissue back that's not there. In a perfect world, if we knew what was causing it, we could slow the progression. I could always make my dear friend John. Who? Had a lung transplant than a double lung transplant because of IPF. I could always make him feel better for two days, but he had to run for them to reduce inflammation and for hypoxia. So it's a temporary palliative fix, but for a condition that is universally fatal. Unpleasantly so. That's okay. That's not. And will reducing inflammation reduce the fibrosis?

Kim Pittis:
Right.

Dr. Carol:
Maybe. It's. I don't. But it's worth a try. It's not like anything else helps. So that's why I treated the lady from New York. It's not like anything else is going to help. It's always worth a try. Hi.

Kim Pittis:
What an hour. What? My heart feels like, filled somehow. I don't know. This was a good one. This was a necessary job. Today.

Dr. Carol:
It's sometimes it's not about the frequencies. It's about how you think and who you are in relationship to yourself and in relationship to your patients. That's right. So what's your closing quote for today? I can hardly wait.

Kim Pittis:
So it doesn't really fit, but maybe it does.

Dr. Carol:
Okay.

Kim Pittis:
Because. So the phrase is. This is from my athletes. Focus on you until the focus is on you.

Dr. Carol:
Do that one again.

Kim Pittis:
Focus on you until the focus is on you.

Dr. Carol:
Okay. You're going to have to translate that one for me.

Kim Pittis:
So the athlete has to do the work. You have to put the focus on themselves. And when they do that, the external focus will become onto them. So it doesn't really fit this podcast so much, but I think it does because if I'm going to extrapolate it and make it work, which I'm good at doing, it's also putting the focus back on yourself as a human, as an honest, caring, empathetic individual, because that's why most of us go out into the field that we did. And taking care of ourselves and being real with our limits and being real with ourselves.

Dr. Carol:
And then there's the what? I didn't teach you what I couldn't teach you that.

Kim Pittis:
You can't sprinkle that now as we're about to leave.

Dr. Carol:
I'll put it on the website. People can look at it and bring Kleenex.

Kim Pittis:
Yeah. I Yes, but it's the same sort of situation, right? It's not just about the frequencies.

Dr. Carol:
Yeah. On that note, I'm going to go talk to RSD patients.

Kim Pittis:
Yes. So tell us where we can find that. That's on Facebook live right now.

Dr. Carol:
Facebook Live in about now, 3 minutes ago. At RSDSA on Facebook, it's the RSD support something. SA. I took our basic RSD presentation, cleaned it up, and yeah. And I told them not to be nervous because I have 58 slides to do in 45 minutes.

Kim Pittis:
Oh, you got this.

Dr. Carol:
Yeah.

Kim Pittis:
Have a great chat with RSD. We will tune in and watch and we will see you next week.

Dr. Carol:
See you next week.

Kim Pittis:
Hi, everybody.

Dr. Carol:
Have a good one.

Kevin:
The Frequency Specific Microcurrent podcast has been produced by Frequency Specific Seminars for entertainment, educational, and information purposes only. The information opinion provided in the podcast are not medical advice. Do not create any type of doctor-patient relationship, and, unless expressly stated, do not reflect the opinions of its affiliates, subsidiaries or sponsors or the hosts, or any of the podcast guests or affiliated professional organizations. No person should act or refrain from acting on the basis of the content provided in any podcast without first seeking appropriate medical advice and counseling. No information provided in any podcast shall be used as a substitute for personalized medical advice and counseling, as expressly disclaims any and all liability relating to any actions taken or not taken based on or any contents of this podcast.

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp4 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including upload many different filetypes, share transcripts, secure transcription and file storage, automated translation, and easily transcribe your Zoom meetings. Try Sonix for free today.