In medicine, there is a tradition of doctors naming diseases after themselves. In keeping with that time-honored tradition, I have discovered a previously unrecognized disease, which I am henceforth naming “McMinn’s Disease.” The other name for the disease is “Total Body Funk” or TBF for short.
My wife is a vet so I have heard it a hundred times, “a dog can have ticks and fleas at the same time.” And so goes for many of the patients in my practice. Patients rarely come in for one isolated problem. In fact the classic patient has profound fatigue, generalized weakness, hot flashes, night sweats, brain fog, weight gain, can’t sleep, and on top of all that she has no libido. Sometimes TBF has an insidious onset. It has a mind of its own. It can smolder for many years, and then for some unknown reason it crescendos to become unbearable. On the other hand, some patients can remember the day it suddenly started many years ago. It’s like the day JFK was shot, or for the younger generation, that tragic day of 9/11 when all of our lives changed forever. For these people TBF came over them like a San Francisco fog. It rolled in one day, but unfortunately it never left.
As a physician from the traditional medical point of view, it’s exhausting to try to wrap your mind around the matrix of all of the differential diagnoses associated with the symptoms of TBF. Not to mention the fact that most doctors have about 10 minutes per patient interaction. It’s a square peg in a round hole phenomenon. The current medical system is just not prepared to deal with multisystem severe chronic illness. Furthermore, we live in a world of specialization. We go to our cardiologist for this and our rheumatologist for that. By the end of the day, we’ve gone all over town getting fragmented care from multiple specialists who don’t always have the opportunity to look at the big picture, and who frequently are unable to communicates with each other.
One of the more common symptoms of TBF is fatigue. None of the medical professionals seem to want to take ownership of fatigue. It’s the last thing a doctor wants to hear about. It can take forever, and he’s got ten minutes, with an office manager cracking the whip over him to see more patients. It overlaps into multiple disciplines, and even spills over into areas that we doctors were never trained to deal with such as nutrition, and thought processes that seem foreign to us such as the mind body connection. Try looking up your neighborhood “fatigologist” in the yellow pages next time you get a case of TBF. You’re likely to find infinitely more plastic surgeons than you are fatigue doctors.
Einstein had a lifelong pursuit of a fascinating concept called the unified field theory. He felt that there was one underlying fundamental law of the universe that controlled all of matter and energy. Likewise in these “total body funk” patients there are often fundamental processes which have gone awry that may affect multiple systems, and in fact may have a negative impact upon every cell in the body. The challenge for the physician is to peel back the layers of the onion to get at that fundamental dysfunction that is resulting in the patient’s constellation of symptoms.
In order for the physician to properly address these patients he/she must first embrace “total body funk” like an ER doctor on a heart attack. He must dedicate himself to a focused learning process above and beyond (and perhaps a bit different) than his traditional medical training. He must open his mind to new possibilities as far causes and treatments of disease. After all, we are not a collection of body parts, but we are a heavily matrixed complex whole being. He must embrace the mind-body-spirit connection, and he must expand this toolbox to include other therapeutic modalities. He should also resist the knee jerk reach for the prescription pad to write another prescription for yet another drug to put another band-aid on another superficial symptom. To optimally benefit the patient he should reach out and expand his referral network to include new partners who can be a part of his overall patient care team, such as a trusted chiropractor, a nutritionist, an acupuncturist, a massage therapist, an herbalist, a counselor, a yoga teacher, or a biofeedback specialist just to name a few. He must recognize the power of the fundamentals of wellness such as exercise, stress reduction, optimal nutrition, and a good night’s sleep. Finally, he must know going into it that TBF takes time, and it is never a quick fix. Doctor and patient must both be patient. Gradually we must unravel the mystery, stop the downward slide, and step-by-step, turn things around to begin a process of healing.
Even in this day of high tech gadgets, I would suggest that listening to the patient is the single most important medial diagnostic tool, especially when it comes to TBF. The next most powerful tool is to have the mind of a 3 year old. Always ask the question “why?” Peel back the layers of the onion, and leave no stone unturned in order to get to the root of the problem. If you just treat the symptoms with drugs, and you don’t get to the cause of the problem, then new symptoms are going to pop up elsewhere.
In summary, judging by the patients I see in my office, McMinn’s Disease, or Total Body Funk, seems to be an emerging epidemic. Many previously robust people have succumbed to it, and for the rest of us, this frightening disease may be lurking around the corner. The best prevention is attention to the fundamentals of wellness. The best cure is a focused, enlightened, overarching and thorough evaluation with a search for and treatment of the underlying root cause of the problem.