And that field of psycho immunology started to really rise. At the same time that we started to really see just the absolute everyday acceptance of high levels of stress rate dysregulation in the nervous system.

And, you know, we all face stress, but are you doing things to counter it in your daily life? That is really the question that and and most people don't do that until they face a crisis.

And then you know, you do that. So but it's so important in healing right. Healing the nervous system helps with physical healing. Your immune system, your hormones, you know, your mental faculties, right?

All of these things are really critical. The question becomes, how are you going to do it? How are you going to integrate it into your life? And again, why is it so important?

It's because your can't live in a sympathetic, hyperactive nervous system. And all of our pans kids, it's rare that I meet pans kids and parents. Welcome to Doctor Talks, the podcast where every episode leads to a healthier you.

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This is doctor talk, real talk from real doctors on the issues that matter to you most. Hi, everybody. Doctor Nancy O'Hara. So excited to welcome Rosanna Hodge to the podcast.

Rosanna. You and I only live minutes apart. And yet it takes something like this to bring us together. We've been talking for a half an hour before we even started this recording.

And you do so much not just in neuro therapy, not just in the products that you sell. Not just in your podcast, your courses, but just in being you and in bringing the message, to a lot of families and practitioners that need to know about this disease and about how to take care of our kids.

So thank you so much for being here. I really appreciate it. Well, that means an awful lot coming from you. So I appreciate that. And we definitely are two committed practitioners.

But first and foremost, for we're mothers on a mission right? So that we teach people about what pens and pandas is. But more importantly, I believe we are purveyors of hope because there's such a misnomer that you can't move beyond pans and pandas, and you and I get to see that all the time.

We've been doing this for decades at this point. And I know it's hard, certainly not just as a practitioner, but a pans mom. This is murky stuff. At at a minimum, it's murky. It's hard stuff.

But there are things there are science backed ways to support the brain and body. And that's why I love we're having this conversation. Absolutely. And that's so important.

Science backs ways challenging disease. But they can get better. So first of all just tell everybody a little bit about your story, how you got to where you are, all of that.

Yeah. Well you know, it's really interesting. I this was a calling for me. You don't even know this about me. So when I was five years old, somebody, my mom's friend Angela asked me, what did I want to do?

And I literally came out of my mouth, said I was going to be a psychiatrist, didn't even know what it was. And I remember Angela starting a look at my mother like, psychiatrist.

What what are these companies doing? You know? And so over time, I realized that I wanted to be a therapist because I really wanted to help people work through their problems without medication.

And so I fell in love working with kids when I was in undergrad. You know, kids just had this magical way of, they don't even know they can't get better.

Or if you're guiding a kid and you're like, hey, this is going to happen. And if you study X, Y, and Z, then you're like, okay, you know. And so I just saw that a little bit of support, a little bit of kindness, a little bit of just direction made a massive impact on kids.

At that time, I was working with kids that were inner city kids, right, that were struggling. And so, as I quickly learned in 1997, I had my first chronic Lyme case, and I was working in a school and I thought, what is chronic Lyme?

I mean, you get bitten by tick, you get some antibiotics, it's over. And this young man had so many symptoms of things that I was seeing, right. He had separation anxiety.

He was, school avoided. He had learning issues, attention issues and sensory issues. And I am just a curious provider. I paid attention, and so he became my first understanding that there was more than just clinical mental health diagnosis, ease of ADHD and whatnot.

And I already was integrative because if you're working with neurodivergent kids, what it says in a textbook doesn't really always work, right? Right.

And it's amazing that you and I have similar but reverse backgrounds. You know, at five I was saying, I'm going to be a teacher, you know, I'm going to be a therapist.

And then I was actually a teacher. And I was lousy at it and took these your route and went to medical school, you know, and I say that all the time that that being a therapist, being a teacher, being on those lines is so much harder than what I do.

As a doctor. So, and I don't remember Nancy. Well, I, I, I have to say there are challenges on both ends. But anyway, I remember what was that first conference that you did that we lecture together?

That must have been like 20 years ago or more. Yeah. I think it was something to do with parent. Or was it like. I mean, it was like I drew the line conferences.

Nancy. Yeah. And you know, you would listen and you would sit in there and I would say, I'm never going to let my feet touch grass ever again. Like you would be so scared of learning, you know, all of these things that were happening.

I mean, I don't think people understand when you are a practitioner at every level and you take a commitment to learn about tick borne illness, it is never ending.

It is an incredibly complex, because this is a very invasive bacteria. Right? And more than bacteria, you know, it's a very, tick borne illness. This can come in many forms, and, boy, it can do a lot of damage.

But and it's not just about the infection. It's about the effect on the immune system, the metabolic system. And then what you and I want to talk about today, you know, the nervous system.

That's right. It's tick borne disease or, you know, strap or mycoplasma or whatever it is. What we're dealing with is how that affects the nervous system.

Yeah. And you know, there are I say this all the time, all the time because, you know, always had complex cases even when I worked in a school. And that is what people come to us and travel great distances for.

That is the norm even more so than it was ten years ago. I think there's so many layers in cases today, and I always like to tell everybody, I don't believe every single person that comes to me has cancer. Pandas.

I actually see people that don't have that. So do I think it pans and pandas occurs more than people are actually diagnosed? Heck yeah. Yeah. But I, I look at it fresh every time and, you know, it is a clinical diagnosis, but, you know, when the nervous system becomes dysregulated, healing is either not possible at all or it's going to be ineffective.

It's going to be slow, sluggish, healing. And, you know, what happened is that when I started doing neurofeedback, PMF biofeedback, I would get line patients, elderly patients, little kids, all ages, and then their symptoms on the line seemed would get better.

Right? So they'd come to me most often, anxiety or chronic pain probably would be the two biggest things. And then they would say, hey, Doctor Rowe, like my Lyme disease symptoms of my joints and X, Y and Z and my brain fog are getting better.

And that field of psycho immunology started to really rise at the same time that we started to really see just a absolute everyday acceptance of high levels of stress, right?

Dysregulation of the nervous system. And, you know, we all face stress, but are you doing things to counter it in your daily life? That is really the question that and and most people don't do that until they face a crisis.

And then, you know, you do that. So but it's so important in healing, right? Healing the nervous system helps with physical healing. Your immune system, your hormones, you know, your mental faculties, right?

All of these things are really critical. The question becomes, how are you going to do it? How are you going to integrate it into your life? And again, why is it so important?

It's because your can't live in a sympathetic, hyperactive nervous system. And all of our pans kids, it's rare that I meet pans kids and parents who are not completely activated.

Right. And that and you know, that goes back to how integrated the immune system in the neurologic system are. I mean, they come from the same cells in the embryo.

We know that 70% of the neurotransmitters start in the gut. You know, at least, you know, this is all so interrelated. So just stepping back a little bit. Yeah.

From your perspective, how does Pans Pandas impact a child's nervous system and lead to this emotional dysregulation? Yeah I mean there are multiple ways the nervous system gets activated.

Right. So you know, at the at the most kind of common sense level is honestly just the trauma of this activates the nervous system, the trauma of, you know, your child having massive tics on the floor and not getting better, you know, the trauma of your kid punching holes in the wall.

And, and sometimes for people, it's an overnight switch, right? With or sometimes there's some symptoms there. And then I always say a sudden acceleration, a worsening, which can be very confusing.

So the, the trauma of not getting proper care, all of that is incredibly activating. And we sometimes think, right, like, you know, you and I are tough people.

You think, okay, well, I'm tough. I got through it. Your nervous system is going to hold on to trauma, right? So it's going to activate your system. Right?

Move you from a calm parasympathetic state into that sympathetic dominant. And that in itself, right is an Achilles heel that sometimes people don't eat.

They ignore it at the expense of I'm only going to work on the medical. But yeah, you know, trauma lives in the cells, you know, and it passes. And then the infections, the toxins, the waste products from infections and toxins can cause, a missed you know, we know that it's a misdirected immune response.

We also know that more and more of our kids are just not just getting neuroinflammation. They're getting systemic inflammation. And once your body is in these activated states, your resources will move to try to figure out why is your body in this sympathetic dominant state.

And that means you have less nutrients available. Your microbiome starts going down. Number one, cause of, you know, besides infection of your microbiome, really not getting the proper balance is stress.

Okay. So you're taking the probiotic and you're doing all that, but your system is so activated that it's never moving forward. And I actually see the improper balance in the gut microbiome being one of the final Achilles heels.

Right. That kids individuals don't get better and so affects your hormones. It affects your neurotransmitters. All of these things pull away from your body properly detoxifying and actually addressing that infection.

That toxin. And it is very simplified. But that is the truth. And so when we get the nervous system regulated, you get an accurate response, right to whatever treatment that is.

And that's why, like so many people come to me and they're going to the finest physicians, they're getting actually proper care. But nothing is getting them over that point.

Or they're stuck in a constant layer pattern. Yeah. And down, up and down, up and down. And really this is a big part of it. Improper detoxification is a big part of it too.

But again everything's so intertwined. Yeah. And and it reminds me so much to remind the parents and the practitioners that are listening or watching, you know, we can't increase the stress just by trying to get something into our kid.

So many times I hear, you know, I'm chasing my kid around the house to get the supplements into him or to give him the medication that he needs. And I always say, you know, what's causing that issue is the stress that you're causing and doing that.

Let's step back. We've got to look at all the lifestyle pieces, all the vagal nerve stimulation to improve, you know, our kids ability to respond if we're just adding to that stress by adding one supplement or one medication on top and every kid has 20 things they've got to take, and we're not dealing with how we're we're improving their parasympathetic tone or or decreasing their, their fight or flight response.

They're not going to get better. I couldn't agree with you more. And in fact, like I have people who come to me simply for the fact that they've been recommended 20 vitamins, right?

Medications, combination of things. And again, you know, Nancy, you are super pro on these things. But they can't get it into their kid. Right. And that's because they're so activated, whether it's their nervous system from the infections or the whole trauma of the event, it's often a combination of both.

Right? Yeah. And what we do is we back, you know, back away a little bit and food to sometimes we, you know, most of our patients kids I would say that 70% of a struggle with restrictive eating, how are we going to force feed kids.

We can't. So we make those eating disorders worse. Oh my gosh, we totally do. And and there's such a line between eating disorders and OCD. You know, I most often have OCD ers start turning into an eating disorder, not the other way around.

And, you know, eating disorders are very, very tricky from a treatment standpoint because when kids get so low, in their nutrient intake, we then start worrying about cardiac issues, you know, is is not to be you know, it's in getting treatment for that.

I mean, that's a whole other story. That's very it's like it's like addiction care eating disorder care. It's a business. You're never going to get places that are high quality because they know that these people relapse.

And so, they there's a real negative message because they're like, you're going to fail. So we'll see you again. I don't I don't believe in that. I don't believe anybody. I there's always degrees of getting better, but everybody can get better.

And not because I'm focused on nervous system regulation. I'm focused on nervous system regulation because it's so important. Right. And you know, there's so much to be said about.

Yes. Okay. So you're like Roseanne, Nancy, what do we do? How do we get these supplements? Then you've got to calm yourself first. You've got to co regulate. Right.

And it reminds me too of the PTSD that a lot of these families go through. Even after years after the the kid is better and it's still within the cells of the parent there.

And believe me I was one of these parents. I mean, I remember case and my son had said to me, I'm not doing well, mom. And I'm like, okay, is it is it Bartonella?

Is it Borelli? Is it strep? Is it viruses? Is it mold? Is it? And I'm going through all the stuff and we're in a hotel together, you know, for four nights I'm not sleeping at all.

And finally, after four nights says to me, you know, mom, it's about a girl. And it was in that moment that I realized, you know what? There's still a lot of work that I did. Yes.

No, no. And that was a good reminder that there's just normal developmental. Exactly. And I had this conversation with the family last week. Their child was getting bullied.

And the dad kept saying, I've got to do these 20 things. He needs this medicine and this supplement in this, and he needs more of it. The he had gotten the kids vitamin D level to 234, because he kept pouring vitamin D into the kid that he didn't need because they weren't doing any of the therapy.

They weren't working together as a family to to help address the issues that were there. They were still stuck. Oh yeah, old pans pandas had been regulated and taken care of.

But the family dynamics, the school dynamics, the therapeutic pieces had not been. And so, you know, I always say it takes a village totally. It reminds me of us.

One of the most traumatic, you know, experiences in our hands. Your journey. My Max, you know, was bitten by tech when he was 22 months old and I already was working with people with Lyme for nine years before.

So, I was like, what's going on? But one of the most traumatic experience, actually, was he got a chance on adenoid removal, and there was just a lot of things.

It was just a very scary thing. He wouldn't let go of me physically for ten straight days. And, you know, I was doing intakes and water in a lot of intakes.

So an adenoid removal and I could feel the activation in my chest. I could feel myself tighten. Right. And I'm not an anxious person, but I'm a very aware of how I respond to things and how I physically feel.

And so I basically said, you know, I've got to do some somatic therapy, which is a great therapy for trauma. And, you know, even though I was doing neurofeedback and biofeedback and all of that, it did help.

But I actually needed some form of it's not a high talk therapy, but it's a I needed to way to release it from my body. And I needed it talked about it with somebody, and it was a game changer for me because I didn't even realize.

So I knew in that moment because it was very clear connection. Where was an intake? And somebody said tonsil and adenoids. And I would be like, oh, how'd it go?

Yeah, you know, but it was infiltrating in other ways, you know, and and I also wanted to show up, you know, for my family as a better human being. But all the kids I worked with, you know, I wanted to be able to tell them, like, you got to have hope, you know?

And it's so easy with these activations, just being a parent with a kid struggling, it doesn't matter what the struggle is. That kid who's being bullied, you know, those parents went right back to the whole pants thing and, you know, I hope they were to understand, like your kids being bullied, that requires a completely different intervention and therapy around that.

But, you know, we often think when you have a trauma back there, it's kind of come up and bite you in the butt when you don't want it to bite you in the butt.

So you got to put it away in the right place. And a professional can help with that. Absolutely. So. So how do you help families parents integrate like these?

I think you call them brain first solutions. Yeah. To a care plan. Yeah. To get better outcomes. Yeah. And you know, and just so I know like I only work with a tiny amount of people 1 to 1.

And as much as I love working 1 to 1, you know, there's lots of things that I do, including my podcast, where I'm telling you what to do. Right? So I don't I understand the the commitment that it takes and pans, you know, is not a one and done therapy right there.

You can takes an integrated approach. I talk about a five pronged approach, but I, I you know, what I like to do is I have a protocol called the comms protocol because I tried to integrate my work into something that's simple.

And the first step is to see is co regulation. And what I found, why I loved working with kids is that, kids don't know that they can't get better. But boy parents will try to outthink themselves right.

And they start driving the worry train and they're spinning just like you were in the hotel room for four days, sweating it out, thinking what? We just got rid of this. What's going on?

And so when we get caught in our own worries and fears, reactivate. I mean, that's normal, right? But you've got to put your own oxygen mask on first.

I mean, it really is true. The problem is we don't prioritize when we're pants parents. We don't prioritize our own mental wellness, our own physical wellness.

I've done that right. And how can you do that very simply? Well, you can. So, you know, you can do simple things like breath work, and you got to do these things as much as you possibly can proactively.

So when the poop hits the fan, your body will go right into a breast state. It will do it without effort because people will say, well, I can't do it right, but I promise you can.

I always say, this is it. Like, just like brushing your teeth. You get a habit, you brush your teeth, they're not as yellow. You don't get cavities. You know, all these good things happen.

And yet most of us are brushing your teeth, hopefully twice a day. So. But you have to practice these. I mean, practice, practice it at times when you're not in that state of crisis.

That's right. You know where you have a little glitch like the busses lead or. Yeah, or you know, the kids are fighting or whatever it may be. Practice it.

I remember when I started doing this work, I had a mantra that I would repeat in a loop over and over and over again whenever I get these feelings. Love that.

Get the squirrels in my head out of the way. And I love a mantra. And in fact, I give all my parents who work with me eight individual mantra just for them.

So like, you know, I can I can see success. You know, people will say things like this too shall pass. I mean, that's a great mantra because, you know, our brain ten, ten acts will see.

It recognizes a negative and one quarter of a second, but it's up to 20s before your brain will see a positive. So we are wired due to caveman stuff. To see negatives.

And we have to actively work to change that. And when we get stuck in that negative thought pattern or our body is feeling uncomfortable, we're going to activate an activation is normal, but we need to to tamp it down.

And so, you know, breathwork, prayer mantra, nature walks, yoga, biofeedback, all these things are ways to regulate. You need to do it. The science says ten minutes a day, ten minutes a day.

You actually, after 40 days can change your brain functioning permanently with just ten minutes of these activities a day. And by doing it as a parent, you can model it to your children.

Exactly. Can your kids can see you taking that breath or going for that walk outside, or doing a yoga move or whatever it may be. And and it can be getting into their DNA.

Yeah. I mean, that's what the M is in the coms, but it's sort of like what you tell me all about. Oh, no. But I you know, when you say model, right? You know, our parents, my mother, Filomena, you know, she would yell at us to not. Yeah.

You know, with a wooden spoon in her hand. So, just for emphasis, she didn't ever get me with a wooden spoon. My sister maybe, but, But you do model it, and it's so significant because kids absolutely absorb what you're doing.

We know they're not as absorbing at the same level. What you say, right? Certainly when it's positive. But they're lecturing these kids, right? When our kids are activated.

And listen, most pans kids, you know, there's different kinds of activations or under stimulation of the nervous system. And there's overstimulation under stimulation could be that, that regression of learning memory problems, you know, shutting off, being resistant to things.

We're overstimulation. Right. Our pans kids like my own when they are explosive, when they're just sensory over the top activated. Right. Those are the kids when we want to putting a lot of intervention because we don't have a choice.

Yeah. Or even I would add the kids with intrusive thoughts that OCD, that's only in their thoughts. They may seem like they're under regulated because they're withdrawing, they're pulling in, but those kids are even more activated because they're all up in their head.

Oh yeah. When you see their brain map, Nancy, literally their brain communication is on fire. And, you know, OCD with intrusive thoughts. It always starts with intrusive thoughts.

We're not seeing compulsive behaviors until it's pretty activated, right. And once it's on the outward, you know, a lot of OCD is completely irrational, but it can sound rational.

So parents get themselves caught in a what we call an accommodation pattern. And so they're not doing anything, on purpose. They're being great parents, but they're rescuing their kids or participating in rituals.

And the rituals can be sneaky and come in. Right. Some some OCD with patterns is like, where did that just come from? Like it happened overnight. And parents will say, what happened on February 12th, you know, of this year.

And then you're like, okay, well, it's clearly pants. But it is. I'm so glad you brought up OCD because it is incredibly common. And not only is incredibly common, it's often misidentified as anxiety and mistreated.

Yeah. And if you have patterns and you have OCD and you're only focusing on the medical treatment, I'm telling you, you're wasting your money and you're wasting your time.

Because when OCD comes into the brain, it forms a behavioral habit. And it gets what's called a negative reinforcement. It gets reinforced reinforce, reinforce.

And it is as tough to break, but not impossible as addiction. And you really need the unexperienced person with pans and OCD. And they're out there and you can get the right kind of therapy, but it's so critical for the parents to get the actual counseling on how to deal with these intrusive thoughts, because they're scared.

And I think that's so important. And I talk to the parents about this all the time. You know, they'll say to me, well, my kid can't do that or they won't do that or whatever. I'm like, you need to do it.

Yeah, because you need to not feed. I call it feed the beast. That's a disease. And you need to learn the therapeutic approaches to help your child get better.

Because you're on the front lines. You're there every day. And if you're feeding that negative feedback loop, as you say, then it's going to be so much harder.

And so, you know, as you and I were talking about before, I'll kick people out of the practice if they won't do therapy. Yeah. Because I it's just so important to getting better for the family.

Yeah. And once OCD I mean shows up. Right. So of course nobody wants to get rid of their OCD. They're going to tell you they don't want to get rid of their OCD.

They're going to you're going to see anger flashes. You're going to see pulling back. You're going to see all kinds of negative avoidant behaviors. Because guess what?

They actually are getting a bit of relief every time they perform a ritual, right? Even though every time they perform their ritual, it actually moves the baseline up and up and up and it becomes harder to, stop.

That's what a negative reinforcement. Just like what, you know, Doctor Nancy or her was just saying that it is feeding the beast. We call it feeding the barking dog and you.

The problem is parents don't know what they don't know. Once they know, like parents come in and they're like, I feel so bad. And I was like, please don't feel bad.

Exactly. Don't feel bad. It's so sneaky. It's going to get you to participate. If there's, you know, when your kid asks you, did anybody breathe over this plate?

And you answer, yes, you're actually feeding the barking dog? Every time you answer the right answer, which a therapist can help you. Who does? Exposure response and prevention ERP?

It should be like, well, what do you think? And your kid's not going to be happy with you because you're not giving it relief. But what's going to happen is they're going to go like, you know, sort of like when the Hulk's trying to come out, right.

Bruce Banner pulls it back in, and then the next day they might ask you the question and you're going to look at them, or maybe ten days later and they're going to say, I know that's my OCD fear, right?

And it's not right. There's nobody breathes on this. I'm so proud of you that you recognize that that is actually, really, truly how you just give the one two punch to the OCD.

Exactly. And, and and what you're saying in there when the phrases were used is the parents not saying, shut up or don't talk about this. They're in a way saying, I get it, but not feeding it.

That's right. I think both of those are important and something you need a therapist to help you do. And to the individual situations. Absolutely. So.

And because who would ever think Nancy like that? You're, you know, when you say to your kid, oh, did you leave the bathroom light on? Yeah, I left the bathroom light on.

Who would ever think that you just got suckered by OCD? And you're actually now making the nighttime ritual go from 20 minutes to 30 minutes, and then it's going to go to 40 minutes.

And, you know, people, you know, people come to us, and sometimes our kids are stuck in these OCD rituals. You know, obsessive thinking has to occur an hour or more a day for it to be OCD, or ritualistic behaviors.

But some of our kids are stuck in it literally all day long, and the whole family set up to participate in it. And they don't know how to stop it. So the good news is, you're as hard as it is in the first couple of weeks.

I'm not I'm not going to lie. It's like. It's like when you had a knee surgery and your knee was bothering you, and then you're like, that is the most painful thing I ever experienced.

And then ten days later, you're like, feel fantastic. I wish I had done that earlier. Yeah. You know, that's what it's like because you're you're removing something that in some way produces a feeling of relief.

And so it's going to be hard. So I hope that's a hopeful conversation. I spent so much time talking to my pants people about OCD. And, you know, we have we have an amazing OCD specialist on our team.

And it is the number one thing that brings people in in a crisis, because it will escalate if you don't put that sucker down, to be honest. Absolutely, absolutely.

So before we move on from it, though, is there anything else you wanted to tell me or our listeners about the columns? Oh yeah. So Connie's protocol is like my simple way of saying, how do we deal with behaviors. Right.

And I know that behaviors and pans autism complex ADHD, these are big behaviors, right. But it doesn't matter if this is a normal developmental issue or it's a big issue.

These are the things that I say to everybody. So step one call regulate. However you got to do it, I don't care if you're going to go hide in the garage and you can do some breathwork.

I like to do mine in the morning. I do multiple things throughout the day. I start with prayer. I have a very conscious, you know, prayer process. But also I like to tell everybody every time I sit down, which could be 30 times in a day, getting up and down, I actually take five seconds 10s and I do a visualization.

I ground my feet. I often just do a quick deep breath and it just integrated into what I do. I don't even know that I'm doing it anymore. I just do it.

So I don't want you to think you have to go get a massage every week. That's great if you're doing that. Some of my people like to get out in the morning before the kids get up and just get some light on their feet.

That's great. It ain't happening here in the northeast. I'm not going out. It's like 20 degrees out. My mother in law. So that's important. So the A is avoiding personalizing.

I think this becomes so tough in pants or like is it a flare. Is it a behavior. Doesn't matter. You're not going to personalize this. This is not about you.

If you're being triggered you got something you got to work through, right. Maybe you have trauma from parenting, your own parenting. Right? Your own parents. It happens all the time.

I mean, that's just what it is. You know, I, I lightly say my mother chases it around with a wooden spoon, but she just did it for emphasis. But I also know that people that can be scary for people and that people were beaten.

And I don't want to disregard it, you know, and say, okay, you know, my own father was horrifically abused as a baby. He was beaten in his sleep. He is a very different guy, though.

Like he isn't affected by trauma in the same way. He's like a rare bird. And he made it like he just is a different person. Like, he, really goes out of his way to do kind things, for people.

So I wanted to say that I understand the into the intergenerational impact. Right. So he actually under parents to avoid hitting us. Right. So the owl is to look for root causes, right?

So when we are not activated, when we are not personalizing their behavior, we can say, oh, okay. So he's been sneaking gluten and the behaviors out of out of control.

We're going to talk about the gluten, you know, or wait a second, his girlfriend broke up with him, right? Maybe that's what's going on. It's so hard to actually be what I call a parent detective.

Detective when you're activated, right? Yeah, absolutely. You're just not going to see it, right? You're going to just go back and you're going to be just like you said.

You're going to go back to this is a pair of pants flare. Maybe it is a pants flare. But guess what? You don't have to freak out. You don't have to go look for a new provider or find a magic wand or any of that stuff.

You can go back to what worked before. Always start with regulating the nervous system. But like in my house, vitamin A is magical. You know, certain things and we just, we just add them in.

Which said to me, because guess what? We know that pants kids respond to anti-inflammatories. You know, if your kid's antibacterial or antiviral, you said a man, you don't have to wait for a big blowout.

But again, you got to be a detective. So the M is that modeling, which we talked about, right. Perfect. I'd say 80%. You're doing a good job, right? And when you do mess up, you do yell at your kids.

You do freak out because they didn't get their homework in. You're going to come in and you're going to apologize and you talk to your kid. What what you should have done.

Yep. So key. So key. Making amends to all the time that exactly. We all do. We're all perfectly imperfect. Yeah. I mean absolutely. And then the S is for support and reinforcement.

So I think people just don't realize how much even neurotypical kids need a lot of reinforcement, like even regulation of the nervous system. We are not born regulated.

Our environment shapes us towards regulate regulation. Yes, some kids have a temperament that's easier. I have two boys. One kid like, you know, it came out like Buddha, you know, like, I mean, he inherited a lot of the Hodge genetics of this kind of chill kind of thing, you know?

So but regulation or is a set of skills that can be learned. Right. And we just have to reinforce, reinforce when you're, when you got it together 80% of the time, not perfect.

And you are helping your kid regulate together your co regulating. You're supporting them and doing the same strategies you were doing. All of this becomes a lot easier and they're much easier to learn strategies because the problem is, you know, once you're super activated, we talked about helps in the body, but your frontal lobes go offline.

You're just not absorbing. You're not hearing in the same way. And you know, I always like to say like if you, it's like you had a big project and, you know, you got a great, you know, eight hours of sleep and you exercised and you had, you know, you knew you had ten hours to do something.

They took you four hours. You're going to go in there. It's going to be easier. It could be more pleasant. Right. You go in, you didn't sleep. You've got two hours to do a four hour thing.

It's not going to be great, you know. And it's that same way. So when we prime that nervous system, even at the height infections and toxins, this will make a huge difference.

The problem is you've got to get over the mindset that it doesn't and that you don't have time because you can build ten minutes in throughout your day.

Just like I said, every time I sit down, you know, and it's even more important when your kid is actually being activated by an illness or whatnot. It makes a big difference.

It will help them get over the hump, and it will prevent that big destabilization that always seems to happen over and over again. Exactly. And and a couple of things I was thinking about as you were talking.

One, you know, one of the other things that that I do when I talk to my parents about in my kids is ending their shower every day with a cold shower. 30s it just resets.

It's it's, a mini cold plunge. And and it may force you to take those deep breaths. It may force you to be more present in your body where you are right now.

Or it may just wake you up a little bit, but little things like that, like your 10s that you take when you sit down every time those little things throughout the day makes a huge difference.

Huge, huge. The other thing I was thinking about is we're talking about parents and helping them navigate their child's dysregulation. But I also think it's very important for all the practitioners that may be listening or watching, because so much of the time, especially when we're we're new to this disease or we we don't really look at the big picture.

We want to dive right in, okay, this kid's worse. What do I need to do? What antibiotic do I need to change, what supplement do I need to add. And and I urge the practitioners to also use these.

Take a deep breath. Be present. Look at the whole picture of the child. Not not getting so wrapped up in what am I missing? What did I do? I've got to fix this. No, it's a it again.

Is that that whole picture of calming down your activation also in dealing with these families. And I think and for the practitioners, you know, you know, I mean I've been working for 33 years in mental health.

Just validating that this is hard stuff is so important. I know it sounds so little, but so many of the times they go right into the medical part. I think validating this is hard.

Also, letting them know that there is no quick fix, but we can actually reduce symptoms. And here are the best things that can help. And where you need to spend your time.

I know I'm very strategic. That's just my personality. It's how I do things. So I spend time strat advising and helping them dissect, you know, what didn't work and why?

Because a lot of times I make people go back to treatments because it was the wrong time, or there were too. Yeah, they did. And, you know, and instead of being, you know, a chase or a therapy or even sometimes a lot of times we will do what I call sprinkle therapy, right?

So they try a little of this or a little of that. So with practitioners really helping to validate but also letting them know what the path is and what needs to happen, even not just in your care.

Because that's what I spend a lot of time doing. Like, wait, I need you to go back to doctor because it did help, but I don't think you did it long enough.

All right, in helping them to understand, because, boy, are they scared. And boy, is there a lot of I mean, I mean, I'm in the Facebook groups and it's scary in there.

And sometimes there's things in there that are amazing, but sometimes is just so much fear. And when you let fear hijack you, which is normal for that to happen, but you have to actually stop it from happening.

And so, you know, having a practitioner who helps to speak to the the worry in the fear you don't have to rescue, you can just validate that's experience.

But you can also say, how are you getting support on that? Because that's important. And we got to prioritize that for sure. Yeah. And we're talking about how to help parents and practitioners and therefore helping their children.

But also, you know, I'll have some parents who either have a child with severe autism and pans pandas or who is really in the throes of this, that, that the parents don't really feel the child can access it.

And I, I know you also have other techniques like your calm pens. Yeah. The pulsed electromagnetic field. You talk about that a little bit. Yeah. So I developed a I don't have it on my desk.

I developed a folder called calm PMS. And PMF is, pulsed electromagnetic field therapy. It's been around a little over 30 years, and it's a type of therapy that actually does three things.

One, it changes the way the cells are communicating, improves the health of the cells. And we're really starting to understand in so many well, ways how much we need to improve cellular health, not just for things like pens and pandas, but aging and all these other things.

It reduce puts you in the parasympathetic state, which you heard about all the good stuff of that. Right. And that's the unlocker that's the unlocker of a lot of, you know, healing, but also moving forward behaviorally because you have the physical space, do hard work, and then it really reduces inflammation, then improves detoxification.

So when I have I have a lot of kids who are nonverbal autistics with pans or without pans. And so they're just very activated. They can't sleep. They may have toileting issues, behavioral issues, all the things that you can think of.

And so this is just a simple device that calms the nervous system. It's easy I wanted something portable because I have a mat and I love a mat. And you know, there's I'm not going to trash talk any devices.

They're all great, right? They just do different things. But a mat, nobody wants to sit on a mat. So this is something you can pop in your pocket. It comes with a fanny pack, but there are brain tools your kids might be able to use for mass biofeedback.

Really inexpensive, easy to use. But you have to be more cognizant it, and you have to sit down and make the time for it. You know, only five minutes and it will make a huge difference.

And then of course we have neurofeedback, but when I have super, super, activated individuals, it can be really helpful if they're willing to do it. If they can't physically sit down to do it, it's like a help.

So there are many, many brain tools that help to regulate both the actual brain waves, but also we've got to get that nervous system regulated. And there are easy ways to do it.

And, and since since you brought it up, I, you know, some of our listeners and viewers may not really know much about neurofeedback in certain. They are an expert in that as well as many, many other things.

But just tell them a little bit more about what it is and how you use it. And just so everybody knows, you know, I started working with these neurodivergent kids and I was like, these meds are not helping these kids.

They're making it worse. And, you know, I already was doing diet and supplements and stuff in the 90s, you know, long before other people were only natural, were doing it then, you know, and so I memorize all these books and I fell into brain tools like neurofeedback.

So brain neurofeedback is, a really highly effective been around, you know, over 50 years. It's a way to, reinforce the brain for producing a healthy combination of brain waves.

And you use technology to do it. There are all different kinds. I do EEG neurofeedback, which is more controllable for a brain that is, this destabilize whether autism pans complex ADHD.

And you're literally putting sensors on a person's head and on their ears, and they're getting visual and auditory reinforcement. We use movies and shows and their brain will reset itself.

It will learn to move from an unhealthy to a healthy state in 2 to 3 seconds, from the first time you're hooked up. And it will just to get this reinforcement.

Now, like exercise, you need a lot of sessions. Definitely less than 20 sessions is a waste of time. We do about 40. That's typically. And what is the goal of it?

Regulate the nervous system and reduce specific symptoms. That's why I use EEG, because I can have a dyslexic with pans or just a straight dyslexic or dyslexic with ADHD, and I actually can go in and address the way their brain is processing phonemes or I can change or executive functioning.

And there are practitioners all over the world, you always want to get a certified practitioner. And you can go to Bishop org to get a board certified practitioner.

I love neurofeedback, it's a commitment. But it really is effective. And the cool part about it is the research, as far as ten years out, shows that the changes in the brain are sustained.

And so that's pretty awesome. Like it gets a bum rap because they'll say, oh, you know, meds work quicker or this it's just not what I see. So, you know, I'm not against meds.

I'm against it being the first line of defense psychiatric meds. So we two quickly go into psychiatric medication, especially when they're doing, like, 15 minute intakes.

Nancy. Oh, I agree. And, you know, I said and I've said this before on this podcast, too many others, you know, said always calls it name it, blame it tainment medicine.

So we name it anxiety or depression or OCD and we blame everything that's going on on that. And we want to tame it with the necessary or our and without getting at the root cause.

And neurofeedback is one of many tools you have. We have that that can get more at that root. And as you said, be more sustainable with without just putting a, a taming blanket on the symptom.

And you know what I just found again in those 90s, even right from the beginning, is that if I wasn't doing to help something very directed towards regulating that nervous system, that they weren't going to absorb the learning, it didn't matter how amazing that social skills therapist was or the dyslexia reading instructor.

Whatever learning they're doing, it's not going to happen. So a lot of people will say, well, we've done talk therapy and it stunk because they were too activated to access it.

Most of the time that is what happens. And so the learning has to happen. And also too, learning isn't just for the child. A real therapist who works with kids, will only take you on if they're doing parenting work, too, because you're not a bad parent.

We just don't know how to parent a kid who shows up like this. I had to do a lot of work when I had a really activated kid. I was like, well, that wasn't in the plan.

I did a pre-conception detox. I had planned for him to go to a montessori school. Life has another plan. You have to adapt, right? And you know there's a process.

You grieve a little bit, you move on, you don't get stuck in it, you know, and and truly, Nancy, the parents who do the best, the kids who do the best are parents that have a sense of faith and and a sense of positivity for the future doesn't mean that they don't experience the rough things, but they don't live in it.

And that takes their own regulation to be able to do that. And I can't say how critical and how much that is a definer in the success of the treatment of the child that I'm working with, I can have two cases.

And that kid who's whose parents or more of faith and positivity, that case could be ten times worse than this kid's case, and they'll get much better results every single time.

Yeah, and I say that because I want you to understand how important mindset is. And for practitioners to say that to parents. Right. So agree. Yeah. Yeah. And you don't have to say in a way it's insulting.

You can say, hey, listen, I can this is what I say to my parents. Like, we've got to tend to ourselves. This is activating. You got to prepare yourself for a marathon.

A marathoner doesn't work like a sprinter, okay? They're going to change their diet. They're going to do this. They're going to practice every day. So you you develop that and guess what?

You all have the ability to do it. I know it's hard. As I always say, I walk the walk like I've done this too. Yeah, exactly. And I think what's so important too is that, you know, yes, strep may have been a trigger that led to pandas in your individual child, but we live in a toxic world where all of our children are going to be inundated with so many other toxins.

And it's not about the strep, it's about the dysregulation of our immune system, of our neurologic system, of what we're talking about in our Paris sympathetic and sympathetic system.

And it's about resetting all of that because your child's going to be exposed to the EMF and the mold and the toxins and the chemicals and the pesticides and and the bullying and everything else doing all of this lifestyle management, this, this five pronged approach, the columns, protocol, whatever you use, really can help you deal with all the things that come down in your life.

It's like a marathon. Yeah. You know, and you know, the kids that I see because, you know, we have so many kids that are adults, right, that we work with, which is amazing.

And the kids that I see do really well in life, they embrace that, okay, I've got to regulate my nervous system. They embrace that. Okay. I got to eat pretty clean.

You know, I, I need to do these things for my own mental health. And they are super awesome adults because life comes with stressors, right? You know, I was talking to my girlfriend the other day, and we're both in her 50s, and she was like, what's going on?

And I was like, I same stuff you got going on. You know, my friend's dad died. This one's this, this is that, this one's this is life. So it's not perfect. It's messy.

And we need to do things to be able to support it, you know, because every day can be a challenge. And so kids who get through this and really learn these skills and learn to embrace them really do better in life.

Absolutely. And, you know, we live in a soundbite world. And so much of the time I think we as parents or practitioners come in. What's the magic bullet?

What can I find that that that's going to change this? I got my magic wand. Nancy. Yeah, right. That's and and that works. Yes. Yeah. Right. Because they're everybody would come here.

There is no magic wand. If we knew it, I swear we would share it. You know, like, and and, I don't want people to feel overwhelmed. That's why I simplify things with, like, okay, there's a coms thing, like, right.

Be logical. You can do this. Like, I don't care. You know, I, I, I had the house with the holes punched in the walls. People I understand, like I've been in your shoes.

And maybe there's days you can do more of this and other days, but the more you do it, the better you can handle. And also the flares that go up and down start becoming less and less and less.

And you have micro flares. Yeah. And that's something that everybody can work towards. I really do believe in that. So exactly. Yeah. And then not when you get a micro flare not having the PTSD to worry and live in the fear again, that you're going to go back to the big flare that's reminding yourself with those micro flares as you come down.

It's a solitary pattern. It's not a straight line in any way. So you're going to get these little flares. That's what, like you said, that's what life is. Yeah.

And I even like we we had Covid this summer and you know I said Max okay you got Covid. So about five days after this results, you know, you might feel extra cranky.

You might, you know, feel more irritated. And, you know, this is how the best way to address it. And he was like, okay, you know, and he got it. He understood. Now it took time to develop.

That's not the first time I've said that to him. And, you know, kids can learn and prepare for things. You're teaching him that you are uncomfortable, right?

And instead of just react acting, he can say he came down. He was like, okay, you you said a bath would help me. How many times should I do that? It was like every day, you know.

And he he listened. He wanted a little coaching about what he did, and then he just did it. And guess what? We didn't have any flare. Yeah, exactly. And you know, you mentioned the bath.

And that reminds me of one of the other things that one of the few supplements that that I think can be a game changer, which is also on your website, the neuro tastic magnesium, you know, we often will put magnesium salts, magnesium chloride in baths.

Love it. You know, love that. And as as much as there are no magic bullets, I think you and I would agree, especially the magic team that's in your magnesium, you know, can help many things in brain health and sleep and calming.

And, and I wanted to mention that one because I had seen it on your website and I, I think, you know, see, and I made Nancy because that tells you something about it's so essential, but also just to know, I take a magnesium bath pretty much every night, like it's a different kind of magnesium.

We need it. It's the most used nutrient in the body. And you know, when you're this activated, whether infections, toxins, stress, whatever we are just burning through it, you know, and there are all different kinds of magnesium, but L3 and glycine and Mally are really designed for the brain.

And that's why it has all three in there. And it really just acts differently. Not that citrate isn't important for pooping, you know. Right. I agree, you know, not all our kids have it.

That's why you have pooping issues. That's why it's not in my magnesium. You can get that elsewhere. Yeah. But it is. It is a, it is a magic one kind of thing.

It's something that I say if there's one, it's that and d d yeah, I agree, I agree there are some oils and and well zinc. Absolutely. Yes. But oils and phospholipids.

Yes. Also so yeah you know I totally agree. And some of my, some of the essential fatty acids, some kids are so resistant to it, but it is definitely in the top five for me.

Like those are the critical ones. But I know that if I can get them to take magnesium, there's going to be at least one positive symptom reduction, like there's going to be at least one.

So that can be a game changer. I had two adult nonverbal aggressive autistics. Their parents tell me this is making a difference. Day one I was like, I know, you know, like it's so exciting to see that.

And and, you know, it didn't stop everything. It just gave a little bit more space to start using some of the other interventions. And, and like you were saying before, you know, sometimes they're so activated you can't access some of the other things.

And so if you can bring that activation down a little bit with magnesium three and eight, for example, you know, then they may be able to access more of these tools.

And so the interplay and I wanted to ask you, you know, I always talk about the three pronged approach. You mentioned the five pronged approach. So I think some of our prongs are the same.

But tell me your five programs. Yeah. So obviously immune, you know, infections, detox suffocation. Then you have behavioral therapy. Therapy. And you have, you know, nervous system regulation in there as well.

So, you know, behavioral therapy and nervous system regulation are two sides of the same coin. And, and they occur together. They work super synergistically and cut down on behavioral therapy.

That's the other part of things. Right. Because if you're regulated, again you can access your thinking brain, your rational brain. And and people say, well, my kid, so smart, it doesn't matter how smart you are, once you're activated, you're just not able to think in the same way.

You can't pay attention to the same way. We know that as adults, right? Right. Yeah. We expect something different from our kids. So so that's those are the other pieces and, that I feel really, really hold people back.

And I do feel detoxification and nervous system, dysregulation are things that are not prioritized in the same way. And they're about lifestyle. And I think that's hard for people, again, because this idea that there's one thing that's going to fix it, like people are like, I'm doing IVIg, it's going to fix it.

Okay, good luck with that. Call me, call me. I know, I know exactly, but I hear you, I think I, I melded a little bit of that together into my three pronged approach, because I put all those, those, three of those into one therapeutic branch and they are interlinked.

But I think, you know, you're right in that we have to look at each state phase of the activation neurologic, immunologic, metabolic. So anyway, and it's hard.

This is all hard stuff. Like nobody neither one of us are saying this is an easy pass path, right? You already know that. What we're saying is this is an easier path in the sense that this is what you're working smarter, not harder, right?

Because every time you delay proper treatment to some of the panels and panels is increased, suffering for that child in that family. And that is what what you're doing by training more practitioners.

Right. Because the and there's been such an improvement in practitioner growth in the last ten years, nowhere near what it needs to be. We need all our frontline workers, all our therapists, all our medical doctors to not only, you know, agree that Pans exists, and there's proper treatments, but to guide them to the right professionals and I think that is just a whole there can of worms that needs a lot more growth.

Absolutely. So, you know, you and I have been doing this a long time. You said 33 years. You must have started when you were like six, but, you know, otherwise I get it.

But but what would you tell your younger self now? What would you do differently or what advice would you give? Your younger self with everything you've learned over the past 30 some odd years, I, I honestly feel that as, as clear as I am with people and you're very much the same.

I would have been even clearer early on. I would have blended my compassionate self with this. Guess what? If you don't regulate the nervous system, you're not.

Nothing is going to stick. Nothing is going to move forward. Because if you got to calm the brain first and then everything else follows, I wish I was stronger in that because people come in and and it's like they're they're drowning in two feet of water and they don't realize they can put their feet down.

And so they get overwhelmed. And so I have to change the way I do things. I tell them right up front, when you meet with me, I tell them exactly what is going on and exactly what to do in the first five minutes.

Then I explain because the explanation gets lost and so they need to know this is what it is. So, you know, I think I've always been somebody who was a purveyor of hope, but by being clearer just how important that is, I mean, it gets it gets the job done and people have much greater results.

And, you know, they're they're hearing that more. So I probably would have started a podcast soon, too. There's I love that they hear you and they get to listen to you and develop a relationship.

And I know it's been so impactful why this is so impactful to both parents and practitioners. And, I just, I love I've been blogging forever, but blogs are different.

You don't get to hear my sassy self, you know? Yeah, you don't get to see my my my magic wand. But I think that's probably what I would say is like, this is critical.

Do not ignore it. Yeah. And you have so much more than we've even talked about on your website, which is d r Roseann. Right? Yeah. D r r o se a and.com.

Right. And is there anything else that you're working on or that you're doing, you know, if you haven't listened to Roseanne's, podcast, please do. And they can find that on YouTube and you can find it everywhere.

Yeah. You can just search Doctor Roseanne and you can go to my page Doctor Roseanne, forward slash podcast, and they'll have the button stop whatever you listen to Spotify.

But it's it's technically called it's going to be okay, but you're more likely to get it to come up if you just search Doctor Roseanne. But yeah, I would say listen to my show.

And and if it resonates with you, you know, share it with people because I design episodes to be their short episodes, most of them are under 15 minutes, and they are designed to be lifelines for parents, because there's a lot of people out there who are not credentialed.

Giving wrong information to parents. And you need practical behavioral tools. And that's what I try to do in every episode. And you do it so well and well. Thank you.

Is there anything else of what you're doing you wanted to tell people about? Well, I'm I'm writing a book. I think that's amazing about dysregulated kids.

So that's not going to come out until 2026. But I it's going to be a game changer in the world. And, between me and my publisher, we're really trying to change what people think about parenting.

And a lot of what we talked about will be in this book. I want to make things easier for parents because, you know, 50% of parents feel overwhelmed. Yeah.

And they just had a research study by Caricom that said one third of parents have thought about killing themselves because of parenting, and it's not okay.

You know, and I'm sure it's even larger in our groups of parent distress. So, you know, please, if you feel that way, just get help. Nobody ever regrets help.

They only regret when they don't. And there's no shame in that. And there are great therapists that can help you process, you know, and you shouldn't feel bad because you're getting therapy and maybe your kid doesn't want to.

So for sure. So, you know, you and I were game changers out in the world and, and, so that's what my next steps are about. I'm always trying to change our conversations, away from medications and put it back in the hands of parents who have way more power than they realize.

They just don't know the right steps. And hopefully, you know, the things that I'm doing simplify it so that they can, you know, have better connection with their kids and much peaceful homes.

Regardless of what's going on, there's always a way to make things better. Yeah. And Roseanne, thank you so much for everything you do. And I'm so looking forward to your book and and watching all the other projects that may be coming up and, you know, empower ING people, empowering other therapists, empowering parents.

It's something you've done for so many years and done it so well. So I for one, really appreciate that. So that's that means an awful lot to me coming from you.

So thank you so much. That makes me pretty Verklempt Beata. So I love the word. I love that. Well thank you. And any last words you want to leave our listeners and viewers with?

I mean just parents, you got the power. And take a minute and regulate yourself and change will happen. Yeah. Thank you so much, Roseanne. And see you again soon.

Thank you for tuning in to Doctor Talks. We hope today's episode has enlightened and inspired you on your path to optimal health. Each day is a new opportunity to make choices that empower your well-being.

For more insights and strategies, subscribe to our podcast and visit our website w ww di doctor Talksport.com. Stay connected, stay healthy and join us next time on Doctor Talks.

Real talks from real doctors on the issues that matter to you most.

From Chaos to Calm: The Hidden Key to Healing PANS/PANDAS

Nancy O’Hara, MD, MPH, FAAP

Roseann Capanna-Hodge, PhD

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