What a fascinating conversation! Regarding dentistry, I had to have a filling late 2016 & long story short that particular filling has been revisited twice since to the extent that what I now have barely resembles a tooth! My new dentist referred to it as “the big fella’! It was interesting hearing how metal could interact with the inside of the cheek. Since 2019 I’ve had knee & back issues, nothing diagnosed, no knee arthritis apparently following an x-ray and the general feeling I picked up from my GP (pre Convid) was that it’s probably psychosomatic. I was offered antidepressants which I politely declined!! I do know now about the brain’s role in chronic pain & I’m trying to work on that, but I’m now wondering if the dental work has played a part.
Also very enlightening about the changes in flu shots since 2019 - though I guess they’ll soon be MRNA 🤷♀️. I took my 1st (& last!!) flu shot in September 2021 after taking 2 doses of Pfizer C19 vax, don’t know what I was thinking & quite honestly my health certainly hasn’t improved over the last 3 years. Glad to say I’m awake now, thanks to you Ahmad & so many other people I listen to but how much damage has been done I wonder. I can say with certainty I’ll never take another shot of anything & have lost so much faith in the medical profession that I try not to go anywhere near them. As if I could actually see a GP if I wanted to, but that’s another story!! Trying my best in my mid 60’s & at least I’m not on any prescription meds which feels like a win! Thanks for all your great work🙂
Ahmad, I'm about 1/2 way through this one and it's amazed me how good it is! Thank-you.
There's a couple of people already I want to share the link with but can't because it's subscriber-only (private) episode. Is there a way around that pretty please?
I have to respectfully disagree with Simon King, as a dentist history taking is very important, and I was advised by my Father and Grandfather, both GMPs that this was very important before you started to examine your patient, it would help to formulate your diagnosis. Mags Stroud x
Just let me clarify - I am not talking about a diagnosis as a label. It would be pretty easy to "diagnose" say kidney stones based on history alone. I am talking about the diagnosis which explains why this patient got kidney stones right now and the best course of treatment to reverse it. I don't think this is possible with just a history else everyone would do it.
This is a place you get to in the "question everything" mindset that us natural contrarians have. Although this is what we are taught, where is the evidence? How often does what you do change based on a prior history, compared to what you do based on your examination? Especially as a dentist?
Of course there are some things that are useful in a history, but I also find that a history can mislead us into assumptions and that everything we think needs to be verified by careful examination, which we would probably get to with careful examination. History tends to tell us what happened, not why it happened.
However, although I would like to think I could reach the correct diagnosis by examination alone, sometimes it saves time to ask a patient where it hurts (and how bad it hurts).
Ultimately it doesn't really matter since history does no harm and is part of developing trust and rapport and it is most useful to establish a baseline so that patient-relevant outcomes can be assessed, so good history-taking is not going away any time soon.
Off on a tangent Simon, from about 1h35m you were talking about healthcare models & my mind flashed back to someone talking about C19th friendly societies & finally realised it was Alan Stevens on this platform, and he's a rabid libertarian, and you're a subscriber here so I'm sure you listened to that episode. But, just in case you didn't!
RESULTS: Of the 56 patients tested in MELISA®, 21 (37.5%) were positive, 16(28.6%) ambiguous, and 19 (33.9%) negative to titanium. In the latter group, 11(57.9%) showed lymphocyte reactivity to other metals, including nickel. All 54patch-tested patients were negative to titanium. Following removal of the implants,all 54 patients showed remarkable clinical improvement. In the 15 retested patients,this clinical improvement correlated with normalization in MELISA® reactivity.CONCLUSION: These data clearly demonstrate that titanium can induce clinically-relevant hypersensitivity in a subgroup of patients chronically exposed via dental or endoprosthetic implants.
Oh what to say about this episode!! So much!! Firstly I LOVED IT!! As a (wanna be ex) physio it was sooon interesting to listen to Simon!!
Why am I a wanna be ex? Well... ever since university (much like you Ahmed) I could not understand a number of things that were being thrown around... 1) here's a disease, we don't know why though... 2) here's an RCT this is the best... and a systematic review of RCTs is even better... oh, and in physio its practically impossible to do a good RCT so heres a load of evidence that is classed as poor, but this is what we Base our practice on, and we can write more poor studies that identify the need for more research... so much to say about that... 3) nothing ever got better, everything was managed... there's probably more too, but off the top of my head right now they were the biggies.
Why did all that bother me? Well, I wanted to be good, I wanted job satisfaction, i wnated to help people... but I wasn't as aware and open minded as I'd like to think I was back then... and I do believe I was brainwashed/indoctrinated into believing that that was how it was. It's what I saw... physio assess, 'treat'/manage... talk bad about private practices/osteopaths/chiropractor etc. (That wasnt me btw... all the senior staff members, and even consultants), discharge... often treatment sessions limited to 3 or 4 per patient, and here's a sheet of exercises to do at home.
Every placement I went on I passed with flying colours because I did what they expected of me, plus I had fantastic rapport with the patients, I was one of the only students that had my head round pain and chronic pain and it's management and the external factors that affected people (stress, lifestyle, beliefs etc)... I was half way there, but after getting to all that, there was no treatment... self management and off to GP for more pain Killers.... and so I fell out of love with physio.
BUT by that point... I had student debt, a house and bills to pay, a lifestyle to maintain, and eventually a family to support... but the WHOLE time I have never been happy, fully happy with the work that I do.
By the end of university I had developed RA, and I was still very much in the medical mindset... Dr told me I was unlucky (despite asking if there was anything that might have triggered it... anything I could do to help myself? No of course not!). I took all the drugs... and they "worked" (by that I mean my symptoms were suppressed for about 7 years).
My red pill moment was when I wanted to start a family and had to come off the meds and my journey since then... that's a whole story in it's self, but that's when I looked back and saw the perfect storm through uni leading to my diagnosis - poor sleep, poor nutrition, STRESS, not loving what I was doing, Hep B after Hep B after Hep B to go on placement, and a root canal.... (I've known teeth/amalgams etc are NO good... and I've recently re listened to Dr Sebs podcast... I need to build up courage to go see him... might be a 40th birthday present to myself!!).
But essentially, every 2-4 years I would get itchy feet and need to move on to the next role (to the outside world, I was progressing, to me I was just getting out of one frying pan into another!)...
I have had maternity leave 🥰 and I am currently on my third and final! Each time wanting to not return... BUT the claws of financial security have kept me where I am... I can not go on much longer in the NHS... everything about the podcast with your Orthopaedic colleague recently and this podcast is exactly why the NHS isn't the place for me... I've been calling it the National Sick Service since I came off my meds and saw the truth nearly 10 years ago... I have tried my hardest to help people holistically along the way, and I know I have... I also know how many patients want a different option... want the risks and benefits explained in detail... I run late on an education clinic EVERY SINGLE WEEK because I allow the patient that time, yet colleagues find that the easiest clinic and finish early, because there's a leaflet with that info on... so, here's a leaflet, here's the meds, see you in 4 weeks, don't forget to get your bloods done.....
Anyway.... I'm rambling!! 🤣 the NHS gets its claws into people and it is VERY hard to leave... (if you're risk averse like me!), but I can see that the benefits of a quality of life now, satisfaction in your work, and actually doing what my calling is (NHS physio isn't it and I've known that since about mid way through my second year of uni!) is way more important.... but, I need to work out how to go about being/doing what I need to do on my own, which is scary! But exciting!
Listening to Simon talk, what an amazing knowledge and so interesting! If I had come across him in my early years what a different life I may have had... actually, sadly if I came across him in my first 7 years as a physio, I'd have probably thought he was a bit of a quack! But, for the last 10 years... I wish I had known about him!! 🤣
Oh, one last thing... I am so sorry for, and cannot believe the lead up to your dad's diagnosis. As much as I cannot be a physio in NHS much longer, I would like to say I have worked with some amazing, conscientious, and thorough physios and even if they couldn't help 'fix' the patients problems... they were highly attuned to red flags. I know of hundreds of patients picked up with significant and severe diseases including lots of cancer and those red flags should NEVER have been missed. Sending you love, as I know your loss is still painful, and I'm sorry that physio didn't pick up on his Tx pain earlier.
Also, lots of love for the incredible work you are doing now 💪
This conversation had been rattling around in my head since I listened to it. It feels pivotal to me in the way that once we are aware of the correlation of effects from jabs we cannot unsee those, that I can see cause/effect in other areas. In the last two days i have re-evaluated all my issues - eg needing hip surgery a year or so after a root canal (age 36) … i would have thought correlation at the time to be daft. I have had all amalgams removed, but not my piercings… going through the mental process of removing 7. They have been such a huge part if my identity, but i am making peace with probably needing to remove them.
Thank you both for sharing this interesting conversation. I particularly love that it feels like you’re just having a chat and we are the flies on the wall. It feels genuine and authentic and HUMAN! I have oodles of respect for both of you. Thanks for the many tips and reminders. I’ll always be the person asking questions!! Kind regards, another grateful subscriber x
Loved this episode, really struck a cord with me as someone who is convinced that my health did a full 180 after having titanium put in my broken leg. I protested at the time because I have always been sensitive to metals but was told this was the only way it could be fixed. a year later I was crippled with widespread pain and diagnosed with ploymyalgia, convinced the titanium was the cause but told it couldnt possibly be, no matter how much i protested, consultant appointments etc they refused to remove it. I could go on but this pod has finally made me feel sane about my personal thoughts on my own experience. Thank you
Oh, I'm sorry you are going through that. I hope you can find a surgeon willing to listen and take the metal out for you. Some will. Most are oblivious to the idea that proprioception matters. The good news is that if you can get it removed, a full recovery is possible.
Thank you for replying Simon, I have given up trying to get it removed, I was banging my head against a wall, no one would listen to me, so managing simptoms holistically as best I can. I originally took the rheumatologists advice and have osteoporosis as a result, so have little faith now.
What a fascinating conversation! Regarding dentistry, I had to have a filling late 2016 & long story short that particular filling has been revisited twice since to the extent that what I now have barely resembles a tooth! My new dentist referred to it as “the big fella’! It was interesting hearing how metal could interact with the inside of the cheek. Since 2019 I’ve had knee & back issues, nothing diagnosed, no knee arthritis apparently following an x-ray and the general feeling I picked up from my GP (pre Convid) was that it’s probably psychosomatic. I was offered antidepressants which I politely declined!! I do know now about the brain’s role in chronic pain & I’m trying to work on that, but I’m now wondering if the dental work has played a part.
Also very enlightening about the changes in flu shots since 2019 - though I guess they’ll soon be MRNA 🤷♀️. I took my 1st (& last!!) flu shot in September 2021 after taking 2 doses of Pfizer C19 vax, don’t know what I was thinking & quite honestly my health certainly hasn’t improved over the last 3 years. Glad to say I’m awake now, thanks to you Ahmad & so many other people I listen to but how much damage has been done I wonder. I can say with certainty I’ll never take another shot of anything & have lost so much faith in the medical profession that I try not to go anywhere near them. As if I could actually see a GP if I wanted to, but that’s another story!! Trying my best in my mid 60’s & at least I’m not on any prescription meds which feels like a win! Thanks for all your great work🙂
Ahmad, I'm about 1/2 way through this one and it's amazed me how good it is! Thank-you.
There's a couple of people already I want to share the link with but can't because it's subscriber-only (private) episode. Is there a way around that pretty please?
No no this is a free one, you can watch on Spotify, apple, rumble and substack, links all on the substack x
I have to respectfully disagree with Simon King, as a dentist history taking is very important, and I was advised by my Father and Grandfather, both GMPs that this was very important before you started to examine your patient, it would help to formulate your diagnosis. Mags Stroud x
Agreed, I found that I could diagnose people 90% of the time from a history alone.
Yes, I understand.
Just let me clarify - I am not talking about a diagnosis as a label. It would be pretty easy to "diagnose" say kidney stones based on history alone. I am talking about the diagnosis which explains why this patient got kidney stones right now and the best course of treatment to reverse it. I don't think this is possible with just a history else everyone would do it.
This is a place you get to in the "question everything" mindset that us natural contrarians have. Although this is what we are taught, where is the evidence? How often does what you do change based on a prior history, compared to what you do based on your examination? Especially as a dentist?
Of course there are some things that are useful in a history, but I also find that a history can mislead us into assumptions and that everything we think needs to be verified by careful examination, which we would probably get to with careful examination. History tends to tell us what happened, not why it happened.
However, although I would like to think I could reach the correct diagnosis by examination alone, sometimes it saves time to ask a patient where it hurts (and how bad it hurts).
Ultimately it doesn't really matter since history does no harm and is part of developing trust and rapport and it is most useful to establish a baseline so that patient-relevant outcomes can be assessed, so good history-taking is not going away any time soon.
Off on a tangent Simon, from about 1h35m you were talking about healthcare models & my mind flashed back to someone talking about C19th friendly societies & finally realised it was Alan Stevens on this platform, and he's a rabid libertarian, and you're a subscriber here so I'm sure you listened to that episode. But, just in case you didn't!
Appreciate that, will check it out. I was referencing HOW GOVERNMENT SOLVED THE HEALTH CARE CRISIS
by Doctor Rod Long, narrated by Stefan Molyneux. Best.
In the interview I misspoke the name of the plant-based calcium research, the trade name is Aquamin, not Aquasol.
Interesting and informative podcast. So dental implants, which appear to be becoming very common are not good?
RESULTS: Of the 56 patients tested in MELISA®, 21 (37.5%) were positive, 16(28.6%) ambiguous, and 19 (33.9%) negative to titanium. In the latter group, 11(57.9%) showed lymphocyte reactivity to other metals, including nickel. All 54patch-tested patients were negative to titanium. Following removal of the implants,all 54 patients showed remarkable clinical improvement. In the 15 retested patients,this clinical improvement correlated with normalization in MELISA® reactivity.CONCLUSION: These data clearly demonstrate that titanium can induce clinically-relevant hypersensitivity in a subgroup of patients chronically exposed via dental or endoprosthetic implants.
Neuroendocrinol Lett 2006; 27(Suppl 1):31–35
Great interview and very interesting. Your always appreciated here ;0)
Thanks brother x
Very informative podcast thank you doc.
Pleasure Lorraine
Great chat, really interesting regarding the changes on flu jabs and Aus/NZD.
It would be interesting to know if any msk problems have been shown to be caused by pacemaker or other ICDs.
Oh what to say about this episode!! So much!! Firstly I LOVED IT!! As a (wanna be ex) physio it was sooon interesting to listen to Simon!!
Why am I a wanna be ex? Well... ever since university (much like you Ahmed) I could not understand a number of things that were being thrown around... 1) here's a disease, we don't know why though... 2) here's an RCT this is the best... and a systematic review of RCTs is even better... oh, and in physio its practically impossible to do a good RCT so heres a load of evidence that is classed as poor, but this is what we Base our practice on, and we can write more poor studies that identify the need for more research... so much to say about that... 3) nothing ever got better, everything was managed... there's probably more too, but off the top of my head right now they were the biggies.
Why did all that bother me? Well, I wanted to be good, I wanted job satisfaction, i wnated to help people... but I wasn't as aware and open minded as I'd like to think I was back then... and I do believe I was brainwashed/indoctrinated into believing that that was how it was. It's what I saw... physio assess, 'treat'/manage... talk bad about private practices/osteopaths/chiropractor etc. (That wasnt me btw... all the senior staff members, and even consultants), discharge... often treatment sessions limited to 3 or 4 per patient, and here's a sheet of exercises to do at home.
Every placement I went on I passed with flying colours because I did what they expected of me, plus I had fantastic rapport with the patients, I was one of the only students that had my head round pain and chronic pain and it's management and the external factors that affected people (stress, lifestyle, beliefs etc)... I was half way there, but after getting to all that, there was no treatment... self management and off to GP for more pain Killers.... and so I fell out of love with physio.
BUT by that point... I had student debt, a house and bills to pay, a lifestyle to maintain, and eventually a family to support... but the WHOLE time I have never been happy, fully happy with the work that I do.
By the end of university I had developed RA, and I was still very much in the medical mindset... Dr told me I was unlucky (despite asking if there was anything that might have triggered it... anything I could do to help myself? No of course not!). I took all the drugs... and they "worked" (by that I mean my symptoms were suppressed for about 7 years).
My red pill moment was when I wanted to start a family and had to come off the meds and my journey since then... that's a whole story in it's self, but that's when I looked back and saw the perfect storm through uni leading to my diagnosis - poor sleep, poor nutrition, STRESS, not loving what I was doing, Hep B after Hep B after Hep B to go on placement, and a root canal.... (I've known teeth/amalgams etc are NO good... and I've recently re listened to Dr Sebs podcast... I need to build up courage to go see him... might be a 40th birthday present to myself!!).
But essentially, every 2-4 years I would get itchy feet and need to move on to the next role (to the outside world, I was progressing, to me I was just getting out of one frying pan into another!)...
I have had maternity leave 🥰 and I am currently on my third and final! Each time wanting to not return... BUT the claws of financial security have kept me where I am... I can not go on much longer in the NHS... everything about the podcast with your Orthopaedic colleague recently and this podcast is exactly why the NHS isn't the place for me... I've been calling it the National Sick Service since I came off my meds and saw the truth nearly 10 years ago... I have tried my hardest to help people holistically along the way, and I know I have... I also know how many patients want a different option... want the risks and benefits explained in detail... I run late on an education clinic EVERY SINGLE WEEK because I allow the patient that time, yet colleagues find that the easiest clinic and finish early, because there's a leaflet with that info on... so, here's a leaflet, here's the meds, see you in 4 weeks, don't forget to get your bloods done.....
Anyway.... I'm rambling!! 🤣 the NHS gets its claws into people and it is VERY hard to leave... (if you're risk averse like me!), but I can see that the benefits of a quality of life now, satisfaction in your work, and actually doing what my calling is (NHS physio isn't it and I've known that since about mid way through my second year of uni!) is way more important.... but, I need to work out how to go about being/doing what I need to do on my own, which is scary! But exciting!
Listening to Simon talk, what an amazing knowledge and so interesting! If I had come across him in my early years what a different life I may have had... actually, sadly if I came across him in my first 7 years as a physio, I'd have probably thought he was a bit of a quack! But, for the last 10 years... I wish I had known about him!! 🤣
Oh, one last thing... I am so sorry for, and cannot believe the lead up to your dad's diagnosis. As much as I cannot be a physio in NHS much longer, I would like to say I have worked with some amazing, conscientious, and thorough physios and even if they couldn't help 'fix' the patients problems... they were highly attuned to red flags. I know of hundreds of patients picked up with significant and severe diseases including lots of cancer and those red flags should NEVER have been missed. Sending you love, as I know your loss is still painful, and I'm sorry that physio didn't pick up on his Tx pain earlier.
Also, lots of love for the incredible work you are doing now 💪
This conversation had been rattling around in my head since I listened to it. It feels pivotal to me in the way that once we are aware of the correlation of effects from jabs we cannot unsee those, that I can see cause/effect in other areas. In the last two days i have re-evaluated all my issues - eg needing hip surgery a year or so after a root canal (age 36) … i would have thought correlation at the time to be daft. I have had all amalgams removed, but not my piercings… going through the mental process of removing 7. They have been such a huge part if my identity, but i am making peace with probably needing to remove them.
Thank you both for sharing this interesting conversation. I particularly love that it feels like you’re just having a chat and we are the flies on the wall. It feels genuine and authentic and HUMAN! I have oodles of respect for both of you. Thanks for the many tips and reminders. I’ll always be the person asking questions!! Kind regards, another grateful subscriber x
Loved this episode, really struck a cord with me as someone who is convinced that my health did a full 180 after having titanium put in my broken leg. I protested at the time because I have always been sensitive to metals but was told this was the only way it could be fixed. a year later I was crippled with widespread pain and diagnosed with ploymyalgia, convinced the titanium was the cause but told it couldnt possibly be, no matter how much i protested, consultant appointments etc they refused to remove it. I could go on but this pod has finally made me feel sane about my personal thoughts on my own experience. Thank you
Oh, I'm sorry you are going through that. I hope you can find a surgeon willing to listen and take the metal out for you. Some will. Most are oblivious to the idea that proprioception matters. The good news is that if you can get it removed, a full recovery is possible.
Thank you for replying Simon, I have given up trying to get it removed, I was banging my head against a wall, no one would listen to me, so managing simptoms holistically as best I can. I originally took the rheumatologists advice and have osteoporosis as a result, so have little faith now.