ļ»æHealing Migraines Naturally
Dr. Leslie Cisar
Recording 0232 | Edited transcript | 44:44
[00:00]
Hi there, welcome to the Healing Migraines Naturally podcast. My name is Dr. Leslie Cisar and I'm a licensed naturopathic doctor, former chronic migraine sufferer. And I've dedicated my life to helping other women with chronic migraines rediscover a migraine-free life. So welcome to the podcast today. This past weekend, a young man named Presley Gerber died. He was 27.
[00:28]
He was the son of Cindy Crawford and Rande Gerber, and he'd been a model himself. He died on Sunday, September 20th at a residential treatment center in Santa Monica, California. He had checked in the night before. The police are investigating it as a suspected overdose. The medical examiner has deferred the cause of death until more testing comes back, and that can take months.
[00:58]
So no one knows yet exactly what happened, and I'm certainly not going to guess. I certainly have no inside information. But when I heard that the son of a famous person had died in rehab, I had that pit in my stomach feeling. Because for the two years that I worked in a drug and alcohol rehab, that was my biggest fear, that someone was going to die in our facility.
[01:24]
It is very, very dangerous to be a drug addict going into rehab. And there's something Presley said last December in a video that he posted about the medications that he was on. These are prescribed medications that I haven't been able to stop thinking about because I've heard it before from my rehab patients and from my migraine clients.
[01:52]
I'm going to get into it today. So from 2012 to 2014, I was a staff physician at an inpatient drug and alcohol detox and rehab facility in Arizona. It was a facility that incorporated a naturopathic approach. I worked Friday, Saturdays, and Sundays. So let me tell you about one patient. I've changed some of the details here to protect her privacy.
[02:17]
She was a young woman in her mid 20s, a heroin and meth addict who flew in from the Midwest. When she landed at Sky Harbor Airport, one of our behavioral health technicians was there to pick her up. The tech was supposed to be with her continuously from the moment she laid eyes on her. She was never supposed to take her eyes off this patient.
[02:41]
But the patient said, I need to go to the bathroom, You're flying in from the Midwest, It's a few hours. I need to go to the bathroom. And the tech said, Okay, go to the bathroom. She did not go into the stall with the patient, which technically she should have, but she didn't. And the patient did what a lot of addicts do when they're going into rehab.
[03:02]
They think, This is my last hurrah, so they use up everything that they have. I had another patient who drank an entire bottle of Listerine right before she showed up to our facility at about 11 o'clock at night because she had no alcohol in her home, but she did have Listerine. That's very dangerous. And that was a very rough night for all of us.
[03:24]
Certainly the patient, our overnight nurse, and for me, because we had to monitor her continuously. Luckily, she pulled through, and she did get sober. But this young woman from the airport gave herself a huge dose of heroin in that bathroom stall. And then she came out and she acted like nothing happened. The two of them got into the transport van and drove down to our facility, which was about an hour from the airport.
[03:47]
And it was a typical Saturday, so we were getting a lot of new patients in. Saturday at the facility was a day when the patients didn't have a lot of programming, so a lot of them had free time. They would come into the medical clinic for nutrient IVs. So when she came in, we had a full clinic.
[04:11]
It was me and the nurse on duty. Of course, we took her vitals. There's an intake process that occurs. Part of that is taking the new patient's vitals. And right away, everything looked good. We brought her into the clinic, and we had these like recliner chairs in the clinic. So everybody was very comfortable. We sat her down in one, and I said, I'll be right with you.
[04:33]
We were just about to start a round of six IVs for existing patients. So after she had been sitting there for about five minutes, something made me look at her. I could not tell you, but my intuition just said, Take a look at her. And I looked over, and I realized, I don't think she's breathing. I don't see her chest moving.
[04:50]
I rushed over. I took her pulse. It was about 40. She was not breathing. We called 911. We got oxygen on her. We called additional support staff, and we were able to rouse her. And the paramedics came, and after that, we did not take her eyes off of her. Back then, we didn't have Narcan in our facility.
[05:13]
It existed at that time, but only as an injection that you would mostly find in ambulances and hospitals. The nasal spray version that you can buy over the counter today didn't come out until the end of 2015, a year after I left. So when she came to, and we got her stabilized, paramedics were there. We ultimately did not have to transport her to the hospital.
[05:37]
We felt comfortable keeping her in our facility. And, of course, I am asking her as the doctor on staff, the head of the behavioral techs, the paramedics. Were all asking her, did you take something? And, she denied it, because that's what addicts in early recovery are apt to do. But, we continued to ask her, and then she did eventually admit that she'd taken that dose in the airport.
[06:04]
She survived. She went through our program, and she graduated. I don't know where she is now, and I pray that she was able to get her life back, because living on the streets as a young woman addicted to heroin and meth is not a life that you want to contemplate. Looking back, we were lucky. Her vitals were normal when she walked in, she looked fine, sitting quietly in a chair in a busy clinic, and the danger peaked after she was already in our care.
[06:32]
That's what the first hours of rehab can look like. So why am I telling you this on a migraine podcast? Because there's a second part to what I learned in those two years, and it's the reason that I'm able to do the work that I do with you now. Drug addicts and alcoholics are over medicated tremendously. The patients who came to us would arrive on a spectacular number of pharmaceutical medications prescribed by their doctor, This was not, a street prescription medication.
[07:07]
This was medication that they were fulfilling at a Walgreens or a CVS because they had a prescription from their doctor. And I'm talking about more than a decade ago before fentanyl changed everything. So some of this is a little dated, but the pattern itself hasn't changed. So if you take a meth addict, when people use methamphetamine, they may not sleep for days.
[07:29]
So it'd be very typical for them to be on a sleep medication like Ambien. A meth can make people hallucinate, so they'd be on an antipsychotic like Seroquel. And fetamines make people paranoid and anxious, so they'd have a benzodiazepine like Xanax or Ativan or Valium. They'd very likely have skin problems, so they might have a prescription cream or be on antibiotics.
[07:55]
And when they crash, they have a low mood, They look like they're depressed, so here comes an anti depressant. Every one of those prescriptions, if you're following the conventional medical model, those prescriptions make sense if you're just considering a particular symptom in isolation, something for the paranoia and anxiety, something for sleep, something to lower the heart rate.
[08:26]
But nobody's looking at what they're adding up to, And the meth addict who's hallucinating from the meth is now on an antipsychotic for hallucinations the meth is causing. You would think that the medical doctor prescribing the medication would get this, I think when you say this to, like a regular lay person, they would think, Oh, that can't be happening.
[08:56]
It is. Now, part of this is because the patient on meth might be lying to their doctor, They may not be saying, Oh, I'm awake for three nights in a row because I'm taking meth. They just say, No, I can't sleep, and so they're getting the Ambien. But, a deeper investigation many times is not done by the prescribing doctor.
[09:13]
And so they're getting prescription medications to suppress the symptoms that the meth amphetamines are generating. Now, take an alcoholic. Years of heavy drinking can damage the nerves. So it would be very typical for them to be on Gabapentin or Lyrica or Cymbalta or amitriptyline for nerve pain. They're frequently on an antidepressant and often something for anxiety. They don't sleep well, so they've got trazodone or Ambien.
[09:46]
Alcohol drives up blood pressure, so there's blood pressure medication. Their stomach is a mess, so they've got nausea medications, Zofran, perhaps. They're in pain, so they're taking NSAIDs, ibuprofen, naproxen, muscle relaxers. And if they've ever had a seizure, maybe during an alcohol withdrawal, they're on an antiseizure drug like Keppra. Again, if you're looking at the conventional model, these medications make sense from a symptom management standpoint.
[10:18]
But again, nobody's looking at what they're adding up to, what the underlying driver of these symptoms is. And then there would be the patients who had already gone through detox at another facility and they were coming to our facility for the rehab portion of their treatment. So in those scenarios, the actual detox is usually pretty brief. So it might be something like three to five days.
[10:44]
And then when they left, time after time, they were handed new prescription medications as they were leaving the detox facility and coming into our facility. A list as long as your arm of new psychoactive medications layered right on top of everything else. So they arrive at our door with all these drugs on board, drugs that they had just started and they really didn't know why they had been given them.
[11:15]
Someone who has just gone through a three to five day detox in a facility is not someone who is really in their best state of mind to engage with a physician around informed consent and deep understanding of new medications for treatment. Let me just put it that way. An alcoholic confronting 30 days of rehab is probably not going to be in the best mood.
[11:39]
So now they've got an antidepressant. They're definitely going to be anxious. So now they've got a benzodiazepine. They've got a sleep medication, maybe gabapentin, maybe Depakote. But listen to this, the American Psychiatric Association's own guideline on medication for alcohol use disorder, recommends against benzodiazepines like Xanax or Valium for these patients, except to get them through the withdrawal itself.
[12:14]
And it recommends against antidepressants unless the person actually has depression. Those are two of the drugs on almost every list I saw. So in our naturopathic approach, the work wasn't only drug and alcohol detox. It was also getting people off of all of these psychoactive drugs that had been prescribed. And we were a very, very different type of facility.
[12:41]
I'm not going to name it because since I left, it was over 10 years ago, it's been sold a couple times. Back then it was independently owned and operated, and it employed naturopathic doctors. Now it's part of a major medical conglomerate, and they don't have naturopathic doctors working there anymore, and it's much more like a standard conventional rehab.
[13:07]
But for a lot of our patients, this was not their first time in rehab. And time after time, they'd say, Wow, this place is so different. It started with the food. And My medical director, my naturopathic colleague, sat down with the cook every week and reviewed the menus. Now, if you worked there over a meal time, you got a free meal, and the food was really good.
[13:31]
About once every three months, they do a big recreation of Thanksgiving dinner. Those were the best meals. And I usually worked from one to nine, so I was usually there for dinner, and I would get that turkey stuffing and gravy and mashed potatoes dinner like every quarter. But I digress. So we had good nutritious foods, but alcoholics and particularly opiate addicts, but, I mean, meth addicts are not eating a lot of food for sure.
[13:58]
So this population has very poor digestion. So we would support their digestion with natural therapies, like bitter herbs or digestive enzymes or, other natural therapies depending on what their symptoms were, so that they could actually get the nutrients out of the good food that they were being served. And then we also did nutrient IVs. And for the symptoms that can come with detox, instead of just loading them up on prescription anti-nausea medications they're just loading them up on all these prescriptions to help alleviate the symptoms associated with detox, we would use natural remedies to support them through that.
[14:41]
For alcohol and benzodiazepine detox, you have to use prescription medication because those withdrawals are life-threatening. So we did use prescription medications, even for opiate withdrawal, methamphetamine and draw opiate withdrawal, it technically won't kill you. Like alcohol and benzodiazepine, can the withdrawal process can literally be life-threatening. That's not the case with opiate withdrawal. You may You may wish you were dead, but it won't be life-threatening in and of itself if you have enough vomiting and loose stool and you lose enough fluid to develop severe dehydration or electrolyte imbalances.
[15:28]
Yes, that can be life-threatening. So it's not like we didn't use any prescription medication. We definitely used the prescription medication that was needed. It's not like we just, sprinkled herbs and waved sage on people. That's not at all. This was a very, very serious enterprise. But we were one of the few facilities in the country that didn't just load people up with prescriptions.
[15:58]
We used nonprescription options to support them through detox, and then once they were through detox and they were sober, to continue to support their health, their continued healing, and then also most of them wanted to come off all of these other medications that they had been prescribed that were interfering with their brain chemistry. We did acupuncture every Saturday or Sunday.
[16:24]
We did spinal adjustments if required. We had a sauna on the facility. In Arizona, naturopathic doctors have prescribing rights. So at that facility, I was the one writing and changing our patient's prescriptions, and I did change them. But only as their bodies were being restored with the food, the digestion, the IVs, health first, and then the medication came down.
[16:53]
Drug addicts and alcoholics have a very high toxin load in their body, and on top of that, they're prescribed all these additional medications. When a patient was with us for 90 days, we had a lot of room to work closely with them and to help them come off of these medications. I remember one young man, a meth and heroin addict, who was on Seroquel.
[17:16]
He was with us for 90 days, and after about 60 days, he was off the Seroquel. And I remember him coming into the clinic, and his eyes were so bright and white. His skin was clear. It was like he glowed. He looked so much better. Because the Seroquel is also adding to the toxin load. It's altering his brain biochemistry.
[17:37]
He's never going to feel like himself, and he's, let's be honest here, he's never going to be fully sober if he's on something like that. He's never going to know himself fully. He's never going to experience what it's like to actually be inside his own body without it being altered. And that's really critical for someone in recovery.
[18:02]
Addicts don't feel comfortable in their own skin. That's part of the reason they use. Part of recovery is learning how to feel good in your body as it is, Accepting yourself as you are, loving yourself as you are, and part of that is experiencing your body without it being altered. When our patients were ready to leave after their 30 or 60 or 90 days, we'd sit down with them for a medical consultation.
[18:33]
We'd go over their treatment plan, their existing medications, and how to talk with their doctor about new prescriptions, Because one of the most common reasons why alcoholics relapse is that they have anxiety, and their doctor who doesn't understand addiction medicine writes them a prescription for a benzodiazepine. That's like a Xanax or a Valium, Ativan. Those are drugs in that benzodiazepine drug class.
[18:59]
I had one woman, I'll call her Mary, who relapsed within a month. And when she came back in, of course I remembered her. She remembered me as part of the intake process. Patients bring their existing prescription medications with, and it's all logged. And here we go. We got a bottle of Xanax. And I said to her, Oh my goodness, somebody prescribes you Xanax?
[19:23]
And she said, Yeah, you know, I have anxiety. So my doctor said, Take this. And I said, But Mary, this is a benzodiazepine. Remember when you left last month, I told you, if you can't take benzodiazepines, you're gonna risk a relapse. She just looked at me heartbroken. I was heartbroken too, because she's a lay person. We went over the material with her.
[19:47]
We gave her handouts. We gave her information. But it's very overwhelming for a lay person. And, she's in early recovery. And she's not the one in charge of her prescriptions. The doctor ought to know this. Alcohol and benzodiazepines work on the same part of the brain. They work on what's called the GABA-A receptor, which is the brain's main calming system.
[20:17]
That's exactly why benzos work to get someone through an alcohol withdrawal. They stand in for the alcohol. And it's exactly why there are a problem afterwards. A 2014 review in a journal put it plainly, Frequent use of benzodiazepines causes cross tolerance, dependence, and cross addiction to alcohol. And the numbers back it up. A huge study out of Sweden, published last year, followed nearly a million people for up to 14 years.
[20:49]
The people who started on a benzodiazepine or a sleeping pill like Ambien had a 56% higher risk of later developing serious alcohol and drug problems. When they compared twins where one twin started a benzo and the other didn't, the risk was more than double. And you know who gets these prescriptions? A Kaiser Permanente study of more than 2 million primary care patients found that heavy drinkers were more likely to be on benzodiazepines than moderate drinkers and non drinkers.
[21:25]
The people who should be getting them the least are getting them the most. That's what I watched happen. So on December 3rd of last year, Presley posted a video on Instagram. He was sitting in a sauna. We had a sauna at our facility. In another part of the video, he said he was trying to work out and sauna and take baths.
[21:43]
Good for him. He was reaching for what helps on his own. And he talked about his mental health and his addiction. He's since taken it down, but it's been widely reported on. This is how I saw it. I was able to watch the entire post replayed on another podcast. So I don't want to replay it on mine.
[22:07]
I don't want to violate any copyright issues or ethical issues. He did take it down, but news organizations sort of maybe they went to the way back Machine or something like that. It has resurfaced. So if you want to hear this in his own words, do a Google, But he started with honesty is the best policy. And then he went through the medications that he was on.
[22:31]
And here's what he listed. Buprenorphine, one milligram twice a day, sometimes a little more if I need it. That's a partial opioid, the drug that's in suboxone, and that's used for opiate addiction, sometimes for pain. Two benzodiazepines, Xanax, he said a little bit at night or when the panic attacks are really, really bad, and Valium, A little bit in the morning.
[22:58]
He said the benzos had been quote fluctuating up and down depending on what's going on in my life. And that he was quote trying to stabilize on just Valium so that it's not two different benzos. Remeron, an antidepressant. He'd just gone up from 15 to 22 and a half milligrams. Presosan, a blood pressure medication, which he was taking for night terrors.
[23:23]
One milligram wasn't cutting it, so he was planning to go up to 2 or 3. Then what he called his comfort meds. Gabapentin, hydroxyzine, and clonidine. He saved those for when he was doing cuts, reducing the other medication, I'll put it that way. His words, Okay, this week we're dropping a little bit on your benzos or we're dropping a little bit on the opiate.
[23:49]
And NAD and ketamine drips, sometimes in Las Vegas, sometimes in California. He said he used those when he was detoxing. So count that up. An opioid, two benzodiazepines, an antidepressant, two blood pressure medications, because clonidine is a blood pressure medication too, can be used for that. An anticonvulsant, an antihistamine, that's the hydroxyzine, and ketamine. Nine prescription drugs, and he wasn't sure himself how much of some of them he was taking about the Valium.
[24:22]
He said, I don't know if that's a little or a lot. Who knows anymore? All these doctors say a lot of different things, so it's kind of scary. You think? Look at the combination. In opiate and two benzodiazepines at the same time. In 2016, the FDA put its strongest warning, which is called a black box warning, on opioids and benzodiazepines about taking them together, because the combination can slow or stop your breathing.
[24:52]
And I'm not saying that's what happened to him. Nobody knows yet. I'm saying that's what he was prescribed. And then he said this. I'd like doctors to be like, Hey, dude, you take this three times a day. You take this at 10am. You take this at noon. You take this at 9pm. But every psychiatrist I've had, and I've had like 15, they're all just like, Well, here's 20 medications.
[25:17]
If you feel like this, take this. If you feel like that, take that. Take this as needed. And I'm like, No, don't give me that much leeway. I need some direction. He also said, The things that scare me are the things that you need to take. Once you start taking them, if you don't take them, something not good happens.
[25:38]
15 psychiatrists, 20 medications. Take this as needed. That's the exact picture I saw walking in our door every weekend for two years. Now, I want you to take a look at your own list Because almost every category on Presley's list shows up in migraine care. Opioids still prescribed for migraine. The nasal spray, opioids in the ER, codeine in some forms of Fioricet, benzodiazepines, Xanax, Valium, Klonopin, Ativan, prescribed to a lot of migraine sufferers for anxiety and sleep, and sometimes as muscle relaxants.
[26:22]
Antidepressants, one of the standard classes of migraine preventatives, amitriptyline, noritriptyline, venlafaxine. Many of you were put on one of these for your migraines, not for depression. Blood pressure medications, another standard class of migraine preventatives, purpranolol, metoprolol, verapamil, Anticonvulsants, gabapentin, Presley's comfort meds, is in the same class as Topamax and Depakote, two of the most common migraine preventatives there are.
[26:55]
Lyrica and Keppra get used for migraine too. And here's one that stopped me, Topamax, also used by addiction doctors to help alcoholics stop drinking. If you're on Topamax for your migraines, you're on a drug they give alcoholics to keep them sober. Antipsychotics, remember my meth addict who came in on Seroquel? If you've ever been to the ER for a migraine, there's a good chance you were given an antipsychotic.
[27:19]
Compazine is an antipsychotic. So is Haldol, their standard ER medication drugs. Most women who've gotten them had no idea what they were. Nausea medications, Zofran, Reglan. Reglan is a standard ER migraine drug. Muscle relaxants, Flexeril, prescribed for migraine and the neck and shoulder tension that comes with that. NSAIDs, ibuprofen, naproxen, and prescription versions like Toradol or Cambia.
[27:52]
The first thing most of you were ever told to take. Barbiturates, Fioricet and Fiorinal, contain butalbital, which is a barbiturate. And ketamine. Presley was getting ketamine drips. Ketamine is now used for migraine. Some ERs and ketamine clinics give it by IV and some headache centers send patients home with a ketamine nasal spray off label. It's not FDA approved for migraine.
[28:20]
The biggest study on the nasal spray comes from the Jefferson Headache Center in Pennsylvania. They looked at 169 patients. Eighty five percent of them had already failed three or more classes of preventative medication. They were using about six sprays a day, around 10 days a month. About three quarters of them had side effects. Fatigue, blurred or double vision, confusion, dissociation.
[28:46]
And the researchers themselves warned that ketamine has the potential to become addictive and should be reserved for the most disabled patients. So who gets ketamine for migraine? The woman who's already failed everything else. It's the newest step on the ladder I've talked about on this show before. You start with one drug, it stops working, you add another and then another, and when you failed everything, now there's ketamine.
[29:15]
How many of these have you been prescribed? Count them. A lot of you are going to find that you're on three or four of the same classes of medications that Presley was on. Migraine sufferers are not drug addicts. Sometimes they get treated like drug addicts. A lot of you have walked into an ER in the worst pain of your life and were looked at like you were there to score.
[29:38]
You're not a drug addict, but tragically, you are given as much medication as drug addicts are given. I had absolutely no idea when I was working in that rehab how useful that experience was going to be for me later on with my migraine clients. Let that sink in. There's one more thing Presley said in that video. He said he was hoping to never have to do a hardcore detox again and to do more of a tapering thing instead.
[30:16]
And then he said, I'm just looking for a doctor that's actually going to help me taper, not just keep me on some stuff. He was already trying. He was making cuts a little off the benzos one week, a little off the opioid another, and reaching for his comfort meds to get through each one. He knew what he needed.
[30:35]
He was trying to get there without the direction that he was asking for. When I heard that, it broke my heart because that's exactly what we did in Arizona. Now, I'm not saying we could have saved him. Nobody knows what happened to him, and I'm not going to grandstand here. What I'm saying is that the kind of care that he asked for exists, and there aren't nearly enough people offering it.
[31:00]
And that's what most of my migraine clients are asking for, too. Most of them want to come off their medication. Most of them have already tried, and they're like Presley. They were unsuccessful because the symptoms came back. My heart goes out to this young man. He's trying to get off his medication. But clearly the symptoms were coming back.
[31:25]
There are two reasons why people fail to get off their medications. I saw both in rehab, and I see both in my migraine practice. Number one, nobody restored the health. If the prescribing doctor is only giving you medication, who's helping you restore your health? Every one of these drugs is there to suppress a symptom your body is generating.
[31:48]
That's what they were designed to do. So if the state of health underneath hasn't been restored, hasn't changed, and you try to come off the drug, the symptoms that drug was suppressing are going to come right back. Why wouldn't they? The migraines come back. The panic comes back. The insomnia comes back. And everybody, including you, concludes that you needed that drug after all.
[32:13]
You didn't need the drug. You needed your health restored, and nobody was working on that. Let me tell you about Tammy. Tammy was on Topamax, and she couldn't think. They don't call it Dopamax for no reason, right? The brain fog was profound. She would walk into her kitchen and could not remember what she came into the kitchen to do.
[32:36]
She was constantly misplacing things in her own home. At work, she couldn't follow what the people were saying in meetings. She was living in daily fear that she was going to be found out. And she had tried to come off Topamax so many times. Her neurologist didn't think that she could ever get off of the Topamax in the first place, and he wasn't doing anything to restore her health.
[32:58]
So when she asked, it was like, OK, well, if you want to do it, we'll do it. And he would taper her off in two to three weeks, and then the migraines would come roaring back. She'd have to go on prednisone taper. She'd end up in the ER, and then she'd go back to the neurologist and get the, I told you so, look, the What did you think was going to happen?
[33:17]
Eye roll. You got a migraine brain. What did you expect? Once her doctor got condescending, she decided that she tried herself. She went through this so many times. She's going to go it alone just like Presley seemed to have been. So by the time Tammy came to me, getting off Topamax was one of her major goals, but she was very nervous to do it.
[33:40]
She didn't want to go through another prednisone taper. She didn't want the pain to come roaring back. She didn't want to end up in the ER again. And the migraines weren't her only problem or the only symptoms that her body was generating. Even on the Topamax, she was still having migraines several times a month. She had heartburn, constipation, alternating with loose stools, abdominal pain, heavy periods and cramping with a lot of clotting, severe irritability, Raynaud's syndrome, and she was having a lot of problems sleeping.
[34:14]
So we went to work on all of that. And like I've talked about before, when we restore our health, the rising tide of health lifts all of the symptom boats. And so over time, all of those symptoms started to get better. And once she was down to one or two headaches a month, not migraines, just sort of headaches, she felt confident enough to start tapering.
[34:42]
And this is important. You have to feel confident to come off of some of these medications. So what I did is I advised her on how to approach it with her neurologist. I put my recommendations in writing for her so that she can bring them in and go over those recommendations with the neurologist. And the neurologist said, You don't need to go this slow, but she held her ground.
[35:05]
She insisted. And that was part of her healing too, gaining the confidence to stand up for herself and advocate for herself. So she got the new prescription to wean off and she weaned off over three months and she did it successfully. And the last time I heard from her, she hadn't had a migraine in over a year.
[35:24]
So two to three weeks taper, she failed every time. Three months with her health restored first, she did it. Reason number two, they take you off way too fast. Most medical doctors take people off medication way too quickly, just like they did with Tammy. Especially medications that change brain chemistry. Your brain responds slowly. Your skin heals itself in a couple days.
[35:52]
The brain is different. It heals more slowly. When you're on a drug that changes your brain biochemistry, your brain adapts to that. It turns certain receptors up and others down to compensate for the drug being there. And undoing that adaptation takes time. It can take months. Sometimes it can take years. So picture it. You've been on one of these medications for five years.
[36:18]
Your brain has built itself around the drug. And then the prescribing doctor weans you off over two to three weeks. This is not going to be successful. The taper can't go at in what you might say even pace either. So the lower the dose gets, the smaller the cuts have to be and the slower you have to go.
[36:42]
So if you're taking 500 milligrams of something, the jump from 500 down to 250 is much easier to make than the jump from 50 down to 25, even though both times you're cutting it in half. And that last little bit, getting all the way to zero, is often the hardest step of all. This is something that I learned years ago.
[37:06]
I've been telling my clients this for years. And the research has caught up. So in 2019, two researchers published a paper in the Lancet Psychiatry explaining why. At a high dose, the drug is already doing close to everything that it can do in the brain. So cutting the dose doesn't register it much. The higher dose is sort of flooding everything and you've got a little excess.
[37:33]
So when you cut, you're just eliminating the excess. At a low dose, every milligram counts. They showed that tapers need to get slower and slower as the dose gets lower, often over many months. They call it hyperbolic tapering. And in 2020, the FDA added another black box warning to the whole class of benzodiazepine drugs. The warning covers dependence and withdrawal, and it says that stopping them suddenly or cutting the dose too quickly can cause severe withdrawal, even life-threatening withdrawal.
[38:12]
Now, the fact that this was released in 2020 is ridiculous. We've known this for a long time. Now back in Arizona, I could change prescriptions. Today, I work with women all over the country, over the phone, and I don't. I've been on the other side of that prescription pad. I know what it takes to bring these medications down safely because I did it, but now I have to be very clear.
[38:35]
I do not change anyone's prescription. Legally or ethically, it is not appropriate for me to change anyone's prescription. Only the prescribing doctor can do that. But what I can do is educate my clients on strategies to bring to their prescribing doctor. It's the same thing we did at that discharge consultation and rehab. While we're restoring health, I'm monitoring the symptoms my client is experiencing, and when I see that the body is ready, I can use my judgment to say, I think you're ready to talk to your prescribing doctor about weaning off XYZ medication.
[39:17]
And if I were going to recommend to start, based on, your whole picture, I start with this one, I start at this dose, I go at this pace, and I'm educating the client so that they can have a truly informed conversation with the prescribing doctor. So I'm not changing her prescription, but I'm facilitating a better way of going about that Health first, then the medication comes off slowly on a schedule that her body can actually handle.
[39:48]
To me, it sounds like that's what Presley was asking for, a doctor with a plan in some direction. In the past few years, more and more people have been calling for changes to our health care system, and I certainly couldn't agree more. This is a health care system that let poor Presley down time after time after time.
[40:06]
But as I've talked about this on this podcast, the change has to start with how we look at health and disease as a society, as individuals. Because right now, the way we look at symptoms is that symptoms are bad. Symptoms need to be made gone. Symptoms need to go away. They need to be suppressed, whatever it takes to make this sensation or symptom go away, we need to do that.
[40:33]
If we start with that assumption, all of this follows, and you're going to get this result. We can tell the tree by the fruit, and this is a bitter, bitter fruit we've been confronting here and that people have been clamoring about for the past few years. You're not going to get a sweet fruit from this tree. I'm telling you, we have to shift our mindset around what symptoms are.
[40:59]
Symptoms are generated when our body is trying to function optimally, but it can't because the environment that it's in is not optimal. The physical, the biochemical environment isn't optimal. So if our cell is trying to run a biochemical process to make a necessary enzyme, and it doesn't have what it needs to do that, it doesn't have the proper cellular environment to do that, we don't just drop dead, thank goodness.
[41:25]
Our body adapts to that less than ideal environment, and it makes concessions in that adaptation, and those concessions are what we call symptoms. We will generate physical symptoms. Not just mental and emotional symptoms, but real physical symptoms if we're in a suboptimal, mental, emotional, or spiritual environment as well. As I followed reports of Presley's death, I found a video he posted last July, part of a series on his Instagram he called Mental Health Mondays.
[42:03]
In it, he talks about how happy he was as a kid. He played soccer, baseball, basketball. Then in middle school, he started surfing and playing water polo. And I didn't know this before, but if you play water polo seriously, you're also on the swim team for conditioning. So he said he was in the water five to seven days a week, a minimum of three hours a day.
[42:26]
Some days 10 hours just getting out to eat and then back in the water for polo practice. This wasn't like some surfer dude hanging out at the beach smoking pot. This sounded like he was a really serious athlete. This was somebody that loved that life. And then around 14, he started working. By 15 and 16, he was traveling for modeling, shooting in New York and Europe, and he stopped doing all of it.
[42:52]
Here's how he put it. The less activity that was in my life, especially for me, the ocean, the more medication I found having to be integrated into my life and his quality of life, he said, rapidly decreased. He said people used to ask him, You were such a happy kid, what happened to you? And he said, oh, that's quite a question, but he understood where they were coming from.
[43:17]
And he said, it took him 10 years of looking back at his life asking, what changed, what changed? That's what I've been describing. Take away what a body and a spirit need to be well and the body makes concessions. Those concessions are symptoms. And then the symptoms get a prescription and then another one and another one until you're 27, sitting in a sauna with 15 psychiatrists and 20 medications, asking for someone to help you get off of them, or you're 50 on nearly the same list of medications, laying in a dark room, missing your life.
[43:59]
This is a bitter, bitter fruit. My heart goes out to Presley's family and I pray that he's now found the peace that he couldn't find here on Earth. If you're living with chronic migraines and other symptoms and you want to get off your medication, working with your prescribing doctor, and you want to understand what those symptoms are actually telling you, I'd love to talk with you.
[44:21]
I offer a free consultation call. The link is in the description. And we'll talk about your migraines and any other health conditions you have, what medications you're currently taking, what your goals are for those medications. And we'll put together a game plan to get you feeling better. It's going to be the best 30 minutes you've spent on your health in a long time.
[44:41]
Thanks for being here. God bless, and I'll talk to you soon.
