Transcript:

292: What These 5 Cases Taught Me About Being a Better Clinician

[INTERVIEW]

Ronda Nelson: Well, hello and have I got some updates for you today. We have covered all of these clinical cases over the last five weeks and I’m gonna wrap them up for you. I wanna give you just a little bit of an update on each one of them — what I know now since the time that I’ve recorded them — because some weeks have gone by and I wanna give you just an update on all of them. So let’s start with the cracked tooth case.

That’s actually someone that I know and she’s doing so much better since starting the biofilm protocol and the stealth pathogen protocol. So she’s doing so, so, so much better. I’m absolutely thrilled with her progress. And it was funny — that case was so weird because literally it was at the very end of our consultation call when she said, “Yeah, this other random thing kind of happened and I went to the dentist.” Sometimes — and it just happened to me yesterday again, the same thing. Maybe I’ll tell you that in a little bit. But it’s like at the very last second, you’re like out of time, and then boom — in comes the thing that jumped right out of the bushes and bit you. You think, my gosh, what did you just say? It was like that. Once we got there, it was like ding, ding, ding, ding, ding, and I knew right away that that was exactly what the problem was. So yes, we’ve got that infection, it’s healing, getting better — I’m super excited about that.

Second case was the panic attacks — her doctor had put her on thyroid, gave her Cipro for food poisoning, compromised digestion, all the things, brain just interpreting as danger, danger, danger. Well, here’s the update on this one. I just spoke with her not long ago, and the anxiety is so high. It’s funny to me how — how do I want to say this? You know how sometimes people need to be sick? Like it becomes their identity. And this young woman is in a brand new relationship, just got married, and I think there’s something going on there. I can see it in the interpersonal way that her and her husband interact with each other — I’m trying to be careful here, can you tell? — I can just see it. Something is not right. And they’ve just been married for like four, five, six months, something like that.

So the funny thing was, she was consistent about taking the supplements for her stomach. She was consistent about that for her digestion. And I know that I know that I know that I can’t go anywhere except deal with this upper digestion. But I also know I have to give her something to calm her down, right? So I put her on a couple of Gaia products, and I’m happy with those. I’m really happy with those. But what I noticed is she said to me, “Well, I’m not always really good about taking those.” And I’m thinking, what? If we aren’t taking the foot off the gas of the anxiety, then how in the world am I ever going to get that upper digestion to function, right? She’s going to stay in a sympathetic state, thereby leaving that stress response high, cortisol is high, and her gastric secretions are going to decrease. So I said, well, you know, those are kind of important. Those would be really important for you to take.

She goes, well — and then she drops it. At the end of our call, of course, she said, “Well, I’ve been to three additional doctor’s appointments, and they’re doing a whole bunch of tests on me — an endoscopy, and I don’t know if they were going to do a colonoscopy, and a few other diagnostic-type tests.” And I said, okay, well, how does that feel for you? She said, well, my anxiety is just so high that I really just need to get these done. And I said, no problem, no problem at all. It’s absolutely fine. I am good with that. You do whatever makes you happy. And so she’s gone down this road. She’s had all this diagnostic testing. And of course, you know what they’re going to say. Everything is fine. You have a little bit of gastritis, of course, and everything’s fine. Everything’s fine. So then they recommended two things — one, of course, was an anxiety medication, and then another one was a new version of a PPI.

And she said, well, what do you think if I take these? So now, between us here, this is when I can sort of see the signs of self-sabotage happening. And I said to her — because if I tell her no, that’s not the answer — where is her belief centered right now? Her belief is 100% centered in the information that her medical doctor or medical team is going to give her. So A, I can’t tell her not to take what her doctor is recommending. That’s the most important thing. But B, at this point, even if I could, I don’t think I would, because she has such a belief in them over me. It’s like she wants to do it the natural way, she wants to work with me, but the anxiety is so high she won’t take the anxiety part of the protocol, and now she’s marching down the medical thing.

So I have yet to see what’s gonna happen here. But her gut is causing a problem and that’s resulting in anxiety, and she’s just anxious already — overthinking it, overthinking it. So this case is still to be determined. But right now I think she’s gonna go on those medications. She then instantly messaged me back and said, well, didn’t you say that some of the medications would not be good and they would actually make it worse? And I wanna bang my head against a wall. I don’t want to take your stuff for anxiety, but I want to go to the doctor and I want to take their stuff — but then you tell me not to take it — and then I’m back over here saying, well, shouldn’t I be taking your stuff? I can’t even. So we’re going to find out what happens with the panic attack girl.

Restless leg — ugh — not making as much progress as I was hoping. She did have one night where she had no pain. Like she literally slept all night long. But she’s back to like, don’t think there’s any change, I don’t think this is working. This has been 20-some years and I’m not willing to give up. I’m just not willing to give up. So I’ve got to go dig a little deeper. I’m going to move her into phase two right now. I’m just trying to calm her. She’s taking bone broth at night. We’re doing some glycine. We’re doing all the things. She’s cutting down on alcohol — she wasn’t drinking much of it. I’m not giving up. I’m just not giving up, because restless leg is not normal. It’s not normal physiology, and I’m not willing to give up. So I told her: you will quit before I will ever quit. I’m not gonna give up on you. So I’m gonna schedule another call with her. I just heard from her in the last couple of days. So that one’s not progressing as fast as I would hope.

The H. pylori one — yes, we’re continuing to make really good progress. And I told you about the GI Absorb — remember the product that created the dark thoughts, the ruminating kinds of thoughts? Well, the good thing about that was she had the aha moment between the connection between the gut and the brain. The vagus nerve, the enteric nervous system — she was able to kind of make that connection. And so now she said, if that anxiety kind of came from my gut, because that’s where the supplement was going in and it was doing something — I still don’t know why, I haven’t found anybody that can help me with that, but it happened — and sometimes there’s just odd random things that happen with supplements. It doesn’t mean you throw the baby out with the bathwater, like I said. But she is now like, well, how do I get my gut fixed? Hmm — this was good. She didn’t believe it was a problem before, because she poops every day. She doesn’t have bloating. I said, it can be asymptomatic externally, but that doesn’t mean that everything’s good on the inside. So that’s a good outcome. I’m still kind of working on that, but her burping is continuing to get less and less and less. She’s not clearing out the room like she used to, and so that’s great.

And then the guy that I talked about last week that I was just so bummed about. I told you that I really care about his family. And I was able to get on a call with one of his family members. And I just said, I need to just get this out in the open. I care about you, love you so much, and I’m so sorry. And what she told me kind of snuck up and grabbed me out of the bushes. She said, “Well, did he tell you about a brain surgery that he had when he was three months old?” And I said, no, he did not tell me that. I did not know that. She said, “Yeah, sometimes he conveniently leaves stuff out that he just doesn’t want you to know.”

And I said, well, had I known that, I would have done something totally different. So that one is just going to have to be a chapter in the book that I’m going to have to close. And if he decides to come back, I’m going to ask him a little bit more, because I’m kind of not supposed to know — I mean, she told me that in confidence. So I’ll have to do a little bit more pushing, maybe a little bit more investigating, a little bit more digging. But for now, I’m just gonna have to kind of close the book and wait until he’s ready — if he ever is — to come back and work with me again. But thankfully, everything was fine. Like there was no problem with the family. They understood. She said, “Don’t you even think one more thing about it.”

So what’s so interesting is that we have five different patients, five completely different presentations, five completely different puzzles. And when I stepped back and looked at them, this is what — and it’s to some degree what I’ve put in the free resource called the Six Principles, which I’ll link to in the show notes — more and more I’m finding that what I often think the first time is not right. I think, well, that’s your gut, or that’s your upper digestion, or that’s your emotions. Or just like a patient I had yesterday — a little 10-year-old girl that will throw up for a month at a time. And I’m like, well, of course, that’s her stomach. Well, then I’m talking to mom, and mom was late getting her paperwork to me, but I felt really bad because she’d waited several months for this appointment. And I said, okay, I’ll just go ahead. And I’m kind of glancing at the paperwork as I’m doing the call — don’t recommend that. Not a good idea. But I did it because it just felt bad.

And as we’re going, going, going, I’m thinking, okay, it’s this. And then mom drops another little nugget. I think, okay, wait a minute. Fork in the road. Now I have to go think about this. And then I get down that road and then mom drops another little nugget and I go, errr — back to where I was in the beginning. And I’m zigzagging, getting whiplash with this case all over the place. And again, it just kind of reaffirms to me that sometimes we go in, we read their information, their paperwork, and we think, okay, this is how I’m gonna do it. But having the patient talk to you — I think this is the big takeaway. You have to allow them time to tell you their story, because they will answer the questions on your paperwork. That’s rote work, right? Check the box, answer the question. But if you can get them to use their mouth, their words, their brain — and they can actually talk about what’s happening, why is this happening, this is what happened, then I went here — it allows you to ask those probing questions. You will get the golden nuggets. You will. So you have to allow them to tell their story, because otherwise — for me, I can speak for me — often I’m wrong the first time. Not always, but I can be. So if I get them to tell the story, then I get the secrets.

And that is my second principle. Often the secrets come at us — I don’t know why. Is the brain just withholding this information? Is someone punking Ronda? I don’t know. I don’t get it. But it’s always like at the very last of the conversation. So I’m going to tell you here about what happened yesterday. I won’t go into detail because we don’t have time, but I had this little 10-year-old girl, and the mom is telling me about the throwing up and all the things, and we get all the way through — we went over on our time a little bit because there were so many little twists and turns.

When she was four or five, she lost her grandmother, who she was very close to. Two months later, her best friend, Dog, died — Dog slept with her every night. They were inseparable. And within the next year, her parents got a divorce. So in my mind, this came about halfway through the conversation — I’m thinking, my gosh, we’ve got an emotional thing about loss and illness, and there’s gotta be some emotional stuff there. No one would disagree with that, right, for this little girl who’s 10 now. But I kept saying to the mom, has she always thrown up? Well, no, but she always had kind of a sensitive stomach. Okay, well, when did the more than just a sensitive stomach start? And she said, well, around five or six maybe. So now I find out about the grandma and the dog and the divorce, and I say, no wonder. Okay, that makes sense on the timeline. Makes sense. And then we get to why at seven years old is when the vomiting starts. And she said, we don’t know what did it.

So I’m zigzagging, zigzagging, getting whiplash, asking questions. She’s telling me this story. The little girl is there. She’s chiming in a little bit. And I’m asking questions. We went over time. We get to the very, very, very end. And I said, is there anything else that’s going to jump out of the bushes and bite me? In other words, is there any piece of information that will help me be able to provide more direction? And she goes, maybe. She said, well, this probably doesn’t have anything to do with anything, but she did have a root canal.

What? What? How old was she when she had that root canal? Seven. Second grade. I said, can you tell me what tooth? She didn’t answer, because she was late getting her paperwork to me, so she skipped over that part of the intake form. And while she’s looking and she’s going through her phone or whatever she’s looking, I’m pulling up a tooth chart on my Zoom call — the tooth meridian chart. You know where this is going, don’t you? Yep, you 100% know exactly where this is going.

The absolute tooth that was associated was tooth number 14, which has to do with stomach and spleen. And when I let the mom see it, she was shocked. She was like, my gosh. And then we were out of time. So I said, okay, I’m going to follow up with a long detailed email. I’m going to give you my thoughts. And then I said, I need dental records. I need medical records. They scanned her gallbladder. They did all kinds of things. You have to give me everything. I had nothing. But there we are with the root canal at the very end. I literally — my teeth about fell out of my head.

So you just have to let them tell the story. And had I not asked the question, I wouldn’t have gotten that information.

All right, principle number three is: don’t let what the patient says drive your thinking or your theory. You have to be able to think independent of what the patient says, because if you don’t, then the patient is gonna be the one that says, well, I think it’s this and I think we need to do this. Never let that happen. Your job is to listen respectfully, and then follow the evidence. You have to look at the test results. You have to look at what they’re talking about, and then you can make a good recommendation. So it doesn’t mean that you’re dismissing what they believe at all. You’re just taking it into consideration, but then as a professional, you have to provide the right information based on your clinical experience, guidance, and knowledge.

Number four is: don’t treat the symptom instead of the system. Sometimes we get so myopic — like you’re having hot flashes, let’s give you something for hot flashes — when really it’s the endocrine system that’s out of whack, including the adrenal glands. That’s an obvious one with menopause, right? So what we wanna do is make sure that we’re looking at the system, not just the symptom. I do this all the time. It’s like with the restless leg — I think, it’s her leg. So it must be mineral deficiency, it must be muscles, it must be nerves, okay. And I’m treating the nerve, but I’m not looking at the system. What system is being impacted? Why does she have this? When did it start? What systems are dysregulated? So look at the system and the symptom — I should say the system and the symptom.

Number five: sometimes the best thing you can do is to just take a step back and not do anything at all. Encourage the patient to look subjectively at their symptoms, but also to give you feedback about what’s working and not working. But also — don’t ask them so often to evaluate their symptoms. It’s kind of like the young man from last week’s episode. I call it navel gazing. When your head is so far in your navel — every symptom, everything, my big toe hurts, this little piece of hair hurts, the little back of my earlobe hurts — you get so navel gaze-y that you can’t see anything else, and then that can increase anxiety. So checking a stool or doing all of those things, sometimes that makes it worse. So sometimes we just have to let it happen and help them feel comfortable just taking their foot off the subjective. Create safety, create consistency, let their body feel safe with what you’re doing, and then you can come in with some support. That doesn’t mean that’s with every single case, but it’s with a lot of them.

And then lastly — have humility. It’s okay if you don’t know, and it’s okay if you say, I don’t know. I’m going to go find out. And if I can’t find an answer that suits me, I’m going to find someone who can help us. Either refer them out — like recently, I’ve referred several people out to a practitioner who does a certain type of tapping. We all know what that is. Because I knew that was not in my scope. I’m not good at it. I know how to do it, but this individual is really good at it. And so I said, okay, I’ve got a couple of people that I want to send. I checked with the practitioner and said, can you take these couple of people? Yes, sure. No problem. And now they’re getting better. And I’m thrilled, because it’s all about working together. So humility is me saying, I’m not real good at this, but I know someone who is. Or I’ll find someone who is. It’s okay. We don’t have to know everything. If you come off like you know everything and there isn’t anything that you don’t know, that doesn’t breed trust. People trust you more when you have humility and you say, I don’t really know. It’s not a weakness, it’s just your job.

So this clinical thinking series — I found it very interesting. And as you know, if you’ve been listening to the podcast for a long time, I don’t often do a lot of clinical. I mean, I do some, because I really love the business aspect and I think that the two go together very well, right? We think about like, well, I just need to know more clinically. So here you go — here’s some of my successes and my failures. But when we know more clinically, if you have a business that’s like a broken down car with only three wheels and no windshield and your lights don’t work — it’s all rickety and ramshackle and not doing well — you’re not gonna be as successful. In fact, I would argue that those businesses are more like a hobby. You’re doing a hobby and you’re saying it’s a business, but you really aren’t treating it like a business. And that’s the thing. We have to get serious about business, but we also have to sharpen clinical skills.

[CLOSING]

Ronda Nelson: So if you are one of those people who thinks, I need to know everything that I can clinically — I’ve got you. You go to Clinical Academy. It’s a monthly clinical membership. Think of it like Netflix. Like you don’t have to watch every movie on Netflix, but when you have something that you want to know more about, you can go log in and watch that movie. Same with Clinical Academy. You can go in and get the answers that you need. It gives you beyond the what — it gives you the how. So when you go to FMU or you graduate from school, you have some clinical advanced clinical training. That’s all the what. Clinical Academy gives you the how. It helps you implement. It gives you the strategies, the supplements, the protocols, the testing results, what tests to order. It gives you the practical how. And yes, you can get some of that in FMU and IFM and all the places. But this is the down and dirty, boots on the ground, in the practice, in front of the patient — how are you going to get them better? All you have to do is go to rondanelson.com/clinicalacademy. Go check it out. Join. If it’s not your flavor, fine, quit. But if you love it and you want to stay, I would love to have you.

And if you are one of those people that says, I really need help with my rickety business — and you know that the business side of things is not working well — that is when you need to be in Clinical Business Academy. It is where practitioners are literally transforming their practice. They’re making more money, they’re serving more people, and they’re doing it so easily. It’s just so easy because when you put the right systems in place and the processes in place and you understand how to structure a cash-based wellness practice, that’s when the revenue starts to come. You’re able to serve more people, and you can do it with so much less stress and such a grateful heart — because you’re doing what you love, but you’re doing it with ease. To learn more, you can go to rondanelson.com/cba.

And if you want the free resource — I’ve talked about it on the other five podcasts — go to rondanelson.com/6principles. That’ll give you a recap of what I’ve talked about today and a little bit more info. But thank you for joining me on this little six-week journey. I’ll be back next week with some more highly compelling podcast material for you. See you then.

[END]

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