Full Transcript Introduction to PANS and PANDAS 0:02 If you're a parent of a child with PANS 0:02 If you're a parent of a child with PANS or PANDAS, or a young adult living with 0:04 or PANDAS, or a young adult living with 0:05 or PANDAS, or a young adult living with this yourself, there's one mistake I see 0:07 this yourself, there's one mistake I see 0:07 this yourself, there's one mistake I see over and over again. PANS stands for 0:11 over and over again. PANS stands for 0:11 over and over again. PANS stands for Pediatric Acute onset Neuropsychiatric 0:13 Pediatric Acute onset Neuropsychiatric 0:13 Pediatric Acute onset Neuropsychiatric Syndrome, and PANDAS stands for 0:16 Syndrome, and PANDAS stands for 0:16 Syndrome, and PANDAS stands for Pediatric Autoimmune Neuropsychiatric 0:18 Pediatric Autoimmune Neuropsychiatric 0:19 Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal 0:21 Disorders Associated with Streptococcal 0:21 Disorders Associated with Streptococcal Infections. In both conditions, children 0:23 Infections. In both conditions, children 0:23 Infections. In both conditions, children can change suddenly. Intense anxiety,
Why Symptoms Can Change Suddenly 0:26 can change suddenly. Intense anxiety, 0:26 can change suddenly. Intense anxiety, obsessive-compulsive behaviors, rage, 0:29 obsessive-compulsive behaviors, rage, 0:29 obsessive-compulsive behaviors, rage, tics, regression, 0:30 tics, regression, 0:30 tics, regression, and personality shifts, sometimes 0:32 and personality shifts, sometimes 0:33 and personality shifts, sometimes literally overnight. And here's the 0:35 literally overnight. And here's the 0:35 literally overnight. And here's the mistake I see repeatedly, treating the 0:37 mistake I see repeatedly, treating the 0:37 mistake I see repeatedly, treating the most dramatic symptom as if it's the 0:39 most dramatic symptom as if it's the 0:39 most dramatic symptom as if it's the main problem. What usually follows is
The Cost of Focusing on the Wrong Symptom 0:41 main problem. What usually follows is 0:41 main problem. What usually follows is painfully familiar. Symptoms improve 0:43 painfully familiar. Symptoms improve 0:43 painfully familiar. Symptoms improve briefly, then plateau, and then flare 0:47 briefly, then plateau, and then flare 0:47 briefly, then plateau, and then flare again. I've seen this exact pattern 0:49 again. I've seen this exact pattern 0:49 again. I've seen this exact pattern repeat for years in PANS and PANDAS 0:51 repeat for years in PANS and PANDAS 0:51 repeat for years in PANS and PANDAS cases, both in families who are brand 0:53 cases, both in families who are brand 0:53 cases, both in families who are brand new to this, and in those who have been 0:55 new to this, and in those who have been 0:55 new to this, and in those who have been struggling for a long time. And the cost 0:57 struggling for a long time. And the cost 0:57 struggling for a long time. And the cost of this mistake isn't just medical. It 1:00 of this mistake isn't just medical. It 1:00 of this mistake isn't just medical. It costs time, childhood, family stability, 1:04 costs time, childhood, family stability, 1:04 costs time, childhood, family stability, and trust. If this feels familiar, stay
Dr. Fred Bloom and the Channel's Approach 1:06 and trust. If this feels familiar, stay 1:06 and trust. If this feels familiar, stay with me, because this mistake is subtle, 1:09 with me, because this mistake is subtle, 1:09 with me, because this mistake is subtle, extremely common, and often missed. For 1:12 extremely common, and often missed. For 1:12 extremely common, and often missed. For those of you who don't know me, I'm Dr. 1:14 those of you who don't know me, I'm Dr. 1:14 those of you who don't know me, I'm Dr. Fred Bloom. I'm an integrative and 1:16 Fred Bloom. I'm an integrative and 1:16 Fred Bloom. I'm an integrative and holistic physician, and I work with 1:17 holistic physician, and I work with 1:17 holistic physician, and I work with complex chronic cases, especially 1:19 complex chronic cases, especially 1:19 complex chronic cases, especially children with immune-mediated 1:21 children with immune-mediated 1:21 children with immune-mediated neuropsychiatric conditions like PANS 1:23 neuropsychiatric conditions like PANS 1:23 neuropsychiatric conditions like PANS and PANDAS. 1:24 and PANDAS. 1:24 and PANDAS. If this content is helpful, I invite you 1:26 If this content is helpful, I invite you 1:26 If this content is helpful, I invite you to like this video, subscribe, and share 1:29 to like this video, subscribe, and share 1:29 to like this video, subscribe, and share it with other families who may be 1:30 it with other families who may be 1:30 it with other families who may be struggling. This channel is about making 1:32 struggling. This channel is about making 1:32 struggling. This channel is about making complex cases make sense, without blame, 1:35 complex cases make sense, without blame, 1:35 complex cases make sense, without blame, and without oversimplifying. 1:37 and without oversimplifying. 1:37 and without oversimplifying. Now, let's talk about the mistake
The Core Mistake in PANS and PANDAS Care 1:39 Now, let's talk about the mistake 1:39 Now, let's talk about the mistake itself. The mistake is this, confusing 1:42 itself. The mistake is this, confusing 1:42 itself. The mistake is this, confusing the most visible neuropsychiatric 1:44 the most visible neuropsychiatric 1:44 the most visible neuropsychiatric symptom with the root cause. 1:46 symptom with the root cause. 1:46 symptom with the root cause. In PANS and PANDAS, that often looks 1:49 In PANS and PANDAS, that often looks 1:49 In PANS and PANDAS, that often looks like treating OCD as a primary 1:51 like treating OCD as a primary 1:51 like treating OCD as a primary psychiatric disorder, treating anxiety 1:53 psychiatric disorder, treating anxiety 1:54 psychiatric disorder, treating anxiety as a brain chemistry issue, treating 1:56 as a brain chemistry issue, treating 1:56 as a brain chemistry issue, treating rage as a behavioral problem, and 1:58 rage as a behavioral problem, and 1:58 rage as a behavioral problem, and treating tics as a neurological 2:00 treating tics as a neurological 2:00 treating tics as a neurological endpoint. And I understand why this 2:03 endpoint. And I understand why this 2:03 endpoint. And I understand why this happens. These symptoms are severe, 2:06 happens. These symptoms are severe, 2:06 happens. These symptoms are severe, frightening, and deeply disruptive to 2:08 frightening, and deeply disruptive to 2:09 frightening, and deeply disruptive to families. So, everything naturally 2:11 families. So, everything naturally 2:11 families. So, everything naturally focuses on stopping that. 2:13 focuses on stopping that. 2:13 focuses on stopping that. But in PANS and PANDAS, the loudest 2:16 But in PANS and PANDAS, the loudest 2:16 But in PANS and PANDAS, the loudest symptom is very rarely where the problem 2:19 symptom is very rarely where the problem 2:19 symptom is very rarely where the problem started. This mistake happens for 2:21 started. This mistake happens for 2:21 started. This mistake happens for understandable reasons. 2:23 understandable reasons. 2:23 understandable reasons. First, crisis-driven care. PANS often
Why This Mistake Happens 2:26 First, crisis-driven care. PANS often 2:26 First, crisis-driven care. PANS often begins abruptly. Families are in 2:28 begins abruptly. Families are in 2:28 begins abruptly. Families are in survival mode, and the immediate goal 2:31 survival mode, and the immediate goal 2:31 survival mode, and the immediate goal becomes symptom control. 2:33 becomes symptom control. 2:33 becomes symptom control. Second, psychiatric framing. Because 2:36 Second, psychiatric framing. Because 2:36 Second, psychiatric framing. Because symptoms are emotional and behavioral, 2:39 symptoms are emotional and behavioral, 2:39 symptoms are emotional and behavioral, care quickly shifts into psychiatric 2:42 care quickly shifts into psychiatric 2:42 care quickly shifts into psychiatric models, even when immune activation and 2:45 models, even when immune activation and 2:45 models, even when immune activation and inflammation are driving the process. 2:48 inflammation are driving the process. 2:48 inflammation are driving the process. Third, 2:49 Third, 2:49 Third, single-trigger thinking. A strep 2:52 single-trigger thinking. A strep 2:52 single-trigger thinking. A strep infection, mycoplasma, COVID, or another 2:56 infection, mycoplasma, COVID, or another 2:56 infection, mycoplasma, COVID, or another illness is identified, and the entire 2:58 illness is identified, and the entire 2:58 illness is identified, and the entire case becomes built around that one 3:00 case becomes built around that one 3:01 case becomes built around that one factor. And finally, the desire to calm 3:04 factor. And finally, the desire to calm 3:04 factor. And finally, the desire to calm the storm. When a child is suffering, 3:07 the storm. When a child is suffering, 3:07 the storm. When a child is suffering, everyone wants relief now, and that's 3:10 everyone wants relief now, and that's 3:10 everyone wants relief now, and that's human. 3:11 human. 3:11 human. The problem isn't symptom management. 3:14 The problem isn't symptom management. 3:14 The problem isn't symptom management. The problem is when symptom management 3:16 The problem is when symptom management 3:16 The problem is when symptom management becomes the entire plan. In real PANS
What Happens When Treatment Stays Symptom-Focused 3:19 becomes the entire plan. In real PANS 3:19 becomes the entire plan. In real PANS and PANDAS cases, this mistake creates a 3:22 and PANDAS cases, this mistake creates a 3:22 and PANDAS cases, this mistake creates a very familiar pattern. 3:24 very familiar pattern. 3:24 very familiar pattern. Parents often say, "The medication 3:26 Parents often say, "The medication 3:26 Parents often say, "The medication helped, but only temporarily. 3:29 helped, but only temporarily. 3:29 helped, but only temporarily. Antibiotics worked, but every flare 3:31 Antibiotics worked, but every flare 3:31 Antibiotics worked, but every flare comes back. Each flare looks different, 3:34 comes back. Each flare looks different, 3:34 comes back. Each flare looks different, and we're always chasing the next 3:36 and we're always chasing the next 3:36 and we're always chasing the next symptom." 3:37 symptom." 3:37 symptom." Clinically, you see partial improvement 3:40 Clinically, you see partial improvement 3:40 Clinically, you see partial improvement without full stabilization, symptom 3:43 without full stabilization, symptom 3:43 without full stabilization, symptom shifting, OCD improves, rage worsens, 3:47 shifting, OCD improves, rage worsens, 3:47 shifting, OCD improves, rage worsens, increasing medication sensitivity, and 3:50 increasing medication sensitivity, and 3:50 increasing medication sensitivity, and flares triggered by stress, illness, or 3:53 flares triggered by stress, illness, or 3:53 flares triggered by stress, illness, or growth spurts. 3:54 growth spurts. 3:54 growth spurts. And this needs to be said clearly. These 3:57 And this needs to be said clearly. These 3:57 And this needs to be said clearly. These families are not failing. Most are doing 4:00 families are not failing. Most are doing 4:00 families are not failing. Most are doing everything they're told. Many are 4:02 everything they're told. Many are 4:02 everything they're told. Many are exhausted, and some feel blamed or 4:05 exhausted, and some feel blamed or 4:05 exhausted, and some feel blamed or dismissed. 4:06 dismissed. 4:06 dismissed. The issue is not effort. It's approach.
Shifting to a Systems-Based Approach 4:09 The issue is not effort. It's approach. 4:09 The issue is not effort. It's approach. Earlier in my career, I focused heavily 4:12 Earlier in my career, I focused heavily 4:12 Earlier in my career, I focused heavily on what was most disruptive. 4:15 on what was most disruptive. 4:15 on what was most disruptive. If OCD was severe, that became the 4:17 If OCD was severe, that became the 4:17 If OCD was severe, that became the focus. If rage was dangerous, that 4:21 focus. If rage was dangerous, that 4:21 focus. If rage was dangerous, that dictated the plan. If anxiety dominated, 4:24 dictated the plan. If anxiety dominated, 4:24 dictated the plan. If anxiety dominated, we chased anxiety. 4:26 we chased anxiety. 4:26 we chased anxiety. At the time, that made sense. What I 4:29 At the time, that made sense. What I 4:29 At the time, that made sense. What I didn't fully appreciate back then was 4:31 didn't fully appreciate back then was 4:31 didn't fully appreciate back then was this. 4:32 this. 4:32 this. In PANS and PANDAS, neuropsychiatric 4:35 In PANS and PANDAS, neuropsychiatric 4:35 In PANS and PANDAS, neuropsychiatric symptoms are often downstream signals, 4:38 symptoms are often downstream signals, 4:38 symptoms are often downstream signals, not the primary dysfunction. 4:40 not the primary dysfunction. 4:40 not the primary dysfunction. With experience, I began to see that 4:42 With experience, I began to see that 4:42 With experience, I began to see that when treatment focused only on 4:44 when treatment focused only on 4:44 when treatment focused only on suppressing symptoms, families stayed 4:47 suppressing symptoms, families stayed 4:47 suppressing symptoms, families stayed stuck in cycles. 4:49 stuck in cycles. 4:49 stuck in cycles. When I shifted toward understanding 4:51 When I shifted toward understanding 4:51 When I shifted toward understanding immune load, inflammatory thresholds, 4:54 immune load, inflammatory thresholds, 4:54 immune load, inflammatory thresholds, nervous system regulation, and proper 4:56 nervous system regulation, and proper 4:56 nervous system regulation, and proper sequencing, cases began to stabilize. 5:00 sequencing, cases began to stabilize. 5:00 sequencing, cases began to stabilize. That shift changed how I practice. What 5:03 That shift changed how I practice. What 5:03 That shift changed how I practice. What works better is systems-based thinking. 5:06 works better is systems-based thinking. 5:06 works better is systems-based thinking. In PANS and PANDAS, recovery depends on 5:09 In PANS and PANDAS, recovery depends on 5:09 In PANS and PANDAS, recovery depends on recognizing immune activation versus 5:12 recognizing immune activation versus 5:12 recognizing immune activation versus immune exhaustion, understanding when 5:14 immune exhaustion, understanding when 5:14 immune exhaustion, understanding when the nervous system is stuck in survival 5:16 the nervous system is stuck in survival 5:17 the nervous system is stuck in survival mode, and respecting the order in which 5:19 mode, and respecting the order in which 5:19 mode, and respecting the order in which systems can safely be addressed. When 5:22 systems can safely be addressed. When 5:22 systems can safely be addressed. When care is sequenced properly,
Who This Applies To Most 5:24 care is sequenced properly, 5:24 care is sequenced properly, flares become less intense, baseline 5:26 flares become less intense, baseline 5:27 flares become less intense, baseline gradually improves, windows of stability 5:29 gradually improves, windows of stability 5:29 gradually improves, windows of stability widen, and families regain 5:32 widen, and families regain 5:32 widen, and families regain predictability. 5:33 predictability. 5:33 predictability. This isn't about ignoring psychiatric 5:36 This isn't about ignoring psychiatric 5:36 This isn't about ignoring psychiatric symptoms. It's about understanding why 5:38 symptoms. It's about understanding why 5:38 symptoms. It's about understanding why they're happening now. This applies most 5:41 they're happening now. This applies most 5:41 they're happening now. This applies most to children with relapsing or waxing and 5:43 to children with relapsing or waxing and 5:43 to children with relapsing or waxing and waning PANS symptoms, kids who improve 5:46 waning PANS symptoms, kids who improve 5:46 waning PANS symptoms, kids who improve but never fully stabilize, and families 5:48 but never fully stabilize, and families 5:48 but never fully stabilize, and families stuck between antibiotics, psych meds, 5:51 stuck between antibiotics, psych meds, 5:51 stuck between antibiotics, psych meds, and uncertainty. It applies less to 5:53 and uncertainty. It applies less to 5:53 and uncertainty. It applies less to single, self-limited post-infectious 5:55 single, self-limited post-infectious 5:55 single, self-limited post-infectious episodes, and short-lived flares with 5:58 episodes, and short-lived flares with 5:58 episodes, and short-lived flares with full recovery. PANS and PANDAS are not 6:00 full recovery. PANS and PANDAS are not 6:00 full recovery. PANS and PANDAS are not uniform conditions, and individualized 6:03 uniform conditions, and individualized 6:03 uniform conditions, and individualized thinking isn't optional. It's essential.
Questions for Families and Closing Thoughts 6:05 thinking isn't optional. It's essential. 6:05 thinking isn't optional. It's essential. If your child improved but never fully 6:08 If your child improved but never fully 6:08 If your child improved but never fully stabilized, if every flare feels like 6:10 stabilized, if every flare feels like 6:10 stabilized, if every flare feels like starting over, and if you've been told, 6:13 starting over, and if you've been told, 6:13 starting over, and if you've been told, "This is just how it is," that doesn't 6:16 "This is just how it is," that doesn't 6:16 "This is just how it is," that doesn't mean you missed something. It may mean 6:19 mean you missed something. It may mean 6:19 mean you missed something. It may mean the wrong thing was treated first. 6:21 the wrong thing was treated first. 6:21 the wrong thing was treated first. This mistake is common, understandable, 6:24 This mistake is common, understandable, 6:24 This mistake is common, understandable, and often correctable. 6:27 and often correctable. 6:27 and often correctable. I'll leave you with a few questions. 6:29 I'll leave you with a few questions. 6:29 I'll leave you with a few questions. Have symptoms been treated repeatedly 6:31 Have symptoms been treated repeatedly 6:31 Have symptoms been treated repeatedly without lasting stability? 6:33 without lasting stability? 6:33 without lasting stability? Were you told one symptom was the main 6:35 Were you told one symptom was the main 6:35 Were you told one symptom was the main problem, but progress stalled? 6:37 problem, but progress stalled? 6:37 problem, but progress stalled? And does this help explain the pattern 6:39 And does this help explain the pattern 6:39 And does this help explain the pattern you've been living with? 6:41 you've been living with? 6:41 you've been living with? If this resonates, share your experience 6:43 If this resonates, share your experience 6:43 If this resonates, share your experience in the comments. Your child's case 6:45 in the comments. Your child's case 6:45 in the comments. Your child's case likely makes more sense than you've been 6:47 likely makes more sense than you've been 6:47 likely makes more sense than you've been led to believe.
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