Top Preventive Tests Every Woman Should Have to Prevent Stroke and Heart Attack with Integrative Family Medicine Physician, Dr. Ellie Campbell, DO

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. Hi and welcome everyone. It’s Jessica Drummond from the Integrative Women’s Health Institute. Welcome to the Integrative Women’s Health Podcast. I’m thrilled to be talking today to Doctor Ellie Campbell, author of The Blood Pressure Blueprint. She tells a really interesting story about why she wrote this book, and it’s so heartfelt and so important. But she raises a really important piece of the puzzle that I think very few of us are thinking about in our practice.

Dr. Jessica Drummond 00:01:32 If you are a nurse practitioner, a primary care physician, a health coach, physical therapist, occupational therapist, midwife, acupuncturist, do not sleep on screening your clients for blood pressure, but also screening your clients for oral health. We talk a lot in this episode about the connections between breathing patterns. Nasal breathing. Mouth breathing. History of dental work. Periodontitis or inflamed gums? I’m saying that wrong, but inflamed and infected gums, which is sometimes just starts as bleeding gums cavities. We don’t think about these things a lot, but they’re directly related to the number one killer of women, and that is cardiovascular disease and stroke. Doctor Campbell is a really skillful physician. She’s a preventative minded primary care doctor, so she sees all kinds of patients, whole families. She has a depth of experience, and she really puts in the work for her clients. The story that she tells, I mean, it’s so important. So listen for that story. And we talk about the cardiovascular risks specific to women, how we can spot those and how Covid impacts women.

Dr. Jessica Drummond 00:02:59 If you’ve been cold, plunging, if you have ever had Covid, if you ever had or needed dental work, if you’ve ever struggled with a little bit of perimenopausal high blood pressure, this episode is for you. Doctor Ellie Campbell is a native Chicagoan graduate of the University of Illinois. She’s also graduate of the Kirksville College of Osteopathic Medicine and the Medical College of Georgia. She’s board certified in family medicine. She’s been practicing for over 30 years. She also holds certification from the American Board of Integrative Medicine. She’s an author, nationally acclaimed speaker, and solo physician with interest in interdisciplinary collaboration, functional medicine, reversing chronic illness, cardiovascular disease prevention, natural treatments for high blood pressure, and the oral systemic connection. She also is just a super fun, sweet person. She loves theater, gardening, healthy cooking, hiking, playtime, and travel with her husband, three adult daughters and two £100 dog she practices in Atlanta. Let’s meet doctor Ellie Campbell. Welcome, Doctor Campbell, thank you so much for being here.

Dr. Jessica Drummond 00:04:24 I’m so excited to talk about your book, because I want to hear more about why you chose blood pressure to focus on, but I think it’s very rare that enough primary care and family medicine practitioners and even physical therapists who spend a lot of time with their patients, health coaches, midwives, think about cardiovascular disease at the forefront. And yet it’s still the number one killer of women. So tell me, what inspired you to write the Blood Pressure Blueprint?

Dr. Ellie Campbell 00:04:58 I would add to that list dentists and eye doctors, right? Because I think that now that we’re so I am so aware about the connection between blood pressure and vision and cardiovascular wellness and oral health, those partners have to have cardiovascular wellness on our forefront. So you asked, why did I write this book? And the answer is fairly easy. I wrote it to teach people what I learned on my journey as I tried to solve a mystery, so I had a very dear patient line. She was one of my favorite. She was 74 years old.

Dr. Ellie Campbell 00:05:33 She was spunky. She came to see me on a referral from her daughter who came to see me because at age 42, she was unable to conceive her second child. And so she came to me for fertility issues. We helped her with all of that. She successfully got pregnant and had another child and she said, wow, you’re really good with hormones. I think my mom could maybe need a little help with her hormones too. So because of my primary care family physician now, I had a whole family to take care of, right? I had the mom and her husband. I had two children, and now I got grandma in my practice too. So it was a delightful experience for me as a primary care provider. And when she came to see me, she was taking hormones, but they weren’t well balanced. So we helped her fix that, and I took care of her high blood pressure and met the guidelines and took care of her cholesterol and met the guidelines. And then one day, Cheryl called me panic stricken because grandma, she called her mother.

Dr. Ellie Campbell 00:06:28 Mother did not come to work that day. She works in the family business and Cheryl drove her to her house, peeked in every door and window, knocked on the door, tried to find her mother who was crumpled on the floor next to her computer in the basement. She had had a massive stroke. She was paralyzed on one side of her body. She was alive, but barely breathing. They called 911. The stretcher came. They took her to a local hospital, which happens to be a stroke center of excellence. So that was really good. She survived that event, and she went to the stroke rehab hospital, where there were a whole bunch of other stroke patients recovering from their strokes. And I talked to her at that rehab facility, and we were joking that, you know, it’s going to take a lot of rehab to fix that arm and leg because you can’t really go line dancing if you don’t have two good legs. So she had a very good attitude about the whole thing, and she had to learn how to feed herself and walk.

Dr. Ellie Campbell 00:07:22 And it was very, very intensive therapy. And even so, we weren’t sure how much she’d get back. Two days into that rehab hospitalization, she had the most dreaded complication that can happen, and that is that she had a hemorrhagic transformation. That means that that blood vessel that had been damaged by the stroke burst and caused a brain hemorrhage, and it caused Dee to die. When I got the news that Dee died from a stroke, I felt like somebody knocked the wind out of me. I felt like I had been punched in the belly because it was my responsibility as a family physician to care for this lady with preventable causes of disease. She had high blood pressure, she had high cholesterol, she had risks. But we mitigated those and she had an event anyhow. So I spent the next three years of my life going to every continuing education course that I could think of, on how to learn what I might have done differently, what I didn’t identify and did. I decided to have a write a book because the solution will learn.

Dr. Ellie Campbell 00:08:30 If you read my book for these case, and for the vast majority of my patients, turned out to be her oral health, that’s not in my per day to take care of her teeth. But I asked her daughter. Once I learned this, I said sure. Was there any chance that your mom had a dental problem right before her stroke. She goes, well, absolutely. She’d been fighting a toothache for some time. She was scheduled to see the dentist the week after her stroke to have her tooth pulled, but she got far. So I know now that I didn’t know then, is that she was in a heightened state of inflammation, and she had this event that put bacteria in her bloodstream that caused her inflamed arteries to burst, and that’s what led to her demise. Now I have leading indicators in saliva, blood and urine that can tell me the patient might be in trouble. Patient might be in trouble. Doctor Campbell, get that patient to the dentist. Get that patient for an x ray.

Dr. Ellie Campbell 00:09:32 Get that patient for a cone beam Cat scan. Give that patient for a periodontal exam with their hygienist, and make sure there’s nothing going on. Because 95 times out of 100, there is something oral going on that’s a driver of poor cardiovascular health. So I wrote the book about oral health, and I pitched it to 82 publishers and nobody wanted it. So I’m like, well, what do people want to know about if they don’t want to know about how to save their own life by fixing their mouth, what do they really want to know about? They don’t know what they don’t know. So that’s why they’re not googling. Could my oral health possibly be contributing to my cardiovascular disease and hypertension? What they Google is blood pressure. And I went back to the drawing board and I completely revised the book. And I used the tag of blood pressure, really as a Trojan horse to get the book into people’s hands and homes so that they would read it, because people do care about their blood pressure.

Dr. Ellie Campbell 00:10:34 And inside the book, I teach them about therapeutic lifestyle changes and oral systemic connections and the myriad ways that the mouth is directly connected to the brain, the kidneys, the cardiovascular system. So it’s a Trojan horse. It’s a trick.

Dr. Jessica Drummond 00:10:51 Yes, yes, but also important because, as you said, people are aware usually, especially if they’re getting consistent primary care or even if they’re checking it themselves, they have an awareness that their blood pressure is out of whack. You know, I work with primarily women in the perimenopausal to menopausal ages, so roughly 35 to 55 and more and more perimenopausal women come to me noticing that their blood pressure is kind of ticking up. Even though they eat well, they exercise consistently. So you wrote in your book that you see heart attacks as being optional because as a preventative, medicine minded primary care physician, you sort of put people through a checklist. So if you have a woman in midlife whose blood pressure is creeping up, maybe her abdominal weight is creeping up, maybe her fatigue is creeping up.

Dr. Jessica Drummond 00:11:43 What are those preventative things you’re looking at specifically?

Dr. Ellie Campbell 00:11:47 Yeah, absolutely. I think that if we kind of think about blood pressure as the first red light that goes off on our dashboard, something metabolic is brewing here. There’s a problem that we need to address. And I think that in one of the courses that I went to attended the Bail Domain conference, and these are the things we look at when a woman comes to us with high blood pressure, these are mostly treatable and reversible if we identify them and you’re willing to do the work.

Dr. Jessica Drummond 00:12:19 Yeah. And just quickly, doc, for those of you listening on audio, Doctor Campbell showing essentially the roots of the tree. Right. The root cause, drivers of poor nutrition, environmental exposures, lack of movement, things like that. So there is some work by the client. Yeah.

Dr. Ellie Campbell 00:12:36 If you’re willing to get the test and do the work, it’s a lot of work to do these things. But so some of the things that I showed on that root tree example are oral health, periodontal disease which is gum disease that which makes your gums bleed when you brush or floss, and endo disease, which is at the bottom of the tooth route.

Dr. Ellie Campbell 00:12:59 Very often we, as part of our dental care, have been recommended to get a root canal. During a root canal procedure. They cut the top of the tooth off, drill down into the roots, suck out the blood vessels and the nerves to that tooth. Stuff it full of a fake material called gutta percha, and then put a crown on the top of the tooth. The good news about that is in that procedure, they can suck out the abscess, any pus that’s been growing down in there, and the nerve. So the tooth no longer has a throbbing toothache. It’s a beautiful, pain relieving procedure, however, that now leaves a dead tooth in our jawbone. There’s little tiny blood vessels and little tiny nerves around the gum that hold it in place, so it usually does not fall out, but no longer does that tooth have sensation. So you can grow an abscess in the bottom of that tooth and not feel it until it gets big enough to touch the tooth in front of it or behind it.

Dr. Ellie Campbell 00:14:00 That happens. Now you have another toothache and they go in an X-ray and say, oh, that root canal, 2000 abscess. We have to pull out that root canal tooth and talk about putting a tooth implant in its place. So that’s the usual progression of a modern tooth in America today. Cavity crown root canal extraction implant. Right. Well, all along the way, from the time of the cavity, there are now a hint that we have abnormal bacteria that are living in our mouth. We’re supposed to be teeming with bacteria. That’s how our mouth stays healthy. That’s how we convert nitrate to nitrite. And we make nitric oxide, the miracle mouth molecule that won the Nobel Prize. Yes. So many benefits to our health from dilating our blood vessels to regulating our blood sugar, our blood pressure. Our immune system is amazing. Molecule. We’d have to have mouth bacteria in order for that molecule to get made.

Dr. Jessica Drummond 00:14:57 Right. So the answer is not just tons and tons of mouthwash, right?

Dr. Ellie Campbell 00:15:01 What’s wrong with bleach? And destroy all the bacteria that will do terrible things to the lining of your mouth, as well as your general overall health.

Dr. Ellie Campbell 00:15:11 But a really good dentist and a really good hygienist can take a look at that mouth bacteria and tell you if it’s in balance or not. And if you have an abundance of pathogenic or bad bacteria. Now we can make a care plan that helps you to normalize them. What are some of the things that drive bad mouth bacteria? Well, they’re the very same things that will raise your blood pressure. They’re eating a processed food diet instead of a natural food diet. They’re consuming too many acidic foods and not enough alkaline foods. It’s drinking acid all day long. What are some acid foods or acid drinks that people might consume that they never thought about? Coffee. Coffee is one. There’s a very interesting thing that dentists all learn and they take on their national board exams. It has to do with how saliva neutralizes acid. Acid will erode our enamel, make holes in our teeth and lead to cavities. So it’s not so much sugar that makes cavities. It’s bacteria that eats sugar, that make acid, that cause our cavities.

Dr. Ellie Campbell 00:16:21 So we won’t want too much acid. Our saliva neutralizes it, and it takes about 15 to 20 minutes after we’ve eaten an acidic food for a saliva to do its job and bring the pH back up to a non enamel dissolving pH level. So that’s an important physiologic thing if I’m drinking coffee. Coffee’s a very acidic beverage. Sometimes pH down in the fours or the fives. Enough to dissolve my acid. It’s fine. I drink my coffee. I enjoy it. In 15 minutes, my pH is back to normal. But what if I just bought a 32 ounce coffee at the store, and I want to sip at that coffee for the next eight hours? And I set it down, and I sip and I set it down. I never give my pH enough time to be neutralized, and my mouth is living in an acid environment, increasing the probability that I’ll get cavities, and forcing the shift of the bacteria from the friendly, healthy kind to the unfriendly kind that can lead to gum disease. Similarly, as beverages include apple juice for our children who think, oh, I’m giving my kid healthy apple juice instead of soda, it’s very acidic.

Dr. Ellie Campbell 00:17:39 We can let our kids drink some apple juice now and again, but it has to be drunk all in one sitting, not sipped on in their sippy bottle or sippy cup all day long, changing the pH of their mouth. Energy drinks very acidic, of course. Sodas very, very acidic. So we’ve got to be careful. Not that we can’t drink these foods, but we need to be careful about when and how we drink these foods.

Dr. Jessica Drummond 00:18:04 And especially that timing like drink, stop and not be drinking it all day long, which I think is a big habit for a lot of people.

Dr. Ellie Campbell 00:18:14 It is. And another one that we think is good for us that’s so healthy is apple cider vinegar, right? Many of us have established a lovely habit of having some apple cider vinegar in the morning. Well, it’s vinegar, for crying out loud. It’s almost pure acid, right? It will dissolve the enamel of your teeth, but if you just sip it all at one time and chase it with a glass of water, you’re going to be fine.

Dr. Ellie Campbell 00:18:38 But if you put that in a beverage drink and now sip it all day long, you’re pretty well guaranteeing poor oral health as a side effect of what you thought was a healthy habit, right?

Dr. Jessica Drummond 00:18:49 You’re trying to help your digestive pH, and meanwhile you’re raising your mouth pH all day long or lowering your mouth pH all day long. Yeah, yeah.

Dr. Ellie Campbell 00:18:58 So that’s one thing that we can talk about. Another thing about one of the common root causes that leads to an acidic mouth is mouth breathing. You look around at church next time you go and look how many people, not while they’re singing, just while they’re listening to the sermon. Have your mouths open and their chins down because they cannot breathe through their noses. They’re breathing through their mouth. They’re drying out their oral cavity. That changes the pH, that makes it more acidic and leads to all those complications. If you’re a snorer at night, if you have undiagnosed sleep apnea, you are probably mouth breathing as well for eight hours throughout the night, leading to an unhealthy oral flora, and furthermore.

Dr. Ellie Campbell 00:19:43 Undiagnosed sleep apnea will lead to low oxygen levels in the middle of the night so that you’re literally choking your organs. You’re joking your heart and your.

Dr. Ellie Campbell 00:19:53 Brain and your kidneys and your eyes because they’re.

Dr. Ellie Campbell 00:19:56 Not getting enough oxygen and you don’t have to snore to have sleep apnea. You don’t have to be overweight to have sleep apnea. And in my very educated opinion, no person with high blood pressure or with ADHD should ever be prescribed medication until they’ve been tested for sleep apnea. Such a powerful root cause, and many of us, as we approach our middle age and we start to lose our menstrual cycles and our hormones go a little bit wonky, we tend to gain weight. And sometimes that £10 difference can make the difference between us having sleep apnea or not. And so if we’re unlucky enough to gain that 10 or 20 or £30 perimenopausal now we may have a serious case of sleep apnea that we never had when we were younger, so we didn’t recognize it. But now our blood pressure is creeping up as a result of our sleep apnea, which is a result of our perimenopausal weight gain.

Dr. Ellie Campbell 00:20:58 Furthermore, the more choked your organs are in the night, the harder it is to lose weight. Often we can get somebody treated for sleep apnea short term, and they lose weight, and then they don’t need sleep apnea treatment long term.

Dr. Jessica Drummond 00:21:13 And in my practice, we have a lot of people who have long Covid. So they have breathing pattern disorder as well. So are you also recommending things like Myo functional therapy and things like that?

Dr. Ellie Campbell 00:21:29 Yeah. So CPAp machines are only one of at least five different treatments that we have for sleep apnea. So people have come to automatically assume if I have sleep apnea, I need CPAp. And that’s not necessarily true. It is probably true for those with severe sleep apnea with an apnea high index of 30 or greater. But for the mild or moderate sleep apnea patients, many other choices can be done. OMT oral myo functional therapy is physical therapy for the jaw, lips, and tongue. Most EMTs were dental hygienist first, and discovered a love of the oral airway and realized that they could make a huge difference in the health of their patients teeth and gums if they stopped having bad habits and stopped mouth breathing at night.

Dr. Ellie Campbell 00:22:21 So they teach us how to strengthen our jaw, lips, and tongue and hold our tongue in the proper position in the roof of our mouth when we sleep. And sometimes OMT can cure sleep apnea. Some patients have developed a condition called nasal disuse atrophy. You know that old adage, use it or lose it? Well, it’s definitely true of our nasal passages. And if we have become so accustomed because of allergies or sinus polyps or whatever, that we stop breathing through our noses and we only breathe through our mouth, our nose forgets to do its job. Its job is to filter the air and humidify it and warm it up before we suck it down into our lungs. And if we don’t give our nose that opportunity, it forgets how to do it. So retraining breathing patterns so that we’re using our nose instead of our mouth results in our nose working better. So how do you retrain your nose? Well, one thing you can do is put a little splint up inside your nose, a little plastic device that holds your nostrils open so they don’t collapse while you’re breathing in.

Dr. Ellie Campbell 00:23:31 They sell these over-the-counter. You can buy them at CVS or Walgreens. They’re called mute. Mute. They come in small, medium and large sizes, and they’re slightly adjustable. So you can make a small and a half or a medium and a half if you need it. They trial package, so you buy three at once. You figure out what size you are, and then going forward, you can buy new ones and they hold your nose open. Some people benefit also from taping their lips closed at night. Yes, mouth taping is a thing. Husband is a mouth breather and he says mouth taping is a recipe for suffocation. Are you take me out.

Dr. Ellie Campbell 00:24:09 Right, right.

Dr. Ellie Campbell 00:24:11 So stuffy. His nose has such use. Disuse atrophy. He doesn’t know how to breathe through his nose. So for somebody like him, if he were ever to listen to my advice, we would have him tape his mouth for one hour during the day while watching TV, not start practicing breathing through your nose. Little by little by little.

Dr. Ellie Campbell 00:24:31 Start using the nasal splinting and often position changing. Sometimes people only have sleep apnea when they lie on their back, or they have it in their line on their left side, and the sleep test can help us identify that. And then we get a position device in their bed so that they don’t ever sleep on their back. They don’t ever sleep on that side. And we can, manipulate their sleeping pattern to enhance a better night’s sleep without Apnic events.

Dr. Jessica Drummond 00:24:59 That’s wonderful. And I think really important things for the physical and occupational therapists in our community to be thinking about, you know, posture, splinting, sleeping posture, nasal posture and tongue posture, jaw posture, breathing patterns. There’s even a deep connection between especially left nostril breathing and nervous system regulation. So we know in women. So women tend to have different kinds of cardiovascular events than men. Men have more of the plaque buildup, whereas women have more vascular spasm and arrhythmia related cardiovascular events. So let’s talk about some of the differences between the symptoms of a cardiovascular event for women.

Dr. Ellie Campbell 00:25:46 I think that’s really important to know. And you touched on something else too, which is Covid, right? Long Covid has really changed the face of what cardiovascular disease looks like. But for women, we generally speaking, have smaller bodies than men. Always exceptions to every rule. But in general, our arteries are smaller than men. And so we have small vessels, and it doesn’t take a very much amount of spasm to cause strangulation of the tissue in the heart muscle. We tend to tolerate less well the sorts of things that cause vascular spasm. And that includes Covid, and that includes nicotine and that includes cocaine. And that includes prescription drugs like Adderall. So we don’t tolerate these. It gives us less room for error if our artery were to spasm and we have one of these drugs or supplements on board, it can really lead to a symptomatic event.

Dr. Jessica Drummond 00:26:49 I’m also concerned about cold plunging, based on the data I’ve seen in women around, that is not a concern for you.

Dr. Ellie Campbell 00:26:56 Yeah. So it’s really interesting.

Dr. Ellie Campbell 00:26:57 It is a concern to me, but it’s not a concern to my cardiologist, which is fascinating, right? Author is friends with a guy that owns a cold plunge company. And so they have these cold plunge events almost on a weekly basis. And my daughter has these big social media things, and they all party up and go in cold plunge and then meditate. And it’s a beautiful thing for them. I asked my cardiologist because when I hit perimenopause, I started to develop cardiac arrhythmia. My heart would get out of rhythm. I was skipping every other and every third beat, so I went through the usual workup and stress event monitor I had to wear for a week, and echocardiogram and a stress test. And the only thing that came back abnormal was my rhythm. And my cardiologist said, here’s a beta blocker you can take any time you have symptoms. And he almost took the prescription back. He goes, but I know you and you’re a natural remedy girl, so you may not take this, but I’m going to give it to you anyhow.

Dr. Ellie Campbell 00:27:57 Right?

Dr. Ellie Campbell 00:27:58 Right back to the drawing board. And I checked my progesterone level, which was in the tank, even though I’ve been taking progesterone for 15 years. So my progesterone levels dropped, I got on a proper dose of progesterone and all my arrhythmias went away. I haven’t had any trouble ever since, but I still have a cardiologist in my back pocket. So I called him up and I said, my daughter wants me to cold plunge. Is it safe? And his answer was, why would you want to do that?

Dr. Ellie Campbell 00:28:26 Yeah.

Dr. Jessica Drummond 00:28:29 yeah. Yeah. So, I mean, it seems to me I’ve really dug into the research on this that we don’t have a lot of data about it.

Dr. Ellie Campbell 00:28:36 Because I started digging in the research myself. I’m like, my cardiologist doesn’t know the answer to this question, so let me see if I can find out. And what I learned is I think what you learned is women have smaller vessels, were more likely to have a spasm. Should we vaso constrict because we jump into this really cold water and really constrict our vessels? Are we going to have a problem? And the answer is maybe.

Dr. Jessica Drummond 00:29:03 Yeah, yeah. Well, and I think that’s sometimes really important to say like maybe we don’t know. And so we do know there are some benefits for mental health which may outweigh in a certain circumstance someone’s cardiovascular risk. But I think it’s important to realize that it’s probably not just carte blanche safe because women do have this arrhythmia issue. So first of all, it sounds like for women in perimenopause menopause whose blood pressure is creeping up, maybe their cholesterol is creeping up. Maybe they’re having some sensation of arrhythmia. What is your sort of checklist? You know, check. Hormones? Check. Sleep. Anything else?

Dr. Ellie Campbell 00:29:44 Vitamin D, oral health. And then we look at their advanced inflammation and cardiovascular markers. Right. So one thing about stress is that if I’m about to be eaten by a grizzly bear, the following things happen to my body instantaneously, whether I want it to or not. My blood pressure goes up, my blood sugar goes up, my blood cholesterol goes up, my heart begins to race, I sweat, my hair stands on and my pupils dilate.

Dr. Ellie Campbell 00:30:11 And I get really strong so that I can fight that grizzly bear to the death, or break through the drywall and get out the other side. Right? Fight or flight? It’s a beautiful, life saving reaction.

Dr. Jessica Drummond 00:30:21 Sure.

Dr. Ellie Campbell 00:30:22 Well, if I go to the doctor and my blood pressure’s up, my blood sugars up, and my blood cholesterol is up. I’m going to leave with three prescriptions. They rarely ask me what’s going on in your life that’s driving your stress levels, that’s making you live in a state of high adrenaline that’s causing these secondary side effects. So when I see a woman in perimenopause who comes to see me, I’m like, all right, girl, what’s happening with your teenagers and your parents at the same time? That’s driving your stress level up. That’s causing you to have this sympathetic response of high blood pressure, high sugar, high cholesterol. Right. It’s normal. It’s physiologic. But the problem is our bodies haven’t learned to undo the stress that we feel. Because in my office right now, there is no grizzly bear.

Dr. Ellie Campbell 00:31:10 But I’m stuck in that pattern. So what can we do for parasympathetic biohacking to help reboot our nervous system and get us back down into that state of rest and digest? And sometimes it’s as simple as that. I don’t need any additional tests. I just need the patient to practice therapeutic lifestyle changes, meditation, good solid sleep time in nature. We can’t serve from an empty vessel. And if we are so overcommitted and overdriven because we’re caring for people at both ends of our life spectrum and we’ve never taken care of us, we’re going to become depleted and we’re going to end up with a stroke or a heart attack. And no, we won’t be good to anybody else. So we should never feel guilty about the need for self-care. If I’m driving from Atlanta to Chicago, I don’t kick the tires in Nashville and yell at my car that it needs to stop and refuel, right? It’s just part of what the journey is. And so this is true for us. We need to stock and fill our own tanks and take a minute and rest and reboot and focus on those fundamentals.

Dr. Jessica Drummond 00:32:23 Absolutely.

Dr. Ellie Campbell 00:32:24 When we don’t, we tend to live in a state of oxidative stress and inflammation. So I start to look at markers in bloodwork that tell me, does the patient suffer from these? One is called oxidized LDL. In my practice that cholesterol is a lot like teenagers. What age teenagers? They’re welcoming my home, but corrupting teenagers. They’ve got no business near my kids. And difference between a well behaved team and a corrupted one. And every mother knows this, right? So cholesterol is the same. Well, cholesterol is good for us. We need it to make cell membranes. We need it to make brain cells. We need it to make vitamin D and progesterone and estrogen testosterone. We need core cholesterol. But when it becomes oxidized or sugar coated or it’s the wrong shape or size, now it’s corrupted. And now it’s an inflammatory molecule that can stick to the inside of our arteries and cause atherosclerotic plaque that dramatically increases our risk of stroke, heart attack, and kidney failure. So I can check for corrupted cholesterol.

Dr. Ellie Campbell 00:33:35 I can look to see how high is your blood sugar. I can look to see do you have oxidized LDL? Have you inherited a really ugly shape or size of cholesterol? One’s called lipoprotein. Little A it’s very rarely tested by most doctors unless you’re a cardiologist. But I think it should be a universal primary care indicator because it have it, you’re much more likely to form disease at a much younger age and a much more aggressive pattern than somebody without lipoprotein. Little a and if you have too much oxidative stress, then we need to give you antioxidants that might be fruits and vegetables. Are you getting 6 to 9 servings a day of brightly colored fruits and vegetables? If not, there’s an opportunity there. If there’s nothing you can do in your life to get that many fruits and vegetables, then we’ll supplement you with vitamin C or E or A, and we can check those levels as well. Extreme. Same for vitamin D I do check a level. And we know that low vitamin D is associated with cardiovascular risk risk for catching colds and flu.

Dr. Ellie Campbell 00:34:43 And that increases. Having certain flu strains can increase your risk of heart attack up to 50%. We saw the same with Covid that you have an underlying inflammatory state, and I throw an acute viral infection on top of you. You’re very likely to have a complication.

Dr. Jessica Drummond 00:35:00 Absolutely. So let’s talk about Covid a bit more as you know. You know, I’ve lived with long Covid for about four years now, almost four years. And obviously I’m much healthier at this point. But we in the study that just came out yesterday showed about 25% of young, healthy, 18 year old average Marines have long Covid. So this is not just a disease of people that have. I was probably in very I was and very, very good health in my 40s. I was very active and fit when I got Covid. So do we know more or what have you seen in the research about how Covid impacts cardiovascular disease, and what are some of the mitigations that you recommend to your patients?

Dr. Ellie Campbell 00:35:50 So I think that we absolutely see a difference.

Dr. Ellie Campbell 00:35:54 You know, Covid first really got into our country in December of 19, January of 20. Those are months. And those are when historically, our vitamin D levels are the lowest. We know that having low vitamin D increases our risk of catching those viruses, rather than letting them run off our system like, Teflon. So so I think that we’re seeing a little bit of correlation here. In my practice, people that are adequately have adequate vitamin D have less long Covid symptoms than people who don’t. Once you’ve contracted Covid or you’ve had Covid vaccines, and there does seem to be a correlation with the more Covid vaccines you’ve had, the more likely you are to suffer from long Covid type symptoms. We think that it’s in part the spike protein that binds to our cell receptors, and when it does so, it makes our blood sticky and more likely to clot. And it makes our heart muscle much more irritable. So we see a lot more arrhythmia, especially atrial fibrillation record numbers. I’ve never seen this much fibrillation in my entire health history, medical history before Covid, so much atrial fibrillation.

Dr. Ellie Campbell 00:37:12 But I also think that it unmasks what many of us had that wasn’t symptomatic until Covid came along, for example. I think if you have low levels of zinc, you may be more susceptible to infection and arrhythmia if you have low levels of magnesium. I think if you are, have infections with Lyme disease or with Epstein-Barr virus, those can live very quietly, very stealthily inside your system, and you peacefully coexist until somebody pokes the bear. And then all of a sudden those infections come back up and they’re full force again. And now you’re dealing with Epstein-Barr. It feels like you have mono, like you did when you were in college. I had not been this tired since I had mono in college. Well guess what? You essentially have mono again now we call it long Covid. Epstein-Barr reactivation. Covid, I think will unmask some of that because it just saps our immune system. So some of the things that we can do to help with that, I have seen. Nicotine is an interesting, finding that when we first had Covid in 2020, smokers were not ending up in the emergency room and in the ICU at nearly the same degree that we would have expected.

Dr. Ellie Campbell 00:38:34 And it turns out that nicotine and Covid bind to the same receptor in the cell. So if there’s a lot of nicotine around, Covid can’t stick his heart. So in long Covid, what we will often do is put somebody on a nicotine patch starting very low, usually a quarter of a patch tight, trading up slowly over several weeks time to help dissociate that spike protein so their body can clear it away. I also like to use a lot of homeopathic drainage remedies to help people’s lymph system move, and I encourage them to do things like bouncing on a rebounder and dry skin brushing to help move their lymph so that their white blood cells don’t get stuck and stagnate. They move around their body and let our body do what it’s supposed to do, which is help clear out this protein once it’s unstuck from the cell membranes. One of the clotting aspects that we see is we see a lot of micro clots. So they’re not much bigger than a red blood cell, these little tiny clots. But they can stick in the tiniest nooks and crannies of our arteries.

Dr. Ellie Campbell 00:39:40 And when that happens, our cells can’t make as much cellular energy as they used to because they’re just not getting the circulation. So we need blood thinners, but traditional blood thinners, they don’t seem to work very well. But ancient blood thinners, things like natto kinase and bromelain, this is pineapple enzyme and the enzyme that you get from fermented soybeans. These seem to work really well together to help thin the blood just a little bit and improve circulation, helping people overcome some of those symptoms of lung fatigue, the breathlessness, the brain fog. By improving circulation to their tiny organs.

Dr. Jessica Drummond 00:40:21 Yeah. I mean, we use some similar things. I’ve seen very mixed results with the nicotine patches. Some real success stories, some people feeling a lot worse. I do think there’s a huge place for the micro clotting. And then the other thing that we’re seeing is the combination, which I think may have a lot to do with the underlying viral and other chronic infections. You were talking about the Epstein-Barr, the Lyme, this cluster of hypermobility, endometriosis, mGUS, Me, CFS and dysautonomia.

Dr. Jessica Drummond 00:40:58 I think that cluster in a lot of people who had very, very mild symptoms, maybe they were a little bit of a fancy kid, or maybe they were mildly hypermobile, or they had endometriosis, but it was well controlled. In fact, one of the most common symptoms of Covid I’m seeing now, and sometimes the only symptom in some of my younger population is an endometriosis flare. Because of that kind of form of inflammation, they don’t really get the much cough cold. They might get that a little after, but the key signal is actually an endo flare. So I think there’s definitely something about a genetic there’s not a lot of this in the literature yet, but I think it’s coming down the pike in terms of who might be most at risk, although I’ve also seen in the last six months or so many more teenage boys who are really, really struggling with the fatigue of long Covid. So it could be just the case that the girls have already fallen into the chronic illness situation with those were going to get it already had endo or something like that, you know.

Dr. Ellie Campbell 00:42:04 Yeah. Have you heard of the spiky leaky syndrome.

Dr. Jessica Drummond 00:42:07 Yes.

Dr. Ellie Campbell 00:42:08 So I think that patient population flare up as well.

Dr. Jessica Drummond 00:42:11 Yeah. Of the brain. Yeah.

Dr. Ellie Campbell 00:42:14 It’s in the brain. And these people get pretty significant fatigue, headaches and disorder. And it’s I think an underlying often hypermobility syndrome is sort of the first thing that we identify. And then they get all these other things. So working on there’s no one treatment for it as far as I’m aware. It’s treating each of the things individually. So you treat them mast cell activation and you treat the hyper ability and you treat the dysautonomia and you kind of treat each little piece. And usually the patients get some better. But this is, you know, a challenge for practitioners across the board, in part because there’s so little published literature. It’s just our collective observations and the way we have to share with each other what we’ve seen and heard and learn and crowdsourcing from the patients. Right. The patient, that’s what worked.

Dr. Jessica Drummond 00:43:07 Absolutely. So I would imagine that, like me, you’re probably a big proponent of mask wearing.

Dr. Jessica Drummond 00:43:15 Any other mitigation since I agree with you. You know, vaccines are very limited in their perspective and their healthfulness, and they may actually make things worse in certain populations. So we we’re still in this ongoing pandemic. I mean, Covid flares roughly every 3 to 6 months in terms of case numbers, other than masking anything else that you’re using with your clients.

Dr. Ellie Campbell 00:43:38 Actually, I’m.

Dr. Ellie Campbell 00:43:39 Not a big fan of masking. I know who’s in the paper industry. He made masks for many years, and he said masks never are and never were intended to prevent viruses. The virus is too small. They’re about one tenth of the poor size of the average mask. And viruses will penetrate through the mask. So bigger particles, tuberculosis, will be stopped, dust will be stopped. But in general, viruses are not stopped by the mask. And so, I’m not that big of a proponent. What I am a proponent of is supporting our immune system and making sure that we try very hard to keep the virus from sticking to our mucous membranes.

Dr. Ellie Campbell 00:44:26 So what does that mean? Hand-washing. Right? You and I probably spend a lot more time in airports than the average person. We bop around the country, we go to these conferences, we go to see our colleagues and airports. Those nasty gray tubs are so germy, and it’s very likely that we’re touching our face. The average person touches their face like 500 times. I think. I forget if it’s an hour a day, but.

Dr. Ellie Campbell 00:44:52 Not a lot. Yeah.

Dr. Ellie Campbell 00:44:54 So wash your hands, soap and water and try not to touch your face, especially if you’re in a public place, grocery store, etc. etc.. Rub your eyes, touch your contact, touch your nose, wipe your mouth. Try not to do that, especially if you’re in a public place. Number two clear nasal spray zippers made with xylitol and grapefruit seed extract. In the research studies that they did before Covid, there was a 90% reduction in the transmission of coronavirus and people who used daily xylitol nasal spray. So it acts a bit like a prebiotic.

Dr. Ellie Campbell 00:45:30 And the grapefruit seed extract acts a little bit like a antiviral antibiotic, so it helps keep viruses from sticking to our mucous membranes. saltwater gargoyles. After at the end of the day, before you go to bed, wash away any bacteria viruses that might have stuck to your oral cavity if your gums are inflamed. We know that people with periodontal disease are a much higher likelihood to contract symptomatic Covid, because those sticky, bleeding gums make a great portal for the virus to enter. So good oral health is a really important thing, not only for your teeth, but for the rest of your body to keep Covid down, keep your vitamin D, level up and get in the sunshine if you can. These are. Sunshine is a natural antiviral. It kills we, you know, we put things in ultraviolet light to sterilize them and keeping our our bodies in the sunlight where we can is a really good health strategy. Just not so much that you burn.

Dr. Jessica Drummond 00:46:33 Right? Yeah. Excellent. Well, any last minute tips you want to share? Anything else for the women in our community who are primarily in midlife, but also practitioners of all stripes? Any number one thing you think we should be screening for or anything else like that?

Dr. Ellie Campbell 00:46:53 Well, I really do.

Dr. Ellie Campbell 00:46:53 I think that first of all, cardiovascular disease is the number one killer of men and women in October especially. We all worry about our breast health because October is Breast Cancer Awareness Month, but ten times more women die from cardiovascular disease than die from breast disease. So we want to make sure that it’s very high on our radar. And that means pretty much every practitioner should be measuring blood pressure as a public health service to all of our patients, to bring it to our collective consciousness, that it’s an important marker, the first red light on the dashboard, that something is amiss. The newest guidelines tell us that normal blood pressure is 119 over 79 or less, and 1 to 80 is elevated. Blood pressure 3080 is now diagnosable hypertension. So we’ve dropped the guidelines. So we have to have an even greater understanding and appreciation for what hypertension is. And practitioners need to be much more aggressive about inertia because the average patient will come to their doctor seven times with elevated blood pressure before we make a therapeutic intervention.

Dr. Ellie Campbell 00:48:06 So if we use the nomenclature, my maximum acceptable blood pressure is 130 over 80. That’s my maximum acceptable. If I go to the doctor with a 132 over 84, that’s not good enough. That’s tension that needs to be treated. Does it need more drugs? Maybe not. Maybe it needs magnesium. Maybe it needs zinc. Maybe it needs vitamin D, maybe it needs a good night’s sleep. Maybe it needs penetration. Maybe it needs a trip to the dentist to treat your periodontal disease. So but it needs attention and it needs to be treated. And it needs to be aggressively monitored both at home and at the doctor’s office. Because heart attacks are optional, strokes are stoppable, and dialysis is not your destiny. If you’re willing to get the tests and do the work.

Dr. Jessica Drummond 00:48:53 Thank you, Doctor Campbell. I love that. And all of us can be screening for blood pressure. Number one, killer of women and postpartum. We can be screening for it through their entire lives. Midlife younger. Older.

Dr. Jessica Drummond 00:49:08 And I think your book is really, really important. Even if you had to go through a little bit of a backdoor way to get this information out there, it’s really important information. So thank you so much for being here.

Dr. Ellie Campbell 00:49:20 You’re welcome. Thank you for having me.

Dr. Jessica Drummond 00:49:28 I hope you enjoyed that conversation with Doctor Ellie Campbell. This is what I took from it. First of all, if you work with people, test their blood pressure. Second of all, do not sleep on oral health, breathing health, airway health, sleep health, including sleep apnea. These are basic things that are really quiet contributors to the number one killer of women. Now we also have to think about Covid. We have to mitigate the risk of being infected with Covid and then of Covid actually turning into a more complicated problem. But we also have to mitigate the risk of flu and flu becoming a more complicated problem. Doctor Campbell and I disagree on the benefits of masking. I have seen many, many studies and I will make sure in our show notes I link to the blog post that we produced, really going into depth about the studies on masking.

Dr. Jessica Drummond 00:50:29 If you are in a situation where you’re with the public, where you’re with people indoors and you don’t know their Covid or flu status, if they are sick or you don’t know if they’re sick or going to be sick, or you just want to be more prevention minded in your community. Really, we do have pretty good data. It’s not ironclad data. There are holes in it, but we have pretty good data that masking is a helpful tool. But there are nasal sprays and rinses that are also helpful. Gargoyles. There is a certain kind of mouthwash that actually kills Covid in the mouth, but it also kills all the other bacteria, so we don’t want to be using that day in and day out. So, you know, saline rinses in the nose and the mouth is safer to protect the beneficial bacteria in the nose and mouth. But in that blog post, you’ll find some of the other tools that I recommend for keeping the eyes, nose, and mouth rinsed on a day to day basis, especially when you’re in high risk situations.

Dr. Jessica Drummond 00:51:32 Masking is controversial. Different people have different opinions. I’ve presented the research to you in the Covid blog post. It’s actually a three blog series. Again, we’ll link to it in the show notes so you can make your own decisions. Other things really help to Hepa filters. Opening a window in your practice even helps, so there’s no simple solution in an ongoing pandemic to have people avoid Void Covid. But Covid is a really important predictor, just as important as high blood pressure, high cholesterol, oral health issues to people having cardiovascular diseases, especially women in terms of arrhythmias and severe cardiovascular events. So keep this in mind. We don’t have a perfect strategy for this yet. I wish we did. I will tell you about it as soon as we do because yes, vaccines have their place. They can be lifesaving in certain situations, but they are also not a complete easy solution. And for some people with certain cardiovascular risk factors, they can actually make things worse. So, you know, there’s no simple answer to this question.

Dr. Jessica Drummond 00:52:51 We’re living through challenging times. But there, Doctor Campbell gave us many, many things on the checklist to start screening our clients for implementing in our practice, and read her book for even more. The Blood Pressure Blueprint by Doctor Ellie Campbell is a really important resource for your practice to prevent the number one killer of women. Thanks so much for joining me on the Integrative Women’s Health podcast, and I will see you next 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.