A Tale of Two Tacks

Dr. Sidney Baker, MD is credited with his great example of the “Tacks Rules” when trying to unravel patient’s health problems.

Rule #1: If you are sitting on a tack, it takes a lot of aspirin to make it feel good.

Rule #2: If you are sitting on two tacks, removing just one does not result in a 50% improvement.

Now you could replace the word ‘aspirin’ with anything else: the hottest selling pain reliever, vitamins, psychotherapy, surgery, chiropractic, etc.  But the rule still applies, and the proper treatment for tack-sitting is…tack-removal.  Identify the root cause of the problem and remove it.  Too often conventional medicine pushes a masking of symptoms with medications, rather than an identification of root cause and proper treatment.

Sometimes the problem may not be so obvious.  What if I were to tell you that a patient came in today with a sore toe.  The pain started earlier this morning when they were getting dressed and used their big toe as a furniture finder.  The cause seems pretty obvious in this case, doesn’t it?  We could assume that it was just an accident, being a little careless, hit the toe and in a few days be back on the go.  However, take the same injury circumstances, but this is the third or fourth time this week that this has happened.  The picture begins to change.  Some may assume that they are just being clumsy.  There could be other underlying problems in this situation.  It could be a balance problem from vestibular disturbances in the inner ear or brainstem.  It could be sensory loss from a peripheral neuropathy due to a herniated lumbar disc.  It could even be the earliest sign of a diabetic neuropathy in a patient unaware they have diabetes.  Moral of the story?  Sometimes root problems can be hiding and require some investigation.

Unfortunately, in today’s modern “healthcare” time is lacking.  Most doctor-patient encounters last a few minutes without time involved in trying to understand the patient’s condition.  Dr. Jerome Groopman, MD, author of How Doctors Think, states that “on average, a physician will interrupt a patient describing their symptoms within 18 seconds.  In that short time many doctors decide on the likely diagnosis and best treatment.”  Some may try to argue that this just shows efficiency.  Really it just shows that doctors don’t take time to listen.  Don’t get me wrong there are many excellent practitioners out there, but they have succumbed to the pressure of treating an HMO, and not the patient.  They have caved in to pharmaceutical education, rather than poring through the volumes of literature that support natural medicine and functional medicine approaches to care.  All patients must be placed neatly in a box, defined by a code number and diagnosis name in order to have insurance reimburse practitioners for their time.  But what about the vast majority of people that don’t fit neatly in a box, what about  the two-tack setters and their symptoms that don’t make sense, but there is no time to fully evaluate them?  If you have been through the medical machinery, you know what happens when things don’t make sense.  You are sent for a psych evaluation because surely you must be depressed, or anxious, or crazy, or just maybe Zoloft deficient.

To begin an investigation into root causes it helps to think of yourself as a plant.  Yes, I know this is rather simplistic, but it helps.  If you had a plant on your window sill and it failed to thrive you would think one of two things.  First, you would consider whether you failed to give your plant something it needed to thrive and flourish.  Second, you would consider if they were exposed to something that harmed them.  These two same questions can be asked of your medical complaints.  That is where the investigative journey begins.

Many individuals today are definitely lacking things necessary for optimal health.  These include vitamins, minerals, fatty acids, amino acids, adequate sunlight, clean air, pure water, positive thoughts and healthy management of stress.  People are also exposed to more things that are inducing harm such as: allergens, heavy metal toxins, endotoxins from gastrointestinal infections and synthetic chemicals.

One thing we see very often in our practice is depression, cognitive decline and fatigue.  These individuals are on an average of 3-5 different medications trying to treat symptoms.  (Many times they are on medications to deal with the side effects of other medications!)  Yet they still don’t feel healthy.  Their primary care provider will inform them that “everything is normal”.  They come to see us as a last ditch effort and as we begin to pull apart their history and gather laboratory data on their individual biochemistry, we find that many have underlying chronic gastrointestinal imbalances that have lead to ‘leaky gut’ and a major drain on neurotransmitters and hormones.  This can be the starting point, or in the tale of two tacks, the tack that is leading to a symptom picture that doesn’t fit in the box.

By removing the offending pathogen, rebalancing gastrointestinal flora, replacing digestive enzymes and repairing the gut mucosal lining these patients experience a dramatic reduction in their depression and significant improvement in their energy levels.  Now this is just one example.  Another patient might be presenting with fatigue because their blood sugars are all over the place each day, placing tremendous stress on the adrenal glands and affecting the conversion of thyroid hormone.

So what can you do?  Find a functional medicine practitioner in your area.  Schedule a consult with them and see what kind of practice they have, what kind of tests they offer, and will they listen to you.  For example, in our office we schedule adequate time to listen to the patient’s history and provide them with a multitude of questionnaires to help identify root causes.  From this information we are able to recommend objective lab testing to show areas of significant dysfunction.  We may test with a stool profile for gastrointestinal health, saliva testing for hormones, blood testing for standard labs or amino acids, urine for organic acids or heavy metals and many other functional tests that are available to health care providers.

It may take some time to identify your “tacks” but you will be much healthier, happier and able to perform better once you truly address your health needs.

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