Immunocompromise After Covid in a Physical Therapy Student – LIVE Client Case Study (Part 2)

Dr. Jessica Drummond (00:00:03) – Hi and welcome to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I am so thrilled to have you here as we dive into today’s episode. As always, innovating and integrating in the world of women’s health. And just as a reminder, the content in this podcast episode is no substitute for medical advice, diagnosis or treatment from your medical or licensed health care team. While myself and many of my guests are licensed healthcare professionals, we are not your licensed healthcare professionals, so you want to get advice on your unique circumstances. Diagnostic recommendations treatment recommendations from your home medical team. Enjoy the episode. Let’s innovate and integrate together. Welcome back to the Integrative Women’s Health Podcast. I’m Doctor Jessica Drummond, your host, and today I have a really special episode for you. We are going to circle back with Terry Brown, our Duke physical therapy student, and all around go getter who has been struggling for the past year or 18 months with constant chronic infections ever since having a Covid infection. Initially at the beginning of her program, and there’s so much to learn here about the complexities of what Covid infection is, how we can mitigate our own risks.

Dr. Jessica Drummond (00:01:41) – If we are at high risk and there’s not enough mitigation strategies going on in our workplaces, and how we can strengthen our resilience to any kind of viral infection or even bacterial infection by optimizing our own physiologic systems, our digestive system, our immune system, and really importantly, our nervous system. So I want you to pay attention in this episode to look, all of us are living in this post-Covid endemic world where we are being constantly exposed to pretty serious viruses on the regular all the time. And yet we have more tools than ever in history to combat the spread and the damage that can be done from these viruses, both individually and collaboratively. So if you are working in a health facility and you are hosting and working with students or employees, that may be a little bit more vulnerable. And quite frankly, we are all vulnerable, even if you are not feeling it. Having a Covid infection is doing damage. We know from a lot of published research now to your nervous system, to your brain, to your vascular system, to your heart, to your hormones, possibly even to your reproductive organs and other organs.

Dr. Jessica Drummond (00:03:13) – It hits people differently, but it’s pretty across the board consistent that Covid is damaging to the system. What impacts that has can be highly variable and some people can recover quite fully and quickly, and for others it takes more time. So especially if you’re working in a health care facility, look around. There are vulnerable people in your waiting room, amongst your office staff, amongst your clinical and coaching staff. Do everything you can to create a safe and nourishing environment for them. Masking, ventilation, Hepa filtration for UV light, nasal sprays, face sprays and then helping people that you work with and that you help from a client or patient relationship and your employees and colleagues to take the steps that they can individually do to optimize their gut immune nervous system interface to reduce the impacts in case they are infected, which is at some level going to be a part of life. So the less damage, the better. The less exposure, the less danger that we submit our patients, clients, and colleagues to the better.

Dr. Jessica Drummond (00:04:34) – And so if you’re in a position where you can make some decisions about that, you can have more of your sessions outside. You know, there are lots of creative ways to work with this that are not only good for you and your clients, but actually maybe even better than the status quo. So let’s get into part two where you’re going to see exactly how we implement working with clients with complex chronic illness in a case study in this example. All right. Let’s get to the episode. Hi and welcome back to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond. And we’re here today for part two of our episode with brilliant physical therapy student Terry Brown, who was so kind to share with us her personal case study experience of Post-viral syndrome, long Covid, and the year to 18 months of constant chronic infections that she was dealing with. The impacts to her overall health in the midst of trying to balance her own health care with a busy physical therapy program schedule. So, as you know, if you’re following the Integrative Women’s Health Institute, we have a seven step protocol that we utilize to give people a sort of step by step system for optimizing their health, no matter what conditions we’re talking about.

Dr. Jessica Drummond (00:06:02) – So in step one, we’re talking about nervous system regulation. In step two, we’re co-creating a vision and goals for the client how they define health. In part three we’re talking about the measures the labs, the history, the insight and information from our client, their health story. And in step four, we do education and recommendations that again, we’re co-creating and collaborating with our clients. So welcome back, Terry. It’s been about a month now since we last connected. How are you feeling? How are the recommendations going. And then we’ll finish up steps five, six and seven.

Terry Brown (00:06:44) – Thank you so much for having me back. I’ve been doing well. I’ve taken into consideration plans of our exercise things we discussed, like cutting back where I needed to cut back and then, you know, maybe increasing other parts of my exercise. And then I have been taking some of the supplements we talked about, just like apple cider vinegar. Let’s see what else. I added some creatine and a few other things just to my daily diet and supplement intake.

Terry Brown (00:07:08) – And then, like I said, cutting back on running has been helpful for me. I believe I am not feeling as exhausted throughout the week and my gut health has improved a little bit. It always is kind of baseline level, a little bit off, but I’ve been doing well. I have fingers, I don’t want to jinx it, but I have not been like sick with anything other than just seasonal allergies since we last spoke, which before I spoke with you, my pattern was about a month between each pretty significant diagnosis sickness. So hoping that it stays this course. But I’m doing well.

Dr. Jessica Drummond (00:07:38) – Yeah, thank you for that update and that’s very encouraging. It is interesting. There is a paper that just came out showing that seasonal allergies are increased for people that have had Covid and long Covid, so hopefully they’re not worse for you. But that’s an interesting kind of insight to share in terms of circling back to step three around your own health history. Is seasonal allergies something you’ve always dealt with?

Terry Brown (00:08:03) – It is a normal thing for me, correct? I can’t say yet if it’s been better or worse.

Terry Brown (00:08:08) – I’ve just been doing my daily allergy medicine ritual, but I do know if I was not taking that, I would be potentially more sick than I am now. And I did have a sinus infection a month and a half back that lasted a good long while, and it did take me longer to get that out of my system than maybe three years ago. It would have.

Dr. Jessica Drummond (00:08:24) – Yeah. And so that was before we met. So it’s good that in the last month it hasn’t progressed to a sinus infection which is showing maybe some more immune modulation. But also histamine is a big factor when it comes to post-Covid immune activation. What is your allergy medicine? Is it some kind of antihistamine?

Terry Brown (00:08:45) – I take Zyrtec once a day, and then I do a prescription nasal spray on my more severe days.

Dr. Jessica Drummond (00:08:52) – Okay. Yeah, exactly. All right. So previous to our talk last time, some of your chief complaints were the digestive issues, which were really sort of long standing. That was part of your, I would even say like, pre-existing vulnerability.

Dr. Jessica Drummond (00:09:06) – Would you agree with that?

Terry Brown (00:09:07) – I would agree, yes.

Dr. Jessica Drummond (00:09:08) – And then post infectiously a lot of fatigue and just constantly getting like an actual new infection every month or so. So let’s talk a little bit about your daily schedule. So in step five of our protocol, our system is essentially saying okay how are we going to implement the changes we recommended. You added some nutrient supplements, made some shifts to your nutrition program, changed how you exercise from being more intense to being more recovery focused and more kind of zone to two training, kind of low grade, consistent training, but also strength training. So talk about how you fit that in.

Terry Brown (00:09:51) – Yeah. So my phase of school I think with probably the most graduate programs each block semester it changes a good bit. I’m finishing out my second year entering my rotational year, so I’m kind of on a downhill slope, thankfully about like class intensity over Over this past summer when I was kind of my sickest, my class schedule was 8 to 5 on campus every day, and then I would typically have about four hours of homework and prep work for the next day each evening.

Terry Brown (00:10:21) – So that was my really intense, heavy semester. Now my days look more kind of on that 8 to 3 range, and that includes some extracurricular activities as well. So much lighter schedule for exercise. It’s just a daily thing. I started working into my routine while I’ve been in school, just to help with stress, to kind of give me some, like, endorphins to help me feel better about myself and have energy to complete the second half of the day. I always get that 2:00 slump. And so if I do exercise around that time, I usually have the energy to take me through 10 p.m., but that’s the main thing. I already had some patterns set up, and so I just adjusted those pre-existing patterns, which has been helpful. However, there was a phase of school, especially my first year, where I did not have a good workout routine, and implementing it was hard when I was so sick that first year, but it was eventually helpful once I kind of got past like the first two covids in the mono, then I could kind of start getting back to the gym.

Dr. Jessica Drummond (00:11:16) – Yeah, absolutely. I mean, that’ll take anybody out. Not to mention a schedule of basically 8 a.m. to 9 p.m.. That’s rough.

Terry Brown (00:11:23) – Totally.

Dr. Jessica Drummond (00:11:24) – So you’ve been adding apple cider vinegar and adding that to your meals, any shifts in your actual nutrition plan, and then kind of update me on your supplements.

Terry Brown (00:11:37) – No major shifts in my nutrition plan. I’m at all times pretty cognizant of like protein intake. And I try and focus on healthy as I can eat as a grad student, but I try and focus on cleaner eating and more whole fats, protein, stuff like that. I wouldn’t say I’ve had a significant change in what I’m eating on my own. However, I did start including the apple cider vinegar and I try and take it on like first thing in the morning on an empty stomach, and it sometimes helps my stomach regulate throughout the day better than it did for a while. I’ve started doing the creatine after the workouts and I have definitely noticed that helping with my recovery, my muscle recovery, and I just been continuing with my daily and my omega three.

Terry Brown (00:12:17) – I was already taking those regularly, and I take calcium because I don’t eat dairy, so I try and supplement a little bit extra that in okay.

Dr. Jessica Drummond (00:12:25) – Do you take any magnesium supplements?

Terry Brown (00:12:27) – I have some, I have not been in a good routine of it, but I have them.

Dr. Jessica Drummond (00:12:31) – Yeah okay. All right. Good. So how are you feeling at this point? You said your energy is up a little bit. Digestion is a little better. Let’s maybe refine that. So two things when we move into kind of step five is we get this integrated in your schedule. And it sounds like you’re really already doing a pretty good job of that. It’s just a matter of tweaking, getting your exercise in or between noon and two. So you kind of stay energized in the second half of your day, adding the apple cider vinegar in the morning, and you could even add it before each meal. If you needed a little bit more boost of that, we could integrate that. Your nutrition plan is pretty clean, the best that you have access to, and you know you’re clear on what your schedule is and trying to get to sleep.

Dr. Jessica Drummond (00:13:14) – So that wasn’t a huge shift, but just adding. And I think that’s something for our students and coaches and anyone listening to this who is interested in women’s health coaching, that it doesn’t always have to be massive shifts in your lifestyle. Sometimes in your case, it was just shifting intensity of exercise, but keeping the time the same, shifting a little bit of like a slight supplement regimen shift. But again, same timing. So it’s changes that are able to be more sustainable because we didn’t overhaul your lifestyle in the midst of a very busy life stage. You know.

Terry Brown (00:13:52) – Definitely.

Dr. Jessica Drummond (00:13:53) – So you were good at with integrating it into your schedule. Did you feel like you needed any support just in any way? Did you find it was hard and you could have used some support along the way with anything?

Terry Brown (00:14:05) – I think for these changes, as you mentioned, like I kind of already had, maybe the blueprint, the foundation set is kind of added a few extra things in or swap stuff out. I didn’t notice times when I was really needing support.

Terry Brown (00:14:16) – However, if anything, you allowed me to kind of give myself grace. I am pretty hard on myself. Like I feel like most people aren’t. So the days when I’d be like running and like I would fatigue after a mile or I’d be feeling awful. You have to go. You have to keep pushing. You know, I would kind of be a little more hard on myself than I should have been. So after having our talk and being like, it’s okay that I don’t run, you know, right now in this phase of life, I can do other forms of cardio that keep my heart healthy, keep my body happy, but maybe aren’t exerting or exhausting myself the way running was. So if anything, it’s kind of. I can tell my voice inside my head to quiet down because I’m like, no, it’s okay, doctor Drummond said. I could hold off on running, so that’s probably been like more of a grace factor than anything. I wouldn’t say I have any support. It’s been like I’ve finally given myself the grace that I’ve probably needed to give myself for this past 18 months of sickness.

Dr. Jessica Drummond (00:15:07) – Yeah, I really think that’s important for a couple reasons. One, you know, the data for women on things like zone two cardio, which I like, that’s essentially power walking, right? It’s like 75% of your max consistently for 45 minutes. There’s a lot of benefit in terms of fat burning and things like that. But what’s very interesting about that is most of the research is actually showing a much more significant benefit for men and that women should do it. Of course, that kind of slow, steady cardio is nourishing for the heart and vascular system, but what ends up happening is women have a tendency to push past zone two into the more intense cardiovascular exercise. Getting their heart rate closer to 70 or so percent is like the top end of zone two cardio training 70% of heart rate max, which is 220 minus the age. Or there are a couple of other more precise equations that you can just Google, but roughly 220 minus your age, 70% of that would be the top, top end of zone two.

Dr. Jessica Drummond (00:16:09) – But because women you know, we’re sort of socialized to exercise not for our own mental health, but also there’s this sense of having to do enough and having to maintain our weight enough and having our body look a certain way enough. And, you know, so the tendency actually in the literature is that women don’t keep their heart rate low enough. They’re actually exercising too intensely for too long. There’s a lot of benefit to the cardiovascular system for intermittent intensity, so things like hit training for ten minutes a few times a week. You know that high intensity intervals but prolonged high intensity is actually somewhat damaging and is more damaging for women because we tend to do it more. Does that make sense? So it’s really valuable to make those little shifts in awareness. And it’s so beautiful that you’re able to see that you still got a lot of nourishment for your heart. A lot of muscle building. You know, your muscles are recovering now because they’re getting a little extra nutrition post-workout, directly with the creatine. So just minor shifts and, you know, so for people that might be integrating these kinds of things, having a fitness trainer or accountability for you, accountability was not the problem.

Dr. Jessica Drummond (00:17:30) – It went all it was more about overdoing it. So we certainly have a lot of clients who are doing that their whole lives. So the accountability is around quieting the voice that it has to be intense and perfect. And every day and pushing through voice is very strong.

Terry Brown (00:17:46) – Definitely. And I know we did discuss Working around my cycle, and I did try and be much more cognizant and respect my body in its cycle phase as well in this past month. So like during my menstruation week, it’s okay if I only go to the gym three times instead of my normal five times, because I’m tired and I need extra sleep and I want to eat food and go to nap. So those have all been really helpful.

Dr. Jessica Drummond (00:18:08) – So how do you feel about the recovery, what you’re doing to really lean into recovery as a part of exercise, if you will, almost the other side of the coin in the last month compared to what you were doing in the year before.

Terry Brown (00:18:22) – I think in the year before, my routine was not as regular with going to the gym, so I probably had a lot more of that guilt.

Terry Brown (00:18:29) – And so when I would go, I think I would really, really overdo it, you know, maybe stay there for like an hour and a half to two hours. And then I was already at such a high, like mental stress load, I probably wasn’t sleeping well. It’s like the kind of phase of school where when I do sleep, I’d be dreaming about school and test and being behind in school until I woke up. You know, I never once felt like I left fight or flight mode, so it’s probably if I’d had a more routine schedule where I could have just done little bits of here and there and then not forced that kind of intense all or nothing. Now I think I have a better approach to recovery. I try and focus on that day in between of my hardcore strength training days. I try and like listen to my body. Like if I’m just really tired and like getting in my gym clothes. Sounds like the worst thing possible. I’m like, okay, I’m gonna respect that and read my book and do some busy work or school work, whatever I can get done at the desk.

Terry Brown (00:19:20) – You know, that’s warming up. I can start doing those things outside. But I think just the biggest thing is just like listening. And then the fact that I had a better schedule to start, I think it’s kind of hard sometimes to incorporate rest when you don’t even have the routine set yet.

Dr. Jessica Drummond (00:19:33) – Yeah. Absolutely. Absolutely. So symptom wise, where are you finding that there are still some things you would like to work on?

Terry Brown (00:19:42) – I feel like my GI system always could use help. I did forget to say that I am taking papaya enzymes after every meal that I remember. Just like digestive enzymes, I feel like my stomach is never calm, but that’s kind of been a normal for about six years of my life. And then of course, I just want to hold on to this one month of health I’ve had. You know, I would love to see this. Like we talked about, our original goal is six months of this where I’m not getting mono or getting the flu or getting Covid or getting pneumonia.

Terry Brown (00:20:09) – So essentially, as I’m entering my year of rotations in hospital systems, that’s something I’m a little bit anxious about. And, you know, we talked today, for example, about how I have two days I can miss for my block of rotations. And if I miss after that, it’s going to start being deferring my schedule. I’m going to make those days up. So that’s kind of something I’m thinking about. Like, I really hope I don’t have one of these sick phases I have had previously.

Dr. Jessica Drummond (00:20:32) – Okay. Yeah, that’s important and sort of a ridiculous request. I’d like to just highlight the ridiculous request from your hospital system, but I’ve been there. So any of us who’ve worked in conventional medicine really understand that it’s tough. I think first of all, strengthening your gastrointestinal system is really foundational to strengthen your immune system. So how you manage your stress around this and I think, well, it’s a lot of pressure because you’re at a very intense program and school, and obviously you want to graduate and get through it and, you know, finish your studies.

Dr. Jessica Drummond (00:21:11) – I think the more that you can continue to leaning into when you need to rest, and sometimes you’re not going to be able to just sleep, for example. But I don’t know if we talked that much last time about tools for just shifting your nervous system back to kind of the regulated state. And for some people, that can be as simple as slow, deep breathing, six seconds in, six seconds out, something like that. Do you find that if you make a little shift like that, or you listen to calming music, like you can go from a more fight or flight or free state into a calmer state?

Terry Brown (00:21:46) – I have used breathing techniques historically. Yes, for that kind of thing. Sometimes it doesn’t always take effect. You know, sometimes I do the things that I think a lot of people do, which is just going on my social media doomscrolling to kind of like it doesn’t help, but just gets your mind off of it, the quick fix. But I do constantly think about how I need to get my nervous system out of that, like high fight or flight freeze.

Terry Brown (00:22:08) – So I think I’m going to use the six and six out next time. I used to do like the cube in four hold for out four.

Dr. Jessica Drummond (00:22:14) – That’s also another good one. You can play with different breathing exercises. The box breathing for in four hold for four hold is also good. Or just keep it simpler and 6 in 6 out. One thing I would suggest is to find a nervous system regulation strategy that maybe you use before bed. If one of your vulnerabilities is kind of dreaming about the stress of school, like you don’t have that complete relaxation during sleep. That having a hard stop time of when you’re on any kind of devices or screens or whatever, and then a 15 minute per night, just simple mantra meditation. You literally just close your eyes, relax your whole body, close your mouth, breathe slowly and gently through your nose. And just think of one word. Could be anything like. Could be the word. One could be just any word. And notice your thoughts. Know that your brain is going to continue to think and it will, but you’re just going to do your best to let them go by.

Dr. Jessica Drummond (00:23:20) – And sometimes you’ll catch them and you’ll remember and then you’ll stop, you know? But it’s a practice. And there are other forms of meditation, things like guided meditation. There are more. You could do that. Slow six in, six out breath for more like ten minutes. You know, taking breaks as much as you need to 10 or 15 minutes. But there’s value in that nervous system regulation in two ways. One is the daily practice taking a walk, running, doing your lifting. It’s like exercise for the nervous system on a consistent basis every day, whether you really need it or not. And then there’s the quick fix, like the box breathing or the six and six out where you might do five breaths like that just in the moment of you’re running around, you can’t find your patient. This is taking too long. You know, whatever. You stop for a second and just settle. Does that make sense? So are there any techniques that feel like you could fit in, you know, for 10 or 15 minutes at night before bed?

Terry Brown (00:24:20) – I like the meditation.

Terry Brown (00:24:21) – Thought. I like the way you said the thoughts are going to keep flowing. Maybe like I can choose whether or not to grab on to them. I like that concept. I try and read before bed just like a few pages of a book, because that’ll make me sleepy. And the hope is I switch to those, you know, thinking about the book rather than thinking about what I just closed on my computer. But I think kind of grouping together the reading and like a meditative slot would be really cool. Yeah.

Dr. Jessica Drummond (00:24:45) – That’s perfect. And yeah, I love fiction. Reading at night is also wonderful. There was an interesting study that just came out about cognition. This is not quite the same as nervous system regulation, but if you sense essential oils or anything like that, rotating different scents, just having like a spray bottle with a little bit of water, an essential oil of. I think the sense they used in this study were eucalyptus, peppermint, lemon, orange, rosemary, some very common ones.

Dr. Jessica Drummond (00:25:14) – Just spray your room like a quick spray or near your bed or something. And overnight, having that scent in the air and rotating them kind of keeps the brain having something interesting to attend to. So that might also be a way to sort of shut it off from the busyness of the day, you know, the stressors of the day. So just something to consider.

Terry Brown (00:25:39) – That’s cool. Yeah. Absolutely.

Dr. Jessica Drummond (00:25:40) – And that meditation technique, I mean, there are a lot of people who teach it, but Emily Fletcher wrote a wonderful book called something like Stress Less Accomplished. More is where I first learned that meditative technique. And it’s just, kind of another nice resource. But the way she explains it, which I’ve always really loved because meditation for me wasn’t intuitive. I think, you know, some people just love meditation. Some people hate meditation. For me, I really like it, but it’s not something that came easy. I had to sort of practice and that she said that, you know, your brain is going to think in the same way your heart is going to be.

Dr. Jessica Drummond (00:26:20) – You can’t just stop it. It’s going to happen. So you just watch. It is much nicer way to approach it without stress, so you can’t really do it wrong.

Terry Brown (00:26:31) – Yeah, right. It’s like staying under the surface of the water and like watching it ripple above you. That’s what I’m going to like.

Dr. Jessica Drummond (00:26:36) – Picture I love that I love that that’s perfect. So that regular practice of nervous system regulation is really at the root of your gut health and your immune health, because both of those things are strained by stress. So your immune system is depressed by stress, and your digestive system becomes like a leaky the small intestinal membrane. Your gut microbiome is not as healthy when you’re kind of living in that constant state of stress. So the more often we can be in that nice, steady state and practicing that on a regular basis is, to me, just as important as lifting weights and getting your walks in and all of that. So we can layer that in. And, you know, you’ve done really well with habit stacking.

Dr. Jessica Drummond (00:27:21) – So just connecting it with that, reading a few pages that you’re already doing at night and then digestive Lee. So you’re using apple cider vinegar. You’re added creatine to help build your myofascial resilience, which having more muscle is a resource for immunity because it’s essentially a reservoir of amino acids. So we want to try to keep that up. And then probably we want to be a little bit more active in your protocol. First of all, I never recommend calcium supplementation without magnesium. There is some research that calcium supplementation can actually cause more plaques to develop in the vascular system. So I actually recommend calcium foods more than calcium supplements. But if you are going to take calcium supplements which may be okay, we could let them go. But just as a point of education, I would always combine them with at least half the dose of magnesium. So if you’re taking, say, whatever, 400mg of calcium, you want to take at least 200mg of magnesium and you want to combine it with vitamin D and K2, which will help put the calcium in the bones instead of the vessels.

Dr. Jessica Drummond (00:28:34) – But my suggestion is that we actually tweak your kind of nutrient protocol a little bit. Fish oil. Love it. I would keep doing that. It’s very anti-inflammatory. Lots of benefits, especially for neuroinflammation and immune modulation in your case. So I would keep doing about 1000 to 2000mg a day of fish oil and fish oil you should take with food. And then I think from a digestive immune interface. So we’ll circle back to minerals in a second. But I think we might want to start building up your gut microbiome. So there’s a couple ways we could do this. One, we could do some functional testing of your stool to see what’s going on in terms of if you have like dysbiosis or yeast overgrowth or whatever, the answer to that is going to be. Yes. Like we don’t have to spend that money. So that’s one option. But I do think we should begin to add some probiotics and prebiotic fiber. But the question is, do we first do some antimicrobials to kind of clean up any more like dis biotic.

Dr. Jessica Drummond (00:29:42) – When we talk about good bacteria and bad bacteria, right. Like kill off some of the bad bacteria. So do you tend to be more constipated or more diarrhea or both?

Terry Brown (00:29:53) – Constipation More common? Yeah, I don’t common have diarrhea unless I’m like on my period week. But I did get my squatty potty this past month, which I’ve been delaying and that has been helping some of my constipation, but more often constipation or hard stool and like difficulty like on the Bristol stool chart. It’s like the harder pass one.

Dr. Jessica Drummond (00:30:11) – Okay, perfect. So I think I would suggest that we do about 2 to 3 weeks of the more antimicrobial herbs, and I’ll send you some specifics. The research around this recommends. So there’s a good study from Jared Mullen out of Johns Hopkins like back at least 2015, but maybe before then where they looked at. And this is for small intestinal bacterial overgrowth. But it does kind of generally help the colon overgrowth and any yeast overgrowth. They looked at two different products. They looked at FC Seattle and Dis Biocide, or a product from energetics called Candi backed an R and b r, which is what I normally use.

Dr. Jessica Drummond (00:30:49) – They’re both good. It’s just the one, you know, I’ve had more clinical experience with or for people that are really sensitive. And so that study from Johns Hopkins GI Department found that a combination protocol of those antimicrobial herbs was just as effective as using antibiotics. And in my experience, it tends to stick more without the side effects to the gut of the antibiotics. So however, if you’re sensitive to things, I prefer a product called biocide in which we can start really, really low dose first. And I kind of intuitively that feels like where we should start with you. Do you have like sensitivities to things or what do you think.

Terry Brown (00:31:31) – Dairy is my most significant. And that’s also I didn’t even know how to classify that because it was like middle of college. I went from eating it fine to all of a sudden, overnight getting so violently ill. And there was about like a five month period where I was throwing up like a ton constantly. And they just really cut out these things and put me on low Fodmap, put me a ton of restrictions, and dairy was kind of the most obvious one at that time.

Terry Brown (00:31:58) – But like on a test, I don’t show up as allergic. It’s just maybe some lactose intolerant I developed in college.

Dr. Jessica Drummond (00:32:04) – Yeah. Okay. So to me that’s more of like a sensitivity to that food or the protein in that food or potentially the lactose, but probably it’s the protein that’s irritating the lining of your small intestine and you’re dealing with Sibo. So let’s start with the biocide. And because we can dose it really, really gently so that it doesn’t make you sicker. And one thing I’ve noticed with my clients who have really sensitive digestion is that, you know, there’s this whole idea that we want to get to the full dose. You can do biocide and dosing it three capsules a day, which is like 15 drops a day, five drops three times a day for you, though, and for many of my clients, we can accomplish the very same thing slower over a longer period of time with two drops once a day or twice a day, or three times a day or one drop. You know, we start really, really low and slow.

Dr. Jessica Drummond (00:32:56) – And I find that to be more gentle, especially when you’re in the midst of this really busy life. We don’t need to be like doing an aggressive detox to your digestive microbiome, because you will often have some side effects of a little bit more diarrhea or digestive pain or things like that. And we want to keep that as minimal as possible, because we also don’t want to irritate your immune system and have it be just more sensitive to everything. So we’ll start with a very low dose of that. Of course, I’ll send you this all written down, but we’ll do some low dose sign in. And then we’ll also start with a really gentle probiotic. That’s kind of a broad spectrum, but again low dose. And we’ll layer that in a few weeks after we start doing the antimicrobials. And the one other thing that I’m trying to think about I’m a little bit concerned about. When do you start your clinical rotations July 1st. Okay. So we’re in April. So we have a few months. That’s good.

Dr. Jessica Drummond (00:33:58) – I want you to really start thinking about a couple of things. Covid like mitigation techniques I think for you masking is just not optional while you’re at work. I mean, you’re going to be exposed to things in the hospital. So not wearing them all the time now, like whatever you feel comfortable now. But in the hospital, I think lowering that exposure is going to make a big difference. And are you doing clinicals like all in a hospital or any like outpatient clinics or anything like that that you’re aware of?

Terry Brown (00:34:29) – My first one’s outpatient clinic, my second two will be more of a hospital setting, with my third being a skilled nursing facility in the acute care wing.

Dr. Jessica Drummond (00:34:38) – Okay, actually, that’s not necessarily so bad, because sometimes facilities like that, because there’s not as much in and out, they can be less problematic.

Terry Brown (00:34:47) – It’s a little bit more locked down. Right?

Dr. Jessica Drummond (00:34:48) – Yeah. But I would say that and since you’re starting an outpatient, that’s also good. Now again, the downside is you’re going to be seeing a lot more people coming and going.

Dr. Jessica Drummond (00:34:57) – But depending on the building and if you need me to write a note for you, I will. But we might want to talk to the owner of that clinic and see if they could just keep the windows open. There’s a dramatic difference in transmission of all of these viruses. When we’re in an environment without air flow and things like Hepa filters are really valuable. You know, there are lots of ways to do that that’s not very expensive. And the other thing that helps is a thing called a far UV light. So it’s actually a light on a stand on a like a tripod that projects light in the space and kills off viruses and bacteria, just like the Hepa filter and that sort of thing. So, you know, since you’re probably going to be hands on with people and doing manual therapy, masking, but then taking breaks because we don’t want to tire out your system, it is fatiguing to wear a mask all day. So, you know, stepping outside for lunch, seeing if you could open the windows in the clinic, depending on the time of year and that sort of thing, because we can really mitigate some of the risk without having to be so aggressive about it, if that’s helpful.

Dr. Jessica Drummond (00:36:07) – And the other two things that I use always when I’m traveling is there are nasal sprays that are known to kill. I believe it’s 96% of Covid on contact in the nose. So every couple of hours step outside, take the mask off, spray your nose. The product is called innovated. You can order it online. I can send you links to that as well. And actually I have some right here. This is a spray called Rio Tech that we originally discovered. When the pandemic first started, I was working in an office in a naturopathic clinic with a bunch of other clinicians, naturopaths, physicians, and we were looking for stuff to clean, like the plants and stuff with and biotech. You can do that with, although you don’t really need to. Now we can just use Clorox wipes or whatever, but this is really good for the skin and you can spray it right on your face. So if I’m traveling or whatever every couple of hours, I’ll spray my face with that. So I can tell you that that’s another option, especially when you’re in like an inpatient acute care.

Dr. Jessica Drummond (00:37:12) – Like every couple of hours I’d be spraying my nose, spraying my face, and then wearing a mask. But an outpatient or any place that has windows. One of the best things we can do to mitigate any viral risk is to be outside, and opening windows pretty quickly approximates that. So that’s another option. If it’s, you know, even on a day where it just feels too much to wear the mask or you need a break, I get that. And it’s hard because, you know, these masks, they’re not comfortable and you’ve got microplastics in them. There’s some downsides to the mask. I don’t love it, but it’s one of the best tools that we currently have, and especially because we don’t want you having to miss so much clinical work and then amplify your stress and worry about your schedule and all of that. So in the meantime, though, we have about three months to really strengthen your gut and your immune system and really focus on the gut microbiome is where the evidence is strongest.

Dr. Jessica Drummond (00:38:11) – Ultimately, I’m going to start you on some very gentle stuff to just, you know, the biocide in and the low dose Lactobacillus and Bifidobacterium kind of gentle probiotics. And then we want to increase. One thing that has been shown to kill Covid in the gut is a bacterial strain called Bacillus subtilis, which also helps kind of remodel the gut microbiome and strengthen some of the keystone species that mitigate risk of, again, any viruses, not just Covid. So we want to shift to that, but that’s a little bit more aggressive of a probiotic and some people get some constipation from it. It can trigger some histamine issues. So we want to add that in. Maybe in the next 6 to 8 weeks we’ll start with some gentler things first. So we talked about omega threes apple cider vinegar I would do that. You know at the beginning of each meal whenever you want to omega three. And oh and there’s one other thing that I think would be beneficial for you. And that is a kind of broad spectrum anti-inflammatory supplement.

Dr. Jessica Drummond (00:39:17) – So it’s mostly based in curcumin, some of the more anti-inflammatory herbs and spices just at higher therapeutic doses, which can also be antiviral. In case some of these viruses, like the Epstein-Barr, for example, from the mono, is sort of hanging out, we can get it to sort of stay dormant by having a more anti-inflammatory support. And you’ll also get that with the omega three that you’re taking. You could do things like drink more green tea, add more berries to your diet, add more herbs and spices, especially things like rosemary and garlic. And fennel is another good one. Like any of the colorful, colorful fruits, vegetables, spices, cinnamon is great, and we can look later at like your metabolic strength, such as your fasting blood sugar and your hemoglobin A1, C and things like that. Because metabolic dysregulation can be stressful to the immune system. But given your long term history with gut dysregulation, I think really starting there is going to be important. And then the final two things I would focus on is a balance of micro minerals like magnesium and potassium.

Dr. Jessica Drummond (00:40:33) – And zinc is very important for lining the digestive lining, which is the digestive immune interface, a little bit of copper to keep it balanced, and vitamin D and vitamin K, vitamin D if If you have a chance in the next few months to just see your primary care physician and get your vitamin D tested, maybe get a general CMP CBC that could be really valuable to. So we have just your metabolic panel, also your cholesterol, your red and white blood cells. Make sure you’re not anemic before you go on these rotations. So you have plenty of energy from an iron standpoint. And then vitamin D, because vitamin D is very strong for the immune system. In fact, the higher the vitamin D level, the more protected you are from any viruses. And then finally we’ll meet again. Maybe, maybe or maybe not on camera. But I think before your clinicals, we might also think about kind of a more acute viral protocol just to have in your back pocket in case you start feeling a sniffle or anything.

Dr. Jessica Drummond (00:41:38) – We want to kind of get to it quickly before it becomes anything else. But you’ve got these next three months to really rest, to strengthen your gut and your immune system and your gut microbiome. Stay focused on your work, but not have it be just over consuming and then really practicing. Like just as important as your exercise doing that nervous system regulation. How does that feel? Overwhelming. Good. Fine. Sounds good. Any questions for.

Terry Brown (00:42:07) – Me? I don’t think so. I think I’m going to go by one of those little pill organizers so I can keep all my little things each day. But no, this sounds cool. I’m always excited to, like, use more holistic and natural ways to improve my gut. Like I said, for so many years they just tried to put me on like a Brazil like that super intense Gerd medication. And I was like, I don’t think this is what I need. So I’m looking forward to kind of not being as anxious about my stomach always hurting.

Dr. Jessica Drummond (00:42:32) – Yeah, I mean, the goal is going to be to get you a much, much more resilient digestive system and gut microbiome. And that comes from having adequate stomach acid and a lot of robust, good bacteria and feeding those things. That’s why, you know, adding all the fruits and vegetables. Adding green tea, adding fatty fishes, adding herbs and spices like how we eat. We need to start thinking about how we’re going to feed our microbiome, not just what can we not eat, you know. All right. Excellent. So we’ll integrate that into your schedule. Not a huge change from what you’re already doing. Just getting a nice pill organizer to get your supplement stack in, and I’m going to keep that as simple and gentle as possible. Go really low and slow with that. And then you are really, I think, doing a great job with the exercise balance. And I would also say that keep it really gentle for the next month or so. And then if you start feeling more and more energized, you can increase it a bit, do a little bit more, running a little bit more outside.

Dr. Jessica Drummond (00:43:38) – But I think this sense of enoughness about what you’re doing is really important thing to lean into. And I think in all ways, I mean, you’re doing it a lot of amazing things. You’re in one of the top PC programs in the country. You’re working really hard. You’ve got a foundation of exercise. So a sense of gentleness about that and what you had said before, and kind of being more graceful for yourself to yourself is a skill that a lot of people have to develop to get to where you are. It took a bit of type anus, I bet. So there’s a learned skill for longevity and the capacity to do the work that you want to do over the course of the next 20, 40 years or longer requires learning that skill of gentleness and implementing it over the long haul. All right. So I will send you your list. We’ve integrated it into your schedule. If you need any other support. Think about that and how you can get that added in. And it might just be a little bit of scent spray or a couple new books for a gift from a friend or a family member, you know, like just allowing yourself to receive some little bits of support is also part of that learned skill of gentleness, because I am sure you’re super, super capable, but receiving might be a little tough.

Dr. Jessica Drummond (00:45:10) – Would that be true?

Terry Brown (00:45:11) – That’s a little true. Yeah.

Dr. Jessica Drummond (00:45:13) – I get it, I get it.

Terry Brown (00:45:14) – Yeah.

Dr. Jessica Drummond (00:45:15) – Certainly guilty myself. So practicing that and then so in step six is our support. And then we’ll circle back in about 4 to 6 weeks from now. And keep refining your goals and keeping you healthy and strong and out of any kind of doctor, hospital office as much as we can.

Terry Brown (00:45:38) – I would love that.

Dr. Jessica Drummond (00:45:40) – With any kind of new bugs. So great. Right. Any other questions for me?

Terry Brown (00:45:45) – I think that’s perfect. Thank you so much.

Dr. Jessica Drummond (00:45:47) – You’re welcome. Thank you so much for sharing your story. I think it’s going to resonate with so many people, and I wish you the best of luck as you keep moving through your program, you’re more than halfway done, so that’s something to celebrate to too. Exactly.

Terry Brown (00:46:02) – Thank you so much. All right.

Dr. Jessica Drummond (00:46:03) – Thanks so much. Take care. Thanks so much for joining me. And thank you to Terry Brown for sharing her story.

Dr. Jessica Drummond (00:46:15) – What a powerful case example of the tools that we now have available to us to prevent and mitigate risk of Covid and all kinds of other infections. And if they should befall any of us or our clients or patients, how we can mitigate the risk of long Covid, how we can more optimally recover, how we can recover more quickly and more fully. We have many, many tools, and it comes down to following the seven step system and taking the time and getting the support that our clients need to help them actually implement these changes slowly, one small change at a time, with as much support and patience as our clients need. Remember, people can only heal at the pace of their nervous system, and Terry is such a beautiful example of that because, as she said, one of the most impactful things to her healing and building of resilience has been focusing on being gentler to herself, giving herself more grace. People can really achieve great things with a powerful pushing through mindset, but that only gets us so far in many cases if the ultimate goal at some point is longevity and enjoyment and really being present in our lives and being able to do things that we love for years and years and decades and decades without being sick.

Dr. Jessica Drummond (00:47:51) – There’s a skill set to develop, particularly among those of us, and I’ll put myself in this category who have a long history from middle school, high school, college, graduate school. Our first jobs of being type A driven, workhorses, productive, efficient, you know, and it gets us to I mean, we have to admit this brings us a level of success, but it’s also not sustainable. And there’s a skill set to be learned the earlier the better. And hopefully graduate schools early enough for Teri’s long term health and longevity. But the earlier we can learn that skill set of nervous system regulation, of quieting that driver self-talk, and giving ourselves the grace and patience to take as long as we need to slow down a bit to simplify and to be patient. That’s really important. We are not machines and we are vulnerable to the stressors of our environment. And that includes pathogens. That includes novel pathogens that we may not have even encountered yet. But the positive thing is, we have more tools than ever to protect ourselves, to take care of ourselves, to help ourselves fully recover.

Dr. Jessica Drummond (00:49:17) – We have to do that in an environment of gentleness and grace for ourselves. So what an important lesson. Thank you for sharing that insight, Terry. And if you want my support personally with your complex chronic illness, with your long Covid, with your endometriosis, with both of those things, with an autoimmune disease, my clients have all the most complicated stuff, but we patiently and thoroughly and from a root cause perspective, navigate it for optimal healing. If that’s what you’re looking for, reach out. Send a note to our team at support at Integrative Women’s Health Institute. Com I have space to help you heal fully from the root cause. Even if you’ve had long Covid for years now, even if you’ve had pain from endometriosis for decades, even if you’ve had multiple chronic illnesses and autoimmune conditions and, and and and that’s what myself and my team specialize in. We’re here to support you. Nothing is too complex. We’ll throw all the resources we know, and we’ll do it with a sense of patience and gentleness.

Dr. Jessica Drummond (00:50:35) – We’re here for you. Reach out if you would like some support. I’ll see you next time. Have a great rest of your week. Thank you so much for joining me today for this episode of the Integrative Women’s Health Podcast. Please share this episode with a colleague and if you loved it, hit that subscribe or follow button on your favorite podcast streaming service so that we can do even more to make this podcast better for you and your clients. Let’s innovate and integrate in the world of women’s health.