brimhall webinar 12-8-2010.ppt · 12/8/2010 · an introduction to functional diagnosis...
TRANSCRIPT
![Page 1: brimhall webinar 12-8-2010.ppt · 12/8/2010 · An Introduction to Functional Diagnosis DickenWeatherby, ND & John Brimhall, DC 12/8/2010](https://reader036.vdocuments.us/reader036/viewer/2022071018/5fd1c39d2f914b071f031e64/html5/thumbnails/1.jpg)
An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
1
Welcome!
The 4 Quadrants of Functional Diagnosis
Sxs of a Functionally Disturbed Patient
• Fatigue or low energy
• Digestive disorders
• Allergies
• Reduced immunity
• Hormonal dysfunction
• Sleep disturbances
• Anxiety or depressive tendencies• Reduced immunity
• Infertility
tendencies
• Weight fluctuations
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
2
What Is Functional Diagnosis?
Why Should You Bother?
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
3
The Four Essential Questions
Question # 1
Is there a dysfunction in this patient? If so where is it?If so, where is it?
The Four Essential Questions
Question # 2
What are the sources or causes of the dysfunction?dysfunction?
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
4
The Four Essential Questions
Question #3
What individualized treatments are needed?needed?
The Four Essential Questions
Question # 4
When has function been restored?
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
5
The Functional Diagnosis Hierarchyh ll i
1. The organs of the GI (digestion, absorption, mucosal barrier)
2. The gallbladder3. Adequate detoxification and
elimination (liver kidneys and
6. Adrenals7. Thyroid8. Sex Hormones9. Inflammation0 h S
Assess The Following:
elimination (liver, kidneys, and large bowel)
4. Optimal nutrient levels: tissue minerals , vitamins, and EFAs
5. Blood Sugar Regulation & Oxidative Stress
10. The Immune System11. Cardiovascular System12. Kidney and Bladder
Quadrant #1
Functional Signs andSymptoms Analysis
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
6
Are You Re‐inventing the Wheel?
4 Common Problems
1. Spending too much time asking questions.
2. Not knowing what to do with all of the information they gather.
3 N l ki h i i i l hi i3. Never looking at the initial history again.
4. Using symptoms as their primary means of tracking progress.
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
7
Health Assessment Questionnaires
• Tracking symptoms over time
• To encourage compliance
• To chart progress
• Substantiate the changes in their symptoms
• Assess Symptom Burden
Quadrant #2
Functional and NutritionalPhysical Exam Skills
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
8
A Y T hi YAre You Touching YourPatients Enough?
Functional and Nutritional P.E.
Skin Examination• Acne in adults
• Dilated capillaries
• Bumps on arms
• Dermatographism
• Low wound healing• Low wound healing
• Skin tags
• Vertical creases on forehead
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
9
Nail Examination
• Spooning of the nails
• Soft nails or poor growth
• Cracking of the tips of the fingers
• Red tips to fingers
• Ridging of the nails
The Mirrors of the Body
• Reflexology• Auricular Medicine• Pulse• Tongue
Ski• Skin• Applied Kinesiology• Neurological Reflexes
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
10
The HCL Point
The Enzyme Point
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
11
Quadrant #3
Functional In‐Office Testing
In‐Office Testing: Advantages• Easy to do
• Results back immediately
E t t t• Easy to re‐test
• Gateway testing
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
12
What are some of the tests you can do in‐office?
23
Functional Urinalysis Tests• Urine pH• Urine Specific Gravity• Bowel Toxicity test • Urine Sediment TestUrine Sediment Test• Urine Calcium• Urine Adrenal Stress Test
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
13
Other In‐Office Lab Tests• Oxidata Free Radical Test
• Salivary pH
• Dr Bieler’s test
• Zinc taste test
• Zinc challenge
• Kane’s mineral testing
• Tissue mineral• Dr. Bieler s test
• Gastro test
• Metabolic pH Testing
Tissue mineral assessment
Summary of the Benefits• Easy assessment of dysfunction• “Gateway” test • Results are immediate • Testing is easily performed • Reference point to make sure treatment is working• Reference point to make sure treatment is working• No expensive equipment• A great source of additional income
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
14
Quadrant #4
Functional Blood Chemistry Analysis
What You Need To Know
Blood Testing Is One of The M t I t t FDM T lMost Important FDM Tools
for the Identification of Functional Disorders and for Disease Prevention
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
15
Blood Chem & CBC Analysis‐Th F i l A hThe Functional Approach
• Oriented around changes in physiology and not pathology.
b d i l h i l• Ranges based on optimal physiology
• Use of tighter ranges
Some Other PointsSome Other Points
• Patterns and trends
• Fitting it into your FDM practice
• Approaching the Analysis
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
16
Sample Case‐34 year old female presents to clinic complaining of fatigue,
weight gain, infertility, poor skin, and a history of increased cholesterol. Past hx. of oral contraceptive use. On Physical exam showed a BP of 106/68, pulse 82, weight 142 lbs, tenderness in RUQ, rest of abdominal exam unremarkable, Q, ,skin: bumps on arms, generally dry skin, flaky on upper arms, nails weak and split. Chem screen and CBC: Cholesterol 210, uric acid 1.03, thyroid panel normal, CBC normal.
Only two values outside the reference range:
U i A id 1 3 (3 0 5 5)
Sample Lab Case
Uric Acid 1.3 (3.0 – 5.5)
Cholesterol 5.30 (3.36 – 5.20)Some reasons for a decreased uric acid?
Fanconi’s syndromeWilson’s syndromeSIADHHeavy metal poisoningMalignancies (Hodgkin’s or
multiple myeloma)Deficiency of xanthine oxidase
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
17
Complete Functional Analysis Using Foundational Hierarchy
GI dysfunction (Hypochlorhydria/ gastric inflammation, Pancreatic insufficiency, dysbiosis): globulins, alk phos, MCV, WBCs, Eosinophils, monos
Liver/Biliary dysfunction with EFA need: TGs, LDL, Monocytes
Minerals: Magnesium, molybdenum and zinc: uric acid, Alk phos, GGT
Vitamin Need: (Anemia‐B12/folate, B6): HGB, MCV, RDW, GGT, uric acid
Blood Sugar: Pancreas glucose, LDH
Blood sugar: Adrenal hypofunction: Potassium, glucose, LDH
Renal insufficiency: Phos, BUN/Creat ratio
Immune insufficiency: WBCs, Monos (recovery)
The Main Role1. The prevention of disease and dysfunction
2. The early detection of disease and dysfunction
3. Advanced patient specific treatment techniques
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
18
Treatment Must…
• Address the underlying cause
• Respect biochemical individuality
• Focus on restoring physiological functiong p y g
• Cause no harm
Benefits to the Patient• Improved quality of health
• Reduced costs
• Reduced suffering
• Increased likelihood of a cure
• Reduced incidence of premature aging, mortality, and morbidity
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
19
S f l I l i fSuccessful Implementation of Functional Diagnosis
Requires a System
S f l I l i fSuccessful Implementation of Functional Diagnosis
Requires Support
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
20
S f l I l i fSuccessful Implementation of Functional Diagnosis
Requires Tools
Who Will Benefit?• Patients with inflammatory conditions
• Patients with energy issues
• Patients with blood sugar dysregulation
P i i h di l di• Patients with cardiovascular disease
• Hormonal issues
• Dermatological conditions
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
21
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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC
12/8/2010
http://www.FMTown.comhttp://www.BrimhallSeminars.com
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