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Recovering from Lichen Sclerosus: A Patient Case Study — Part One

By |2024-05-31T20:13:00-04:00May 22nd, 2024|Categories: Lichen Sclerosus|Tags: , , |0 Comments

Editor’s Note: Today, we’re taking another detour from our usual blog posts that present information from our own medical team and staff. As we did a few weeks ago, we’re presenting a case study that we recently received from a patient who wants to share her personal journey with our healthcare practice, this time for a case of Lichen Sclerosus.

Below, in her own words, is 42-year-old Janet’s experience with Lichen Sclerosus. If you’re not familiar with Lichen Sclerosus, it is a chronic inflammatory skin condition primarily affecting the genital and perianal areas, although it can occur on other parts of the body. Common symptoms include:

  • Smooth white patches of skin
  • Itching, discomfort, and pain
  • Easy bruising or tearing
  • Painful sex and painful or difficult urination (if it affects the genital area)

The condition is more common in women, particularly those who are postmenopausal, but it can also affect men and children.

Next week, we’ll be back to our normal format with a blog post featuring our plan of care and some additional thoughts about treating patients living with Lichen Sclerosus.

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My Journey With Lichen Sclerosus

The most important thing I learned from my journey with Lichen Sclerosus is that the first thing I should have done is visited with someone like Dr. Matthew Lewis at PROKOVE Health.

Prior to seeing Dr. Lewis, I had been dealing with the symptoms of Lichen Sclerosus for more than 10 years. At first, I suffered from itch and irritation, but I didn’t have the classic “white patches.” I consulted multiple doctors, primary care and Ob/Gyn, who diagnosed me as having yeast infections and prescribed repeated courses of fluconazole (an anti-fungal medication). Given the inconvenience of repeat visits to doctors who provide little to no relief, I started using over-the-counter creams, suppositories, and probiotics, none of which was very effective.

Lichen Sclerosus medical form image

Four years ago, the disease progressed to the point where I could no longer tolerate it. My skin began to tear when I had intercourse, and I was dealing with persistent irritation and discomfort. I consulted three more Ob/Gyns and received ineffective treatment recommendations — from changing soap and laundry detergent to using prescription estrogen cream to having surgery. I went to a functional medicine doctor and saw minor improvement after addressing nutritional deficiencies and making dietary changes. However, the discomfort was still consuming my life and causing tension in my marriage.

About three years ago, after conducting my own internet research and bringing it to the attention of my doctors, I finally received a diagnosis of Lichen Sclerosus and was prescribed the standard of care — topical steroids. When my condition continued to worsen, my physician performed a series of experimental, in-office procedures with the goal of rejuvenating the affected skin. The procedures brought me no relief, and the only option I was offered was to try another round of procedures. The physician went so far as to say I should lower my expectations. I continued to seek alternative solutions through Chinese medicine, acupuncture, and experimental laser.

In December 2023, we uncovered mold in our home, and I was referred to Dr. Lewis for his expertise in mold and mycotoxin exposure.

My Medical History

Dr. Lewis conducted a thorough review of my Continue reading…

Personalized Long-COVID Treatment: A Case Study – Part Two

By |2024-05-20T16:15:39-04:00May 10th, 2024|Categories: Long Covid|Tags: , , |0 Comments

Last week on our blog, one of our patients shared his experience with Long COVID and how we have been helping him on his journey to recovery (see “Recovering from Long COVID: A Case Study.”) His symptoms started after three bouts of Covid-19 in as many years, and even though he was a strong and healthy 63-year-old, the disease had taken a toll on his resiliency — his body’s ability to bounce back after a serious illness.

Long Covid Patient Frustrated

When we first met him, Doug was physically weak and exhausted and cognitively impaired (both thinking and memory). He had already consulted two other doctors who told him that conventional medicine had no effective treatment protocol for Long COVID and that his symptoms were likely to last for six to 24 months. They recommended that he enroll in a Long-COVID program available through the University of Florida.

We offered a better solution — a personalized plan of care to restore his health, fitness, and resiliency.

In this post, I share additional details about the personalized treatment protocol we prescribed for Doug at PROVOKE Health. But first, we offer a few words of caution.

Not a One-Size-Fits-All Approach

Here at PROVOKE Health, we practice functional medicine and integrative healthcare — a systems-based, whole-body approach that focuses on restoring health instead of merely eliminating illness or suppressing symptoms. That’s why functional medicine is effective in treating health conditions that conventional medicine cannot resolve.

Unfortunately, it is also why what works for one patient may not work for another. Every patient is unique and has special medical needs based on their age, genetics, medical history, family health history, lifestyle, health and fitness objectives, as well as other variants. We do not have a “long-COVID treatment protocol” that we prescribe to all our patients who report symptoms of long COVID. What we offer is a personalized plan of care, which evolves over time as the patient’s health improves.

In this post, I share the personalized plan of care we prescribed for Doug. We caution against using this as a standardized long-COVID treatment protocol or as a way to self-medicate. Prior to treating any patient, we conduct a thorough evaluation, which may include ordering lab tests to determine specifically what the patient needs. Taking too much or too little of a medication or supplement, poor quality products, or the wrong combination of medications and supplements, can do more harm than good. We recommend that you work closely with a certified functional and integrative medical practice in order to obtain personalized, medically supervised treatment.

Doug’s Long-COVID Plan of Care

For Doug, we developed the following personalized plan of care. Below, Doug’s doses have been omitted intentionally because they are patient-specific and because recommended doses of some medications and supplements change as the patient’s health improves over time. Medical interventions, including prescription medications and intravenous treatments are provided by our medical team using trusted compound pharmacies: Continue reading…

Recovering from Long COVID: A Case Study – Part One

By |2024-05-20T16:17:21-04:00April 30th, 2024|Categories: Long Covid|Tags: , |0 Comments

Editor’s Note: Today, we’re taking a slight detour from our usual blog posts that present information and analysis from our own medical team and staff. Instead, we’re presenting  case study that we recently received from a patient who wants to share his personal journey with our functional medicine and integrative healthcare practice.

Below, in his own words, is Doug’s experience with Long COVID and PROVOKE Health’s founder Dr. Matt Lewis and our team of healthcare providers, including our Medical Director — Dr. Karalynne Blochberger, MD. Next week, we’ll be back to our normal format with a blog featuring Dr. Lewis’ care of plan for Doug and some additional thoughts about treating patients living with Long COVID.

Here then, is Doug’s story in his own words:

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I’m a 63-year-old man, 5 feet 11 inches tall, about 190 pounds, a father, physicist, businessman, preacher, and author. I exercise regularly and am generally in good health with no prior major medical issues except for a previous bout with black mold toxicity from 2010 to 2012.

Long COVID Case Study Graphic

I contracted Covid-19 three times — each about one year apart — in 2021, 2022, and 2023. The first two cases were mild, and I recovered in about a week. The third time, however, the symptoms were more severe. I discovered that I had Covid-19 for the third time on Dec. 20th, 2023. By Jan. 1st, 2024, I thought I was fully recovered. However, two days later I began to experience symptoms that would later be attributed to Long COVID.

My Long COVID Symptoms

Long COVID is a collection of symptoms that last three months or longer after the first symptoms. I experienced the following three severe and debilitating Long COVID symptoms: Continue reading…

Chronic Itching? It’s Usually More Than Skin Deep

By |2022-04-21T16:00:24-04:00April 21st, 2022|Categories: Skin Conditions|Tags: , , , , , , , |3 Comments

If you are suffering chronic itching — a common but difficult-to-treat symptom of an inflammatory skin condition — then you’ll want to read about my experience with diagnosing and treating Lexi.

Chronic Itching

Lexi is a 25-year-old woman who came to see me about a skin condition that was causing persistent itching. She was suffering with cellulitis on her face and eczema on her hands. (Cellulitis a common, potentially serious bacterial skin infection. With cellulitis, the affected skin appears swollen, red, and is typically warm to the touch and painful.) In Lexi’s case, she had been previously treated by another doctor with several rounds of topical steroids, oral steroids, and antibiotics.

She told me that, at first, the infections and skin cleared. But after a few short weeks, all of her symptoms reappeared. She said the skin on her hands was itchy, and the cellulitis on the side of her face was causing her to feel depressed and self-conscious.

The astonishing thing to me, was that her dermatologist continued to write prescriptions without actively seeking out the cause — the root cause. Lexi was never questioned about her environment at home or work or her stress levels, and her diet was only briefly discussed. And perhaps most shocking of all — no lab tests were ever ordered.

If this sounds familiar, you might be relieved to find out that skin conditions like Lexi’s — while often more than skin deep — can be effectively treated. In fact, you can start experiencing relief in a matter of days and be on your way with a treatment plan aimed at curing you in a matter of weeks.

Common Skin Conditions

Before we investigate the causes and cures for itchy skin conditions, let’s take a look at the most common diagnoses: Continue reading…

Anxiety is Normal But Also a Hindrance to Optimal Health

By |2021-05-19T19:20:42-04:00May 19th, 2021|Categories: Brain Health|Tags: , , , |2 Comments

At some point in our lives, most of us can expect to experience some form of anxiety. It might occur as the result of a life challenge, whether that be a relationship, health issue, work conflict, finance, or traumatic event. Such anxieties are normal and seldom anticipated.

Having said that, I believe it’s important to avoid downplaying the impact that stress has on our lives. It can ruin a person’s health and yet it’s so often treated superficially or worse — it’s blown off by the medical provider.

However, if you are going through a period of acute stress, or you remain in a state of chronic stress and now find yourself feeling fatigued, unmotivated, or irritable, you may be experiencing the negative health impacts of stress. And that stress might possibly be diagnosed as Generalized Anxiety Disorder (GAD).

Anxiety is Normal but Not Optimal.

In our culture — curated as it is by conventional medicine — anxiety is often seen as a disorder and, in such fashion, labeled GAD. However, anxiety is also a normal part of life. It’s a normal part of physiology and in many cases it’s not a disorder. When anxiety becomes a disorder, it is far more obvious to recognize in ourselves and those around us and there is a greater likelihood a diagnosis of GAD will be provided by a psychologist or similar health care professional.

Whether you actually have GAD or just suffer mild to moderate anxiety, it can feel as if you’re being treated for anxiety or depression abstractly, and even with such treatment your health can decline because the underlying issues have not been resolved.

I have observed many patients seeking out functional medicine or holistic medicine who are struggling with a low to moderate anxiety level that doesn’t fit the formal diagnosis of Generalized Anxiety Disorder.

Some men and women can be reluctant in acknowledging their anxiety, while others freely discuss their concerns. It is also common for people to dismiss anxiety or lower the value it has on their health outcomes.  In some ways I think we have the wrong understanding of what anxiety is and how it blocks us from reaching our optimal health.

Breaking anxiety down, I like to classify it as follows:

  1. Generalized Anxiety Disorder — advanced anxiety often benefitting from prescription medication
  2. Moderate/ mild anxiety — successfully treated without the use of prescription medication

Conditions and Symptoms Associated with GAD and Moderate to Mild Anxiety

Anxiety can create or exacerbate many conditions including:

  • Chronic Fatigue
  • Cortisol Imbalances
  • Hormone Imbalance, altered libido or painful cycles
  • Hypoglycemia
  • Irritable Bowel Syndrome (IBS) — Constipation or Diarrhea
  • Insomnia or restless sleep
  • Neurological Symptoms
  • Restless Legs
  • Weight Gain or Loss

Besides the commonly known symptoms of anxiety, which cause worry, upset and inability to relax, there are others, including: Continue reading…

The Unintended Side Effects of Birth Control: A Doctor’s Case Study

By |2021-03-17T19:44:11-04:00March 17th, 2021|Categories: Hormones|Tags: , , , , , , |0 Comments

If you’ve been taking birth control and feel bloated after eating, or have gained weight that is difficult to drop, or have been set back by sports-related injuries that happened years ago, perhaps this case study on the unintended consequences of birth control on women’s health is for you.

Meet Stephanie — a 24-year-old professional who came to see me with a concern about her digestion. Well, it turned out to be more than that, and as you’ll see, very much related to her use of birth control pills.

Stephanie’s most pressing concern was related to her constant bloating after eating, along with constipation. During her initial consultation, she also told me that while playing sports in high school she suffered a terrible ankle injury that required surgery and months of bed rest. During this time, this 5-foot, 4-inch young woman went from weighing 120 pounds to 183 pounds.

Stephanie’s pediatrician recommended a gluten-free diet to assist her with digestion problems and weight loss. As a result of following her initial doctor’s advice, she did manage to lose a little more than 20 pounds, but still wasn’t comfortable at 162 pounds.

So far, Stephanie’s scenario seemed pretty straightforward to me. This young woman, concerned about her weight, had experienced a setback due to a sports injury a decade earlier as a teenager. Since then, exercise and diet haven’t helped her lose weight, and now she’s stuck at 162 pounds.

More to the Story

One important lesson I’ve learned over the course of my 20-plus years in practice is that there’s usually more to the story leading up to a patient’s primary symptoms, and this was certainly the case with Stephanie. As we explored her medical history, including the information she provided on the functional medicine analysis form she completed prior to her initial consultation, I discovered some interesting and enlightening details: Continue reading…