Tired of Being Told It’s Normal

Opening: Feeling Dismissed by Normal Labs 0:00

There's a sentence I hear in my office There's a sentence I hear in my office almost every week. almost every week. almost every week. It comes out quietly, usually near the It comes out quietly, usually near the It comes out quietly, usually near the end of the first visit end of the first visit end of the first visit >> [music] >> [music] >> [music] >> after someone has finally felt safe >> after someone has finally felt safe >> after someone has finally felt safe enough to say it out loud. enough to say it out loud.

enough to say it out loud. >> [music] >> [music] >> [music] >> They look at me and they'd say, >> They look at me and they'd say, >> They look at me and they'd say, "I'm so tired of people telling me this "I'm so tired of people telling me this "I'm so tired of people telling me this is normal." is normal." is normal." And every time I hear it, something in And every time I hear it, something in And every time I hear it, something in me leans in me leans in me leans in because that sentence, [music] because that sentence, [music] because that sentence, [music] that exhaustion is almost never about that exhaustion is almost never about that exhaustion is almost never about being dramatic. It's [music] the sound being dramatic. It's [music] the sound being dramatic. It's [music] the sound of a person who has known in their own of a person who has known in their own of a person who has known in their own body for months or even years body for months or even years body for months or even years >> [music] >> [music] >> [music] >> that something is wrong.

>> that something is wrong. >> that something is wrong. And who has been told over and over by And who has been told over and over by And who has been told over and over by people they trusted [music] people they trusted [music] people they trusted [music] that it isn't. that it isn't. that it isn't. So, let me ask you something. So, let me ask you something. So, let me ask you something. Have you ever sat in a doctor's office Have you ever sat in a doctor's office Have you ever sat in a doctor's office holding a piece [music] of paper that holding a piece [music] of paper that holding a piece [music] of paper that says everything is fine while every cell says everything is fine while every cell says everything is fine while every cell in your body is telling you it isn't?

Welcome and Mission of Wellness Focus 0:57

in your body is telling you it isn't? in your body is telling you it isn't? Welcome to Wellness Focus [music] with Welcome to Wellness Focus [music] with Welcome to Wellness Focus [music] with Dr. Bisma. Dr. Bisma. Dr. Bisma. >> I'm Dr. Bisma Ifan, a physician on a >> I'm Dr. Bisma Ifan, a physician on a >> I'm Dr. Bisma Ifan, a physician on a mission to help you break free [music] mission to help you break free [music] mission to help you break free [music] from symptom management and step into a from symptom management and step into a from symptom management and step into a life of thriving health.

life of thriving health. life of thriving health. Together, we [music] will uncover Together, we [music] will uncover Together, we [music] will uncover simple, powerful ways to prevent simple, powerful ways to prevent simple, powerful ways to prevent disease, restore energy, [music] and disease, restore energy, [music] and disease, restore energy, [music] and take control of your health naturally. take control of your health naturally. take control of your health naturally. Your prescription for vitality starts Your prescription for vitality starts Your prescription for vitality starts now.

now. now. >> [music] >> Have you ever started to wonder >> Have you ever started to wonder quietly,

Why Normal Can Miss the Real Problem 1:25

quietly, quietly, >> [music] >> [music] >> [music] >> where no one can hear you, whether maybe >> where no one can hear you, whether maybe >> where no one can hear you, whether maybe it really is it really is it really is >> [music] >> [music] >> [music] >> all in your head? >> all in your head? >> all in your head? If you have, I want you to stay with me If you have, I want you to stay with me If you have, I want you to stay with me because [music] what I have learned because [music] what I have learned because [music] what I have learned after years of looking closer at exactly after years of looking closer at exactly after years of looking closer at exactly [music] these cases is that normal is [music] these cases is that normal is [music] these cases is that normal is one of the most misunderstood words in one of the most misunderstood words in one of the most misunderstood words in all of [music] medicine.

all of [music] medicine. all of [music] medicine. And the gap between normal and well is And the gap between normal and well is And the gap between normal and well is where so much of the real story lives. where so much of the real story lives. where so much of the real story lives. Let me explain what I mean. Let me explain what I mean. Let me explain what I mean. When you get a standard [music] set of When you get a standard [music] set of When you get a standard [music] set of labs, the results come back compared to labs, the results come back compared to labs, the results come back compared to something called a reference range.

something called a reference range. something called a reference range. And a reference range is not a And a reference range is not a And a reference range is not a definition of health. definition of health. definition of health. >> [music] >> [music] >> [music] >> It is a statistical band essentially >> It is a statistical band essentially >> It is a statistical band essentially where most people [music] in a large where most people [music] in a large where most people [music] in a large testing population falls. The trouble is testing population falls. The trouble is testing population falls. The trouble is the people in that population aren't all the people in that population aren't all the people in that population aren't all healthy. Many of them [music] are tired, healthy. Many of them [music] are tired, healthy. Many of them [music] are tired, inflamed, stressed, underslept, and inflamed, stressed, underslept, and inflamed, stressed, underslept, and headed towards chronic disease headed towards chronic disease headed towards chronic disease themselves. So, when we say your result

Reference Ranges and Hidden Disease 2:26

themselves. So, when we say your result themselves. So, when we say your result is normal, what we often mean is you is normal, what we often mean is you is normal, what we often mean is you look like most other people we tested. look like most other people we tested. look like most other people we tested. >> [music] >> [music] >> [music] >> That is a very different statement from >> That is a very different statement from >> That is a very different statement from your body is functioning the way it is your body is functioning the way it is your body is functioning the way it is designed to. [music] designed to. [music] designed to. [music] And here's where it gets interesting. A And here's where it gets interesting. A And here's where it gets interesting. A reference range is built to catch reference range is built to catch reference range is built to catch [music] disease that has already [music] disease that has already [music] disease that has already arrived. It is not built to catch the arrived. It is not built to catch the arrived. It is not built to catch the slow drift towards disease. The years slow drift towards disease. The years slow drift towards disease. The years when your body is compensating, [music] when your body is compensating, [music] when your body is compensating, [music] working harder and harder behind the working harder and harder behind the working harder and harder behind the scenes to keep your numbers inside the scenes to keep your numbers inside the scenes to keep your numbers inside the lines. During that whole period, you can lines. During that whole period, you can lines. During that whole period, you can feel genuinely awful and still be told feel genuinely awful and still be told feel genuinely awful and still be told [music] accurately that your labs are [music] accurately that your labs are [music] accurately that your labs are normal.

normal. normal. Both things are true at once. Both things are true at once. Both things are true at once. >> [music] >> [music] >> [music] >> That's the part almost no one explains. >> That's the part almost no one explains. >> That's the part almost no one explains. I think about this a lot with the I think about this a lot with the I think about this a lot with the kidneys because the kidneys are kidneys because the kidneys are kidneys because the kidneys are >> [music] >> [music] >> [music] >> quiet. They are some of the most >> quiet. They are some of the most >> quiet. They are some of the most patient, uncomplaining organs in the patient, uncomplaining organs in the patient, uncomplaining organs in the entire body.

Kidney Function Can Decline Quietly 3:26

entire body. entire body. You can lose a substantial amount of You can lose a substantial amount of You can lose a substantial amount of kidney function [music] before a kidney function [music] before a kidney function [music] before a standard test flags it out loudly standard test flags it out loudly standard test flags it out loudly because the remaining [music] filtering because the remaining [music] filtering because the remaining [music] filtering units simply work overtime to keep the units simply work overtime to keep the units simply work overtime to keep the numbers looking [music] acceptable.

numbers looking [music] acceptable. numbers looking [music] acceptable. Your kidney is in sense covering for Your kidney is in sense covering for Your kidney is in sense covering for itself. [music] itself. [music] itself. [music] So, a person can have real early changes So, a person can have real early changes So, a person can have real early changes happening [music] happening [music] happening [music] and a lab report that shocks. This and a lab report that shocks. This and a lab report that shocks. This reminds me of something I see [music] reminds me of something I see [music] reminds me of something I see [music] often. Someone comes in having been told often. Someone comes in having been told often. Someone comes in having been told for years that [music] they're fine, for years that [music] they're fine, for years that [music] they're fine, that they're just stressed, that this is that they're just stressed, that this is that they're just stressed, that this is what getting older feels [music] like.

what getting older feels [music] like. what getting older feels [music] like. And when we finally look, really look And when we finally look, really look And when we finally look, really look beyond the standard [music] panel, we beyond the standard [music] panel, we beyond the standard [music] panel, we find the thing that was there the whole find the thing that was there the whole find the thing that was there the whole time. time. time. >> [music] >> [music] >> [music] >> An inflammatory pattern, a protein >> An inflammatory pattern, a protein >> An inflammatory pattern, a protein leaking into the urine that a basic leaking into the urine that a basic leaking into the urine that a basic [music] test wasn't designed to catch, [music] test wasn't designed to catch, [music] test wasn't designed to catch, an infection no one thought to check

Looking Beyond Standard Tests 4:25

an infection no one thought to check an infection no one thought to check [music] for, a nutrient the body had [music] for, a nutrient the body had [music] for, a nutrient the body had quietly run out of. And the relief on quietly run out of. And the relief on quietly run out of. And the relief on that person's face, not because the news that person's face, not because the news that person's face, not because the news is good, but because someone finally is good, but because someone finally is good, but because someone finally said [music] the words, "You are not said [music] the words, "You are not said [music] the words, "You are not imagining this." That relief tells you imagining this." That relief tells you imagining this." That relief tells you everything about how long everything about how long everything about how long they have been carrying this alone.

they have been carrying this alone. they have been carrying this alone. [music] [music] [music] Because that's the real weight here, Because that's the real weight here, Because that's the real weight here, isn't it? It's not just the symptom, isn't it? It's not just the symptom, isn't it? It's not just the symptom, it's the loneliness of not being it's the loneliness of not being it's the loneliness of not being believed. [music] When you have been believed. [music] When you have been believed. [music] When you have been told enough times that nothing is wrong, told enough times that nothing is wrong, told enough times that nothing is wrong, >> [music] >> [music] >> [music] >> you start to do a quiet, corrosive >> you start to do a quiet, corrosive >> you start to do a quiet, corrosive thing. You start to doubt yourself. You thing. You start to doubt yourself. You thing. You start to doubt yourself. You wonder if you're [music] weak. You wonder if you're [music] weak. You wonder if you're [music] weak. You wonder if you are overreacting. Some wonder if you are overreacting. Some wonder if you are overreacting. Some people even start to [music] feel like a people even start to [music] feel like a people even start to [music] feel like a failure, like their body's struggle is failure, like their body's struggle is failure, like their body's struggle is some personal shortcoming.

some personal shortcoming. some personal shortcoming. >> [music] >> [music] >> [music] >> I want to say this as clearly as I can.

How to Interpret Trends and Ask Better Questions 5:23

>> I want to say this as clearly as I can. >> I want to say this as clearly as I can. Feeling unwell when your labs are normal Feeling unwell when your labs are normal Feeling unwell when your labs are normal is not a character [music] flaw, and is is not a character [music] flaw, and is is not a character [music] flaw, and is not in your head. It is very often a not in your head. It is very often a not in your head. It is very often a signal [music] that we are looking at signal [music] that we are looking at signal [music] that we are looking at the wrong map. So, what do we actually the wrong map. So, what do we actually the wrong map. So, what do we actually do with this?

do with this? do with this? >> [music] >> [music] >> [music] >> Let me give you a few things you can >> Let me give you a few things you can >> Let me give you a few things you can take with you today. take with you today. take with you today. First, understand the difference between First, understand the difference between First, understand the difference between a normal range [music] and an optimal a normal range [music] and an optimal a normal range [music] and an optimal range. For a lot of markers, there is a range. For a lot of markers, there is a range. For a lot of markers, there is a meaningful difference between meaningful difference between meaningful difference between >> [music] >> [music] >> [music] >> not yet diseased and genuinely thriving.

>> not yet diseased and genuinely thriving. >> not yet diseased and genuinely thriving. When you look at your own results, it's When you look at your own results, it's When you look at your own results, it's reasonable to ask, "Where do I fall reasonable to ask, "Where do I fall reasonable to ask, "Where do I fall [music] inside that range? Am I sitting [music] inside that range? Am I sitting [music] inside that range? Am I sitting right at the edge, drifting in a right at the edge, drifting in a right at the edge, drifting in a direction over time?"

direction over time?" direction over time?" >> [music] >> [music] >> [music] >> Trends across several years often tell a >> Trends across several years often tell a >> Trends across several years often tell a richer story than any single result on richer story than any single result on richer story than any single result on any single [music] day. any single [music] day. any single [music] day. Second, ask what wasn't tested. A Second, ask what wasn't tested. A Second, ask what wasn't tested. A standard panel is a starting point, not

Trusting Symptoms and Looking Deeper 6:22

standard panel is a starting point, not standard panel is a starting point, not the whole picture. the whole picture. the whole picture. >> [music] >> [music] >> [music] >> For the kidneys specifically, there are >> For the kidneys specifically, there are >> For the kidneys specifically, there are markers that look at the system from a markers that look at the system from a markers that look at the system from a [music] different angle than the most [music] different angle than the most [music] different angle than the most common ones.

common ones. common ones. Ways of estimating [music] function that Ways of estimating [music] function that Ways of estimating [music] function that don't depend only on muscle mass, and a don't depend only on muscle mass, and a don't depend only on muscle mass, and a simple urine test that can pick up simple urine test that can pick up simple urine test that can pick up protein leaking through long before protein leaking through long before protein leaking through long before other numbers move.

other numbers move. other numbers move. You don't need to memorize the science. You don't need to memorize the science. You don't need to memorize the science. You just need to know that my basic labs You just need to know that my basic labs You just need to know that my basic labs were fine, [music] and we have looked were fine, [music] and we have looked were fine, [music] and we have looked thoroughly, are not the same sentence. thoroughly, are not the same sentence. thoroughly, are not the same sentence. And third, and maybe most important, And third, and maybe most important, And third, and maybe most important, >> [music] >> [music] >> [music] >> trust the signal.

>> trust the signal. >> trust the signal. Your body talking to you is data. It is Your body talking to you is data. It is Your body talking to you is data. It is not noise to be silenced. [music] The not noise to be silenced. [music] The not noise to be silenced. [music] The goal was never to panic. The goal is to goal was never to panic. The goal is to goal was never to panic. The goal is to get curious. The right question isn't, get curious. The right question isn't, get curious. The right question isn't, "What's wrong with me as a person?"

"What's wrong with me as a person?" "What's wrong with me as a person?" [music] [music] [music] The right question is, "What is my body The right question is, "What is my body The right question is, "What is my body trying to tell me, trying to tell me, trying to tell me, >> [music] >> [music] >> [music] >> and has anyone actually looked?" >> and has anyone actually looked?" >> and has anyone actually looked?" Your body talking to you is data, Your body talking to you is data, Your body talking to you is data, [music] not drama. You're allowed to

Precision Nephrology and Closing Message 7:26

[music] not drama. You're allowed to [music] not drama. You're allowed to trust here. Here's what I keep coming trust here. Here's what I keep coming trust here. Here's what I keep coming back to. Normal was meant to be back to. Normal was meant to be back to. Normal was meant to be reassuring, but for the person who feels reassuring, but for the person who feels reassuring, but for the person who feels unwell and keeps getting waved away, unwell and keeps getting waved away, unwell and keeps getting waved away, it can become the opposite. A door that it can become the opposite. A door that it can become the opposite. A door that quietly closes on the very investigation quietly closes on the very investigation quietly closes on the very investigation [music] [music] [music] that could help them.

that could help them. that could help them. I don't think the answer is to be afraid I don't think the answer is to be afraid I don't think the answer is to be afraid of your labs or to distrust your of your labs or to distrust your of your labs or to distrust your doctors. The answer is to understand doctors. The answer is to understand doctors. The answer is to understand what those numbers can [music] and what those numbers can [music] and what those numbers can [music] and cannot see and to keep asking until cannot see and to keep asking until cannot see and to keep asking until someone looks closely at the whole someone looks closely at the whole someone looks closely at the whole system, not just the organ, not just the system, not just the organ, not just the system, not just the organ, not just the number, but you. Because the people I number, but you. Because the people I number, but you. Because the people I have watched recover the most are almost have watched recover the most are almost have watched recover the most are almost never the ones with most dramatic test never the ones with most dramatic test never the ones with most dramatic test results.

results. results. They are the ones who refused to accept They are the ones who refused to accept They are the ones who refused to accept [music] that feeling terrible was simply [music] that feeling terrible was simply [music] that feeling terrible was simply their new normal and who finally found their new normal and who finally found their new normal and who finally found someone willing to look deeper. [music] someone willing to look deeper. [music] someone willing to look deeper. [music] If this conversation resonated with you If this conversation resonated with you If this conversation resonated with you and you have been living with the and you have been living with the and you have been living with the feeling that your labs say one thing and feeling that your labs say one thing and feeling that your labs say one thing and your body says another, you can learn your body says another, you can learn your body says another, you can learn more about our approach to precision more about our approach to precision more about our approach to precision nephrology. [music] nephrology. [music] nephrology. [music] Where we look at the whole system to Where we look at the whole system to Where we look at the whole system to find the root cause behind how you find the root cause behind how you find the root cause behind how you actually feel. [music] actually feel. [music] actually feel. [music] There's no pressure here. If this There's no pressure here. If this There's no pressure here. If this episode simply gave you language for episode simply gave you language for episode simply gave you language for something you have been carrying alone, something you have been carrying alone, something you have been carrying alone, that's [music] already worth a great that's [music] already worth a great that's [music] already worth a great deal to me. Thank you for listening and deal to me. Thank you for listening and deal to me. Thank you for listening and I love you.