E218: Dr. Jill Carnahan’s new book and film and approach to MCAS: MCAS Matters with Tania Dempsey, MD

Episode 218 August 13, 2024 00:42:57
E218: Dr. Jill Carnahan’s new book and film and approach to MCAS: MCAS Matters with Tania Dempsey, MD
The POTScast
E218: Dr. Jill Carnahan’s new book and film and approach to MCAS: MCAS Matters with Tania Dempsey, MD

Aug 13 2024 | 00:42:57

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Hosted By

Cathy Pederson Jill Brook

Show Notes

This is a not-to-be-missed episode between two incredible physicians: Dr. Jill is a highly sought-after leader in functional medicine and a survivor of cancer/crohne's/MCAS.  She and Dr. Dempsey compare approaches to treating MCAS, discuss Dr. Jill's new book and film, and describe some lesser-known treatment strategies like methylene blue with red light therapy. 

Connect with Dr. Jill at the links below.

 Instagram:  

 / drjillcarnahan  
Facebook:  
 / flatironfunctionalmedicine  
New Book: Readunexpected.com
Documentary: doctorpatientfilm.com
Dr. Jill's Website: https://www.jillcarnahan.com/

More information about Dr. Tania Dempsey and her practice can be found at https://drtaniadempsey.com/

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Episode Transcript

[00:00:00] Jill Brook: Hello, Mast Cell Patients and wonderful people who care about Mast Cell Patients. I'm Jill Brook, and today we have an episode of Mast Cell Matters, Deep Dives on Mast Cell Activation Syndrome, or MCAS, with our incredible guest host, Dr. Tania Dempsey, world renowned expert, physician, and researcher. Dr. Dempsey, thank you so much for being here today, and which of your illustrious colleagues did you bring with you today? Dr. Tania Dempsey: I'm thrilled to have Dr. Jill Carnahan here today. And let me introduce her for those who might not know who she is. She is an extraordinary functional medicine expert, and with incredible training. I'll give you a little bit of a a rundown of her training. She did her residency at the University of Illinois in Family Medicine at Methodist Medical Center, received her medical degree at Loyola University Rich School of Medicine in Chicago. She did her BS degree in Bioengineering at the University of Illinois and and she's [00:01:00] duly board certified in family medicine and integrative holistic medicine. She, her current practice she founded in 2010 in Boulder, Colorado called the Flatiron Functional Medicine, where she is widely sought after for treating a broad range of of medical issues and she has a very, very comprehensive practice there. She herself is a survivor of both breast cancer and Crohn's disease and is passionate about teaching patients how to live well and thrive in the midst of complex and chronic illness. She has a new book a memoir called Doctor / Patient that was just released in 2021 and has a new film and documentary about, about it as well. We're excited to, we're going to talk all about it. So welcome, Dr. Jill. Dr. Jill Carnahan: Thank you, Dr. Dempsey. I am delighted to be here with you. Dr. Tania Dempsey: Okay. So, Let's let's dive in. So, we're gonna, we definitely want to talk about your book and I want to talk about your film, but I'd love to maybe just start a little bit and talk about just your approach to medicine and what's [00:02:00] different about the way you practice medicine compared to, you know, the conventional way of thinking about medicine. Dr. Jill Carnahan: Yeah, well, I think you and I shared that we're conventionally trained, so we went to regular medical school. And it's interesting because I grew up on a farm in central Illinois, corn and soybeans. I was one of five children. My mother was a retired nurse who had to retire to take care of us five children. And I had this idea, like we grew up, I mean, we went to the grocery store, went to the doctor, but we did have a garden. And we knew that food was powerful medicine and like before we go to the doctor for maybe a cold or flu, mom would give us some soup and make sure, you know, soothe our fevers and like do some kind of basic stuff first as her nursing background. So I kind of grew up with the idea that our bodies could heal and that our bodies have the power to change and transform if we gave it the right inputs. And I didn't really know I was a healer back then, but I remember growing up really understanding the fact that we, toil the earth and produce crops and those organic crops actually fed us and my mom would freeze food like corn and and you know salsas and different things for [00:03:00] our meals and so I really understood this connection between soils and our human microbiome and our health but I didn't know that that I was going to be a healer, that I was going to be in medicine, and there was no one in my family that had been in medical school or in conventional medicine, except for nursing, so I was the first, and I actually first applied to like chiropractic, acupuncture, traditional Chinese medicine, because I had much more of a holistic philosophy, but then I remember the day where I was like, well, why don't I apply to medical school, and why couldn't I go there, and why couldn't I learn the best system that our, our U. S. reimbursement goes for, not necessarily the best for everything, but the best reimbursement, and then maybe, maybe start to change or shift the thinking. So I actually went in kind of a little bit like a rebel to think about like I want to learn because there's a lot of knowledge and importance here of value, but then also knowing that I wouldn't agree with everything and that maybe I could shift the thinking and I had no idea how big that would be in my life. Like that's my purpose. But I got this great training. I got this wonderful training. And you and I [00:04:00] love, I mean, that's the foundation of really like understanding the system. And if you get a heart attack or stroke, or you're in a car accident, you want the major medical system to take care of you because there's nothing better. But the world that you and I are now in, which is complex chronic disease, infection, toxin, mold related illness, Lyme disease, Epstein Barr reactivation, long COVID, and many other things like mast cell activation, which plays into almost every one of the things I just mentioned. There is not a drug or a procedure that's going to cure these people. And we know that. And we've lived through this ourselves in different ways and aspects, whether it's family members or friends. So I am so passionate about combining the best of scientific medicine, literature, research, and also this more intuitive, open minded approach that really takes into account the fact that we can heal giving the right nutrients and inputs. And I just am so passionate about how do we really teach not only doctors, but patients to be their own advocate, and actually really reverse the irreversible. Dr. Tania Dempsey: I love that. I could not agree more. [00:05:00] We could not have a more similar sort of background and, and passion for, for sort of changing the system and hopefully helping more people, right? The reality is that we have to educate and we have to help our patients you know, figure, figure out their own, their own illness, right? So we're, we're, we're after the same things. I love that. So speaking of MCAS though, you mentioned that, you know, it does it does affect a large number of your patients with complex chronic diseases. How do you see it in your practice? Do you have a sense of the percentage of patients? How it affects them? You know, I'm curious about your practice, let's say compared to my practice. Dr. Jill Carnahan: Yeah, so before I say that, if you're okay, I want to share just a little of my own journey because it frames everything that I see in clinical practice. So I grew up on a farm and I had very, very severe allergies and my brother had asthma. I didn't have the asthma, but I had horrible eczema. I literally would, my skin would be raw and bleeding. My, my both my arms, my legs, my throat. I mean, I was, it was a mess. It [00:06:00] was, if you've ever seen severe eczema and then my gut was a mess, and then I developed cancer at a young age, and then Crohn's disease, and looking back, I didn't know this until probably the last decade or so, the unifying factor in so much of my illness was mast cell activation, and one of the clues in my own history was, when I got Crohn's disease and realized my doctor said, you know, this is irreversible, you're gonna need immune modulating drugs, there's no cure. I mean, it was awful what I heard and I thought, well, that can't be true. And right before I left, I asked him, I said, well, doc, you know, does diet have anything to do with it? Because that's something I have control over and I'm willing to do whatever it takes. And at that time, I didn't know it, but probably due to lack of stomach acid, low zinc, I'd become a vegetarian at 14. I didn't know it, but meat didn't make me feel good. But it was a wrong diet for me because, you know, in the farm community, no one knew what a vegetarian was. No one was teaching me how to eat right. So I became more of a carbotarian and eating lots of gluten and all these inflammatory foods and then got cancer, realized that wasn't the right diet, made some changes, eventually got Crohn's disease, but I was [00:07:00] still not really knowing what diet had to do with it. And this instance where the doctor said, Jill, diet has nothing to do with it. My rebellious German Swiss background kicked in. I'm like, that can't be right. I'm going to prove him wrong. And I went down a journey. And this story relates to mast cell because I didn't know it at the time, but what I found out was the low histamine diet was one of the biggest changes in my Crohn's disease. And so I started, I didn't know this commonality with fermented foods and vinegars and yeast derivatives and things like aged meats and cheeses or leftovers or avocado or, and you're hearing this because anyone who knows this, these are all high histamine foods, and I didn't realize that. All of those foods, starting to avoid those, that was one of the first, and then gluten of course. That was a big, big transforming factor in the beginning of me healing from Crohn's disease. And so, as I look back as a physician now that understands mast cell activation, I see so many echoes of mast cell activation in my history. From the allergies, the eczema, to the, even the [00:08:00] cancer and the Crohn's disease, and then my improvement with a low histamine diet, among other things. So it's fascinating to me because my own story really contains a lot the mast cells. Dr. Tania Dempsey: Yeah. And thank you for sharing that. Thank you. Jill Brook: That's so encouraging that you were able to heal after so long because it sounds like you were, what, in your 20s or 30s by the time you figured this out and you still made the comeback into the vibrant, healthy person that you are today? Dr. Jill Carnahan: Yeah, so I was 25 when I got diagnosed with aggressive breast cancer and then 26 with Crohn's disease and it took a couple years, but literally probably by 28 years old, I was completely healed of Crohn's and I'm even to this day, almost two decades later, I have no symptoms or signs of Crohn's disease anymore. So it's one of those things where that was told. Yeah. And again, at the core of some of these inflammatory bowel issues is histamine and Mast Cell Activation. I now see this underlying so many issues and it can be triggered [00:09:00] by either infection or toxin. So when we see Epstein Barr reactivation, long COVID, Lyme disease, Borrelia, Bartonella, Babesia, all of those co infections, or for my practice, a huge portion is toxic mold exposure. And I remember talking to Dr. Theoharides and Dr. Afrin, your partner and, and hearing from both of them that mold was probably one of the number one triggers of mast cell activation and then back to my childhood. I'm like, oh, guess what? I grew up with corn and beans that were a little damp stored in bins and one of the biggest things was to dry out that corn so the fungal growth wasn't too high and I was horribly allergic to corn and soybeans. But in hindsight, guess what? I don't think it was the corn and soy itself. I think it was the mold growing on the crops that are still prevalent. And then all that dust would be all over the yard, and I couldn't even go outside for a couple months of the year. And looking back, I'm like, oh, I think mold was a trigger all the way back to my childhood. Dr. Tania Dempsey: So, yeah, so these are the, I think, you know, [00:10:00] I think in this world of, particularly in functional medicine, I think that many of us, have had either our own journeys or journeys with family members and it does give perspective when we're treating our patients, right? And so now you have that perspective of your own your own journey, what's worked for you, so now you, you, I'm assuming you apply it to your patients. Dr. Jill Carnahan: Yeah, and I'm sure you see this too, but what I see now is like, oh, I see something that the traditional medical system, okay, eczema, or they have horrible cognitive issues brain fog that comes and goes intermittently, or gut issues, massive permeability. And instead of just like, relegating that to leaky gut or subjective cognitive decline, I say, oh, I bet Mast Cell is underlying this and let's check and see and then I'll do the test and and confirm. And obviously it's a clinical diagnosis, but often I'm looking deeper than just what they present with because many, many times at the root, especially those who aren't getting well with what should be working, Mast Cell Activation is at the [00:11:00] core. Dr. Tania Dempsey: Yeah, I couldn't agree more. So what is your, what is your go to? It sounds like for yourself, obviously you started with a diet. What do you do with your patients? What's a, what's your first step? Dr. Jill Carnahan: So I do do clinical lab tests, which you were an author on my favorite paper, The Consensus 2, you know, so I use all that data and do those tests. But as you and I know some of the tests like tryptase were developed with mastocytosis, which is this proliferative disorder that doesn't always replicate in the mast cell activation. So there are patients who truly have mast cell activation and the labs will be normal. And I like to say that because if people think that that's the only way to get the diagnosis, it's just not true. So what I typically do is talk to them and get a great history and then just based on the history I can usually tell things like triggers or mediators or things that make sense with mast cell activation like an allergen or a high histamine diet or, or some of the things that we know like histamine creates permeability. So leaky gut, leaky brain, leaky mitochondria are usually commonalities. And as they see these patterns, then I'll [00:12:00] start to implement. I love natural things, but I layer, and you and I know it often takes an army of things, right? So, and I tell them that because they're like, well, can I just do quercetin? That's great, but you're probably going to need, the severe cases need a whole number of things, but I'll start with quercetin, nettles, luteolin, Chinese skullcap, I love vitamin C, any sort of things that we can do on that natural realm, and then I'll layer H1 blockers, H2 blockers, mast cell stabilizers. Ketotifen of course, is one of my game changers over and over again. I find that to be so, so powerful. And some of the new kids on the block like low-dose Naltrexone and even Methylene Blue I found to be shifting sometimes. But I'll usually really, and even benzodiazepines, which I don't love because of the addictive factor, but in certain cases they shift. And then it's funny, I was just getting over a podcast earlier about vagal nerve stimulation and that's a whole other way to help the mast cells, through the vagus nerve, but I'd love to know what else is out there that I've forgotten because there's a lot of different... Dr. Tania Dempsey: No, you covered [00:13:00] it. I think limbic, limbic retraining in addition to the vagal nerve, right, is a big piece of it. And then really, I think it's, it's getting to the, to what is, is activating the mast cells ultimately, right? I think there is. you know, probably this underlying vulnerability that's there already. You know, maybe you had a family history of Mast Cell Activation Syndrome, right? But then you had these triggers that brought it out. And so, you know, working on eliminating those triggers, right, I think is key, right? If they're in a moldy home, you've got to figure out how to deal with the mold, right? So I think, you know, I think it's a, it's a very comprehensive approach, right? Dr. Jill Carnahan: I love that you said limbic activation because that maybe is the most important thing that we talk about. And especially like maybe 20, 10 years ago, at least not all of us were talking about that, but now we all see. And again, just getting off this podcast with a vagal nerve expert, it was so profound because he's like, vagus nerve is all about creating safety in the body. And it makes so much sense because mast cells are the cells roaming out there trying to find out what's a threat to [00:14:00] our system, is it a pathogen or a danger response or a PAMP or a DAMP or one of these things. And as our body encounters these things in the environment, like mold, the body's like, wait, this is really not good for you. It's a threat. And then the mast cells do their job. And I actually like to think of it that way because it's not like our body is betraying us, which so many of us think, but it's actually our body is doing what it's supposed to do, protecting us. And unfortunately, we are swimming in toxic soup with so many stressors and many of us are becoming activated, so our mast cells are doing what they're supposed to be doing. But I love going to the root of that and just being like, hey guys, calm down. I remember, I'm just going to tell a really quick story because I think it's relevant. Years ago, I had had the cancer and I fought the cancer and won. The Crohn's disease, I fought the Crohn's disease and won and got over these things and I had this like mentality of, I'm going to fight and get over these things. And then years and years went by and I got mold related illness after the flood in Boulder, very, very sick from mold and I'll never forget the day I'm walking, doing my evening walk, and I just had it hit me. [00:15:00] If I fight mentally, subconsciously, physically, this mold, that's what's killing me. It's literally my own immune system, my cytokines trying to fight the mold and not being able to eliminate it from my body. That's creating collateral damage in my cells. That's my own immune system doing the damage and if I still have that mental image of fighting, I'm going to die from this. Like, I won't do well. I mean, I die, but I'm not going to do well. And that moment I had that epiphany, I thought, well, I can retrain my subconscious. What if I created a new paradigm around getting rid of the mold? And this is related to mast cells are primordial fighters. And if we have that idea that we're going to fight this illness, we're going to overcome that battle, and cancer's like this, everybody talks about the battle, the fight. I don't think it's a good way of wording it. It's neurolinguistically programming ourselves to fight, which may make our immune system more overactive and not do us good. So that very day I thought, I need to think of an image or a program. And I thought, Oh, those little yellow minions on Despicable Me, they're kind of cute and friendly. And I thought, I'm [00:16:00] going to pretend like that's my immune system. I'm going to start every day on my walk imagining these little minions. And they're whistling like, Hey, Mr. Mold, let's take, let's just escort you out of the body. And they're like, friendly, friendly immune system pieces. And I imagined my immune system to be these Minions, Dr. Jill Carnahan: and I started meditating on that image every day and I really believe, Dr. Dempsey, that that was one of the changes that shifted me out of mold related illness and out of some of the mast cell activation that came with it. Dr. Tania Dempsey: Wow. Jill Brook: I love that! Dr. Tania Dempsey: That's very powerful, I know, it's so powerful and I love that image and I can see how others listening might, you know, might gravitate to that image, maybe they have another image in mind. But yes, that sort of guided imagery sort of technique is, is, is really incredible. It's changing, right? It's changing the narrative of what is going on in your body. And that's, [00:17:00] that's really a big piece of healing people and getting them better. Dr. Jill Carnahan: Yeah, it was around that time that I really understood that the self conscious just, whatever programs that we have, and most of them are unconscious, and they could be from childhood, like, I'm not enough, or I'm not safe in my body, or whatever things that we have accumulated over our ancestry, or our childhood, you know, home, or our family members, or even relationships, but those programs that we have, if we're not aware of them, our body just goes ahead and acts out those programs. And so I started to realize, oh gosh, if my programs aren't healthy and helping me and healing me, then I have to change that program. And one way is repetition and emotion, and that can be done through this repetition of meditation. So when I heard that, I was like, oh, let's make a new program. And then we know our subconscious will literally, when we really believe something at that level, it will just make it happen. And that's what happened for me is it really transformed my health. Jill Brook: Wow, can I just say that that is sort of an epiphany for me because I think what you're also saying is that it's okay to bring [00:18:00] some humor into your meditation. And so for those of us who kind can't stand meditation, because it just seems like it insists on itself too much. I love the thought of bringing in some humor and it doesn't, you know, it doesn't break it. It can still work. Dr. Jill Carnahan: For me, I always wanted to think more thoughts, not less thoughts. I don't like to I like to, I'm like, really like, I want to be creative and all that. And I think there is a subset of creatives like myself that actually do, I call it it's like lucid dreaming or visualization where you actually create a movie in your mind and that's how you meditate or manifest. And I think it can have the same health benefits, but it's a very different, it's almost like I'll, I can close my eyes and create a vision of something happening or what I want to be or where I want to go or what I want my body to do healing. And it's a very different deliberate visualization than just like going blank. And for me, that works better. And I think I wanna give permission to the listeners. You don't have to meditate like everybody else. You don't have to do yoga like everybody else. [00:19:00] You, I just heard from a previous podcast guest that is this laughter yoga. And I've never liked yoga because it's too slow for me, but I'm like, Oh, laughter yoga. I love that idea. You go and laugh with people. So we can kind of make these things our own and do it in a way that resonates with our body. Jill Brook: Oh, I love that. That's huge. Dr. Tania Dempsey: Amazing. So, so let's transition a little bit. I want to, I want to hear about I want to talk a little bit about your movie. So you made this film. I want to talk about, and the book, and I want to, I want to talk about, because I think it's a lot about your journey. Tell us about the process and, and, you know, what sort of your message is to people watching and reading. Dr. Jill Carnahan: Sure. Thank you, Dr. Dempsey. You know, it's funny because there's so many how to books out there, and I knew that I had to give practical information, but from the very beginning, I had actually arguments with the publisher because I wanted to write story because the truth is story is what connects us, and often if it's someone telling their story, we hear or see ourselves in that journey. And it gives us [00:20:00] permission to also overcome or achieve or do something differently and really from hundreds and thousands of years ago, telling stories around a campfire is how we connected and how we healed and how we just, you know, had that community. So I knew that story was important, but everybody said, unless you're, you know, Barack Obama or you know, the Prince of Wales or whatever, you can't do a memoir. But I was like, no, I feel like this is so important. So I kind of went against the grain and I wrote my story. But again, not the hopes that, not even that it's about me, but what I hope is that each of these pieces, these chapters, different parts of my journey, that the reader can actually resonate with their own journey and see parts of themselves in that and have hope that they too can overcome or heal or do something differently. So it's a woven in there, but then what I did to make it practical is there's these sidebars on like how to heal from mold related illness, how to help your vagus nerve, how to, you know, these kind of very practical sidebars on tips, what to use for lab testing for functional medicine, or you know, those kind of practical things. So [00:21:00] you can either flip through those sidebars and ignore the story, read the story, ignore the sidebars, or do both, and it's kind of all woven together. And that was my goal in just connecting with people. And it goes from everything from cancer and Crohn's disease and mold related illness to growing up on a farm feeling like I wasn't enough becoming an overachiever at some, at part of my life, and then learning that I had to, you know, reprogram that mental part, and then going through difficult relationships and divorce, and all of the things that I learned in that journey. And that book, it's called Unexpected, Finding Resilience Through Functional Medicine, Science, and Faith. And the title really alludes to the fact that we use both our left brain and our right brain, we use the science, we use the intuition. For me, there's the, you can actually have this cohesiveness between a belief in a higher power, which is my faith, and the science, and they both can coexist in a beautiful synergy. And that was, that book was actually the impetus for the movie. We thought we were going to do a movie on environmental toxicity and toxic load and mold. And then once again, the [00:22:00] producer director were like, we need story. So it ended up being a documentary. It's called Doctor / Patient. It's at drpatientmovie. com. And that is just also parallels the journey of overcoming, but also includes stories of patients who have overcome mast cell activation, Lyme disease, breast cancer, and mold related illness. Dr. Tania Dempsey: Wow, so you've been busy and it's been, it was incredible. I haven't had a chance to watch the full movie but I read your book and I thought it was really, really incredible. And I, what I love about it is that you, you really are very vulnerable, right? You're exposing yourself and that's something that I think that as medical professionals we're often taught not to do, we're often taught to have this sort of distance right between you and the patient and I don't believe in that. I know you don't believe in that because I think that there's, there's a lot of, there's healing that can happen when you don't put a boundary, and so you've made yourself vulnerable, you put yourself out there as a patient and that's what [00:23:00] makes you an incredible healer, I think. Dr. Jill Carnahan: Thank you. Thank you. You know, I want to give permission, and again, I know you do this in clinical practice too, because you're right. If people knew how we were trained, I mean, there is such an absolute, like, do not share your personal journey. Do not cry in front of a patient, God forbid. Like, do not share that, you know, because the idea was that you must you must keep this wall so that you remain objective and you remain the authority. And the truth is, especially how our society is going, people need connection, they need to know. I just read a book called Super Communicators, one of the best books I've read on communicating, and literally the number one rule in there was listen, ask people about their emotional experience, their their joys, their hopes, their dreams, their desires. And then share just a little nugget, don't take over their story, it doesn't have to be about you, but if you don't share vulnerably, there's no exchange of information, and then they feel alone in whatever they've just shared, and there is actually, literally, so much power to you revealing just a little bit, like, oh, you know, I'm so sorry you're going through cancer, I know how that feels, I went through [00:24:00] it, tell me more about your journey, and you can turn it right back to them, but that exchange, like, for me to say, oh, I remember going into surgery and being a little bit scared about what would happen, how do you feel about that surgery or that thing that's coming up? Or mold related illness affected my face and I had acne and it was so hard to go out in public. I remember that. How are you doing with the skin issues that you're having with mast cells? You know, so these things, when we reveal the vulnerability of ourselves, all it does is create connection and trust. And that's a foundation of healing. Dr. Tania Dempsey: Yeah, yeah, exactly. So how do we, how do we teach other doctors this, and just in general, about complex chronic diseases? What do you think we need to do to spread the word? Dr. Jill Carnahan: Oh, love this question because I know you and I are, I'm so passionate about reaching physicians. First of all I think fostering curiosity. If I think if there's one thing that's kept me going remaining curious and even as I've hired mid levels for my practice, the number one quality I wanted was someone [00:25:00] who's curious because the complexity that you and I deal with on a day to day basis is not necessarily fun unless you're curious. So most, I remember back in family medicine, now I'm seeing all the patients that my other colleagues didn't want to see, right? Because they were so complex. I love it. But that, it takes someone who's curious. But the truth is, most people, I would say 80 90 percent go into medicine because number one, they really want to help people. And number two, they are curious. They love to learn. So if we can kind of re engage that curiosity and learning, and it really brings, I'd love to hear your comments, but for me, I love what I do every day because it's always different, it's always deep, it's always complex, I always have new problems to solve, and it never gets boring and so if we can re engage that curiosity, that desire it brings back the life to practicing medicine for most doctors, but they have to realize that, you know, it might take a little bit of curiosity in order to get there. Dr. Tania Dempsey: Yeah, I agree, but I guess I question how to make other doctors curious, you know, [00:26:00] I have conversations sometimes with, with primary care doctors or specialists that my patients have seen and, and for some of them, they're, the reason I'm on the phone with them is because they are curious. They may not understand it, but they're, they're at least, they're curious, but they also care. Okay. They, they will be the first to say, I don't understand all this, but I care about the patient. So I'm here to talk to you because I don't know what to do. And I'm hoping you can guide me. Right. And that's always like a breath of fresh air, because for me, it's like, it doesn't matter if they understand the intricacies of what we're dealing with. They care, but, but there's a whole community of doctors and medical professionals in general who they're, they're, and I hate to say they don't care. I, I think that the care has been beaten out of them, to be honest. I know they all go into it with good intentions, but I think our medical system is such that, that they really they can't care. They have [00:27:00] five minutes, seven minutes, four minutes, whatever it is with the patient. They have a thousand notes at the end of the day. They have a thousand portal messages. They have emails. And they literally are drowning. And so we've beaten the curiosity out of them, right? So, you know, we're lucky. I really consider myself so fortunate to be able to practice the type of medicine that, that I practice, to be able to have the time with patients, to give them what they deserve. But I don't know how to, like I almost feel like the entire medical system has to be revamped and I don't know where to start. Dr. Jill Carnahan: Oh boy, I couldn't agree more. And if you want to develop a system that takes the empathy out of a physician, you have the U. S. Medical Training System because it literally is how how long can you go without eating, without urinating, without you know, sleeping? Like, how can you push yourself so hard that you are about ready to collapse? And that's our residency program, right? Like, and then, like, don't share emotion. [00:28:00] Don't share if you're vulnerable. Don't, God forbid, don't say you're tired or exhausted or you're, and I remember back in my residency, like, you would report to duty unless you were in the hospital or dead. Like you, there was no choice. So now COVID has given a little bit of leeway. We're like, like being sick is okay. But I remember back then, I mean, I reported to the ER when I, before I knew I had Crohn's, I was having cyclical fevers, like up to 101, 102, like really sick. I didn't tell anyone. I just kept reporting to duty with fevers. And I look back, I'm like, what was I thinking? But that was the culture, right? Dr. Tania Dempsey: Yeah. No, that's right. That's right. And yeah, and I had a few talking to's by my residency directors and others, my superiors. I'm a little bit of a rebel too, right? I'm a rule follower by nature and, and I'm a perfectionist. But I also have this little bit of like a rebel in me, and I will do whatever it takes to treat the patient, and I don't care if you tell me that I can only have five minutes, [00:29:00] because if I need an hour, I'm going to take the hour. And so I used to get in trouble all the time, I remember during my residency program, we had we were, we were seeing patients at a, at an off site facility. And the patients would come in and they had, you know, honestly, I think they were these complex chronic patients. Looking back, these are patients who were living in moldy apartments. I didn't know that. I didn't know to ask that then, right? Moldy apartments, very stressful situations, financial, financial hardships. Taking care of multiple family members, right? You could just imagine what was going on, right? These patients, they come in, they have pain, they have high blood pressure, they have headaches they have you know, high cholesterol, but then they also have, you know, like specific, you know, GI symptoms, right? They're constipated, they're, they're nauseous, they're, you know, so anyway, they come in with all these complaints and I would sit there and, and this is just, this is always me, I'm trying to figure you know, put the puzzle pieces together, right? So I'm listening to them, I'm talking to them, I'm trying [00:30:00] to figure out if there's any connection, not understanding back then that there was a thing like integrated functional medicine, and I'm trying to put the connection together and I'm trying to, to figure out how to deal with as many things as possible during this visit, right? And I remember this one time I came out of the room and it must have been an hour and a half later. We only were, we only had 20 minutes per patient. This was like an hour and a half later. I walk out of the room, right? And my, my supervisor was was like appalled, you know, and he's like, okay, well, we got to sit down and talk about this. Right. So we sit down, he goes, Tania, you can't deal with all their problems in one visit. You can't, you know, if they have high blood pressure, deal with the blood pressure and tell them to come back for another visit and you can deal with their headaches at another visit. Why do you have to do it all at once? And I said, no, no, I'm not doing it all at once. They're all connected. I know they're, these problems are intertwined. I'm trying to figure out how to deal with all of them at the same time. You can't do that. You can't do that. You're not going [00:31:00] to survive. You're not going to make it in this world as a clinical practice. Well, guess what? I think I'm, I think I'm doing okay. Dr. Jill Carnahan: You are and I love that. Oh my gosh, you are and I love that. Yeah, it takes a little bit of, you know, I think you, cause your original question was how do we get doctors on board? I may, I think maybe it's speaking to the dissatisfaction and the burnout that comes from like ignoring the intuitive sense that there's more and there might be some deeper way to connect. Because even for us, that connection is actually powerful as part of our journey. When we connect with a patient or we have them come back, I'm like, Oh my goodness. Thank you for helping me. Like to me, that's my reward is that thank you. My life has changed, right? Dr. Tania Dempsey: I think more books and movies and things about this, podcasts, you know, we just will keep getting the word out. And I, and honestly, I really think that the revolution is, is from the patients. The patients are, I [00:32:00] want to give them credit because honestly, I think that we are where we are today. I, I, I have to thank every patient I've ever seen, right? Because I am what I am today because of, of their experiences, because of what they've taught me. And so the patients now are the revolution in medicine. You know, it's unfortunate. They, they're the ones that, that are suffering. They shouldn't have to also change the medical system. But it's those, you know, just, you know, I tell, I want to tell the audience, you know, keep telling your stories to the doctors. There will be a doctor who will listen. There will be a doctor who will, who will, you will change their, their mind on things. It's, but it's a, it's a bit of a, bit of a journey and not an easy one, but anyway. Dr. Jill Carnahan: I couldn't agree more. Dr. Tania Dempsey: So anyway you know, maybe, maybe, you know, we'll we'll maybe have a, a couple more questions. I wanted to see if there's any new treatments, any new research, anything that you're really excited about that you think is on the horizon for, for this, [00:33:00] for complex chronic diseases. Dr. Jill Carnahan: Yeah, so we mentioned obviously limbic retaining we've been doing. I think that vagal nerve simulators are good or breathwork in those realms. That's kind of the thing that's become more and more popularized and super important. And then I mentioned methylene blue, which you and I have used forever for Lyme disease and Bartonella, but I'll just say my shift has been years ago using it for those indications, it's an antibacterial, antimicrobial, but we use, at least for me, I use very high doses and I'd have side effects and have to mitigate interactions with drugs and things, and now I've been using these micro doses, very low, like anywhere from 5 to 10, 15 milligrams and having almost no interactions, no side effects. And I feel like, especially with long COVID, so you got, we all know the triad, which is the mast cell and the dysautonomia POTS and the Ehlers-Danlos Hypermobility. One of those pieces that POTS dysautonomia, is because of this kind of endothelial dysfunction and vascular collapse, and they're not getting blood flow back up to the brain or up that I was thinking of it as like a water tower, right? Let me get, I'm not sharing anything you guys don't know, but the methylene blue, I remember [00:34:00] being the aha when I started looking at studies and one of the, actually multiple studies showed use of IV methylene blue in the hospitals after cardiogenic shock. And I'm like, huh. Cardiogenic shock, that's collapse of the vascular system and they're using methylene blue. What does this do? Well, it acts as a presser. It acts as actually a presser for the endothelium to, you know, and I found those micro doses are profound for POTS and dysautonomia. Even personally a year ago I had long COVID and some definite POTS dysautonomia came up and pretty significant where I would be exhausted running like a 85 over 55 blood pressure and had to lay down. And the methylene blue for me was a game changer. So I've been using that in patients in the low doses like I said, anywhere from five milligrams to to 10 or 15. And having great success with no side effects, and to me that's a really big deal because anything we can do to kind of keep that vascular system in check in addition to the salt and the compressions and all those things is profound and this is super safe, super easy, it's not super [00:35:00] expensive, that's been my big takeaway lately. Dr. Tania Dempsey: I love the repurposing of drugs like that. What other things do you see with Methylene Blue? So I, I definitely use it sort of like you, and I've micro dosed it. It does raise blood pressure a little bit, right? It helps the endothelial function. But what else are you, what else are you seeing? Does it, does it help with mast cells? Do you see it have mast cells directly, is there any mast cell activation sort of control? Do you notice anything like that? Dr. Jill Carnahan: Yes, so my theory, and this is purely theoretical and clinical observation, but we know it can decrease redox in the mitochondria, so that oxidative stress that happens with mold or Lyme or any of these things can damage mitochondria, and that's one of the core things with that cell danger response, and so I felt like it might be one way to kind of shift the cell danger response, and what I found is when you combine methylene blue at that low dose with red light therapy, it actually potentiates the activity of the mitochondria, and if you get restored mitochondria, a lot of times these things start to change and shift, so even though it's not directly like the mast cells, well, I'm [00:36:00] sure the mast cells cause mitochondrial leakiness due to the stuff they put off, but I feel like as you rehab this mitochondria, and then if you combine it with red light therapy it's super powerful in mast cell activation and kind of that cell danger response Dr. Tania Dempsey: Yeah, I love it. We have a red light bed in our office now too, so we've been doing that a lot, and we've been combining it now with methylene blue. And a lot of people ask, you know, because of the heat, whether it could, you could red light, you know, make mast cell activation worse? And I, and, and, and there are patients who are sensitive and we do have to, we have certain settings that we can change. We, we start kind of on the low side, so it can absolutely be a trigger for, for a subset of patients. But there are other patients that I see that with time and with a little bit of methylene blue, it's like a shift that happens and all of a sudden their tolerance for heat, for other things improved. So I agree, I love that. Dr. Jill Carnahan: No, [00:37:00] I love that too. I think it's interesting too because like PEMF is another thing I really, really love personally and professionally with patients that shift. But there is a subset that even with PEMF, they'll be more reactive, like they'll actually get a mast cell activation. I'm sure you've seen that as well, but I'd say maybe 80 percent of them do really well with these things. Jill Brook: For people who maybe don't know what PEMF is, do you just mind giving a... Dr. Jill Carnahan: Sure so PEMF is Pulsed Electromagnetic Frequency. It creates a magnetic field and there's many, many ways that this can help the body. And there's different frequencies. We can use everything from the Schumann frequency, which is the Earth's natural frequency. So it's kind of another way of grounding, like if you're walking barefoot on the beach. But in my mind, one of the things it does is it actually increases the circulation of blood. So when the blood, red blood cells can get kind of clumpy, if there's, if there's an increased frequency, Fibrin Production, Endothelial Damage, or Long COVID, or any of these things that have kind of a vascular effect, which makes all the POTS, Dysautonomia, Mast Cell stuff worse because the body's like, Whoa, what is this clumping in the blood doing? And one thing [00:38:00] PMF does is actually charges those red blood cells so they don't stick together. So often people are suffering from that hypercoagulability or symptoms related to that do really well with PEMF like 20 minutes a day. Jill Brook: Fantastic! I know that your time is so, so precious, but I guess, can you just tell us like one story of somebody who seemed hopeless, who had to turn around and did well? Is there like a patient that sticks out in your mind? For the person who's out there listening right now who feels like their situation is hopeless, can you tell them someone who is worse off than they were and still did pretty well? Dr. Jill Carnahan: Yeah, I had a patient in Steamboat and he had suffered years and years of very severe Crohn's disease and even though inflammatory bowel is not traditionally associated with mast cell activation, there's often a component of the bowel issues, especially inflammatory bowel that is mast cell related and I think he had a little bit of both. He did not want to go on biological meds, and he got so sick at one point where he was, you know, six foot in POTS, Postural Orthostatic Tachycardia Syndrome, Ehlers Danlos [00:39:00] Syndrome. The great thing about him was he was so motivated to do whatever it took, and he integrated changes in his diet, and then we did all the mast cell activation stuff, and then we did all the gut healing stuff, um, and slowly and slowly and surely he improved. And today he's like trading on Wall Street. He is highly successful. And what I love, I almost cry every time I talk to him because he is like, Dr. Jill, I want to write a book, I want to be a motivational speaker, I want to tell people, other people, that they can heal from this incurable thing. And I remember back in the beginning, I shared, just like we talked about vulnerability, I don't always share my story, but I shared a couple times when he was about to give up hope, I said, You know what, I had Crohn's disease at one point, and I thought I wasn't going to make it, and this is what happened, and this is why I felt like I could overcome, and even to this day, he'd be like, you know, it was your story that you could do it, that allowed me to do it, and now he's going to go out in the world and share that same story with people on so many levels. And I just love that echo of my healing, encouraging patients, and then patients going out and telling other patients and other people, because that's really, we're all in [00:40:00] this journey together. And if we can share a story of overcoming all And even the bumps in the road, because I would tell him, you know what, I still have rough days in this area, maybe not the Crohn's or whatever, and that was an encouragement too, because so many people look at me and like, oh, well, Dr. Jill, you're speaking, you're traveling, you're doing all this stuff. The truth is, we're all on the journey, right? Yeah, and I still have days where I'm really tired or I have brain fog, and I love sharing that, because patients are always surprised, like they think it's all perfect. I'm like, no. I'm in the journey with you, and I every day just get up and try again and learn things every single day, and I think that's the biggest encouragement is that we're all in the journey, and hopefully we can just continue to share what we're learning along the way. Dr. Tania Dempsey: That's right. Thank you for sharing that. I think that's such a beautiful message and I think people listening will, you know, will feel encouraged by that. That was a good question, Jill. I love that. So, Dr. Jill where can people find you? Dr. Jill Carnahan: Yeah, so Instagram is just Dr. Jill Carnahan, and then my website is [00:41:00] jillcarnahan. com, which is the podcast, the blog, the movie, the book, everything you can find there. Dr. Tania Dempsey: Awesome. Thank you so much. Thank you so much for, for, for being here today. I could talk to you for hours. I mean, we, we just, you know, have such a synergy between the stuff that we do. Jill Brook: I feel like, oh man, this was not long enough, but maybe we could do some more sometime. But thank you both so much, this has been amazing, and these little nuggets, and I know all the other patients, and probably doctors too, like me, are like, okay, time to go Google methylene blue, so that's what I'm going to do next. Thanks a million you're both amazing. And hey listeners, that's all for today. We'll be back again soon with another episode. But until then, thank you for listening. Remember you're not alone. And please join us again soon.

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