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Episode 97: On-air session - Daughter is having health problems, what do we do
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good evening everybody it's Nate G along with dr. Doug Lyall with the beat your genes podcast tonight we have a pre-recorded on-air session with a listener of ours who has a particular problem that dr. Lau is gonna try and help her solve so let's listen in hey Tracy how you doing I am good how are you good good alright you calling to calling us from where Canada okay very good go ahead gorgeous up there but getting cold I suppose yeah bright blue skies very cold very cold okay very good all right well let's uh just give me a feel for what we're working on and what we're trying to get better well um I I had a coaching call with chef AJ and she basically gave me a I can't help you you need to talk to dr. Lyle and I went okay yes so that's okay here all right basically she was she thought that you could give a new angle my daughter and she asked me what is the biggest dress in your life and I said my daughter she's got an illness she's had birth and trying to deal with it has well basically my family trapped into I don't know what trying to deal with it and trying to make a make her life happy and normal and yet trying to deal with it okay she has diagnosed within she's been diagnosed within caprices and and ureases do I need to explain what it is are you aware of what it is yeah we'll just tell ya let's tell folks what this is just explain it to us um an caprices is the inability to hold your bowel and enuresis is the inability to hold your bladder so okay like most children get potty-trained to 3 years old she is now 12 and she still has daily accident okay we have been I've been to doctors I I decided it was it was my problem to fix and I I've been very active trying to fix it but I have I've had varying degrees of accept success and our current situation is that oh where should I start that's why I'm looking at my notes the one thing that interested which I'd love to know your if you agree with the following I was told by the pediatric GI not to use depends or absorbent underwear because that will harm her emotionally and she will no longer play and although he's not concerned about the impact on me and my family and washing fecal matter out of clothes every single day so that is one thing that you know I don't understand with the advice I'm getting she has a different she has a difficult topic part of and caprices and enuresis is physical physically the body is there's no signal saying hey it's time to go to the bathroom now and a lot of what I've read is there can be an anxiety component so she's been looked at by psychologists psychiatrists and none of them have said have indicated anything of anxiety disorder which I kind of unquestioning because I have general anxiety disorder and I think if I ID is a component of this disease and mom has it I'm thinking it most likely would be that but none of them have said anything but anything saying she's got anxiety but currently the doctor like she has a difficult time dealing with accidents she does not have my help and has started - about a year ago instead of going to the bathroom to wash up her hands she like grabbed clothes and white or on the wall and she'll wipe it try and wipe it off because if she goes into the bathroom then you know Mom or someone's like oh do you need any help you know do you know dude like she people can tell if you go into the bathroom something's going on so I got my guess although it's only mom's gas but so now she's you know towels are being soiled and I'm washing walls and the the doctor went well then this has gotten a little bit weirder and she says now it's time to go to psychiatrist I think it's time you know she needs to be reassessed because she was assessed and in grade 3 and now she's in grade 7 she needs to be reassessed because we're looking at medication and I don't like dedication you don't like medication I'm like oh so now this new behavior is now causing more concern and what else can I explain to you we so to me she's like I've been reading by the executive function and the short term I just need to get pretend that I'm okay and cleanup is very much ingrained in her but the long term geez people will see that this towel is messy this wall is messy this she she doesn't get that she doesn't get that later on people are going to see it and it's going to take twice as much time to clean up and I'm wondering if there's an anxiety component there that she's panicking but I never see that because she's always hiding there's a big shame factor in this so right that quite and that she you know she does retreat kind of into herself and she spends a lot of time on the computer but if you're not sensing a sensation from your body normally computer also zones you out so she has more accidents on the computer so I'm like okay you can't do that but in this day and age it's kind of hard for me to say now you need to do some crafts and you need to read instead of going on the computer because of this illness and she hates this illness more than all of us and we really hate it so so I like I'm trying to you know guide her to do other things right and you know anyway so that I think that's a short thing if you have any questions here I am well let me ask you just a few questions about this about both these things so she's got and capricious and enuresis both the yes let's let me ask this what do we know about nature of her bowel movements are they are they hard and dry are they mushy what do they like well they yeah depends on we follow the Collins protocol which is okay kind of for you for years and years we we did the peg or whatever you call it in the states that add draws water into the intestines and move things along and it didn't solve the problem it just made her more frequent accidents how was that done what was the mechanical method by how did they do that well we gave her a drink every single day at night hmm okay it has a polyethylene glycol in it yeah got it okay all right that's got so some Mickey Mickey Mouse way of doing this let's uh and so tell me now what what are her bowel movements like today what's what's typical typical is the Colin protocol says if you have not had a large bowel movement during the day then there there is a series of first relaxation it's called power hour for an hour you try to have a movement and its first relaxation then suppository and if that doesn't produce a bowel movement then it's more relaxation and then an enema and I think that's it at the end of it and it's like every 15 minute okay healthy design job no worries what I what I'm asking is I'm asking what the nature of the stool is like it can it its lows between pebbles and um large we always part large and sutt like it depends if she has a blockage than there's leakage around the blockage if she's constipated it's little pebble pebble if if we've got enough fiber into her diet then it's normal if there isn't uh she's like there's a the stool scale she doesn't have a specific all we the one or always a to it changes around depending hey so let me let me ask you this has she ever consistently and I'm buying me consistently for maybe a couple of weeks has she ever consistently had a diet that that was essentially plant-based high-fiber where she had basically normal mushy soft but well-formed stools for a couple of weeks no because okay ah go ahead and fighting against I'm fighting against the pleasure trap and she won't eat my food she looked a little bit we're talking a little bit and I've tried yeah I'm beating my head against a wall right alright so tell me tell me more about your daughter in terms of her is she she like in regular school right regular rec social skills they tell me all about her regular social skills she went to one of our hospitals for like three months when she was in grade 3 and they did like academic testing and trying to figure out what was wrong with her and basically came back that she was above average very smart very social okay so she's above average smart social so she has essentially normal social skills she's not in special ed no behavioral problems etc okay alright so she's a twelve year old right now and does she have any siblings yes of course general 14 year old sister okay the all right now here's here's my first pass okay so this is not a problem I've dealt with before but I've certainly dealt with a lot of people with a lot of GI problems and and certainly an anxiety plays a role in some of these GI problems so the that's because there's so there's so many nerves attached to the bowel there's reasons why that's probably true I mean there's there's a lot of the the nerves will attach to muscles and so that they can contract muscles and the bowels need to contract in order to push a stool through the whole process and it's also true that that if you are in in trouble in the wild you and you need to you need to run for your life or you're under great threat you will very often poop because there will be such a high amount of nerve activation essentially encouraging those muscles to contract in order to empty the bowel so that you'll be faster okay so that's that's what we call being scared shitless and that that's characteristic of prey animals including humans the now I will I'm just going to tell you what I believe the truth is in this situation and I would be happy to talk to your daughter if she's bright and she's emotionally stable and she's a kind of a normal kid I it would be it would be my pleasure to walk her through the following logic the my my understanding is that a big component of this problem or a big observable component is a chronic constipation and so what what happens is is that you don't get you you get a lot of problems associated with this so oftentimes what are her bowel movements painful or does she tell you no they're not painful she does see your stomach hurts but she it's not - it's atypical because generally they they're painful but not for her though got it okay but her stomach hurts so there's things that are not square basically her GI tract is is not healthy now that doesn't mean it's terribly unhealthy and that she's courting any kind of disease process that's not what I'm saying I'm saying is is that her GI tract is not functioning properly and the reason it's not functioning properly is that she she can't tolerate the food that she's eating so the food that she's eating is is doesn't have a high enough fiber and water content when you when you gave her that drink that the the geniuses told you to give her that's like a hyper stimulating mess so that's not actually a consistent with the natural history of the organism and so what this kid needs is a shot at getting this right which means she needs to consistently three meals a day and everything else in between for a couple of weeks give her body a chance to actually regulate this process okay she's probably needs to have the bowel stretched out enough by fibrous enough diet in order to signal enough urgency she probably did she probably strains and so probably there's a little unconscious guarding of of actually making bowel movements the notion of sitting on the toilet and have having toilet hour I mean this is incredible this is this is Western medicine not staring in the face or not understanding what it is that they're dealing with you you won't see this problem in rural Africa okay the people that are eating non processed food ever have this problem they always have big spongy high water content stools that never cause any they're never little pebbles okay if your stools are little pebbles you know this is uh this is characteristic of an organism dead that the stool is staying in there too long she's eating animal food she's eating low fiber content diet she's eating processed flowers so that she's wicking water out of the colon there's a there's but the kid is not being fed I a lot of kids could tolerate this but a lot of kids can't and a lot of people can tolerate it and a lot of people can't so she's got you know this is just a digestion 101 problem that we've got the food wrong and everybody's looking in the wrong place so everybody's looking at her poop and everybody's everybody's looking in her bowel and everybody's you know looking at her habits and looking at her anxiety and nobody's looking at what's going into her mouth except her mom like you know but you're fighting the pleasure trap okay yes so you're fighting the pleasure trap the and you don't probably have enough authority to ram this concept down her throat okay because your mom so loudly need a higher authority you need dr. Schmo and I'm dr. Schmo okay so probably what we ought to do is we ought to have a Skype session where I talk to I talked to Tracy and I'm pretty good with kids I goof around with them and I get their anxiety down and then we'll start talking to her about poop I'll talk to her about my poops I'll talk to them about my mom's poops okay and I will talk about about this and we will joke around and then I'll walk her through some logic okay and what we're going to want to do is we're not going to want to tell her what's going to happen we're going to want to have an adventure that it's going to be an experiment and an experiment where we're going to keep our fingers crossed and hope that we just might have a solution okay and that I think that we do have a solution but I'm not sure so that's that's what it is that we need to do and so what I would recommend that you do is that you uh you tell her that you talked to dr. Schmo you know he's a man from California dr. Lisle and he's an interesting guy and he had some interesting ideas you've heard him speak and he's spoken about digestive problems like this and he you're not sure he's right okay so make sure you tell your daughter that you're not sure he's right okay but but he but he sounded like he's dealt with cases like this before which incidentally I have I just haven't dealt with this specific case but dealt with cases very similar and so he's dealt with cases like this before and he feels like he might be able to help you and it might be worth a try okay okay and so if she says no then you don't touch it for a while okay back off about two three four weeks and then just say you might might want to try to doctor tried to talk to dr. lion one of these days he he said he'd be happy to talk to you okay and then just shut up okay and then we're going to circle back around probably sometime if we're cool enough about it sometime in the next couple of months she's going to have to nibble at this cracker okay okay you don't have to sell it hard you just say well I doctor says he thinks he can fix it okay that kid is suffering it's embarrassing to daily crisis okay and so sooner or later she's going to nibble and when she nibbles you say oh he said he'd be happy to talk to you and and then I Skyped his best because I can read facial expressions and I've got kind of a friendly smile so I can I can con kids into believing in me and that's the best shot we have I have to tell you excuse me what's your daughter's name Emily and got it yeah I was I had taken notes here and I was thinking it was Tracy I'm sorry you're Tracy yeah you're what we want to do Tracy is we want to see if we can we can actually take a serious run at what I actually believe the Cure is okay so I think I think this kid for all individual differences both genetically and probably in the early setup of microbiome in the in the colon that there's going to be pretty significant individual differences in how easy bowel processes go for people and I think from the jump Emily had a rough go for whatever reasons okay and and now what we've got is we've got a kid in the pleasure trap that happens to have a particularly problematic bowel situation and now she she can't see her way out of this and she doesn't believe in any in any chart that would get her you know any stepping stones that would get her out and she doesn't believe in mom mom doesn't have enough authority and all these other doctors nobody's talking about this okay yeah so she's not been hit between the eyes by an expert and it's better that it's an expert from afar all the way in in California USA all right and so the expert from afar is going to tell her how this is done and then we're going to roll up our shirt sleeves and I'm going to tell her that we're going to choke down this food and we're going to just see if the great dr. mcdougal is right because of course I'm going to blame it on higher authority than me okay so this is all going to be the great authority dr. mcdougal who wrote a famous book called dr. MacDougall's the digestive tuna and it's a terrific book and right and digestive tune-up he would go right down the line with what it is that we're suggesting I'm pretty sure it's been a long time since I read that book but the we we will also we will talk over what kinds of foods gosh you know the truth is the truth of the matter is is that we have a really smart digestive doc here named dr. Michael clapper and I think what I'm going to do when you tell me that we've got an appointment I will get myself a 10-minute consult with dr. Klapper as fast as I can so actually after after we talk with Emily then I will run to dr. Klapper so I will get from dr. Klapper the smartest list of the food process to make sure I'm not missing anything important I don't think it's that hard okay I think this kid needs to eat steamed vegetables and needs to eat some salad and need to see some baked potatoes and needs to eat you know she did she have any other GI any stomach pain on digestion or anything like that any problem digesting food burping you know anything like that no no yeah probably she doesn't have any problem digesting things like rice and beans and potatoes and you know etc so but I will I will check with dr. Klapper because he has vast experience in GI issues and I'll make sure that we get a list of foods that are approved by by the doc and then we will see if we can get your daughter to roll up or shirtsleeves like a good little scientist and let's go and we're going to run a grand experiment we're going to try to solve the problem okay okay okay I will go to her tomorrow and I'll plant the seeds and see if she bites or not well let's see how we're going to do it I just want to I want to reiterate how it is that we're going to do this we're going to say that you you got a chance to talk to the doctor in California who actually knows quite a bit about this sort of thing and and he said that he thinks he knows how to fix it Hey and and so if you want you you've arranged so that she can talk to me okay and he's goofy he's got to use a really nice sky and he's a little bit goofy and and you're not sure he knows it all but he's got some interesting ideas and it might you know there might be an answer okay okay that's what we're going to do and then keep in touch with me by email let's just see how that goes okay now I wouldn't be at all surprised to see her pull away from that you know there the initial reaction of many people is no okay they can feel the anxiety that it won't work for them that they're going to be examined again that they're that they have to go through the embarrassment of acknowledging that they're a person with a problem even to a new doctor they don't they don't conceptualize it think of it think of a 60 year old man going into his urologist talking about erectile dysfunction like not too wild about having that conversation okay so no twelve-year-old kid is wild about having a conversation that they can't hold their poop in their pee so I'm wondering if the enuresis is is taking place at the same time as the bowel movements or do you know I don't know the mean opening problem the end caprices the enuresis is just as prevalent yeah I'm wondering if a lot of times those things could be taking place at the same time okay so yeah and so it could be that we basically really have one problem and we've got a kid with a with a very haywire bowel system you know a real touchy sensitive bowel system that cannot handle the diet that it's being fed and in that that system cannot handle that kind of confusing neural inputs that are coming from that diet and you know you're fighting the pleasure trap inside the kid's head any do we have and the rest of the family you got you've got another what you've got another daughter and you got it you got a daughter and then a husband yeah so you got four of you in the house the what's the what's the state of situations in the house with respect to food healthy food all that sort of jazz mm-hmm oh where do I start I have my side of the kitchen with a freezer in the fridge if they have their side of the kitchen with a frittata or in the fridge doesn't have any Emily doesn't have any dairy because she's allergic to dairy that's one of the things the hospital found out okay beyond beyond that my oldest and it drives me insane yeah but yeah they're they're learning they will eat what I feed them grub for grudgingly my job and cooks some some whole food plant-based food sometimes he does it all depends um got it good so your husband's not like openly hostile and making fun of you and that sort of thing no okay that's good yeah so yeah they're it's not a it's not the best situation it's fine it's not the worst situation at all this is sort of situation normal where there's a respectful resistance in the family to somebody who's trying to do a really good job because everybody's got their own life and they've got their own risk assessments etc so but in this case it's going to need to be true Emily rolling up your shirt sleeves in a grand scientific experiment the chariots to run and and she that is going to make her special and it's going to make her heroic she's going to be like a little a little soldier for truth here for a couple of weeks and what's in it for her is we may win okay so we're going to try to put that excitement in front of her and a sense of adventure and a sense of that we're going to learn something no matter what happens and so that the etc so we're going to that that's what we're going to try to do Tracy and like I said let's put it in front of her now then you you let me know by email what the reaction is if it's negative we're going to be real patient and then we're in a circle back down in two to three weeks and just touch it again okay and very often people will bite on three four you know a couple months three or four hits down the road they will suddenly the idea gets less and less scary and and and then then we can sell them okay and there's a lot of other things we can do to sell but we're going to just start there and see what happens okay I will do that jump sound good sounds like a plan thank you twelve twelve years it's been a it's been a long hard read and I'm sure very frustrating yeah yes it it is if someone said hey for 12 years you're gonna have to deal with this I would have said I can't do it so it's a circle for me difficult difficult right well you got to the the good news is that the very good news is that there there's probably nothing significantly wrong with your daughter physically other than you know this this moderate level abnormality that is probably probably fairly easily corrected and so he's gonna be pretty darn once she finds the answer she's not likely to give it up because I the enormous relief socially and the inconvenience of it all humiliation the once she actually discovers the solution she'll be on your team forever so the yeah let's give this thing a shot let's see if we can let's see if we can get a kid home okay okay I'm good I will let you there very good Tracy well thanks for calling in and keep in touch and let me know how things are transpiring and and we will we'll team up on this thing and see if we can get a win okay I'll let you know very good thank you bye-bye okay bye all right well that concludes the on-air session with dr. Lyle and Tracy I want to thank Tracy for calling in and sharing her story with us and we're gonna hope for a for a resolution to this problem
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