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Practical Healing

Bethany Ortlip, FNP from Practical Healing discusses functional medicine and empowering patients with Nick Angelis, CRNA. Cutting-edge TMS, ketamine infusions–or breathing and eating better? What happens when we get too obsessed with our health? Chiropractors, naturopaths, nutritionists, psychiatrists–how much is too much? Transcript below.

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hello and welcome to the Ascend Health show I’m Nick Angeles I’m a nurse anesthetist and one of the owners of ascent Health Center and I’m here with Bethany ortlip a nurse practitioner which I’m so excited that I have a fellow nurse on the show yeah I know I was excited to see you’re a CRNA and you can collaborate on that absolutely so instead of this being an interesting show for our viewers about functional medicine we’ll probably just talk shop for half an hour exactly all our nursing experiences right and everyone will be like maybe I should go watch a cat video instead this isn’t really doing anything for me so in order to prevent that I’ll start right away by asking what’s the philosophy of functional medicine because they’ve had several functional medicine providers on the show I have a background in it myself nowhere as extensive as yours but a lot of times it it’s not something where it’s like oh the medical doctor believes that or here is a holistic practitioner or a naturopath so what is the philosophy of functional medicine for you it’s a great question functional medicine is root cause medicine and it’s holistic so what does that mean it means that we care about the whole body we care about the body mind Soul and Spirit that’s what holistic care means and then root cause medicine is not just what are you dealing with what is the diagnosis you have or what are the symptoms you have but what is the why behind that why do you have a headache why do you have eczema and how did we get there so functional medicine really does a lot of investigative work and trying to look at what’s Upstream causing these Downstream symptoms what how did we get there to begin with where was the root cause and then rather than just for example since I mentioned eczema putting a topical steroid or a cream on top of the skin to treat that condition and you have to rely on that for the rest of your life what could we do to understand what’s the root behind that why did the rash present in the first place so that’s kind of the approach we take and we really do a lot of questions ask lots of questions and do a lot of listening and try to understand that Upstream cause yeah that makes sense because I think sometimes uh in digging for the root cause you might find out that the answer is not in a medicine it might actually be an avoidant for example uh for I think it was in 2008 when I first started hearing about gluten-free yeah it was very exciting and then within a few years there were so many processed gluten-free foods on the market that all of a sudden became grain free yeah and I was like well what’s next there are people just going to be eating solid water this ice that’s all your diet that’s all that you can have everything else will cause you all these autoimmune issues so this is how you have to live yeah so is there an end to it sometimes of like listen this is the best we can do we’ve dug down as deep as we can and you just have to live with this how do you find that balance yeah and that

that men either with in a symptom or something going on we and a lot of patients come in with multiple things right it’s like I have headaches that’s why I’m here but I also have this rash and these infections that have been recurring for years and digestive complaints and oh I can’t walk because of joint pain so it’s a wide variety of symptoms and when we look at the foundation of our lives so what are what does our sleep look like what does movement look like what is our nutrition do we have significant stress in our lives are we in community with relationships and once we kind of address the those foundational Five Pillars then sometimes a lot of those symptoms will start to go away and then we identify well what remains right so okay the headaches are still there so we’ve worked on all these things what’s the next step um so kind of taking a a holistic natural lifestyle approach initially can kind of help us narrow down our Focus right so what you’re saying is that it’s a patient empowering thing because it doesn’t necessarily mean the solution is medicines and seeing me all the time yeah because a lot of times especially with self-care practices like functional medicine usually is the patients say well I don’t have that much money yeah and so you can say something like well you know what it doesn’t cost that much to have a healthy relationship with your family or to get in touch with your spirituality or to do some of these other things that are 100 in your control breathing is free right it is free to breathe yes although we did have a contract with an oxygen company at our clinic for a while and I was like you know what this is very expensive for oxygen or something that’s in the air right so I bought an oxygen generator instead sure certainly but but point is like often four out of those five things are completely under the patient’s control and so then with more Authority we can say okay you’ve done this then absolutely we need to do this extensive process with medications or supplements or testing because we’ve already taken care of everything else correct you’ve done very well you’ve gotten the ball rolling and rather than giving up now is the time that we use our medical expertise to keep going that’s right um we you know once we address those foundational principles and we continue to do that the next layer up is okay well maybe there’s some nutrient deficiencies we need to supplement or correct or in our diet or through supplementation or both or testing additional testing do we need to do some more investigative work behind the scenes of what’s our cortisol levels throughout the day and adrenal function and so yes there’s definitely layers to it as we go now granted I’m talking about an ideal situation sure sure I own practice at Ascend we’ve noticed it often works the opposite way where we’ll use a ketamine infusion or a new psychiatric drug or some intense EMDR therapy and then because the ball is rolling then the patient’s like you know what I am willing to try all these things sure yeah and sometimes it takes just stabilizing someone and showing them hey you know magnesium and Omega-3s in a good multivitamin that can might help to decrease the amount of headaches that you’re having and then you’re able to do more walking outside because you’re we’re addressing a symptom where we always want to look at the root cause but it’s okay to treat a symptom that might give us a clue as to what the underlying causes okay so then um this is all great topics but I think because is so you work at practical healing which is inside Marigold Wellness yes which they have I assume infrared saunas correct who wouldn’t have one of those and massage therapists and a lot of other holistic modalities probably some yoga classes too correct they do yep you think of it they’ve got it pretty much right because I mean and I think that is the Future model of healthcare like in Fair law collaborative team yeah in Fairlawn we have Dr Mikhail Rath and the chiropractor at HealthSource yeah um Dr Bob as well and then we work a lot closely with them and massage therapists and we say look between the three of us we’ll get this figured out because in the past I would try to send patients to Exotic Specialists and they nod and smile but they won’t really go yeah so it helps to have a very close connection right there yeah so how does the process start for a patient like they have some issue usually they’ll see their doctor first that’s you know they’ll go Primary Care it doesn’t get better they might go to a specialist or two realize oh this is covered by insurance but not really and I’m no better and now I’m confused and have a few extra meds to take every day so then I assume they show up at your doorstep what happens next yeah so if they come in as an initial patient we sit down with them for about an hour and a half and really just dive into their entire history and let them speak freely about what’s going on we often create a timeline and really look at their whole life as a whole to address you know where did things start to go off the bandwagon so we do that a long initial appointment and then at the end of that after we’ve been able to speak for a long time develop a relationship and identify some areas to work on right from that appointment that might include referrals within our team so within practical healing we have a wonderful nutritionist and dietitian we have

a pelvic floor therapist we have counseling we often do referrals to health coaches and there’s a chiropractor at Marigold there’s infrared sauna magnesium float pools we have a lot of different modalities to use right right at our fingertips right in that space okay that makes sense so and again I usually don’t bother doing this during the show because it’s kind of boring but in this particular episode it actually makes sense at Ascent Health Center you just start with a therapist or with a psychiatrist that go over all your meds and then they decide you know what all you need is a simple antidepressant and you’re good or you actually just need therapy why don’t you continue seeing a therapist every week or in this particular case ketamine infusions although they’re mostly self-pay is going to be what helps with all these troubling symptoms of fibromyalgia and depression and just this huge web of interconnected issues or hey you know what it’s bravado which is paid for by insurance is a ketamine product that you should look at because it’s more sustainable or yet again transcribing magnetic stimulation because it doesn’t involve any pills it’s just an electromagnet helping your brain get over anxiety and depression yeah that’s what’s going to help especially if there’s digestive issues or strange responses to meds because we can do Gene site or other testing that will say okay this med and this med works with your genetics but as you’re aware because functional medicine does take genetics into account it’s one thing to say okay here’s a gene that’s triggered it’s something else to say well here’s the exact Pathway to inactivate it or activate it a lot of that sounds great but again your guy’s name is practical healing yeah and it means that the reason we talk about that in our visits a lot of we want to you know develop a plan that the patient is going to be able to do the best plan best nutrition plan is one that you can commit to so we kind of Meet the patient where they’re at um but yeah it’s it’s a pleasure to be a part of and it I really think that it’s like you said um I think you mentioned earlier how needed it is in our role today conventional medicine you know we work alongside them and we’re not against conventional Medicine by any means we’re thankful for life-saving services and surgeries but I think we could do a lot better on the preventative side of things and Longevity and quality of life and I think that’s where functional medicine comes in and I think part of that is probably educating the patient because uh so this is just me it’s not really my patience I really shouldn’t do it as often as I do but I often talk about the economic portions of the care like here’s how much this will cost you or here’s what it’s worth because for me if I go to a restaurant like well yeah I do think these cheese sticks are worth six dollars right so a lot of times things are Financial but I feel that your health should be actually because whether it’s your time your money the risk of a medicine actually making you worse like these are all actual issues that should be evaluated when you’re deciding a treatment and you know 40 years ago the doctor would say here’s what you’re going to do and the patient would say yes sir and because those are usually a sir and then go and do it and that’s the end of it but now like the patients say yeah I’ll do this prescription and then they look it up on the internet and then they look at their bank account and then things sort of get muddled so in order to have that kind of agreement between patient and practitioner it does take okay here’s your Alternatives or here’s the specialist that may be covered by your insurance although you even though we take insurance at Ascend usually I refer to it to insurance as um a Groupon for a restaurant you don’t want to go to yeah it’s a discount but we’ll actually do what you need it to do will it cover what you really need done yeah so do you all use any conventional medicines or is it usually supplements yeah we definitely try to focus initially on As Natural as we can um if we can avoid using a medication great but we’re not against it we will prescribe medication if it’s if it’s needed my background is in Primary Care family nurse practitioners so it’s within my scope uh certainly but we we definitely take more of a holistic traditional approach but work with medicine too if we need to that makes sense so like you mentioned a steroid cream for eczema so you do usually not bother with the sort of quick fix type of medications I would yeah I would say usually patients have tried that by the time they come to us patients have gone to their Primary Care referred to Dermatology have this cream and then didn’t work or it’s working but they want to get to the underlying cause and then they come to us and that’s where we can look at gut health or look at inflammation in the body or what are the food triggers that potentially are causing this inflammatory rash so that’s kind of what most patients are coming to us looking for and you know certainly if you’re at work and you can’t stop itching and your your hands are inflamed use the cream while we’re working on all these other things so we’re not going to say throw it away but we want to do both if we can so what you’re saying is that the a Functional Health philosophy is holistic not in a way like we’re going to use natural things but holistic in the practical way of like oh what’s working and if you really believe this is the way but it’s not working then you have to abandon it yeah which I think is very important because having been in the natural world for many years I’ve seen so many people who are like nope I’m not going to eat gluten ever again yeah and they’re the ones eating the gluten-free crackers corner of the party while everyone else is enjoying themselves or another example I give to my patients is it’s often too much of a cost to be 100 well meaning that for example um if you want to be vegan and you believe in the philosophy and then same party so in one corner as a person with a gluten-free cracker in the next corner is a person with a stick of celery yeah like again you’re missing so much on the other holistic things that you talked about spirituality a relationship with your friends um and I’m not saying that well like I said better go to all those cookie parties and eat all the cookies but there is a balance there where sometimes here is the wellness that I need to function and have a fulfilled life right not necessarily the wellness I need to have an easy life and you know it’s different for somebody who has celiac disease avoiding gluten is is a must for them but for if we have gluten sensitivities we know that we can take that out of the diet temporarily and reintroduce it maybe just at the birthday party during the week and throughout your normal life right you might be able to tolerate things much better and be able to enjoy yourself it’s reality it’s practical so well and that’s a practical thing you’re saying that you avoid it when you can but maybe you won’t avoid it to the point where you’re trying to get that lunch meat in in a lettuce wrap and it’s just not really working okay that makes sense like for myself what I do is I don’t buy any sweets for myself in the house like I can go without it it’s not a big deal and then if someone’s giving me free cookies I’m gonna eat the free cookies right so that makes sense and even the example of eczema so this is a personal example for me when I worked as a nurse anesthetist at hospitals 60 70 hours a week I’d get eczema so I did all the natural things and they helped for a while and then I went to medications I actually had a probably a every seven years it’ll get bad enough for the natural techniques of something that wouldn’t work I go back to dermatologists it’ll improve and they don’t get worse than it did before and I go back to Natural Things So I did that three times every seven years or so yeah and at the end I realized well now I’m using trim fire which is biologic injecting my leg and uh I’ve used natural I’ve used uh The Cutting Edge medical therapies and all of these sort of work but here’s another solution maybe I don’t work 70 hours in a hospital right so even though it’s difficult sometimes the root cause is like nope we’re not going to solve it we can keep on right trying to make this happen or we can just take something out of our Lives even if it’s precious to us because it’s not worth our health yeah and environment is huge and a lot of patients come in and and their work life balance or their stress at work or in an environment that they’re in is part of what’s exacerbating their symptoms and so we do a lot of conversations about how can we restructure things or how can we um we can’t always take stress out of real life what are things we can do to take a scoop out of that bucket of stress then that boils up and to prevent it from overflowing right like breathing and meditation and um calming things for the body and that switch us out of a constant fight or flight mode into parasympathetic yeah which I believe what’s supposed to be our original topic yeah but that’s fine but I’m thinking about because of the bucket because usually for Mast Cell Activation Syndrome or a lot of histamine disorders it is considered a bucket where you’re doing fine maybe they’ll eat some restaurant Food they’ll do this and also the bucket overflows and you have all these symptoms yes yep that’s right and I think one way to think of that is instead of this this bucket analogy it is well how can I start living this life and that is one reason why our clinics work so well together because a lot of times it is that mental health aspect of okay if I can see myself and who I am and my strengths and weaknesses better and not have this almost like this desire to be healthy for the sake of other people or for looking good on social media if I instead have a healthy relationship with with my own health yeah instead of a civil war of like oh I can’t believe I have this issue I must destroy it with we see this a lot in Lyme disease where I Must Destroy these hidden Invaders with every single thing yeah and then they’ll say well am I is this just a reaction of the medication and I’ve seen patients for years they’ll try toxic herb after toxic Urban continue to get worse but they’re like nope this is just my body fighting it off I just gotta stay strong it’s like well if you’re worse off than you were before maybe we need to reevaluate what are we really doing here and I think we live in an imperfect world where there’s no way we can get to a hundred percent perfection in our health at least not with still having some friends without living in a box of your own um yeah and so you know realizing what you personally are what you can handle and what level of extreme you’re willing to go right to accomplish that Perfection and I think at practical healing we really try to have a balance of that and say okay we want you to live a quality life in a long life and how can we get there but we also want you to enjoy it along the way yeah that makes sense so you’re saying it’s a mixture of precision and good enough for example the Mast Cell disorder I think I mentioned uh to previously there’s a new medicine out for his sonophilic esophagitis which I see a lot because I do a lot of anesthesia for endoscopies that actually inhibits mast cells I think it’s the walks of liver we can say whatever we want it’s Community TV so obviously they didn’t sponsors but um but it has some promise for other Mast Cell disorders or other disorders where the immune system isn’t working right and it won’t work as poorly as some of the humerus or other drugs that just you know they’re very expensive and all they do is take out your immune system it’s like well of course I feel better because my immune system isn’t working anymore but sometimes you can take those very precise medical Cutting Edge steps and realize nope still didn’t do it okay now I need to go back to the basics what you were saying let me work on my mental health let me get some good relationships and also if it doesn’t help you at least have some good support systems all of a sudden and it’s a both and right doesn’t have to be either or with conventional medicine and functional medicine or holistic medicine it’s both so try The Cutting Edge medication but you know are we working on shifting your brain out of a fight and flight response which is going to increase the histamine production from Mast Cell Activation in your body trying to flush out everything can we shift it to a rest and digest State and are we doing that while we’re taking the medicine and could it be even more effective because of that so we like to come alongside people wherever because there can also especially once you start more natural techniques it can also be guilt like oh I’m really going to pay for that cheeseburger I shouldn’t have done it I knew better and look the consequences of my actions are all you know all over my face in the case of eczema so I think and this goes into the spiritual component of right and wrong it’s not a it’s not the idea of like I can do whatever I want and my own health is more important than anything else because again we said you should still had friends and family around you and you won’t for very long if you have that sort of that attitude but it says okay well in this case I was out with friends and the enjoyment that we had together made it that it was okay to do this at this point so it’s not this very rigid guilt system because that itself will cause a multitude of mental health problems where you know maybe they came in with one problem to see you and then all of a sudden they have to come to my clinic because now the pervasive issue is this perfectionism of I must do better I must be better yeah and we’re on a health Journey continually and we’re always learning new things and that’s what medicine does and science does and we’re always researching a new Cutting Edge Products and just because you didn’t do something in your past and you say oh I wish I knew no where you’re at is where you’re at and it’s a health journey and that we often say when patients come to our door we say you know this is this is a start of a New Journey for you and um there’s going to be ups and downs along the way there’s going to be two steps forward one step back um and it’s okay to have the have the cheeseburger and not say I’m deviating from my journey but this is part of it right um and but giving patients the tools like you said earlier to empower them giving them the education the knowledge and the tools to when they don’t have to always come see us like right let’s get to the point where okay you’re you’re feeling well you are empowered you have the tools to leave our office and live a a quality life that’s what I think of too when you said Journey that a lot of times in the standard Healthcare System it is the idea of like come here often so we can bill your insurance often and you’re always gonna be stuck with us because we’re giving you medicines six months and so it becomes this whole system that you’ll get stuck in forever but I think with both of us we share the philosophy of like this is a journey you won’t hurt our feelings if at some point during the journey you’re like I don’t think I need them because you’ve got our number yeah if you’re wrong you can call us yeah if there’s many patients where I’m like you know what I haven’t heard from them for a year this is so great I’m glad that we got them to where they needed to go and they didn’t need me anymore that’s exactly right and also for the patient it’s a much more relaxing journey of Health knowing that you’re still in control knowing that you’re perceiving how you’re getting better and you can make an informed decision of I actually don’t need to make that next appointment I’m good yeah and again being with providers like you and I who are not letting our ego get in the way of it where if you can get better without me or just with a few tools that’s the best case scenario it’s a partnership it’s not like you said sir Talent yes sir it’s not me telling you what to do it’s uh developing a plan together and having a shared partnership right and then so where are you all located because this is one of the rare instances where one of my guests here on Wadsworth Community television is actually very close to us yeah we’re on Sharon Center Circle in Wadsworth that’s where Marigold Wellness Collective is and practical healing is located within that the best place I say too you to get a hold of us or to kind of start your health Journey with us is look at our website um it should be listed on the screen practicalhealingcenter.com and that will give you next steps and a lot of information about our services who we are our philosophy what we believe and information about each practitioner and there you can schedule a 15 minute complimentary curiosity call with a practice conditioner and so you can find if this is the right fit for you if we there’s something that you are coming in with that you need help with and if we can help you and so I would recommend patients go to that website if they need more information absolutely and for us we’re about 15 minutes east near Copley High School and it’s the same thing because both of us have continued to make inroads and finding different practitioners in this area it may be that hey you know what I don’t think we’re the next step for you for example we do a lot with ketamine infusions for migraines it’s not something I’d ever do on a patient unless they had tried and failed three or four different things because there’s plenty of options and it’s that same idea of like okay are you at the point where this is the right step for you or do you need to go make more friends go talk to Jesus like the the many things that are in what should be involved in holistic care where it’s not necessarily like okay I found all these supplements at Walmart and I’ll take them all and then I’ll feel better or here’s what WebMD taught me but instead of partnership where here’s what we feel here’s an Next Step so yeah absolutely wonderful yeah well it’s so great having you on the show today yeah great to meet you Nick and get to know you more and absolutely this is such a practical way to meet new practitioners yeah we can all pick our brains together let’s do it again absolutely well thank you all for joining us once again I’m Nick Angeles and this has been the Ascend Health show [Music]

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