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Medical Editor, Health&Healing

Joanne Pizzino, MD, MPH, is board-certified in Preventive Medicine and diplomate-certified in Integrative Medicine. After her own self-empowered healing epiphany in 1997, she has guided people to live healthier through both Eastern and Western medicine, ancient and ultra-high-tech healing.

Challenging Cases: Complicated or Complex?

By Joanne Pizzino, MD, MPH
Medical Editor of Health&Healing

Dr. Pizzino

The words health and healing come from Old English and Old Norse roots that mean “wholeness, a being whole, sound or well,” “holy, sacred.” As a whole being, you are so elegantly complex, it is awe-inspiring. This is what sent me to medical school so many decades ago. An important part of what over 50 years in health care has taught me is: “Don’t fix what ain’t broken.” A well-kept secret, even from the medical profession, is that much of what we think of as “symptoms” is really the body’s innate intelligence working to bring itself back into balance. There is even a specific medical term for this called homeostasis. For instance, if we get an infection that leads to a fever, the fever is not a bad thing to be avoided. Rather it is the mechanism of homeostasis working to rid the body of the invader.

Our fear of discomforts in the body often leads us to project they will result in dire consequences. While this may be an alarm bell signaling us to pay attention and take action to correct our environment, cutting the wires to that alarm can actually lead to unintended complications.

By suppressing symptoms so they don’t bother us, we can push the body out of balance in another area, like   squeezing a water balloon. Not only do medications and surgeries have known side effects, often there are bigger, longer lasting repercussions downstream. An example would be taking an antibiotic that not only kills the offending pathogen, but also wipes out a significant part of the microbiome upon which our immune system and digestion depend. This is an example of the difference between complicated and complex. When we mess with the body’s exquisite interacting complexity, we can quickly get very complicated.

The Challenge of Treating Symptoms

So, does any of this mean we can’t intervene to relieve suffering? Of course not. What it does tell us is to become much more aware of unintended chain reactions in our complex system.  That some “treatments” can lead us to other diseases and conditions is a concept which science is only just beginning to connect. For instance, having a cesarean section delivery may make your child at higher risk of multiple sclerosis. Or, frequent use of antibiotics for childhood ear infections may make autism more likely.

In my practice of Functional Medicine—which includes treating many complex conditions such as autoimmune disorders, cancer, chronic infections, gastrointestinal disease, etc.—when we take the time to follow the patient’s story all the way back, often into the womb or even genetic antecedents, we find that the trigger for the condition was actually a previous injury or illness. Sometimes a treatment contributes to promoting the ongoing condition. For instance, a woman who had multiple pain points after a motor vehicle accident was taking a lot of acetaminophen (Tylenol), ibuprofen (Advil) and other pain killers. These affected her liver and kidneys, causing further detoxification problems. The build-up of toxins caused her more pain, in an ever-increasing vicious cycle. Did you know that overuse of OTC acetaminophen is now the second-leading cause of chronic hepatitis after alcohol abuse?

Post-Surgical Challenges

Long-term consequences from surgeries are another area that is often not anticipated. Even after a successful surgery for, say a herniated disk, or bariatric “gastric bypass,” there can be after effects many years later. For instance, many people are ignorant of the toxic effects of anesthesia medications on liver or kidneys, or they do not forecast the massive stressful aftermath of major surgery on their hypothalamic-pituitary-adrenal (HPA) axis.

Changing anatomy can put stress on other areas. For instance, when part of a vertebra is removed to ease the herniated disk, it creates a new physical relationship on the vertebrae above and below the surgical site. When internal organs are rerouted as in gastric bypass, nutritional deficiencies can result that have far-reaching ramifications.

Medical Treatments that Cause Problems

Complications from our well-intended medical treatments are now so common they comprise the fourth leading cause of death. Truly, the cure can be worse than the disease. When we consider that the average American over the age of 65 is on five medications, we quickly become aware of the issues of polypharmacy. This is a set of complicated biochemical interactions that cause myriad side effects. These range from suicidal thoughts to toenail fungus; from one cancer that results from previous chemotherapy to hip fractures from previous steroid treatment; from weight gain due to anti-depressant treatment to heart irregularities from asthma medications.

One of the routine procedures I do with patients on multiple medications is to run a drug interaction checker. It often turns out that some of their symptoms are resulting from current drug interactions. You can find many free drug interaction checkers on the Internet, to start to coordinate your medications through your various health care providers.

Whenever possible, consider opening your mind and your heart to receiving effective care options that may not require medications or surgery. Get second opinions. Consult an Integrative Medicine provider to learn about complementary and alternative health care opportunities. If you have mystery symptoms or are uncertain what messages your health condition is giving you, try looking beyond lab tests and IDC-10 diagnoses by consulting a practitioner skilled at looking at you as a whole being.