Episode Sixty-Four – RSD/CRPS
Carolyn McMakin, MA, DC Kim Pittis, LCSP, (PHYS), MT
0:21 Kim's other podcast 2:14 RSD/CRPS 4:29 Onset of RSD/CRPS 8:49 Tarlov Cysts 10:21 Phantom limb pain 13:46 Penis pain, pelvic floor, trigger points 20:25 Cystic condition 24:13 Low back pain 27:48 Omentum toxicity 31:40 Brain fog, breathing 36:22 Two ways to detoxify stress hormones 41:59 Being a Game Changer 43:17 Pay attention to what's in front of you and take it apart 44:10 Missing history solves the problem 49:10 Headaches 54:16 FSM Advanced Event, FSM Sports Course, San Francisco FSM Practicum 55:38 Kim's quote
Episode Sixty-Four: Video automatically transcribed by Sonix
Episode Sixty-Four: this mp4 video file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Dr. Carol:
Hi. Hi.
Kim Pittis:
It's so funny. I'm good. I'm good today.
Dr. Carol:
Oh, good.
Kim Pittis:
It's been a… It's been a… It's been a couple… It's been a week. It's been good.
Dr. Carol:
It's been an interesting week.
Kim Pittis:
Yes. It's so funny. I was talking to. So I have my Side Hustle podcast, right? Which I've been trying to do my interviews Wednesday mornings because let's face it, Wednesday is podcast day. And we're friends, this trainer and I that I've been talking to. And I almost forgot that I was doing a podcast. Very similarly, how it is when I talk with you. And we got off of it and he called me after and he that was the funnest interview I've ever done! And I'm like, that's the style. I just love picking people's brains and if there's some education that flows from it, I think, bonus. And we've been getting some unbelievably great comments about the podcast lately.
Dr. Carol:
Yeah, I love those. There's so much fun. It's like okay. Everybody bring a cup of tea and glass of water and come and hang out.
Kim Pittis:
It's just so funny because it really has come full circle because this is how I interacted with you when I first took FSM because it was on DVD back in 2007 and I was in Switzerland and I had babies and I would get my cup of coffee during nap time and I would just watch slides and listen to you. And now look at us.
Dr. Carol:
There you go. This is how we interacted in the kitchen the first time you came up to help teach the three-day Pain and Injury. And we tell stories and have fun. And there's two things I'm really excited about since I usually derail whatever train track you try and get us on. I get that over with at first so then you can get back on the track.
Kim Pittis:
Get to business.
Dr. Carol:
Two things. Next Wednesday after our podcast. There is a Facebook Live podcast on the RSD Facebook page. RSDSA page. What does the S-A stand for? I don't remember. Anyway, the people that organize it saw the RSD video and tracked me down. So I took the RSD section of the core and modified it into, this is what FSM is. This is how we think about CRPS or RSD. This is the mechanism as I understand it. And this is what FSM does to treat it. My problem is I haven't found anybody it doesn't work on and even I don't believe that.
Kim Pittis:
For the laypeople that are listening or watching. CRPS stands for Complex Regional Pain Syndrome. And RSD is the new term or the old term?
Dr. Carol:
Old term. It's Reflex Sympathetic Dystrophy. And they change the name because it doesn't affect reflexes. Sympathetic. And it has to be pretty bad for the skin to get dystrophin. So they locked six neurologists in a hotel room over a weekend and made them come up with a new name for it. Complex Regional Pain Syndrome means even less than RSD. But what can you do? So that's what I did for a good portion of this morning was work on those slides. It just got me all excited about treating RSD, CRPS again because it's not like you can make them worse. There is. These people have no hope. Zero. They do sympathetic blocks at T-12.
Kim Pittis:
Why don't you talk a little bit more about like, onset and who these who this condition affects? Just again, we have a lot of laypeople listening, so I just think it would be helpful.
Dr. Carol:
Okay. So the onset is usually something trivial and peripheral. So I've seen it from the first case was from a tetanus shot. The I've seen it from a sprained wrist of in the "Resonance Effect" it's a tibial plateau fracture with a cast that was too tight. Neck injury, nerve traction injury, wrist sprain, ankle sprain, something peripheral. And it's in somebody that's neurologically susceptible. They tend towards sympathetic dominance anyway. And the peripheral inflammation, the inflammation at the owie, causes the nerves that attach at the sight of the owie to disconnect. They just go (baaa). That's the technical medical term for it. They disconnect, and when they disconnect, it's hyper hypersensitive to soft touch. And the first 6 to 24 to 48 hours, it's freezing cold and wet because the sympathetic nerves are still connected, but they're hyperactive. So you get all sweaty and cold like an extreme case of stage fright. And then after that the sympathetic nerves disconnect. And so you have all the nerve pain. You have hypersensitivity to soft touch and the sympathetic receptors proliferate. So let's say you had ten to start with. Once you disconnect the sympathetic nerve, the peripheral tissue sprouts like mushrooms. So you go from ten receptors to 100 trying to attract a sympathetic nerve. And so those receptors in the blood vessels are sensitive to epinephrine and norepinephrine from the adrenal glands, not just from the nerves.
Dr. Carol:
So the area gets super cold because you get vasoconstriction, but it's dry because the sweat glands only respond to sympathetic stimulation from the nerve. So it's pretty fun to treat. I blow past it in the core because it's complicated. And by the time we get to nerve pain, everybody's brain-dead anyway. And in a class of 20 or 40 people, there'll be four or five that ever see or treat CRPS. So I blow through it and tell them to study it on their own time. But it's super fun. To me it's super fun to treat and you don't treat it in the middle of a busy day because it's so much easier to just get it finished in one treatment. Just get them to zero the first time. On pain medication. On 1200 milligrams of Gabapentin their pain level is still a six or a seven, and the affected limb is any place from 5 to 25 degrees Fahrenheit colder than the unaffected limb. Sometimes it spreads. So Adam had it in his right leg and his left leg and both hands were achy, so it had spread to certain parts of his brain. Anyway, so on the YouTube channel, if you just put in Frequency Specific and RSD, you'll find the video where Adam had a flare up. He'd had RSD for 15, 13 years.
Dr. Carol:
He had a flare-up and he happened to be working that seminar and we were videotaping it because it was important. And so we caught it on film from beginning to end, from the physical exam to the treatment to teaching him to walk again, to getting the muscles to work again. Teaching him to walk again. And it was done. It was permanent. Never came back. And that was like the ideal. And in the real world it's not always that simple. But that's how this group found me. And that reminded me of the other thing I wanted to tell you about, which was; patient I saw this week had tarlov cysts which are little outpit pouchings in the dura, the meninges, around the nerve roots. But her's were in the sacrum. And, that's a good face. Save that face because it's going to get better. So the surgeon was a specialist in tarlops cysts, and he took the roof off of the sacrum. So we took the back off of the sacrum and he drained one of the cysts and took another one and just wrapped some stuff around it and compressed it to shove the… See, that's the face I was anticipating.
Dr. Carol:
And the patient came in a week ago with her left heel numb and hypersensitive. So that's S1. The back of her leg on both legs painful and her sacrum painful. I assume the sacral pain was from having it cut off and then put back on. And I treated inflammation on the nerve and increase secretions in the nerve. And about the third day that I treated her, I thought to myself, What if the S1 nerve root is so damaged that it's like phantom limb pain? So when the physical exam is numb and hypersensitive, that's like phantom limb pain. You can't feel it and it hurts. So I did 40/89, which is what we do for phantom limb pain. And her left heel didn't hurt. And then she came in the next day and my left heel is still a two, but my sacrum is just a six. When is the sacrum, not the sacrum? And then you look up at the diagram on the wall and you pretend that you remember. Then you pretend that, of course, it's the S3 nerve root. S2 is the back of the leg. S3 is like a target right on your butt over the sacrum. That's S3. So I ran 40/89, phantom limb pain, from the neck to the sacrum. And from the next to the heel. And she left with her pain of the two.
Kim Pittis:
Cool. So 40/89 on two machines?
Dr. Carol:
Yep. Because I wanted to target both nerve roots.
Kim Pittis:
Yeah.
Dr. Carol:
And this lady flew from New York in a private jet because she can't sit. So then we started treating. Why can't you set? Because it feels like I'm sitting on rocks. So then I palpated. Free basically, or pelvic floor and the females which are as one as two. So I did increase secretions in the nerve because reducing inflammation in the nerve didn't do anything. If you have a nerve that's not working, how do you force it to work? You run increased secretions in the nerve. And her butt just melted. The rocks went away. The spasticity and the malaise and the pelvic floor went away. So. That was my day yesterday.
Kim Pittis:
Sorry.
Dr. Carol:
And the patient after her was released somewhat similar. It was a patient who came from California. Pelvic pain specialists, trigger point specialists. He's had this for two years. And pelvic floor trigger points. Exquisite pelvic and testicular pain. So you look up at the nerve diagram on the wall and it's like testicular pain and pain in your penis. Two and S3. Pelvic floor trigger points S2 and S3. You know how the sacrum doesn't usually have a disc? If you google S2, S3 disc. Sure enough, some people do. So what if somebody's posture while they're sitting, puts their tailbone and their sacrum and a lot of flexion? He was sitting a lot as a student. So what if his sacrum was in a lot of flexion? What would that do to the S2 disc?
Kim Pittis:
Compress it.
Dr. Carol:
Yeah. So what if you had a disc bulge at S2? And you inflamed or irritated the two nerve root. What if? So I traded from his sacrum to his crotch. Inflammation in the nerve. Subacute disc. 80% of the pain was gone. And said, I don't treat muscles. I treat why the muscles are tight. Having pain in your penis and pelvic floor trigger points doesn't make any sense unless you figure out why to interpret. So two patients right in a row that made my brain hurt.
Kim Pittis:
Yeah.
Dr. Carol:
It's like they get on a bus and God says, you really should be aware of the S2 two and S3 three nerve roots.
Kim Pittis:
Yes. And then you get on the podcast and we can share this information with the rest of us, because now that you're saying this, I do remember hearing the anomaly of having sacral discs, but it's one of those classes that you take it goes in one ear, you hesitate. Your like okay, whatever, and then it goes out the other and you never go back there. Because why would you?
Dr. Carol:
Because you never see it til you do.
Kim Pittis:
Until you do. And to your point, you talk about being Eurocentric, and I value that. It's just such a objective way of starting because regardless if you're Eurocentric, remember your target. Your intent is to always just not make them worse. Yes, but try to bring the pain down. And the only way you're going to bring the pain down right away, regardless of where it started, is by starting with the nervous system. So always start there and then you can start thinking, why? Yes, we got the pain down. 40/89. You tried 43/396, 81/396. But why is that nerve doing that? Or trigger points.
Dr. Carol:
Because some well-intentioned neurosurgeon basically destroyed the nerve. That's the bottom line. She has phantom limb pain from S1 to S3. And for that matter.
Kim Pittis:
Would you or did you try or would you have tried nerve trauma at all? Did you try all of those?
Dr. Carol:
Yeah. Treated the nerve first.
Kim Pittis:
Yeah.
Dr. Carol:
And she left with her pain. Her pain is always better when she's laying down.
Kim Pittis:
Like, supine.
Dr. Carol:
She can't lay supine and has to lay on her right side.
Kim Pittis:
Lateral recumbent.
Dr. Carol:
And the interesting thing is that there's two possible models for that. One is that if she still has tarlov cycts, because she had two MRIs in 2018 that showed that there was still a centimeter and a half tarlov cyst at S1 and S2. And, whereas, in most people, S1 and S2 are separate nerves. During the surgery, he noted that S1 and S2 were joined. They were one nerve root, and then they split after they got out of the cauda equina then they split up and came out of the foramen. But she still had two relapses in 18 and 22. The MRI said venous congestion. And that's okay. Where did those go? So when she's laying down, are the troughs draining or the thing about phantom limb pain is that if you have. Phantom limb pain. If you have central sensitization, anything peripheral that happens. Becomes centralized. So anything you do peripherally. So if I worked on her ankle, it would have increased the pain because anything you do peripherally increases the central pain, gets turned into central pain. So it was it's and God said, you should know about us two and three. And who I would never, ever have remembered that S2 an S3 are the penis and the testicles. Who knows that? I didn't know that. And there it was, right there on the diagram. It's like on the wall. There's that thing. No wonder that hurts. Let's try treating the nerve. And it was mostly gone.
Kim Pittis:
So these patients that came in to see you waive your magic wand and they're in and out. And how long do you suspect their pain reduction is going to last?
Dr. Carol:
It really depends. Some of them go home with CustomCare's because they need maintenance. The lady from New York is going to have a CustomCare just because there's nobody on the East Coast that I know of that she wouldn't scare.
Kim Pittis:
Leif put in a quick question here with that person. Could they not be treated with cystic condition? I believe that's one of the constitutional. Right? Is that what?
Dr. Carol:
The cystic condition is 59 and my problem with that is I've never found anything it's good for. Makes this go away. So patient with breast cyst. Did a four-centimeter cyst. We treated it for cystic condition, redid the ultrasound 20 minutes later, nothing changed. Treated it for inflammation and toxicity and reduce the cyst by 40% in 30 minutes. So I'm still looking for something that's good for, but it's worth a try. We never know when it's going to work or under what circumstances.
Kim Pittis:
And those are part of that column right from the Advanced.
Dr. Carol:
Cystic condition, I think is even in the Core.
Kim Pittis:
Is it?
Dr. Carol:
It's on the Channel A list and we never use it because I don't know of anything it's good for. But the young man with the S2 disc. It was his second treatment. Monday I spent 4 hours with him because that was the night I didn't get home till 9:00. So got him down to baseline. He came in. He was still doing well, treated him some more. And then as a finish-up, Susan got him into the gym and put him on the reformer, and got him to use his transverse abdominals and exhale as he used his muscles instead of holding his breath and inhaling. And increasing intra-abdominal pressure. Because along with all of this stuff that was going on, he had a little teeny hernia. Little teeny one. Like not an actual surgical hernia. One ultrasound said he had one. One ultrasounds that he didn't. So I ran torn and broken in the connective tissue and 81/142 for an hour and a half as I worked on the nerves and the floor and the muscles and all that stuff, and at the end of it instead of any, it was like firm. So he will probably not need a CustomCare I hope on Friday. He goes back to. I guess he's only about an hour and a half away. So we just drive. And so I think we'll be able to get him functional with exercises to do at home. And if it comes back, I can get him back in. So it really just depends on what they have and how likely it is to be lasting.
Kim Pittis:
My brain is still all over the S2 disc right now.
Dr. Carol:
If you have your phone, Google S2 disc and you'll see the MRIs. It's right there. There's actually a perfect MRI of L5-S1, S2-3. Two complete discs in the sacrum.
Kim Pittis:
And that was so funny. That was just going to be my follow-up. Are they like micro discs, but they're actual the same. Like they are disc, discs.
Dr. Carol:
The 2-3 disc was really tiny because it's so small there. I guess that's one of two. Yet the S2 disc was a disc. It's not as big as L5 S1 Because the bony structure is smaller. But it was right there. So I keep my phone on the counter so I can search for things while the patients are stoned and they know that I'm looking up. Is this a real thing?
Kim Pittis:
I use my phone on my laptop all the time. Sometimes I'll just be like, I just want to show you a picture of something. Meanwhile, I'm just trying to confirm, like, my hypothesis, like you said. Is that real or not? Because so many of us treat obviously, low back pain is the number one ailment Americans have right now as far as pain goes. But to take it from low back pain, where we're so inundated with it's the muscle, it's the nerve, it's the cord, it's the dura. And then you start to think that you're savvy because you're treating the S.I. joint like a sprained ankle, because that's how I talk to my patients. And I try to show them how the SI joint moves, how these joint surfaces. And I have knocked low back pain out of the park by just treating inflammation or torn and broken in the joint surfaces of the SI, because when… I'm very pelvic-centric, everybody knows that. So when I'm assessing gait and I'm looking at the dominance and I'm looking at the front of the ASIS and how it matches up with the PSIS, and I'm looking for symmetry. And there's never any symmetry. When we start thinking about the shear forces that happen when someone's SI or nominace are locked in a, to borrow your term, cattywampus fixation, you have to go to, that joint is torn and broken. There's tearing in the SI joint. Like people. It's hard to wrap your brain around that, but now you start throwing in discs in the S2. My brain can't handle this stuff.
Dr. Carol:
Now it's even worse because his low back pain was an issue too. They had fussed at him because his lumbar curve was so accentuated. And so he had low back pain. Almost all low back pain is facet joints. And then I asked him. Did you ever have a kidney infection? A kidney stone? No. Did you ever fall flat on your back? Oh, yeah. When I was about 10 or 11 he was playing on the monkey bars and slipped and fell flat on his back. And then in middle school, he played football and he got tackled really hard. And he said, does getting the breath knocked out of me count? Yeah, that would do it. And so the first thing I did was treat adhesions in the ureter to get the psoas to release. So if you have somebody with a pelvis that's cattywampus, you have to look at the psoas. And if you're going to treat the psoas, you almost always end up treating scarring in the ureter scarring and the kidneys, sclerosis and the fat pad. The psoas releases his low back can now flatten. His pelvis is now movable and the strain on the. So now he can flatten his back. And S2 is not under compression, it all fits together. But I started. The first thing I did to him was get rid of the trigger points in the psoas.
Kim Pittis:
Yeah, when I was in college, the first thing that we're taught from an osteopathic manual therapy model is if you're going to treat someone's low back pain, you have to start supine and treat the abdomen. You have to release what's happening anteriorly before you can even attempt to see what's going on on the posterior side.
Kim Pittis:
But that gives me a segue to a very cool story that I had this week. And it's so funny how the universe, God, whoever throws these little nuggets at us because we were talking about Hannah a couple of podcasts ago. I'm not sure if it was the last podcast or the one before that. And Hannah's mom, Heather, came to the last sports course that we had in Arizona. She came to the Sports Advanced, I think. And I spend a good chunk of time talking about treating the psoas and the organs and all the things that are lying on top of the psoas. And I have this really cool slide of the omentum. And in the class I said is that a made-up Canadian term? I've never heard of the word omentum before. And Heather stood up and she just, she's like, excuse me, Kim, for a second. And she started talking about the omentum and how exciting it was and just this big glorious fat pad. And she was talking about the omentum has permeability and can store things. So I was totally stuck trying to treat someone's anterior. I couldn't get even close to what I needed to get at. And it felt like the omentum, it felt like the fat pat. I tried sclerosis, I tried everything. And do you know what worked? Toxicity.
Dr. Carol:
No way.
Kim Pittis:
Yes, way. Blew my mind. We talk about smush all the time. But this was a whole. It was like that when we talked about the rocks. Thixotropy when something goes from solid to liquid and it was like, if you have Jell-O and you left it out on a hot day and it just liquefied, I sunk in and I was trying to be calm. I looked at my patient face and she was like, "this is smush"!
Kim Pittis:
I'm like elbows deep into her abdomen. And it was the most amazing thing. So talks. And I almost always just. If I try 397, sclerosis in the fat pad and if that doesn't work I go off of it right away. But I heard Heather and I'm like, I just, I knew it was still 97 and toxicity was what spoke to me. And after 2 minutes it was done.
Dr. Carol:
Amazing. And the omentum is immune active, incredibly vascularized and it's got lymphatics and immune responses. And it's vascularized. But I never thought of it storing toxins. Okay I'll put that on my to do list. And we'll add it the Core or their brains really will explode.
Kim Pittis:
Absolutely. And all of this is in my advanced sports class because even that is a lot to take in for just a basic sports course. But again, I just had so much gratitude. Here we are teaching people and then our patients and our students are constantly teaching us.
Dr. Carol:
You treat a patient, you learn something.
Kim Pittis:
Absolutely. And I just have so much gratitude because of the practitioners that take the course, because they come from so many different professions and backgrounds. It's not just a PT or a chiropractor or massage therapist. We have anesthesiologists, we have veterinarians, we have, you name it, and they all brought their plethora of information to help us.
Dr. Carol:
Different perspectives. It's pretty fun.
Kim Pittis:
Yeah. Yeah. There's a question says, Doesn't all fat cells store toxins? I believe so. Maybe
Dr. Carol:
There's there are people that do fat biopsies and send them off to get analyzed for toxicity and then they put you on glycine to help detoxify whatever. So I hadn't ever thought about that. It's like we're all exposed to toxins so much, and that actually makes you think about the protocol for brain fog. Yes, the brain is 85% adipose. That put two and two together. But in the brain fog protocol, there's 57, 900, 920, are toxicity frequencies, all with the cortex. I hadn't thought about that. That's the thing.
Kim Pittis:
There goes my brain again. But again, I want to touch on what you're talking about, going back to your patient who was on the reformer and teaching him to breathe and move. That is a huge and often overlooked component when we have patients returning to exercise or returning to just active range of motion is patients will hold their breath and they are so used to, whether it's in anticipation of the pain or bracing themselves for the pain or just bracing themselves, thinking that they have to hold their breath to tighten up their core. It works the opposite. In order for a muscle to stretch, in order for a muscle to contract, it needs oxygen. So getting that breath under control is huge. So kudos for you for for talking about that and for spotting that because it's often overlooked. And in order to sometimes get the diaphragm back on board again, because the diaphragm is not used to expanding and compressing the abdomen the way it's supposed to. So treating the transverse of dominance is a huge component like we have for abdominal muscles that transverse abdominals, like it's name runs transversely, it's our corset muscle. So that transverse dominance and the diaphragm actually have to work together to compress the core and also to relax it. So when we're treating diaphragm, I always tell patients and practitioners you have to treat the omentum first. You have to release anything that is on top of the diaphragm that would limit it from expanding and contracting the way that it should.
Dr. Carol:
Well, and if you look at the blows that he had on his. Oh yeah, and his hobby was boxing. If you look at the psoas and the quadratus lumborum, they interweave with the posterior surface of the diaphragm. So if they're locked up, the diaphragm isn't going anywhere.
Kim Pittis:
Absolutely.
Dr. Carol:
So you release that. And because his hobby was boxing. You do hold your breath and tighten everything to be able to take especially body blows. And Tuesday night, after he got off the reformer, as he's heading out the clinic, his question to Susan was, how soon can I go back to boxing? That's a good face. So that's the reason we have the gym at the office. We've got a reformer and just one pulley set and some free weights. And that's what we've got. And so we'll talk about how to find him a different outlet for what he enjoys about boxing. Because in order to get him back to boxing, it's going to be six months to a year of correcting his body mechanics so that he's balanced and strong and can work from his hip as opposed to. It comes back to not just getting them out of pain, but getting them back to a sport they love. And given the injury that they have, because sometimes the answer is no. Yeah, no, we'll find something else. How do you feel about shooting guns? How do you feel about some other outlet that gives you the same sense that this does? And when you look at how and this is the functional medicine part, when you look at his history, he is a person that always has to be moving. He's running or training or lifting weights or working out in the gym and he's always moving.
Dr. Carol:
And it's so. There are only two ways to detoxify stress hormones. And my question is, rather than. I don't know, $600 worth of genetic testing. My question is, do you have to exercise? Or are you a crazy person? And he said, Yeah, that if I'm not working out, if I'm not running, if I'm not doing stuff. I was so anxious and agitated, I can't stand it. And then you explain about Catechol-O-Methyltransferase and they go, what? C1-T. There's only two ways to detoxifies stress hormones, epinephrine and norepinephrine on the brain. One is this enzyme COMT, and the other is sweaty exercise. And there are two. You have a gene from your dad and a gene from your mom. So you have two copies of COMT. And for example, me, I've got. There's five versions of the enzyme. I've got half of four of them, and I'm completely missing the fifth one. Like, I don't have either copy of the fifth one. And I've got half of the fourth one. So if you look at my history before I got to be 60-something. I was a runner, basketball player. mountain climber, scuba diver, horse rider, runner, mountain climber, hiker. I was moving all the time. And then. So explaining that to him. So I get it. I'm not crazy.
Kim Pittis:
That's a huge component to anybody, any of us who treat any kind of patient. I think asking those valuable questions about exercise or who they were before they got to where they are now, because.
Dr. Carol:
Exactly.
Kim Pittis:
That is a huge part of the rehabilitation. I'm treating at least five or six patients that I didn't know were elite athletes back in the day. And the minute I heard that story, I changed the way I spoke with them. I changed the way the exercise rehabilitation went. I would talk to them like the athletes that they still are. I don't want to even say that they were because once an athlete, always an athlete, and they would do just anyway. Absolutely. They would just get the cues. We would talk about the sport that they played. So I would take them back to if they were a football player, I'd be like, okay, if I want them to just change their posture for a second, I'd say, I want you to pretend you're about to take the huddle and you just see the connection in their eyes. They know what to do. There's joy on their face. So I think we do want all of our patients to become as active as possible. And will they be a football player again? No. But if you can start using the right language with patients to build that just that inspiration of moving.
Dr. Carol:
Well, it's in muscle memory. There's sensory and motor cortex knows what that feels like. It's in their spinal cord. There's wiring for that posture. So knowing that I used to ride dressage and hunters. Core strength, posture, legs. You ride. And there's that. And then you have a patient that's a sedentary housewife. And has never been an athlete. We can't talk to her about that. But you can ask. Have you ever noticed that you're better or worse depending on what you eat? And she said, Oh, yeah. I said, How do you do with corn? And she said, corn and wheat, not good. And she said, I really like corn. And I said, so then you explain about rotation diets. So you can eat corn one day and that as long as you don't need it again for another week, you might get away with it. And then if you eat corn one day and you're going to be your joints are going to be sore the next day, then it's a benefit-risk ratio. I thought I could get away with corn. I found four little ears of corn in the store and went, Oh, that'll be so cool. And then next day I could make a fist. Now there's two more years of corn in the fridge. Maybe Friday night when I don't have to use my hands Saturday.
Kim Pittis:
It's so funny how you have to plan for what you eat like that. Cynthia wrote, If we don't have a metabolic pathway to digest a substance, it is stored in fat. All right. There we go.
Dr. Carol:
What does that mean? If you can't. Metabolic pathway as in the P450. So if you're missing your CYP182 is not present anything that would go through that pathway, you can't detoxify it because that part of the P450 is either really sluggish or not there. I think that's what she means. Yeah, interesting.
Kim Pittis:
I don't know. That stuff is like speaking another language to me, and which is why I'm very grateful that I have people that I can call and talk to about all these things. Going back to the podcast that I had this morning, some of the trainers that I've been putting on have been in the industry for a long time. A lot of them trained under Charles Paul Quinn back in the day. Yeah, and yes, the podcast is educational, just like you and I have education, but a lot of it is, I think, finding out what makes people tick. And one of the questions I like to ask people who have been in whatever industry for over 20 years, obviously. So my podcast is called Game Changer. So I'm like, what makes you a game changer? It doesn't necessarily mean you're doing something new, but. Being in the same industry for 20 years, you constantly have to be on top of things and you're reinventing and you have to be open to ideas because health and medicine constantly changes. And so one thing I value so much about our conversations is as long as you've been doing this, you're constantly asking questions and are being open to all the things that are happening, and that's what makes you so great.
Dr. Carol:
I don't think of myself as great. I think of the frequencies as amazing. It's like I would never ever have thought of an S2 disc if I didn't have a way of treating nerve pain that was 100% reliable. So you look at his crotch and you look at the diagram on the wall and the guy that came up with that diagram 150 years ago. Okay, so you go to the sacrum, you go to the crotch, you're on inflammation and the nerve and is testicular and penile pain goes away. Ergo, it is nerve pain. Right. And it's like a thing that makes you grow as a person and grow as a practitioner is being willing to pay attention to what's in front of you and take it apart.
Kim Pittis:
Yeah.
Dr. Carol:
Another patient. This patient I almost fired this week because she comes in universally angry. So this time I had two choices. One was to fire her. I said, You can't come in here and behave like that. That's just not okay. I don't need the attitude. I don't need it. So you want to get treated? We will collaborate. You want to mouth off and be angry. You're going to have to find somebody else. So boundaries good for all of you. And then she said and my dead digestion is always a mess. And it's like, when did your digestion start being a mess? I thought I had a uterine prolapse but the urologist said that it was my small intestine that was coming out. That's a good face. And so they. I don't even know how that's possible. Maybe because she'd already had a hysterectomy. So it wasn't her uterus? I don't remember. But they put mesh in on the pelvic floor, attached it to her sacrum. She said they attached it to a spinal cord. That's not possible. Attached it to your sacrum. Okay I get the mesh thing. And my digestion has been a mess ever since the small intestine obstruction surgery. Obstruction surgery? Just now when she first came in, she said, I have SIBO and I have mold. And that's what we've been focusing on for, I don't know, six, eight months. The four times I've seen her this time, she said. I asked the right question. When did this start? After the obstruction surgery. What caused the obstruction? I had this pelvic floor mesh thing put in and two weeks later I had a small bowel obstruction.
Dr. Carol:
Really? And then what happened? They went in and they unobstructed it. And then. Sorry I was in the hospital for three weeks and they had to do two surgeries, three days apart because they were trying to get it to obstruct without taking out the chunk that was ischemic. Now what people need to look at is Netter and the small intestine. And I wouldn't recommend googling what a bowel surgery looks like because it's really gross. But when they take. When they do an obstruction surgery, they literally take your small intestine, all 22 feet of it, plus the omentum. They fold the omentum up. They take the small bowel out and put it on a tray and saline and they find the kinky thing and they cut it out and then they sell it back together. And then they're not always tidy, especially if it's a teaching hospital. They're not always tidy about how they put it back in. They figure, Oh, it'll wind itself out. It'll figure it out. I've seen her four or five times and I've treated the wrong thing every time because I listen to her. It's mold. It's SIBO. We treated mold, we treated SIBO doesn't do anything. This time, I had one machine that ran 970/35 for anger for 60 minutes while it worked on the small intestine and the sclerosis and the omentum. For scoring. So I'm just that's the other take home messages. It's okay to make mistakes and miss things.
Kim Pittis:
You can't possibly knock it out of the park on every visit all the time because we're not given all the information all the time.
Dr. Carol:
We don't always ask the right questions all the time.
Kim Pittis:
No, that is very true.
Dr. Carol:
It's I believed her. It's Siebel and Mold. And it's no.
Kim Pittis:
We go from saying you have to listen to the patient to. No, just kidding. Don't listen. I know it's going at times.
Dr. Carol:
But yeah, maybe you have to do both.
Kim Pittis:
You do absolutely have to. I know even from an assessment perspective, people come in, they're like, I have pain on my left and I'm looking at their right side and they're like, I just said, the paint is on my left and I'm like, But your problem is on your right, and they are telling me this stuff. But again, you have to ask the right questions and use the skills that you have to the best of your ability and put it all together the best that you can.
Dr. Carol:
Yeah, just it makes it so much fun.
Kim Pittis:
Yeah.
Dr. Carol:
Why on earth are you still in practice when you're 76? It's What can I do that's more fun than this?
Kim Pittis:
That's a very good question.
Dr. Carol:
I hope you get home before 8:00.
Kim Pittis:
Right. Dana asked a question about headaches, which I think is probably good to touch on before we and I've been trying to figure out what teeth for headaches, but no luck so far with FSM. I'm guessing that even though I'm drinking the two quarts of water before and after and maybe it's hydration resistance in some way, which would in turn not allow the FSM to work.
Dr. Carol:
What? No, no, no. Headaches Depends on. Okay. At least in my world. Depends on what's causing it. Where is the headache? Is it this one around the back? That's from the Sub-occipital muscles. That's the supine cervical practicums. And it's not possible to treat that on yourself. You have to find somebody that you can train and teach them how to do the supine cervical practicums on you. Sometimes the headache is just right here in front of the eyeball. That's the C-2-3 facet. Which is also the supine cervical practicums. From when the air pressure changes. Any time on a sunny day, you're fine. On a day when it's raining, you have a headache, especially in the back of your head. That's the vagus nerve where it follows those little blood vessels into the back of the door. Sometimes you get headaches when you eat certain foods. Sometimes you get headaches because your head is like this. And what you need to do is activate your upper thoracic. Keep your nose horizontal. Do the supine cervical practicum. Keep your nose horizontal. And your nose is. You're in extension either because your glasses need adjusting or because you've got a 5-6 disc and you have to stay an extension to keep the disc from making your shoulders hurt.
Dr. Carol:
So when I worked for A-Hearst, it was right after Indral got approved for migraines and we had 6 hours, 7 hours of lecture from his last name was Diamond, and he had a headache clinic in Chicago. And we found out all about different kinds of migraines, different kinds of headaches, how many different kinds and what causes them. I had one patient one time came in with a terrible headache and she she said, Yeah, I wanted to make sure I was properly hydrated. So I didn't have coffee this morning, but she didn't tell me that till after I'd worked on her for 45 minutes. And it's, do you usually drink coffee? Oh, yeah, every day. I have at least one or two cups in the morning. And you didn't have those today? No. So let's go. Get rid of your headache. You go out there and you make yourself a cup of tea and drink the caffeine, and then we'll deal with whatever else is wrong. There you go. Dana, it's I think early in the day, like 25 years ago, hydration was a thing and now it's most people are normally hydrated. So a quart of water in the four or 5 hours preceding treatment, which is about four ounces an hour. You can do that.
Kim Pittis:
Yeah. Like, to your point, I treated a triathlete right after a 22 mile run, like literally ran 22 miles to my clinic to get a treat, ran or 22 miles and then came to get a treatment right after.
Dr. Carol:
That might be.
Kim Pittis:
But still wasn't super dehydrated. How to drink some water? It's electrolytes, but I mean. It's still very effective. So I have yet actually to find somebody where it wasn't working. I was thinking it was hydration. It was just me thinking I malfunctioned somewhere. My hypothesis was wrong. I don't ever go to it's not me, it's you. It's always me.
Dr. Carol:
So what kind of headache, what's causing it, and how can you think about it differently? And if you've been trying to treat yourself, I don't I've never been able to figure out how to do the Supine Surgical practicum on myself. We have 2 minutes left. It's not possible.
Kim Pittis:
No, it is possible.
Dr. Carol:
Get to your list.
Kim Pittis:
We never get to my list. My list. You should see my office. You've seen my office. But it looks like.
Kim Pittis:
Its not the right angle. It's the stuff that's behind the computer that looks really bad right now. The lists grow and grow. My ideas grow and grow. We get to bits and pieces of it. And here's the message for the day. Even the bits and pieces are going to be enough.
Dr. Carol:
Yeah, that's pretty fun.
Kim Pittis:
It is. It's really fun. Just my housekeeping notes that I want to get to. You guys have the end of year sale going on for Precision. That is something everybody who is listening, if you're a practitioner, you want to get in on these deals now because you can save a lot of great money.
Dr. Carol:
Because of the whole supply chain thing. The prices are going up in January along with gas and lettuce and everything else.
Kim Pittis:
Yes. And register for the seminars as well. Because your Earlybird prices start or end at the end of the year. I believe you want to.
Dr. Carol:
Things are coming right along. I'm pretty excited.
Kim Pittis:
I'm so excited. And the sports course, I believe has two spots left. So if you're still interested in doing the sports course, don't wait. Register today. Email Kim or [email protected].
Dr. Carol:
Absolutely. For those of you that have taken the Core on video, we're going to be in San Francisco next weekend, Saturday and Sunday for a two day practicum. And the classes, what we have ten spots left? Right now we're at 30 and we max it out at 40. So 30 is a big class, but it's there's.
Kim Pittis:
Always a lot of fun.
Dr. Carol:
Yeah, it is. It's really a blast.
Kim Pittis:
Okay, I have to. It's 4:00. I have my quote because my quote was a good one today.
Dr. Carol:
Oh, goody. It's always good.
Kim Pittis:
The world is changed by your example, not your opinion.
Dr. Carol:
Oh. Yeah.
Kim Pittis:
Oh, that just like a yummy one that just gets you right right here.
Dr. Carol:
And George used to say people learn more from what you do than what you say.
Kim Pittis:
Yes.
Dr. Carol:
Yeah.
Kim Pittis:
Yes. So thank you for doing good and being you and being such a good example to all of us.
Dr. Carol:
Thank you very much. And the same to you. Do good things.
Kim Pittis:
You too. Bye, everybody. See you all next Wednesday.
Dr. Carol:
Bye.
Kim Pittis:
Bye.
Speaker3:
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. FSS expressly disclaims any and all liability relating to any actions taken or not taken based on or any contents of this podcast.
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