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ďbrain sprainĒ of CFIDS
Eric R. Braverman, MD, believes that an integrative
approach is the key to successfully treating
CFIDS. His practice, The Place
for Achieving Total Health (PATH Medical), utilizes a wide range of alternative
and complementary therapies ó in addition to Western medical techniques and
drugs ó as part of its treatment protocol. In this edition of the Chronicle
Q&A, Dr. Braverman outlines some of his unconventional beliefs about the
care of people with
In your opinion, what causes
Fatigue is a multi-factorial problem. Chronic fatigue syndrome patients come
here with a very rich history. They may have had Lyme disease in the past, or
Epstein-Barr virus ó but itís not uncommon for people to come in with past head
trauma, or having undergone chemotherapy. Iíve had patients with infections of
unknown origin, or with borreliosis (diseases, such as Lyme, caused by
spirochetes), Q fever, you name it. I have treated every rare,
treatment-resistant condition imaginable. And fatigue is commonly part of that
The key, however, is that it doesnít really matter that much
what happened in the past. The key is whatís going on now in the patientís
brain. The brains of chronic fatigue patients donít make enough dopamine (a
neurotransmitter, similar to serotonin) ó and this is what causes the
People end up looking for a direct cause. But in most cases,
the infection or trauma or immune episode is gone, no longer active. What
patients are left with are residual effects. MRIs or CAT scans come out normal,
and the patients are told that itís all in their heads. But MRIs donít show
wrong with MRIs and CAT scans?
Theyíre anatomy tests. If a person comes to you and says, ďI have three arms,Ē
all you have to do is look at them and count the arms. Thatís all you get with
an MRI. Itís an internal anatomy look.
Most disorders of the brain are functional. You get no value
from an MRI in that respect. Whatís revealing is the function of the brain, the
speed of the brain, the energy of the brain. The sleep cycle, the rhythm.
Thatís why we do a procedure called the BEAM (Brain Electrical
It takes about 40 minutes. Basically you put a cap with
electrodes on the head of a patient and you stress the brain. Itís kind of like
a cardiac stress test. The BEAM gives us a functional look at how your brain is
working. We can see how you respond to different stimuli, and compare that to
how a typical brain responds. This gives a much better picture of whatís really
going on, and how we can treat the problems.
Brain health check-ups are the cornerstone of our practice. We
have discovered a lot about fatigue this way. We think that fatigue, for
instance, is why a lot of people use cocaine. Itís the same for overuse of
caffeine in working men, and for nicotine use and other stimulants. Fatigue is
really a very multi-factorial diagnosis. But, as Iíve said, while chronic
fatigue has a lot of etiologies, the etiology is not as important as the
I donít need to know that to fix people.
Q. So how
do you fix people with
Hereís an analogy for you. When you sprain a leg, you treat it in several
different, synergistic ways. You put ice on it. You elevate it. You do some
physical rehab. And maybe you treat the pain with medication.
Chronic fatigue is a sprained brain. In all cases. Itís a
sprained brain that gets rehabbed with electrical therapy, massage therapies
like chiropractic, relaxation therapies, adequate sleep, proper sleep. You add
in neuro-rehabilitative approaches including hormones, nutrients, lifestyle
changes. Itís multi-modal human repair.
Every program is different, but we match them all to the four
great areas. The first is the brain and brain chemistry. Each patient has a
brain print, so to speak, based on the BEAM results. There are also
psychological needs, and emotional needs, that have to be met. Plus, heavy
metals and toxins need to be removed.
Number two is the hormonal state. If a woman is in
perimenopause, for instance, she may need progesterone. That could be
contributing to fatigue. She may be missing estrogen. A man might be missing
testosterone. Both could be missing growth hormone.
Third, you match it to their nutritional state. Better diet.
Nutritional supplements, amino acids, whatever it takes to make them whole
Finally, conventional medicine can bail people out. This is
generally a short-term fix, whatever they need immediately. But sometimes people
are very broken. Some-times people are like Humpty Dumpty, and they need
medication to hold them together. In that case, they can be on medication the
rest of their lives.
can say that dopamine agents, stimulants, are the single most effective agents
in dealing with chronic fatigue. Also amino acids, tyrosine and phenylalanine.
Hormones are essential. And conventional drugs, from antidepressants like
Wellbutrin and Effexor to the mega-drugs like Provigil, and drugs like
How long they stay on these treatments depends on how well
they heal. Remember, itís a brain rehab program, just like someone would rehab a
sprained leg. You immobilize it and treat it until itís working OK on its
Q. How is
compliance with your program?
ask people to do a lot more than just take a pill. Compliance is a challenge. A
physician has to be his patientís therapist. You have to deal with peopleís
Probably 80 percent of what a doctor knows will help patients,
what will improve them, is not complied with. My success is when I can connect
with a person. Building rapport is successful. We have to convince them that
what weíre doing is going to work ó but only if theyíll follow the program.
Q. Why do
you feel that your approach works?
Itís integrative. Itís multi-disciplined. It doesnít stop at taking a
When I interviewed at Harvard Medical School 23 years ago, the
interviewer rejected me. He said that nutrition had no role in health care. He
said that the EPA was right when it said that lead wasnít toxic to children.
Since then, Iíve seen the FDA, the EPA,
School ó all the so-called geniuses
of 23 years ago ó admit that they were wrong. These things do play a role in
health and well-being.
American medicine makes a bundle on specialization. The
economic niche of promoting overall well-being for citizens was lost. Thatís
what we have returned to, and thatís why our integrative approach has been
successful in chronic fatigue and many other conditions.
PATH Medical has offices in New
York City, greater
For more information, visit www.pathmed.com, or call (212)
The CFIDS Association of
does not endorse any products, claims or practices mentioned in the Chronicleís
Alternative and Complementary Therapies features.