The Tick-Borne Infections Hiding Behind Your Child’s PANS/PANDAS

Podcast Introduction and Guest Welcome 0:00

You know, you become this green monster that you can't control. It's this rage that is inappropriate for what just happened. They don't even remember that they had that outburst. I think it's at least 40% of my kids with pans. Kills me when they come in and they say, oh, my pediatrician said that's from growth. Our sickest patients, sometimes their antibodies look fine. And they look negative because they can even make antibodies to fight these infections. Now I'm seeing at leased an 85, 90% return.

The blood brain barrier really does try its best to keep the infections out of our brain, but we know they get in there. It will never be FDA approved because it's made for you and you alone. Welcome to Demystifying Pans and Pandas, the podcast where we uncover the mysteries, breakthroughs, and hope behind these life-altering conditions. I'm Dr. Nancy O'Hara, a board-certified pediatrician, educator, an advocate with over three decades of experience helping children and families navigate the challenges of neurodevelopmental and neuropsychiatric conditions, especially PANS and PANDAS.

These disorders can feel overwhelming, but here we'll break down the science, explore transformative treatments, and share stories of resilience and recovery. If you've ever wondered what's possible for your child or how to find answers, this is the place to start. Let's dive in. Hi everybody, it's Dr. Nancy O'Hara and welcome back to Demystifying Pans Pandas. I can't tell you how excited I am to invite Dr Casey Kelly to be here today. Casey's the founder and medical director of CASE Integrative Health and Integrated and Functional Medicine Practice in Chicago, Illinois.

She specializes in complex chronic diseases, especially tick-borne diseases. And she has a really integrative Can blending conventional and integrative therapies approach to her practice, which I so enjoy? She's a graduate of the Ohio State University, or college, university, college of medicine? Do they say both? Anyway, a 15-year member, more than that, of, the IFM and previously on the boards of ILADS. And more that that Dr. Kelly is just an amazing clinician. a great lecturer. I've heard her and lectured with her many, many times and really brings a wonderful perspective to all things integrative and functional medicine.

Tick-Borne Infections and Bartonella in PANS 2:25

So Casey, thank you so much for being here. No, thank you so much for having me. It's such an honor, Nancy. Thank you. Now, I love to get perspectives, different from mine, but when they're somewhat similar, love them even more, on pans, pandas, and especially what I think is missed a lot in this category, tick-borne infections, vector-born diseases. So can you talk a little bit about that? Absolutely. Yeah, we see a lot of kids in our practice and it's vector-borne infections are hard to treat, they're hard diagnose.

They're this big kind of nebulous gray cloud, none of it is black and white and so it really tricky. And it hard even for kids, especially they can't express their symptoms the way an adult can. So it harder to kind pinpoint it sometimes. It's actually pretty rare when someone remembers a tick bite. They're so small, they don't hurt, They don t scratch, you know, t don' itch. They d n't cause these issues. And so it's really easy to miss a tick bite. So the vast majority of people come in saying, I've never had a tic bite, how could I have a Tick-Borne infection?

Right? So that makes it even harder to pinpoint. Yeah. What they have and when they got it. And not to mention not remembering the tick, but now we know there are many other vectors that can do it, whether it be fleas, maybe mosquitoes, you know, bed bugs, and then lice. Absolutely. Then not mention the whole role of Bartonella and cats and even dogs and all of that. How often are you seeing Bartonella as a vector-borne disease in pans? Huge, huge, especially with my kids with the anger outburst.

So I call it hulking out. And you know, the little kids can get behind that. They understand that and parents can understand. You know you become this green monster that you can't control. It's this rage that is inappropriate for what just happened. it's not just, I'm mad that your using the purple fork instead of the red one. Its anger and hulk and throwing stuff that those rage out bursts are really common. with Bartonella patients. And then the kids sometimes don't remember it. They don t even remember that they had that outburst.

Yeah. I totally agree. It's like I visualize the picture I put on a lot of my slides when I say Bartinella, it's that kid that's puffing out smoke out of his ears and that rage. Absolutely. I think it's at least 40% of my kids with pans. Do you think that's more than that or is that about? I'm seeing it. Yeah. At least. I would say at 40, if not more. But anytime there's these kind of neurological mood shifts, I immediately think about Bartonella. And Bartronella, they are finding it on ticks, but it is actually more likely on the lice, on those fleas, those other biting insects.

Almost every horseback rider that I treat. You know, there's these other vectors that we're missing and we kind of lump it into these ticks, but they're getting somewhere else too. And besides the rage, which I totally agree with and anytime I see that it's Bartonella, you know not even till improving otherwise, it is Bartinella. What other symptoms are you seeing in kids especially when it makes you think about Bartonella? With Bartinella, yeah. So another big one is POTS and dysautonomia symptoms.

When they get dizzy and they stand up too fast or they're passing out or their heart rate is racing when they are just very still and stagnant. Those are another one. with Bart. Bart also causes headaches. They tend to be more in the back of the head if they're able to verbalize kind of where that is. Stretch marks. So stretch marks on a little kiddo, especially weird ones. You know, they are not necessarily where you would get stretchmarks with a pregnancy and they go in that other direction. Yeah.

If they change color they get purple or red and angry. And little kids who have not gone through a growth spurt, there's no reason for them to have stretch mark right so those bark marks can be it kills me when they come in they say oh my pediatrician said that's from growth I'm like no that that not from gross and it's on your knee it on the back of your head you know it is on I know. Absolutely. And the other one I see is rolling up their socks and their shoes or the heel pain, the sole of the foot pain.

So it's very similar to plantar fasciitis and it is often worse first thing in the morning. Sometimes these kids will scoot down the stairs because it hurts to walk that early and then it gets better as the day goes on usually. That's another big one. Yeah. And what about Babesia? Are you seeing a lot of that in kids also? Yeah, we do here in Illinois. We see a lots of Babessia actually. Those are more of the anxious kids usually. I also see more deja vu and depersonalization with Babesseia. I will explain it to kids.

Does it feel like you're watching yourself as if your life is a movie? You're kind of outside of yourself watching things happen. It feels really strange. That weird sensation will often accompany that too. Yeah. And I've lectured on Alice in Wonderland syndrome, which is just that with Babesia. I had a few kids that I treated for Babessia after they've had that feeling for six, seven, eight years get better once it's recognized. Yeah, so I totally agree. And how are you seeing these pathogens present, like from an autoimmune or a PANS perspective, besides just those clinical things we've talked about?

What other things are we seeing? Yeah, so they fit into the pans world because they can be very abrupt, that kind of night and day change that happens. Sometimes they're associated with fever, flu-like symptoms. Lyme can do that, definitely. But it's that quick change. You know, it was my kid who was one way this day, going to school, thriving, straight A's, all the good things, and the next day they cannot get out of the car and walk into a school building. Something. changed in these kids. And parents notice it, because it's not their kid anymore, overnight.

Exactly. It's interesting. I recently interviewed Ed Breitschwertz for this podcast.

Babesia Symptoms and PANS Presentations 8:40

Ed is the international expert on Bartonella, plus just such a wonderful guy. He talks about, in the AIDS epidemic, how he used to think that Bartronella was only an animal disease. how he wasn't thinking that humans could get it, which unfortunately for most of our conventional medicine colleagues, that's what they still feel. But he was talking about how when the immune system is compromised with something else, then the Bartonella symptoms come out. And I've seen that a ton with COVID. Yes. Bringing out chronic viruses, bringing out...

Lime. ... chronic botanil, lime of others. Yeah, absolutely. And it's been crazy. Go ahead. It's wild. it has changed the entire landscape of what we do. I mean, I was just having a conversation about this today with a patient. Like, this is a common story we had. People didn't know they had Lyme. They didn' know had Bart. they didn''t know any of these things. The were fine. It chalked it up to aging. You know, some aches and pains here, fatigue, brain fog, da-da-duh-dah. And they got COVID and just all this stuff came out that they don'''t they know that had because their system was managing it well enough.

Right? Yeah. Yeah, it''s been wild. This Ignite... And so many more kids with it. What tools are you using to help parents see? I mean, whether it be tests or other things to them see that these vector-borne diseases may be part of the problem. Yeah, testing is important, but unfortunately, it's still so yucky and mucky, and not great. I mean, we are making some progress, But I can't wait for the day when it is very clear this is acute, this ongoing, you know, all these differences. Because these infections are so stealth and they hide.

And a lot of the testing we have looks for antibodies, which is our body's reaction, Which could be a memory. We could have some antibodies floating around just surveillance and just make sure we're staying clear. So it's hard to say, yes, for sure. That's an active infection. But if they'd never been treated for it, like we, we treat it right in there. Exactly. These antibodies are tricky because in Western blight is a typical lab. For example, with those antibodies, our sickest patients, sometimes our antibodies look fine.

They look negative because they can't even make antibodies to fight these infections. So they can look falsely negative, even though they're the sickest patients in there. So we go digging. We use a lot of different labs in our office. If I'm really highly suspicious of something, sometimes with parents' permission or patients' permissions, we'll go ahead and treat empirically to see what we get with. knowing that, but we look at antibodies, we looked at FISH testing, which is an RNA test. We use different labs for that like T-Labs or Igenex.

Um, We sometimes do T cell testing with ILabs. we use Galaxy a lot for Bartonella. It's one of my favorite Bartinella labs. They have some urine tests too. You can look for some year in tests for patients. So there's sometimes we have to look under six different rocks. There it is. Exactly. Yeah, exactly. And I agree with you, you know, if we have the symptoms, we can talk about it that way and we'll use questionnaires, even like Dr. Horowitz's questionnaire and documentation and a lot of the times, the test will be negative anyway and the other thing you didn't mention in addition to the muckiness is the expense.

And, you know, being a girl from West Virginia, I walk around with my mouth open at the cost of everything, including us. I'm not trying to exclude us, but it's one of the things that we have to think about as we investigate these things. Absolutely. And the insurance-based stuff is just crummy. It's even crummier than crummy. That's not worth it in so many sense, you know? And I do try to be very judicious. Like, this lab is important because it will change the treatment or help find the way.

Testing Challenges and Treatment Approaches 12:40

If I don't think it's going to help me, I won't spend the money or ask the parents to spend money. I always tell parents, what are we going to do differently with the results of this test? If I would treat you anyway based on this, this and this. Let's think about that. And what about the ways you treat this in kids? How do you do it? It varies. We treat kids with pretty similar array of treatments as we do adults, but in kid-sized doses. With the chronic cases, I do like to start with herbs in kids because I want to protect their gut.

And this is a chronic issue. Sometimes I have to, sometimes I HAVE to use antibiotics, and with an acute issue I will. But if I try herbs and we don't get anywhere, or sometimes you just know. We got to do some medications here, but I do worry about all the antibiotic resistance and gut healing and that stuff. So I try to be very mindful about that. But I know this isn't a quick and easy fix. It's not two weeks of an antibiotic and you're done. This is months and months, and years of treatment. I do tend to use a lot of herbs in kids and kids respond beautifully to herbs.

Don't they? I so agree. And like we were talking about, they may not show the antibodies because their immune system is suppressed or dysregulated from the actual tick-borne disease. And the antibiotics will even do more to suppress that because of the way it is affecting our guts, you know, the first brain and the 1st line of defense of our immune system and all of that. I so agree with you. And I know you like some of combination herbal treatments, but there are so many different ways to skin that cat as long as you have a good practitioner The herbs are so safe.

Oh, yeah. I have found them to be extremely safe, extremely. Yeah. And I think, you know, one of the things I've heard you talk about a lot is detoxification, is the whole role of whole body. You know people hear me say it too much. Talk about it from your perspective. We're also toxically burdened, just period in general. It's just been building over the years and our bodies are meant to detox, but they can only detox so well. And when you start to throw infections and mold and COVID and all these things on top of it, the system is just overwhelmed.

But when we start treat these cases, we often kind of muck all that up, kind of like shaking a snow globe, right? And that makes people feel really worse. That's part of that Herxheimer reaction. And so opening up those pathways and making sure we have exits for the toxins and the waste products and things to clear out is hugely important. If I have a kid who'll come in who's really constipated, can't sweat, You know, often we'll start with the detox. Let's open up those pathways first, because you will tolerate treatments better if you are starting to and being able to manage and clear that out of your system, first and foremost.

It's tricky with kids because not only timing of everything, but pills. A lot of them can't swallow pills, so we have to get really creative with how we support that. Yeah. And, and the herbals don't taste good. I mean, we're not going to lie, you know, but maybe you add a little stevia. Maybe you put them in something, that tastes a bit better or dark cherry or pomegranate juice or something. But I was going say I like the pomme granite. Yeah, I do too. Medicinally as well as, as taste. Absolutely.

And, and, but I think that one of the things you said that's so important is this is a marathon. You know, when parents come in to either one us and think, okay, now we're seeing Dr. Kelly, we are going to get better, it's going be better next week, reminding everybody that, that you know this going take time. Yeah. Yeah, and really finding those victories. You know, kind of try to pick some short-term goals. Where do you want to be? Where are you not now? And what are some small-terms goals that we can do that note that can kind-of help us prove that, we are seeing improvements.

We are getting better. This is all worth it. Right. And as you said, treating the constipation, getting them to sweat, and getting to sleep, you know, so important before we even throw in the antimicrobials of any sort. Yeah. Sleep regression is a big one with kids. Bedwetting, that comes up. Are you seeing any other reasons besides inflammation and constipation for the bedwetting? Do you have any thoughts on the bedtime specifically? I think it's some neurological development regulations too and there's that disorder that gets thrown out of place.

The body just gets totally dysregulated and so sleeping becomes an issue and it is a different kind of sleep and all of a sudden they don't know they're sleeping. Yeah. Yeah, and then it affects everybody because then mom's not sleeping, dad's, not sleep, brother and sister, you know, the whole family comes in sleep deprived. Now, one of the things that I recently heard you talk about and I know you're lecturing on again is the role of endothelial dysfunction in chronic disease. And I think that's fascinating.

Can you explain that vascular inflammation and all of that a little bit more and how it impacts Pans Pandas? Yeah. So I really got interested because of COVID and how, again, I feel like that just, it changed the playing field. It changed everything. And all of a sudden, everybody got stickier. Our blood got sticky. Why? What is going on here? And we know Lyme and tick-borne infections can create hypercoagulation. BBC is bad at it, especially creates these nests in the blood vessels. It attaches, it attacks red blood cells.

So it creates that. And this, so microclots and all of this. We just threw COVID on it. I mean, we do ozone in our clinic and we have to use heparin with it to make sure that the blood doesn't clot. We had to increase our heprin since COVID because we weren't able to get the bled out. There's too many clots because it changed the train. It's wild what happened. So I started to dig into it and learned that it's not just COVID. Its chronic infections that play a role in creating this dysfunctional endothelium.

which is the lining of our blood vessels, which are so important. And this is a really important immune and hormone and endocrine organ that is 60,000 square feet or whatever to the size of the world. It's crazy how big this thing is and how these different infections affect the endothelial lining differently is really interesting. These guys are smart. Yep, much smarter than we are. smart and terrifying and they know how to get in there and They've found their own little ways to figure this out and get In there.

And when that endothelial system is disrupted, it creates ongoing perpetual inflammation So it create can just continue this inflammation signal in our body.

Detox, Sleep, and Stress Support 19:45

So we just continued to spit out all of these inflammatory cytokines and that's exhausting and that in and of itself creates its own set of symptoms, chronic fatigue, circulation issues, numbness, tingling, the brain fog, gamut of all of this, because those pathways are broken and inflamed and leaky. And it's just these compounding issues. Unless we look at that and try to reset those signals to get that lining in the glycocalyx, the, I call it seaweed, this seaweed flowing inside of it that helps with all the signals.

Unless we, like as part of the healing process, take a look at that, make sure it's okay to the best of our ability and try and heal it. We're just going to continue to perpetuate these inflammatory signals because your body is under attack. So two questions. One, how does that affect the blood brain barrier? And two, How are you treating it in kids? What's been most successful? Yeah, so it's going to affect all the barriers really, potentially. You know, the Blood Brain Barrier really does try its best to keep the infections out of our brain, but we know they get in there.

And then once they're in, how do they out? What do we do now? But it affects kidneys. It affects the gut. it effects the lungs. Everything gets affected by this because we have blood vessels everywhere in that. The leakier our blood vessel are, the leak our gut is, leak your brain is it all just kind of perpetuates. So with kids, I try food as much as possible. Some of the foods that are really great for this, though, are things like beets and green leafy vegetables, which aren't necessarily the most kid-friendly foods to pick.

But, you know, we can hide spinach in applesauce. We can use beet powder and green powders to fit into a smoothie or bake into. A muffin, you know, like we can hide these in spaghetti sauce. Meatballs. That's a good one. We could hide this stuff in there. So then like, we could use food to get in. They're all the better. Some of my favorite supplements are arterosil or endocalix pro. These things have seaweed in it to help repair and just a whole bunch of food that does this. they are capsules and they're powder.

we just open them. and put that into their applesauce or food to help repair that. Yeah. And I always remind families, you know, capsules are easy for kids to take. They're just opened up powders. You know? Now, in my head, I'm hearing the mom I am seeing tomorrow who believes that all the issues are oxalates, and you say beets and green leafy vegetables. I hear her saying, wait, your increasing my child's oxolates. What do you to the parents that say that to you? Then you go to the endocalex or what?

Yeah, maybe go supplement. Some of the things that are going to help boost nitric oxide, which is a big part of endothelium too, would be watermelon, melons, those kind of foods. Nuts and seeds are also really high in this, so you're going be able to find some low oxalate foods if they really have an issue with oxolates. We try to avoid that. I just don't find that super duper often that that's really the issue. I agree. Thank you for saying that again. I did not feed her any of this information.

Those of you who are listening and know me well, I didn't prep her. So anyway, no, so I so agree and I think those things are so important and it takes me back to Bob Navio's persistence held danger response because we're really in that same world with all of these. Uh-huh. Agree. Uh huh. Agreed, agreed. And I can't wait for the day when we can test where someone is and they're still danger responses. You know, I'm sure their bodies are different parts are in different stocks responses, but yeah, that that is such a huge part of this.

Yeah, huge part of it. And a huge of that is also what I hear you talking a lot about is stress and Vegas repair and any way to decrease stress. Talk about that a little bit. Yeah. I tried to, like, especially when I'm talking to kids about stress, I try to normalize it a Little bit, you know, we think and talk about Stress. It's this awful thing and too much of It is, but a bit of stress also helps us get our homework in on time. Yeah. And get stuff accomplished. So we can kind of wrap our head around maybe that, okay, there's some good support here and try to keep that positive attitude about things.

But when we're overly stressed, forget about it. Our system is just burned out. I think a lot of these patients, the other problem is a lotta these patient's, their symptoms just get chalked up to that, oh, you're just a stressed out mom, that's what's going on. And it's not fair because that not what this is. But you throw the psychological stress of life on top of this, and then the physiological stress, of chronic infections, this a perpetual fight or flight situation. We are stuck in fight-or-flight.

Our systems are not designed for that. We're not. And we have to learn how to relax and recover because otherwise we're never going to get better. I have say it all the time because I'm in part reminding myself. Me too. Oh, yes, that's right. Breathe. That's good. Okay. Yeah, we got this. Kids, I think, have a hard time wrapping their heads around stress too, but a lot of these kids come from broken homes. Then when they're not feeling well, the parents are often at odds related to it. It just puts the kids in the middle, which is just this thing.

We talk about deep belly breathing. I often will have kids lay on the ground. on their back because that's a much easier way to get your belly up and down and wrap because trying to give a kid a deep belly breathe is entertaining. But if they lay on the back, all of a sudden, it makes sense, you know, and kind of blowing the balloon and talking through that. There are some limbic systems out there that are a little more kid-friendly, like what's it called, sound and... Safe and sound? Yeah, safe and sound, thank you.

And even just music. Just playing music, calming music for the kids, even if they're not in a flare. It's actually sometimes better just to have it like regular. So when they are down, we can try to really... Yeah, for me too. I mean, my husband brought music into my life and it brings us all, just you can feel it in your body. And I always say to the moms, you're doing this for your kid, but the putting your oxygen mask on first is a real thing. If you cant do it for yourself, know that your breathing, your bringing it down a notch is really treating your kids too Beautiful.

So true. Yeah, absolutely. And then, you know, I heard you talk about the binaural beats, like the headphones at night. I have never used that one. Talk about that. Yes. Oh, so I love binaral beats because it's very passive. It just, it doesn't work for you. if you will, and you have to listen with headphones because one ear is hearing a different hertz than the other ear and that difference correlates with certain brain waves. So there's different kinds of binaural beats out there. And there are free apps out that do this.

There's also paid apps that also do it as well. I have this little headband headphones for my little one, but the over the ear ones too. They're wired. And so, but for sleep or stress or focus too, you know, that you can listen to these and you, can just have it on in the background and it, it biohacks the brainwaves to go up. I'm supposed to be sleepy now. Yeah. Good thing. Which doesn't require any. thought process. And the good part about kids is they don't usually have the ability to override it.

Adults can still override. But kids, they're like, oh, that's nice.

Endothelial Dysfunction and Blood-Brain Barrier 27:45

Exactly. While we're talking about stress, one other thing that I've heard you say that is so resonates with me is we talk about having a good diet. We talk an anti-inflammatory diet, you just talked about the beets and the green leafies and way to get good things into kids. They're still kids and even as adults, we'll sometimes eat something that we shouldn't. Like, let's be honest. And one of the things I've heard you say is the stress about eating it is worse than eating. Talk about that a little bit, because I love that.

Yeah, you know, I'm in the 80-20 camp over here. I think having done elimination diets and do them, and I do think they're useful tools, but the distress of having to worry about every single last morsel that goes into your body is overwhelming and causes more stress and keeps you in that fight or flight a lot of times. I think as humans, no one's perfect. And so we can allow ourselves some grace. If we make smart choices with our treats, but when we cheat and when treat ourselves, my other saying is you have to enjoy it.

So if your thing is pizza and you just have a piece of pizza, you need to sit and enjoy and relished in it and how it's the best pizza you've ever had. This is so good and chew it a hundred times and not shovel it in your face and feel guilty because that defeats the entire purpose. Exactly. I know. My mentor was Sid Baker, one of the most brilliant men, and he always ate a piece of chocolate. Now, it was dark chocolate, so a little bit better. after every meal, breakfast, lunch and dinner, and a little bit before bedtime.

And to watch him eat it and savor every little morsel, you know, that if we're going to do it, let's enjoy it. I just love that. When you look at the food pyramid, the good food pyramids, The Bottom is about people dancing and smiling and enjoying eating. and I, I Just got back from Tuscany recently and it reminded me about the joy of eating, And so much of our lives are rushing. Or, you know, let's eat this as we go to this sports thing. Everybody's watching TV while they're eating. The enjoyment of it is such a big part.

Yeah. It's lost in our culture a little bit, too. And I think you're right, it's the rush of all the activities, all of the things we have. But to get to sit down and really, and it not just the food, but the community. Which is so good for us, And enjoy that time and slow down. Yeah, and don't process every food. Don't eat every processed food that goes without saying. I know. And I've also heard you talk about trauma as one of, you know, we know COVID, mold, that's all reactivating these vector borne diseases, but trauma too.

And talk about trauma a little bit. Well, you know, I call it kind of trauma with a capital T. So there's these events that happen to us that create this trauma, and our body doesn't forget. And some of these traumas are actually can kind of seem not to be a capital T, like they might seem, but you could just like, that wasn't really traumatic, it really was to your system. And it feeds the loop in your brain, this post-traumatic stress loop, which keeps you in that hypervigilant, fight or flight state.

So if you have a history of, and trauma can be that other inciting incident. We talked about COVID bringing out tick-borne infections, trauma, can bring out, tick borne infections. And the flip side is the physiological trauma, let alone the medical trauma with a capital M and a T with these patients. But the physical trauma of these, these infections perpetuate that same loop. That same. Loop. And so we just get stuck and God love our brains and our bodies are trying to protect us. You know, don't, go down that alleyway.

They're trying, but, and they just stuck in these hypervigilant modes and actually makes everything worse. And that's part of that healing journey to get from being that sick person dealing with this to a healthy person and being able to enjoy being healthy. And out of, that is that gap to learn how to rewire that system. It goes back to stress, it goes to the vagus nerve, all of those, they're all connected and rewire that so that you feel safer in your own body. And dealing with that trauma can do so much for all of your physical symptoms.

Absolutely. I mean, we have patients, that's all it took. You didn't need all the pills. You don't all of the IVs. Just needed to have the courage to face that trauma and process it. It's just terrifying. I've had so many kids. And, you know, I had one young woman. We had done absolutely everything, but we had missed the trauma that she had had as a little kid. and it wasn't until we went back and really resolved that and helped her to work through that, that then, she was great. And is now a spokesperson for Pans Pandas and all the ways you get, you know, it just, all of these things play a role.

So true. And that's why these are so complicated. Yeah. It's not as simple, oh you have this and here's your treatment and you're done. Yay. Yeah, exactly. And that reminds me about flares. What are your go-tos for what we call flairs in Pan's Pandas? Yeah. So for us, there's a couple kind of areas that I focus. One is support detox, flush out the toxins, lower that. Two is lowering inflammation, and they kind go hand in hand, in a lot of ways. But I think Berber Panela is a wonderful Especially for the neurological stuff that can, and people won't take enough of it.

You can take a lot. An adult can it eight times a day if they need to. In my opinion, so can a kid. I don't think you can overdose on berber panela. I also really love Epsom salt baths for kids, but a lot of Epson salt, it's not just a little bit, two cups or more. You can put baking soda, you can some lavender, or you could put some of that in there, that can turn off the hurts and the flare pretty quickly. I really like sweating and having them run around if they're able. Yep. That can be a good one.

And getting out in the dirt, even if you live in New York City, you know, a little flower box, getting your hands in dirt. Tumeric. Yes. You know as an anti-inflammatory, I love that. Yeah, but I so agree. Although I need to use more Epsom salt. I mean I use EPSOM salts all the time, right?

Flare Management and Supportive Therapies 34:25

But I'm usually telling people a cup, so I needed to up that, okay, got it. Now, you do do bigger ticket items, I call, and you have talked about them. Talk a little bit about a couple of those. talk to me a bit a thought. What it is, what it means, especially when it comes to Bartonella, Babesia, things like that. And we have had success with this in kids, too, with parental consent, obviously. So, SOT is Supportive Illegal Nucleotide Therapy. Here's how I describe it. Now, one, it will never be FDA approved because it's made for you and you alone.

So, you know, that's off the table. And because of that, I can't give it to anybody else because this is made specifically for. It's very targeted anti-pathogen technology. Let's just say we're treating BART, and we know it is Bartonella hensile. We generally need to know is it Hensilae, Quintana, etc. The lab is in Greece, so we draw the blood, send it into Greece and they look for Bartonella hensele. And they look, and they find the DNA of that pathogen. And, they found the area that says grow and replicate.

They make the antidote for that, basically. So, the make opposite of it. This is what we give in an IV infusion. It's a simple push, it's not hard. That goes around, this is a very, very targeted approach. and it is not going to affect our cells. it doesn't teach our cell to make anything. Our cells are going ignore it, It is going right to the Bartonella, link up to there. Then the bartonell can no longer grow or replicate, Yep. And so it's very, very targeted, which is great when we have GI issues.

We can't take antibiotics anymore for one reason or another, we're plateaued, et cetera. I actually use it earlier and earlier now. After I've used it now for about four years in practice, I started to incorporate it sooner, because I think it actually ends up saving a lot of time. Yeah. You really found that recently. Yes. But it is all manageable. than SOT. And the problem is sometimes you have to do it a lot because you 10 bugs, and you have to go through one at a time and do them. But each time you do it, a little bit is lifted.

And then the next thing comes up. It really is a cool way to really try to get rid of these guys. I like that. Now, you're still detoxing them, bringing down inflammation at least somewhat as you can, then doing this hot. If you do it once for, let's say, Bartonella hensile, not that it ever happens that you just have one germ, but we have seen kids get better with one sought. Oh, yeah. Do you have to repeat it for the same germ? Or is it repeating it, using it unique to each one? Explain that just a little bit more.

Yeah, I do sometimes have to repeat it. It's usually a year or so later. They're better. it's much easier this I can go around, but it still there on lab, so we can still treat it because we just want to get rid of it but, it is not as common. I, It is often more of doing the next one and the the one, and, or different strains. So, we did Bartonella hensile, But now we have Quintana. or a different one in there. And where I hear some people or patients talk about how they heard so-and-so had a really bad go of it or whatever, what I see though is if Bartonella just seems to be the biggest culprit, it's causing the big amount of symptoms and we treat it, now all of a sudden this new stuff comes up.

that they weren't necessarily experiencing before, it was really quiet. And they're like, I'm worse than I was before. You're different than you were before because now it's this guy. We got to treat this guys. So I try to warn people about that too, because that definitely happens. in there, but it just means we're peeling away the layers. In my opinion, it's all good. That's what I was going to say. Exactly. Yeah. Okay. Well, I think it is a very good treatment that most people don't know anything about and think about it incorrectly.

So I appreciate you expanding on that and talking about because I agree. I mean I'm seeing at least an 85-90% return. Do you agree? Yeah. Yeah, it's definitely one of the highest. I never want to promise, yes, this is going to work, but it is one the higher things. You know, medications, herbs, a third, roughly speaking, you know where a real plateau will get stuck somewhere. But this one has a much higher efficacy. Yeah, I agree. Now I know you also use peptides. You use Flopressa, you use IVs and other things.

Are there others of those that you think are really helpful to our kids that want to expand on a little bit? Yeah. I really do like IV ozone for the right kid. We've had a good amount of Pans Pandas kids who, and slime kids in general, we've tried other thing, et cetera, whatever reason. But if we can get some ozone in them, that's where they start to really turn the corner. Really decreasing the inflammation. Yes. Yeah. And it helps to treat the bugs, too. There's an antimicrobial component, especially babesia, because the ozone is treating the red blood cells.

It's treating blood, and that's where babeseia lives. So I really like to go after it on the hard-to-treat babesseia kids. But again, you have to have the right kin because as an IV, they're going to draw out blood and put their blood back. So, but in the right kid, we've seen some really cool quick. Yeah. Turnarounds too, which is great. Yep. And again, We're not saying that, okay, you've got Bartonella go right to Ozone, go to Dr. Kelly and her group, and they will help you decide together when to put that in.

But I do think those are both, I've seeing great responses with both of those. Absolutely. So any others that you wanted to mention? So another one that I actually like in kids a lot is just molecular hydrogen. I don't know if you use that at all. But especially when they come in really anxious and riled up, we have some of the kids that come on and they're like banging their head type of things too. It's just a simple nasal cannula. They breathe normally, but it helps to convert cytotoxic radicals to water.

And it crosses the blood brain barrier so it can get into that brain and help calm down that inflammation. So simple, it's harmless. You're just going to make a pee. Because you get more water. But that's another one that we will incorporate.

SOT, Ozone, and Advanced Treatments 40:45

That's generally easier in the case. Right. And without the IV. Yeah. Absolutely. I know we have some practitioners that listen to this podcast also, and I knew you have an online course. Is that true? Can you talk about that a little bit? Absolutely, yeah. So right now I have my Groundwork for Healing course available at healwithcase.com. And this is, I designed this to kind of get those foundations. So for, especially for people who don't have immediate access to integrative medicine, what can we do to like, like I don' know what's going on with me, but there's something, What do I do help?

And it really focuses on what I call a five foundation. It's what you eat, how you sleep, How you move, stress, and how do you detox. And it goes through in detail how to effectively manage those, and that alone should make some huge impacts on your symptoms. And hope to quiet down some of that noise, too, because sometimes we're so inundated, our symptom list is three pages long, right? This can really help to calm it down, so it's more like one page. or five, you know? And that makes it much easier when you do get to the provider to go, oh, that make sense.

I know exactly what's going on with you versus, three pages and everything's out of that. So I really wanted to create, and I think it's good too for people to back to those basics. Absolutely. And when things get flared up and life comes at us, so just go back to those basics. Yeah, and so I'm really excited. It's a good one. I am working on a Lime one as well. This one's going to be more like 10 modules and four or five videos per module and all kinds of good stuff. So it's the labor of love and it is a process and its coming.

Okay. All right. We'll watch for that. But the other one is healwithcase.com. Okay, all right, and you know, after listening to you, I'm sure there'll be lots of people that want to find out, can they see you? How do they get in touch with you please? I know there will be stuff in the show notes, but please let people know. Absolutely, yeah. So our website is caseintegrativehealth.org on social media as well. We're based in Chicago. If you're an Illinois resident, for sure give us a call. we see patients from out of state.

They fly in to see us so they can establish care with us in Illinois. I have a team of three PAs that work with me dealing with our chronic complex illness cases. And they're wonderful. My team is really good. Really good, so if you can't get in Like I have trained these women, they're brilliant. They're going to talk to me too, we're all going help you together. We treat everybody as a team here at the office. we also have a longevity and hormone arm of our clinic too. There's a physician and two PAs over there.

And we have cardiologists in our office too so we try to cover the gambit and not just the chronic complex, but also my goal is to get those chronic, complex cases up to what I call a disco ball. So they've got their life back. And we celebrate this. We drop the disco ball, we play music. It's a big thing in our office. But once we're there, I can hand them off to the longevity group. Now let's keep you well. How do we keep them here? You know, in that aspect. So it's really fun. it is a fun group of people.

we really care and listen. I work with some great people, so if you, please, We would love for you to call and come see us. I really appreciate your approach. The joy and the knowledge, but more than that, the compassion sort of emanates from your website, from you, and I just, I appreciate what you do. That means a lot coming from you, so thank you Nancy. No, I mean that sincerely. And any last words of hope or wisdom or experience you want to leave our parents or practitioners with?

Course, Clinic Info, and Closing Advice 44:25

So it is a marathon, like we said, it's not a sprint. So kind of picking some of those small victories and focusing on that and try to have fun too. It's okay to try to have fun and enjoy this life. I think that's a big part of our healing too. Laughter is the best medicine, they say. But we don't always give ourselves that opportunity, especially as parents. Especially parents of sick ones. You know, we're so hyper-focused on that. but create joy and try and have to fun. Even if it's just being silly and dancing in the kitchen.

That counts. Yeah, I agree. Find that and then you'll start to see fun in other things and life isn't as, it just becomes a little less hard. I love that. I'm going to go dance. All right. Casey, thank you. So appreciate it. And we'll see everybody next time on demystifying pans pandas. Take care. That's it for today's episode of demystifying Pans Pandas I hope you're walking away with insights, tools, and hope to help you and your child on this journey. If you found today's conversation valuable, be sure to subscribe so you never miss an episode.

Share this podcast with anyone who might need it. It could be the lifeline they're searching for. And if you have a moment, leaving a review helps us reach even more families who deserve answers. Also, for more information, training, and community, check out our website, drohara.com and join our annual membership. And remember, every step forward, no matter how small, brings us closer to healing and understanding. Until next time, be present, Be hopeful, And we look forward to seeing you next on Demystifying Pan's Pandas.