Practitioner Question of the Month – May 2019
Dr. Michael Ruscio’s Monthly – Future of Functional Medicine Review Clinical Newsletter
Practical Solutions for Practitioners
In Today’s Issue
Practitioner Question of the Month
Practice Tip
Practitioner Question of the Month
Keri asks, “Is having elevated ASCA and taking S. boulardii a concern for you? If not, why?
Was it the reduction in gas that prompted you to stop the digestive enzymes? I’m still trying to figure out when to pull them out of protocols.
In the last visit, the impression says she will continue EPA/DHA and the recommendations say she will stop. Which one and if stopping, why? Thanks!”
First, regarding S. boulardii: In my opinion, no. Mainly because those with IBD (Crohn’s) have shown benefit with S. boulardii.
Next, I look to risk factors for HCl (age, autoimmunity, history of anemia) and response to treatment to dictate. In those with suspected histamine intolerance, I am much more cautious.
Finally, it’s optional, can’t hurt but also not essential.
Alberto asks, “I´m relatively new to the group. I practice in Mexico. Just wondering what´s the rationale behind the visit flow in your practice. I’ve noticed that you have an initial consultation and then some days later testing and recommendations, why is that? Why not make those in the initial consultation? Are you reviewing the case?”
Great question. In my opinion, it’s important to take some time with all the data from the exam visit and spend some time thinking and constructing your therapeutic hierarchy for the patient. So I take time right after the exam and construct our big picture plan/map.
Practice Tip
Reminder, take time to step away from the minutia and think about your practice.
Every time I do this something significant comes to my attention and I make a meaningful change. Schedule time once per quarter for this.
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Discussion
I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!