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Candida auris is here-Be Aware

CANDIDA AURIS HAS ARRIVED IN THE US!

Heads up, folks! Candida auris is on the scene.

“What is it?”, you may ask.

Candida auris is a recently discovered strain of yeast related to other Candida yeasts such as Candida albicans, the yeast that commonly causes thrush and female discharge especially after taking antibiotics.

The important thing about Candida auris, sometimes just referred to as C auris, is that it is deadly and it is not killed by most of the manmade antibiotics that work on most other yeasts!

Candida auris is a dangerous new germ that arrived in the US in 2013

Candida auris was only first discovered in the ear of a 70 year old Japanese woman in 2009.  The name “auris” is Latin for ear.  Since then it has spread to 27 countries including the United States.  The first case in the United States was in 2013. It has now been found in 11 states including one case in Texas as of February 2019.  Candida auris is spread from one person to the other by direct skin to skin contact or it can be spread from one person to another by hand contact as for example a healthcare worker.  The germ Candida auris is extremely hardy and has been cultured from the arm pit or groin of someone affected (colonized) for many months.  It can also survive on a surface like a doorknob or countertop for over one month!  Some of the more common cleaners and disinfectants will not kill it, but alcohol based disinfectants like many hand sanitizers will.  The EPA has a list of sanitizers approved to kill the bacterium Clostridium difficile which seem to work agains C auris.  Note that bacteria and yeast are different, but C auris acts much like a bacteria in the body.  It can infect wounds, blood and tissues including the brain.

Candida auris is often fatal if immunosuppressed

Research has shown that infection with Candida auris is more likely to occur and to prove fatal in folks who have weakened immune systems (depressed immunity/ immunodeficiency).  This makes the very young and very old more at risk.  Also anyone whose immune system is weakened by diseases like cancer or AIDS or immunosuppressing drugs is more prone to infection and serious outcome from infection.

Public health organizations around the globe are extremely concerned about the threat of Candida auris including our own Center for Disease Control- the CDC.  Tom Chiller, PhD who heads up the Mycotic Disease Branch (MDB) is a lead spokesman for the CDC on the danger of C auris.  All confirmed or even suspected cases should be reported to local public health officials.

The US Center for Disease Control is very concerned about Candida auris

Candida auris grows readily in a petri dish but identification is tricky.

In studying Candida auris, scientists discovered something quite unexpected.  The unique DNA genetic material of isolates has been characterized and to the surprise of the scientists there are actually four distinct types of C auris depending on the geographic region.  This has generated one theory that the four different types all “evolved” at the same time, perhaps in response to some, as yet, unidentified environmental stimulus.  This makes one speculate about a wide range of environmental toxic threats like emf’s which now inundate us or the presence of many antibiotic and antifungal drugs or their breakdown products that exist as contaminants in our food and water.

In order to differentiate Candida auris from other less serious types of Candida, special drug susceptibility tests need to be performed in a specialty lab set up to do this type of testing.

Candida auris causes an illness similar to the blood infection known as sepsis.  This is characterized by fever and chills.  Depending on where in the body the infection occurs, other symptoms are possible.  Candida auris infection may sometimes be treated with the class of antifungal drugs known as Echinocandins.

To prevent infection with Candida auris or to prevent spread from one infected individual to another it is important to practice what is known as universal precautions especially hand hygiene and contact precautions.

Many healthcare providers don’t know about the threat of Candida auris

At least for a time, don’t be surprised if you know more about Candida auris than your healthcare provider does.  This is a new threat and the word is just now getting out.  Some predict that this may prove to be a serious calamity to our overall health so it’s good to pay attention.  Hopefully now you will have the information you need to protect yourself, your loved ones and your friends from this menace.

https://www.medscape.com/viewarticle/884470?src=par_cdc_stm_mscpedt&faf=1

https://www.epa.gov/pesticides/new-guidance-environmental-control-candida-auris-antimicrobial-pesticides

https://www.cdc.gov/fungal/candida-auris/index.html

https://cmr.asm.org/content/31/1/e00029-17

Book Review: TOXIC-Heal Your Body-by Neil Nathan, MD

Book Review: TOXIC Heal Your Body by Neil Nathan, MD-Victory Belt Publishing Inc. 2018

As a physician treating multi-symptom chronic, complex illness (CCI) caused by environmental illness arising from the cumulative exposure to a wide variety of environmental toxins, I have been finding Neil Nathan’s book, TOXIC, to be a very useful resource for patients and practitioners alike.  It is a valuable message of hope and healing.

Dr. Nathan has been treating this rapidly enlarging group of patients for a handful of years longer than I have, and he has created a tool box and approach to treatment that has proven extraordinarily successful.  Many of my diagnostic and treatment protocols align closely with those of Dr. Nathan; in fact he has been a mentor to me over the past few years.

” In my experience, the two major causes of overwhelming sensitivity are mold toxicity and Lyme disease (with its co-infections).  Neil Nathan, MD

In the introduction of Part 2, he admits that of all the environmental toxins that contribute to chronic illness in his patients, he finds the worst to be indoor mold toxins and infection with Bartonella bacteria.  This is probably surprising to some who might have assumed Borrelia spirochete infection (Lyme disease) to be at the top.

Dr. Nathan makes a clear distinction between the direct toxicity effect of environmental toxins and the sensitivity effect of the body to toxins which he ascribes to the nervous system.  I would include the body’s immune system as a source of this sensitivity effect, as well.

In the midsection of his book (chapters 8-20) Dr. Nathan lays out strategies for “rebooting the system”.  He chose this computer metaphor as an apt comparison of how in CCI it is often necessary to reboot various body systems before a state of wellness can return.

Dr. Nathan clearly explains the role of mast cells (a component of the immune system) in perpetuating many of the chronic symptoms of this complex illness as he explains Mast Cell Activation Syndrome which is getting lots of attention nowadays.

Dr. Nathan helps the reader understand the critical role played by the digestive system in CCI and the intimate connection between the digestive system and the nervous system (gut-brain connection) mediated in part by the important vagus nerve.

“Getting the intestines to work well again is an integral part of treatment, but this outcome may be difficult to achieve until the primary causes of illness have been adequately addressed.” Neil Nathan, MD

Dr. Nathan has had a close academic relationship over the years with Dr. Robert Naviaux.  In chapter 8, he summarizes beautifully the concept of the Cell Danger Response, as developed by Dr. Naviaux and the team of scientists with whom he is associated.  Although the science gets a bit “deep”, I really recommend this to patients and providers as well.

Dr. Nathan reaches upon his 47 years of treating patients with chronic illness to present in a very tender way that this illness is very real and that the prospect of total recovery is absolutely achievable.  I honestly  believe that many folks suffering from illness as well as there family and friends will be able to use his narrative to achieve a deep level of understanding and renewed optimism for the future.

“Because I have seen this process work for hundreds of patients, this is also a book of hope-realistic hope for really, really sensitive and sick patients.” Neil Nathan, MD

In the Afterword Dr. Nathan offers a message that is very close to my heart and one that I know many of my patients will relate to.  I think the best way for me to share this is to offer a direct quote from the author.  “Mother Earth is looking more and more like my chronically ill and sensitive patients.  If I were to apply the paradigm expressed in this book to her, I would immediately find the specific chemical toxins that were making her sick, remove her from those exposures (how I do not know), and detoxify her.  I would find ways to reboot those systems that are not functioning properly so that she could thrive again. … We must come together to do this.  We must reach out, talk with one another, and reestablish real connections to begin this process of neurological rebooting on a planetary level.”

He sprinkles in helpful case studies to illustrate many of his points for emphasis.

Veteran practitioner of environmentally acquired illness and author, Neil Nathan, MD

In my opinion, Dr. Nathan’s book, TOXIC, will prove to be a paradigm changer for those affected by and attempting to treat chronic complex illness.  I can’t recommend it highly enough.

Is Stress Making You Sick?

Tina’s Story

Tina recently came to see me as a new patient in my clinic.  Tina had always been a worrier and she had battled feeling anxious and having trouble sleeping through the night for years.  These had been manageable problems for her.  Then something happened that changed things for Tina in a big way.  Tina’s young adult son was convicted of a serious crime and he was facing imprisonment at exactly the same time that her husband was laid off from his job of twenty five years.

Almost overnight, Tina began to experience a dramatic increase in anxiety, a sense of hopelessness and marked increase in her insomnia.  She suddenly would experience a sense of panic.  She began to notice a host of new gastrointestinal complaints including diarrhea, heartburn, loss of appetite and bloating after eating certain foods.  She started noticing trouble remembering names and finding words.  She could not stay focused and was always forgetting why she had come in to a room looking for something.  She noticed that her muscles and joints ached almost all the time and she began to experience frequent headaches.  She had an overwhelming sense of fatigue and felt like she could not get out of bed on some days.  It seemed like she would cry over anything.  Tina told me that she wanted her life back.

Prescription medicines are often not the answer to chronic, complex illness

I see folks like Tina in my practice of chronic, complex illness due to environmental toxins almost every day.  Often patients like Tina are told that there is nothing wrong with them other than they are under too much stress.  This is not the case.  Usually the basic blood tests and xrays don’t show much, if any, abnormality.  Indeed life stress is often the straw that breaks the camel’s back when a person, like Tina, is struggling with disease due to progressive, on-going exposure to environmental toxins such as viruses, germs, molds, toxic chemicals like pesticides, toxic metals like mercury, and toxic electromagnetic energy from wifi’s and other electronic devices.

Reversing Chronic Fatigue Requires Addressing Three Areas

I have learned that to help someone like Tina return to her former state of wellness, I must help her address three things.  First, we must try to identify ENVIRONMENTAL TOXINS that she is suffering from in order to stop exposure and eliminate them from her body.  Second, we must identify why she manifests an increased sensitivity to the toxins.  This is called her BIOTERRAIN.  An individual’s bioterrain is what makes that individual act like a canary in the coal mine. The third thing that has to happen to return an individual like Tina to a state of wellness involves correcting an impairment of the body’s stress center known as the LIMBIC SYSTEM.

Correcting the limbic system is the subject of this blog post.

The Limbic System is the Motherboard of Our Brain’s Computer

The limbic system is that part of the brain that controls our sympathetic nervous system (FIGHT, FLIGHT, FEAR, FREEZE) and our parasympathetic nervous system (REST, DIGEST, REGENERATE, REPAIR).  It is made up in part by the hippocampus, hypothalamus and the paired amygdalas.  The limbic system is interconnected with the smell brain or rhinencephalon and is wired to almost all of the other systems of the body including the immune system, endocrine/hormone system/digestive system, energy system and higher brain systems emotions and problem solving.  It is like the motherboard of our brain’s computer.  The limbic system is especially susceptible to injury or impairment by environmental toxins and infections.  In Chronic Inflammatory Response Syndrome or CIRS as described by Dr. Ritchie Shoemaker, injury to the limbic system accounts for much of the pathology that he describes in his protocol.  Limbic system injury also explains much of the pathology described by Dr. Richard Horowitz in Multiple Systemic Infectious Disease Syndrome or MSIDS.

In centuries past when the world was not a toxic place as it is today, the limbic system would respond to THREAT with fight, flight, fear and freeze such as a fire, an attack by a wild animal-something obvious.  The sense of panic caused a response that helped the individual survive that threat.  The limbic system would then return fairly quickly to a state of rest, digest, repair, regenerate.  Unfortunately, the situation today is that the limbic system gets stuck in a setting of perpetual threat (fight, flight, fear, freeze).  This is also called SYMPATHETIC OVERDRIVE.  When this happens the limbic system generates false signals that cause real and measurable changes of the various systems under its control.  The immune system is off, the hormones are off, digestion is off, mitochondrial energy production is off, and your higher brain functions are off.  In short the whole body is in a state of disease.

Although I have known for years that stressful life events would trigger real disease, I used to think, naively, that elimination of the stress would allow the limbic system to return to a state of normalcy.  I now understand that except in rare circumstances, this is not the case.  I now understand that although it is important to 1. identify and remove the environmental toxins and 2. reverse the person’s increased sensitivity to toxins, it usually requires resetting or reprogramming the limbic system to completely clear the symptoms.  This process is fairly easy to learn but requires much repitition to accomplish.

Limbic System Retraining is not Difficult but Requires Repitition

There are a number of ways to accomplish this.  Some call it STRESS MANAGEMENT.   The term I like to use is LIMBIC SYSTEM RETRAINING.

Some of the most successful programs that I have found to accomplish limbic system retraining are Lindsay Mitchell’s Vital-Side program ( https://vital-side.com ),  Annie Hopper’s Dynamic Neural Retraining ( https://retrainingthebrain.com ) and Ashtok Gupta’s Amygdala Retraining ( https://www.guptaprogramme.com ).  These are not the only systems or ways to reset an impaired limbic system but simply methods that have worked for my patients frequently in the past.  Other systems that may be beneficial are HeartMath, Emotional Freedom Technique/tapping, NeuroBio Feedback and Eye Movement Desensitization and Reprocessing/ EMDR.  There are a number of other techniques that may also help.

To learn more about how you can recover from chronic, complex illness, I welcome the opportunity to work with you and my team of healers at Texas Integrative Medicine in Austin, Texas.

Aboutdr_tyler Wally Taylor MD

Dr. Taylor practices integrative medicine at Texas Integrative Medicine in Austin, Texas.  After obtaining a degree in Zoology from the University of Texas in Austin and obtaining a general medical doctorate degree from University of Texas Southwestern Medical School in Dallas he completed a general medical internship and residency training in head and neck surgery ENT and allergy.  After 20 years service in the US Army Medical Corps and practice in Colorado and Texas he founded Texas Integrative where he now offers a functional/holistic approach to disease which treats the entire individual instead of each separate symptom.  He has taken this integrative approach to chronic illness for the past 25 years.  His special interests are chronic, complex illness due to environmental toxin exposures such as mold, germs and chemicals.  He has found more satisfying results using this Systems BioIndividualized approach.  He is board certified by the American Academy of Anti-Aging Medicine.  His motto is Health and Wellness from Head to Toe”.   www.texasintegrative.com     office phone-512-800-5309.  

 

Exploring the Pain-Inflammation Connection

I sat down with Becky Andrews recently to discuss the approach that we take with our guests experiencing pain at Texas Integrative Medicine.

Dr. Taylor:

“Pain.  It’s just part of life, but It is definitely a two-edged sword.  On the positive side, pain signals danger to your body.   In fact without the ability to sense pain, you are at a big disadvantage.  The genetic inability to perceive pain sets you up for serious injury-say for example the inability to sense a hot stove leading to a serious burn.  Without pain limiting motion of a sprained joint, additional injury would likely occur.

Even though pain is a necessary part of life, pain that persists beyond the state of providing a protective warning signal, can lead to misery and disability.

When pain persists beyond the protective stage, misery and disability often result.

What is the root cause of pain?  Signals for pain come to the brain from nociceptors which are receivers in our skin, muscles, joints and other tissues that can convert pain-causing triggers like toxins, chemicals, acids,  heat, cold, pressure when they are strong enough to carry a pain message to the brain.   This is where the connection to inflammation comes in.  Inflammation is directly generated by actions of the immune system.  No immune system response equals no inflammation.  This would seem to imply that the answer to inflammation-caused pain is to “turn off” the immune system.  In fact some protocols to control inflammation-caused pain do exactly that.  Examples of this would be high dose synthetic steroids, methotrexate, adalimumab and etanercept.  The obvious down side is the fact that turning the immune system off or way down can leave your body unprotected.  After all, the role of the immune system response is to eliminate and contain the foreign infection threat.”

Becky Andrews:

“As a naturopathic doctor, bodyworker and acupuncturist, when considering a patient with pain, my first question is “what is the cause?”  I look at the pattern, history, location and quality of the pain.  If the pain is in a specific, fixed location,  I first look for structural issues.  Starting with skeletal alignment – checking to make sure joints are properly aligned and tracking correctly.  Then looking for muscular  / connective tissue injury or imbalance.  Improperly aligned joints can both cause and be caused by muscle spasm.  Muscle spasm and misaligned joints can cause pinched nerves.  Soft tissue pain from structural issues is localized and fixed (stays in one spot) and is often burning, gnawing, tingling, or sharp.  Joint pain that is due to injury to a specific joint is also localized and fixed with a similar pain pattern.  Acupuncture and bodywork are an amazing combination for correcting structurally based pain.  In Chinese medicine pain is considered a “stagnation” of either Qi (energy) or blood.  Acupuncture is able to correct the blocked flow of energy and restore function to injured or restricted tissues.  Pain relief can be immediate in some cases, especially for acute injuries.  My background in body work and physical medicine gives me a more complex and precise understanding of anatomy and structure, allowing my treatments to be more focused.  Combining the power of acupuncture to restore and correct the flow of energy with soft tissue release techniques facilitates a more rapid and thorough return to function and comfort.”

Dr. Taylor:

As an Environmental Medicine specialist my first considerations when considering patients complaining of persistent pain that is not readily explained by an injury or structural abnormality is to consider what root cause triggers may be inducing inflammation leading to the pain.  Infectious agents such as viruses, bacteria, molds, yeast and parasites, toxic chemicals like pesticides and toxic metals like lead and mercury, and physical toxins like emfs and dirty electricity are usually the most likely culprits.

I find that these environmental toxic triggers may be well tolerated by some folks while other individuals develop massive inflammation with only minimal exposure.  These sensitive folks act like canaries in the coalmine.

My job is to identify the toxins, eliminate on-going exposures, maximize the body’s ability to clear the toxins in a process I call detox and take steps to reverse my patient’s excessive sensitivity to the toxins using diet, nutrients, stress management, and lifestyle changes.

I have found this approach to be quite successful in clearing inflammation and the pain it causes.”

Becky Andrews:

“When pain is “everywhere” or is wandering around, then I consider systemic causes of inflammation.  Acupuncture can still be helpful in systemic inflammation by helping release “heat”  or “damp”and even signaling the body to improve its defenses, balance hormones, etc.  With systemic issues, however, I find that acupuncture is more of a “guide to the body” than the primary tool.  I rely on herbs, diet and nutritional supplements to help restore balance to the immune, inflammatory, hormone and nervous systems.  In some cases there is a pathogen (stealth infections) that needs to be addressed.  In some cases global pain is caused by consuming inflammatory foods (gluten, dairy and sometimes nightshades being the most frequent culprits).  In some cases exposure to mold causes systemic inflammation and body pain (often the fascia and joints of hands, feet and hips are first).  Having a body burden of heavy metals (lead, mercury, aluminum, etc) can also cause chronically tight, rigid muscles because the heavy metals get in the way of not only mitochondrial function, but they prevent calcium and magnesium from working correctly to contract and relax our muscles.”

Dr. Taylor:

Combining these techniques with other inflammation-reducing tools available at Texas Integrative Medicine like infrared sauna, photobiomoduation or “cold laser” treatments, ozone, and IV nutrients add  powerful approaches to reduce the pain associated with inflammation and structural abnormalities.”

In summary, when addressing pain, figuring out the cause of the pain is pivotal in selecting the correct tools to resolve the pain.  Pain resolution is not a “one pill fits all” situation.  It requires some good medical detective work, good physical assessment skills, and a wide pallet of treatment options.  On a more personal note, helping reduce pain is something we are both passionate about.

BECKY ANDREWS ND, LAC, MSA

Dr. Becky Andrews

Dr. Becky Andrews is a naturopathic doctor, acupuncturist, herbalist, body worker and is certified in permaculture design. On her meandering journey through life, she has been a ballet dancer, musician, amateur theologian, master gardener, mountaineer, cyclist, and a circus artist. Her passion is the fusion of paradigms and disciplines.  As a naturopathic physician, acupuncturist and student of permaculture she focuses on a “whole systems” approach to health challenges of the individual and the human condition as a whole.

Dr. Andrews  received her Doctorate of Naturopathic Medicine and Masters of Acupuncture at Bastyr University in 2003.  She is a graduate of the Boulder College of Massage therapy (1995) and also holds a BA in psychology from the University of Kentucky (1992).  Prior to practicing in Austin, she was medical director of Mosaic Natural Health Clinic in Seattle, WA and served as faculty at Bastyr University.  She has advanced training in environmental medicine, IV therapy, chelation, injection therapies, massage therapy and permaculture design. She has apprenticed with master herbalists, and native healers around the globe, and led a medical volunteer team in Kenya.  She has served on the board of directors for both the Washington and Texas Associations of Naturopathic Doctors and was the education coordinator for the American Botanical Council. She currently offers naturopathic consultations at Peoples Rx in Austin and serves as faculty at AOMA Graduate School of Integrative Medicine.

In addition to faculty appointments, she offers lectures & seminars for public, government, corporate, student and professional health education. Her practice specializes in complex, chronic and “difficult” cases, especially relating to digestive health, fatigue, hormone balancing, mood and detoxification. She works extensively with MTHFr and related genetic challenges as well as environmental illnesses from mold, heavy metal, and chemical exposures. Her combined training in massage therapy, acupuncture and naturopathic medicine give her a unique and multi faced approach to  treating chronic pain and injuries. Her decade of primary care experience in Seattle gives her special insight into combining naturopathic, traditional western and eastern paradigms with conventional medical approaches.  In addition to seeing patients and teaching at AOMA, she has a “secret” life as a trapeze artist.              Dr. Becky is accepting new patient consultations.  You can schedule an appointment by calling 512-800-5309.

dr_tyler Wally Taylor MD

Dr. Taylor practices integrative medicine at Texas Integrative Medicine in Austin, Texas.  After obtaining a general medical doctorate degree from University of Texas Southwestern Medical School in Dallas he completed a general medical internship and residency training in head and neck surgery ENT and allergy.  After 20 years service in the US Army Medical Corps and practice in Colorado and Texas he founded Texas Integrative where he now offers a functional holistic approach to disease which treats the entire individual instead of each separate symptom.  He has found more satisfying results using this Systems BioIndividualized approach.  His motto is Health and Wellness from Head to Toe”.   www.texasintegrative.com     office phone-512-800-5309