Episode 118: LLMD Dr. Casey Kelley

Episode 118: LLMD Dr. Casey Kelley


Casey Kelley, MD, ABoIM is the founder and medical director of Case Integrative Health. Dr. Kelley is relentless about getting to the root cause of chronic disease and transforming health through Functional Medicine. On faculty at Northwestern's Feinberg School of Medicine, she is Board Certified in Family Medicine and was also among the first physicians to become Board Certified in Integrative Medicine. She has studied the causes, effects, and treatments of disease extensively, and lectures nationally on this and other topics. Dr. Kelley graduated from The Ohio State University College of Medicine and completed her residency in Family Medicine at St. Joseph Hospital in Chicago. She is a ten-year member of the Institute of Functional Medicine (IFM), a Director on the board of The International Lyme and Associated Disease Society (ILADS), and is a Founding Member of the Academy of Integrative Health and Medicine (AIHM). Prior to founding Case Integrative Health, Dr. Kelley practiced medicine at WholeHealth Chicago, Michigan Avenue Immediate Care, and St. Joseph Hospital. And get this: she is not only an LLMD treating those living with chronic Lyme — but she was once also a patient herself. This ep is not to be missed!



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Dr. Casey Kelley MD ABoIM Integrative Medicine Case Integrative Health Ali Moresco Lyme Disease LLMD Uninvisible Pod

Lauren: Okay, guys, thank you so much for joining us. I'm here today with Dr. Casey Kelley. Dr. Kelley is the founder and medical director of Case Integrative Health. She's also an LLMD, or a Lyme Literate Medical Doctor. We're going to talk all about that. She is also, also the treasurer of ILADS, which is the International Lyme and Associated Diseases Society. So we've got plenty to talk about today. Dr. Kelley, thank you so much for joining us.

Dr. Kelley: Thank you for having me.

Lauren: It’s an absolute pleasure. And we actually got connected through Ali. And we're airing your episodes back to back. So it's great to be able to get the patient perspective, followed immediately by this Integrative Health Practitioner perspective. And I would love to just start this conversation by hearing from you — if you could tell us about your practice. And if you have any personal connection to invisible or chronic illness.

Dr. Kelley: Yes, yes. So I founded Case Integrative Health almost two years ago, at this point. I had been in integrative health for a good eight years or so prior to that. That's kind of always been the kind of medicine that I've done.

And then got into Lyme because of my own health issues. Chronic fatigue, brain fog, things that I had been dealing with for years and not really knowing why.

Which a lot of people can understand. When I got diagnosed with Lyme and went through treatment, I started finding it in my patients, and started helping my patients — and it kind of became my little niche. But I didn't found Case Integrative Health specifically for Lyme; I wanted to create a place for people with chronic illnesses who were misunderstood by conventional medicine, who needed help and a different approach to their health. And so while my particular practice is mostly Lyme, the practice as a whole is not focused just on Lyme. There’s a lot of other things that we can do and help. And once we get people feeling better from what they came in for them, we can go back and focus on how we keep them well. And dig a little deeper and really keep them well for as long as possible. So it's been quite an honor. It's got its own challenges running a business, and all that fun stuff, especially right when the pandemic starts.

Lauren: My goodness. I can't even imagine. And you'll have all new patients because of long COVID, I'm sure, too.

Dr. Kelley: Actually, we are seeing that. Absolutely. And it fits right into the paradigm and my expertise. So we know exactly what to do, and how to help these people.

Lauren: That’s amazing. So there's answers on the horizon, which is good for these long COVID patients. And I imagine that any chronic disease patient, particularly a Lyme patient who discovers you and ends up at your practice, has got to be so comforted knowing that they're working with a doctor who has literally been through the same thing. And you can speak to the experience of these patients with a much deeper empathy than many other conventional medical doctors.

Dr. Kelley: Yeah, absolutely. It's a different level of patient care when you've been there, done that, you know, and come out on the other side. So yeah, it's a different perspective that I bring.

Lauren: And fosters a sense of community between you and your patients, I imagine as well. So it sounds like you're on the other side of Lyme now, that you've gotten through treatments and managed to get to a point where you are more able-bodied and obviously able to help other people. And I'm wondering … because this comes up so much, we hear so often, especially from Lyme patients, but from all chronic disease patients … about how often they're gaslit, brushed aside, told it's all in their head, all that kind of thing. So I'm wondering how you balance the occurrence of hypochondria with the reality of these invisible symptoms when you have new patients come into your practice. Do you believe in hypochondria at all, as an integrative practitioner?

Dr. Kelley: That’s a really interesting question! I do, I do. But I think at the end of the day, I trust my patients; they know their body better than I do. I just met them two minutes ago, right? And when people come in and they say, “Something's not right, this feels off. I'm telling you, I know, my labs are normal, but I don't feel good,” I trust them, I trust them. And when we're not getting the results that I'm expecting or wanting, then we have to look under a different rock. Sometimes those rocks include diving into our psychological demons, and trying to repair those toxic pathways as well. Which I think kind of lends to that hypochondria type. But that's a part of all of our healing, dealing with that. So I suppose I believe it. But at the end of the day, when someone says they don't feel well, I trust that they mean, they don't feel well.

Lauren: It’s very comforting to hear that, and you are not the first practitioner who has answered that question along the same lines. And I must say, as a question that I frequently ask practitioners who are on the show, the resounding answer seems to be, “Well, you know, hypochondria exists, but I also believe my patients.” And for patients who are listening to this show, to know that there are doctors out there who believe them, that’s kind of a groundbreaking thing for some of us. Many of us have been through the wringer with the medical system. So I'm wondering what drew you into this integrative approach, how you discovered integrative medicine, and why it's so important for the entire healthcare system, really, but especially for these chronic disease patients.

Dr. Kelley: I started really looking into it, probably in residency, but I dabbled in med school. It certainly wasn't taught. I went into family medicine, because it felt like it was the branch of medicine that dealt with the entire family, and the entire course of health overall. And that pace, and that lifestyle, and getting to know people on that level really intrigued me.

But I got really frustrated, because we're taught really well how to diagnose things, and how to give a pill. But we weren't being taught why people are sick.

What’s underlying their diabetes, what's underlying their gut issues. I would have patients with a list of 12 medications, most of them for the side-effects for the first medication they were put on. They felt worse than they did before, and it wasn't fixing anything. So that sparked me. I'm very curious, I’m a very curious person by nature. So I kind of started to figure out why … like, what’s going on. And so I learned more about nutritional therapy and some integrative therapies. And then in residency I really got into it, and when I went to conferences; it was a lot of self-teaching through conferences and books and other things that were available out there to me at the time, and just building upon that. To me, the body is all one big huge system. You can't just break it apart into little pieces. It's not the heart and the gut and the brain. They're not separate; all of those things are highly interconnected. And so when you start to really look at things like a web, and how the pieces, parts connect, then really start to see some cool changes in people's lives when you fix their gut — and all of a sudden their brain is different. It’s fascinating. And the chronic illness, the patients with chronic illnesses, I don't think they're served very well by our conventional medicine paradigm. I think our conventional medicine works wonderful for acute issues, and there's nowhere I would rather be if my appendix bursts … I’m going to the hospital, right. But for the chronic illnesses, I'm not sure if our current paradigm is the right one. Actually, I'm sure it's not; I'm biased. I think integrative medicine is the way to really approach that, because it looks at the system and the body as a whole. I think I might have lost a little track there …

Lauren: No, I mean, I asked you what drew you into integrative medicine, And this is exactly it. I mean, I guess this is also about distinguishing what this traditional paradigm of Western medicine is, versus the integrative approach. For people who are new to this term, integrative medicine … is this when we talk about “alternative therapies” with big quotes around it? Is this a little woowoo for people, or is it also sort of more on the cutting edge and more about root cause and about healing from within?

Dr. Kelley: All of the above. Integrative medicine is a little bit of an umbrella term. So there's a lot of different spokes underneath that. I have my board certification in integrative medicine so it is becoming much more centralized, and there are now fellowships and things you have to complete. But under that, too, there's functional medicine, there's A4M (The American Academy of Anti-Aging Medicine), there’s all these different groups underneath that. But really at its core, integrative medicine is the medicine of ‘why’; it's why people are sick. But it allows to open up other ways to help people feel well — whether that's acupuncture, massage, physical therapy … what other pieces, parts of the puzzle, and what other pieces from our toolkit that we can pull on to help people. It could be medications, it could be surgery, it could be supplements, it could be tai chi. It’s what's right for that person in looking at their history, and everything else. So it gets really confusing! 

Lauren: Yeah, I think it does. I mean, even for someone like me, who's pretty well-versed in integrative, functional, alternative, complementary therapies. But you're right about it being this umbrella term. And really, it leaves sort of an open playing field for there to be experimentation and to play around with more options than just the pill.

Dr. Kelley: Yeah, we can kind of look back to the last 2000 years of medicine, and open up our toolkit a little bit. But I agree with you, though, in the statement that it's the forefront. It's innovative, and it's leading the charge. And at the end of the day, this is how we get people to feel better, and it's way less expensive than all these medications and other things that we're throwing at people. If we can actually heal people and change their lives, if we keep them out of the hospital, we keep them out of the system …

Lauren: Would you say also … we know that chronic disease is on the rise. And of course, there's a number of factors that contribute to these numbers increasing, be that environment or even the acknowledgement of a number of conditions under the chronic disease banner. But when we know that, say, a third of Americans are living with chronic disease … and that's a conservative number, right … would you say that the future of medical training actually needs to include this integrative approach and not just have it as sort of like an additional option that you have to self-teach?

Dr. Kelley: Yes, again, I am biased …

Lauren: You’re allowed to be, on this show!

Dr. Kelley: And bias isn't necessarily bad! I do. And I think that it is slowly but surely being incorporated more into different medical schools. I mentioned that there are fellowships available now that are connected to universities. My alma mater, Ohio State, has an integrative medicine fellowship now. So it is being incorporated into education, even starting in undergrad now as well; they’re trying. So I do think it is being built-in. I wish would go faster, for sure. But I'm very happy to see it expanding like it is, being embraced.

Lauren: Absolutely. I wonder what is your response to other practitioners … Ali told me a story when I interviewed her earlier today, about, within the last five years, visiting a doctor, and her mother suggested … and you’ve probably heard the story … her mom said, “Hey, could we look into Lyme disease?” And the doctor said, “Anyone who tests for Lyme is a charlatan.” What do you say to practitioners who refuse to acknowledge the existence of the diagnoses that you're dealing with every day?

Dr. Kelley: I try to approach it with respect and calm. I have a hard time because I don't understand what science they're reading or not reading.

Because, in my view, the science that's out there, which is grade-A science, proves the existence of chronic Lyme disease and other tick-borne infections. Beyond a doubt, it's there. It's making people sick.

So I have a hard time having those conversations. I don't get into fights. I don't get into shouting matches. That’s your opinion. If you would like I'm happy to send you lots of peer-reviewed journals that explain that it is real. But at the end of the day, I don't bother trying to change their minds. Because that's energy I don't have to waste.

Lauren: Yeah, that's very true. It's energy you need to put into your patients. But it's interesting because we do exist in this … and I'm going to put big quotes around it again, “this era of post-truth”. Right? In the last several years, we've been hearing about alternative truth. And the kind of resources that are available to people to seek information, not everyone knows how to vet those sources. Of course, we would expect someone who's been through medical school to be able to vet those sources. So, is it a source of frustration for you? I know you're not putting the energy into shifting those people's opinions necessarily. But is it something that needs to change in terms of the way we look at healthcare training, that people need to be looking perhaps further afield into other evidence-based trials and tests and studies?

Dr. Kelley: Yes, absolutely. And the data is there. I know the the Illinois Lyme Association is trying to get out, at the very least, the data about what the ticks in Illinois, for example, are carrying. And how prevalent not only Lyme but other tick-borne infections that people don't believe exist in Illinois … exist in Illinois. And we have that data. So trying to get that out to the hospitals for a grand round … that is not inflammatory. It's just very factual; like, here's the information. And say, these things exist. So hopefully, that is kind of a door to help people go … ‘Huh, Babesiosis. That's in Illinois? What is that? What is that cause? What do I need to be looking for if I see a patient with it?’ I think that's one way to enter into that data. But I mean, it's all very, very, very frustrating. I know it's frustrating from the patient standpoint. It's frustrating from the physician standpoint, as well. I'm okay being on the fringe, being the cowgirl out here in the Wild West, treating this. Because somebody needs to help these people feel better.

Lauren: The Wild Midwest! Absolutely. So a new patient comes into your practice, and they name a host of symptoms. What tests are you turning to most often? And what diagnoses are you finding to be most recurrent among the patients who come to you, including Lyme? 

Dr. Kelley: Well, I think the testing is part of the reason why the conventional medicine has such a hard time with this, because it's not black-and-white, it's very gray. These are stealth infections, and there's just not been the money and the research to do enough seeking to figure out the best way to test these. There are some cool new tests that are coming out. And there is new stuff being developed, new testing being developed. But a lot of the testing that we have is still inadequate. And I think that that’s probably a large reason why people have a hard time with it, because they kind of base their understanding on the CDC guidelines, which, say, on the CDC website, "only meant for surveillance purposes, not for clinical diagnosis.” But everybody skips over that disclaimer. But at the end of the day, the history and the clinical exam are the most important parts that we do. And that's why my visits, especially my new visits, are so long; they’re at least 90 minutes. That gives me a chance to really dive into that history, and try to put those puzzle pieces together. You can figure out a lot from the history in and of itself. And the testing that I do, it really depends on what I think they have, based on that. So if I think they have Bartonella, I may be more likely to use Galaxy lab, which is kind of the gold standard of Bartonella testing. But there are multiple labs that I really like — Vibrant America, I like IGeneX, I use Infectolab, I use Medical Diagnostic LaboratorIes. Some of them take insurance, some of them don't. So sometimes that makes a difference. But sometimes you have to do multiple; sometimes you have to do three different labs from three different lab companies in order to prove that they have what you think they have clinically.

Which all just makes it super, super complicated and very gray. And so you have to kind of get comfortable in that not knowing.

Lauren: Yeah, absolutely. Well, and that's something, isn't it, that so many chronic disease patients are coming to you and are already frustrated — because they've probably been to a number of other doctors who have told them it's in their head or that they can't help them, right. And by the time they come to you, they're feeling like they've been shuffled between specialists. You’re spending 90 minutes with them on the first consult, which is kind of unheard of, right. It's fairly exceptional. So it sounds like it also means that you are already projecting a greater bedside manner, a greater sense of empathy to these patients because you know that they need that. Is that something that's also maybe missing in medical training, this idea that like we need to sit with people and get this full history and create this relationship?

Dr. Kelley: Yeah, I think so. And I think part of that is because doctors are kind of forced to see as many people as they possibly can. They're spending what, on average, seven minutes per patient? Which is absolutely not enough time to deal with someone who has been sick for 5, 10, 15, 20 years. You're not going to figure out anything in seven minutes. Right? It's not doing anyone service. Some of that's the insurance model and pushing that through and making people rush. Doctors don't feel like they have that time, either. I think if doctors felt like they had the time and could take the time, they would. But I don't think they're given that opportunity.

Lauren: Many doctors would probably really like to engage more with their patients, but they're strapped by private interests. So what kinds of questions are you asking patients when they come in for their initial consult? Is there a specific line of questioning that you've developed in order to get this full history together? That's something that maybe separates you from the pack?

Dr. Kelley: My background is in functional medicine. So a lot of it goes back to the clinical history. I don't usually have time to go back to birth history, where you see C-section or a vaginal delivery. But I try to go back to the beginning of when their symptoms started, at the very least, and then I will filter back behind that when I have time. At the end, if I have time. But back to the very, very beginning, what was happening in that time? How did it start? What did you try? What worked? What didn't work? Who have you seen? And asking a lot of clarifying questions about things. And then there's some weird questions … did you have a pet when you were growing up — because most people never saw a tick on them, they didn't know they had a tick. But if they had dogs who slept in their bed, and the dog had fleas or ticks, then they’re at an even more increased risk of having had a tick bite. People don't think about things kinds of things. Or bunnies. There's some weird questions that you have to ask to filter in and get back to that. But the history is really important. And being again, curious and asking more, like, Why? Why did this happen? What was going on? 

Lauren: Yeah, that curiosity. I'm so glad you bring that up, because it's so often connected to these conversations that I have with practitioners or with patients who have had good and bad experiences with different health practitioners … the ones who really seem to work with patients, who they are able to create the relationships with, seem to be the ones who are able to set an ego aside, and actually just be curious. That curiosity is kind of the answer to bridging the gap in many senses in the way that we communicate with one another, isn't it. I'm wondering as well … you mentioned the role of private interest, doctors being strapped by the system. I'm wondering, in terms of affordability for patients … many doctors have to work outside of the health insurance paradigm, which it sounds like you are doing to whatever extent you are forced to do. But how do we make this kind of care, this level of care, accessible to people who maybe struggle to pay those bills?

Dr. Kelley: That's a great question. Especially when we pay hundreds or thousands of dollars a month for insurance that doesn't cover anything,. We’re just kind of throwing money at insurance, and not getting anything out of it. Extremely frustrating. I'm out of the insurance model, so that I can spend that time with people.

My idea being, if I can spend that time with you, I'll actually end up spending less time with you. I’ll hopefully get you better faster, because we're able to invest in it.

There are multiple different Lyme support groups out there who do offer financial support to patients who apply, for adults and for children. Those things are definitely helpful. There are very savvy patients who get their insurance to help cover these things as well, even though they're out of network. So there's some savvy ways to do that. I'm no expert in that. I can give you no insider tips or anything on it. There’s no one who takes insurance who does what we do. So there are definitely some ways around it. At the end of the day, I just want you to feel better. So we're gonna work with you, whatever way.

Lauren: It sounds like the idea here really is, also, if people are concerned about paying upfront for things — because we've been trained that we just pay a co-pay with our health insurance or whatever — that part of it is also, as you say, if you invest the time now, if you invest the money now, it's less money down the line. Because we hear stories about people who've spent tens and hundreds of thousands of dollars and trying to get better, and then they find an integrative or functional medicine practitioner, and they're like, oh, this was the answer all along, and I could have just spent this much money instead of all of that. So really about being more targeted in our approach. And it sounds like, as patients, being more educated, doing more research about healing approaches and modalities, right?

Dr. Kelley: Absolutely. 

Lauren: So we've touched on it already a little bit, the US healthcare system. And this cultural expectation of the idea of work/life balance, that work comes before life for a lot of us … would you say that, culturally speaking and in terms of the way the healthcare system is then sort of echoing this idea of overwork … that perhaps we are harming ourselves with our lifestyle expectations, rather than healing ourselves? Is this part of the cause for the rising chronic disease diagnosis?

Dr. Kelley: Oh, I think our culture is really horrible at the balance, and horrible at relaxing. We do not put any clout in relaxation. We are go/go/go. I had a patient today who's working 16 hours a day; I had a patient last week who finishes at 8pm every night and then eats dinner, and then is expected to go to bed. This is unreasonable. And this is unsustainable. And our adrenals, our stress system, cannot live in this fight-or-flight. That is not a healthy place for us, at all. Our fight-or-flight is supposed to be on when the lion is chasing you. When the lion is gone, it's supposed to calm down, right? But we're just living in this perpetual state of ahhh!. So it's unhealthy for all of us. For all of us. It is absolutely the worst. How do you change that? That's a deeply-rooted American cultural thing.

Lauren: But then you're forced into a healthcare system, for so many of us, right, where there's a fail/first mentality. There's maybe not standardized testing or properly recognized standardized testing for certain diseases like Lyme. So what happens; those patients are the ones who get lost in the system. Right? So how do we change that from within? Is it about patients stepping up and saying, We need you to take the approach that Dr. Kelley's taking? How do we make that happen?

Dr. Kelley: I think it goes back to starting the education, for integrative medicine in undergrad in med school and residency and beyond, and teaching that. A big part of it at my alma mater, at Ohio State, is practitioners teaching future doctors how to manage their stress, how to meditate, because doctors get burned out. Compassion overload is a real thing. When you have to see six people an hour, and work for four hours every night answering phone calls and emails and doing all these things. And people are calling you constantly and you've got your own family to deal with … Doctors are horrible at this as well.

I was trained in med school … you go, you go to work, it doesn't matter how sick you are, you go.

And that's definitely one thing I think COVID is teaching us is, it's okay to stay home.

Lauren: It’s taken a global pandemic for us to be like, we're gonna stay home now? What does it mean? If we sort of zoom out of this picture, what does it mean? That it has taken a global pandemic for people to stop? I mean, as a practitioner, do you see that? And does it scare you?

Dr. Kelley: Yeah, it's mind-boggling. And I think for me, that's a big silver lining and the lesson that I've learned from from COVID is, it's okay to pause. It's okay to take a break. I'm allowed to be sick. And I can also take a break, and that we should expect other people to stop and take a break when they're sick. We're not superhuman. We're just human. All of us. I think there's a lot of really interesting things we've all learned from this, but that's definitely one thing that I have.

Lauren: I’m curious as well … when you were dealing with your initial Lyme symptoms and going through that diagnostic period for yourself, were you in medical school? Did you go through medical school with the brain fog? And how did you do that?

Lauren: I don't know! I'm apparently very stubborn. In med school, I got myself diagnosed with POTS, postural orthostatic tachycardia syndrome. Went through the whole tilt table study, the whole rigmarole. Tried multiple different medications, none of which really worked because I was working 24 hours in a row. Med students have this thing where they think they have everything that they're studying! I knew that something was weird and off, and I felt different. So, I poked the needle until I was able to get myself diagnosed. But I remember standing on rounds; you stand on rounds, and you go from room to room to room to room for hours. And the attending physicians are pimping you, they're asking you questions on your feet, and my mind … all I could think about was, don't pass out. Don't pass out. I'm focused so I'm only seeing one of them not two of them. And they're asking me questions, and I couldn't answer them. And I felt horribly stupid. There was lots of crying. Not a great experience for me. I never had that before. It was horrible. And not knowing that there was really something rooted underneath it all that was playing along. Residency was also bad. All of that just got exacerbated. But I learned ways to manage it better in residency. I still didn't know I had Lyme. But I had compression stockings, and salt water, and I found better ways to manage it. But it wasn't until really when I was done with residency and working a normal schedule and getting more regular sleep and working on adrenal fatigue and other things, that I started to feel better from all of that. But yeah, I don’t know …

Lauren: Sometimes it’s just youth, isn’t it … like, we can push through more because we're younger. For whatever reason, we have that little extra to give. But I hear stories so often on the show where it's people who are in high school or in college, or in med school for you, and that's when the onset of symptoms happens, because you're under the highest amount of stress and you're not treating your body right. But it's fascinating to me that you had to almost de-humanize yourself to provide a human experience for your patients while you were in med school. That dichotomy, that both/and, these two polar opposites existing simultaneously, is fascinating to me — with you as a product of the system. Wild, totally wild. So okay, we talked about Lyme a bunch. We've had people on the show who live with Lyme. Can you tell us a little bit more about what Lyme is. We know people get it from a tick bite, usually. What are Lyme and its co-infections? How do they exist in this world? And why do we need to take them seriously?

Dr. Kelley: Lyme is a bacterial infection. Typically, we think of Borrelia burgdorferi as the specific bacterium that causes Lyme, but there are other Borrelia species that can cause Lyme-like illnesses. And so Lyme is another one of those umbrella terms that we use to mean a lot of different things, actually. When we say Lyme, we usually mean more than just Borrelia burgdorferi. There are European Borrelia species, there are tick-borne relapsing fever Borrelia species, there’s all these different guys. And Lyme always brings its buddies, it brings its entourage with it. So, ticks tend to carry more than just Borrelia species; they carry Anaplasma, they carry Babesia, they carry Rickettsiae species. So there's all these different bacteria and viruses and parasites that you can get from biting insects. Not just ticks, but other biting insects as well. And if you are “lucky enough” to catch it right away, and you are “lucky enough” to get a bullseye rash, and then lucky enough to find a doctor who can recognize that it's a bullseye rash and give you medicine for at least a month, then it's usually a moot point. You can kind of deal with it, and move on.

But some of these infections are life-threatening, especially acute issues. I mean, they can kill you. 

Lauren: We hear about Lyme as the great imitator all the time, don't we.

Dr. Kelley: Yes, we do. For me in med school, it was syphilis. Because syphilis is Lyme’s dumb cousin. It’s a different kind of spirochete bacteria. And syphilis is a great mimicker as well; it can cause all kinds of different illnesses. And Lyme is incredibly intelligent and stealth, but it can present in so many different ways. So acute Lyme is very, very different than chronic Lyme. And chronic Lyme is going to manifest differently in every single person. Depending on what other entourage bugs they have with it, depending on how their gut health is, depending on how their stress is, depending on all of these different things that are going on in the terrain of the body that gets Lyme. So it can mimic rheumatoid arthritis, multiple sclerosis, Parkinson's, chronic fatigue, fibromyalgia … anxiety, it can just be new onset anxiety. So you really need to be thinking about it as this possible differential diagnosis for so many things. But again, that's another reason why it's so complicated, and so misunderstood. Because it's not … here are the three symptoms that you get. Everyone’s different. 

Lauren: Do you think we can eradicate it? Do we have to kill the ticks? How do we stop worrying about this every time we're outdoors?

Dr. Kelley: If only, I'm not sure. You know, you start to get rid of one species, I don't know how that affects how many other species out there. So it starts to get a little complicated with the ecosystem. But I think at the end of the day, if you protect yourself and you’re smart about it, and you learn how to do a tick check, then you shouldn't worry about being outside. You should go outside; outside is wonderful and nature helps replenish us in so many different ways. You just have to be really, really cool and stick your pants in your socks, and you have to wear bug spray. And do a tick check afterwards. And you may not even see them, you just kind of have to feel around and see if you feel anything weird.

Lauren: Where are they most likely? Is there a spot on the body … do they like to go to like warmer areas? What's the best way to do a tick check and to be thorough?

Dr. Kelley: They like to go up, and they like to go warm. So they can end up in your hairline and your hair, under your arms and your neck behind your ears. But anywhere that they have access. So if they can crawl in under your pant leg, they’re going to tend to crawl up. So they're going to go as far as they can crawl up. It's great if you're going out and you're hiking, and you're in an area that has a lot of ticks, come inside, immediately throw your clothes at least in the hot dryer, because that's what's actually going to kill them. And then take a shower, and just feel around, and make sure that you don't see anything and you don't feel anything that's weird. It can feel like a grain of salt or something weird sometimes, but they're tiny so you may not feel them.

They're not necessarily going to fall off in a shower.

Lauren: They latch on.

Dr. Kelley: Exactly.

Lauren: Yeah, they get those claws in, right.

Dr. Kelley: So if you find it right away and get rid of it right away, you're less likely to get sick.

Lauren: And also important, isn't it, if you find a tick on yourself, to save it and bring it to your doctor — because they can as easily test the tick before they test you. Right?

Dr. Kelley: With like one caveat, I wouldn't necessarily take it to your doctor because they might go, “What am I supposed to do with this?” There are a couple places that you can send them online, though, for various different costs, that will test for various different bugs. Within a week or so you'll know what was in there. Ticknology; tickreport.com, there's a couple different ones out there. And they'll test for some or a few things or a lot of things, depending on what you want. And that's one of the best ways, because they're much more likely to find it in the tick than you are to find it in your body.

Lauren: Right. Absolutely. So what about these treatments for chronic illness, Lyme, all of it? Are you finding that there are different treatments that are going to be more successful than others, that perhaps people who are tuning in may not have heard of before. And obviously if you're thinking about pursuing any of these treatments, make sure you speak to your medical practitioner. But what are the practices that are on the forefront that you're using to address these chronic diseases?

Dr. Kelley: I don't have any set protocols, per se. I try to approach everybody individually, But I do have a big toolbox, which is great. So for Lyme, there are about antibiotics, there are herbal antibiotics. But we also use nutritional IVs; in our practice, we also use ozone. We do high-dose vitamin C, we have molecular hydrogen, NAD. We do all kinds of nutritional support IVs. We do peptide therapy; peptides can really help to boost the immune system and help the body heal. Lots of supplements. There definitely are some newer things on the horizon out there that are still very, very new that I don't even know enough about to really comment on; SOT is one of them. So there's some promising stuff out there as well. For me, one of the areas that I think even some Lyme docs can kind of fall short in, is the healing aspect. You have to fight the infection, or infections, but then you have to put the body back together, and you have to help it heal and repair. And that's where you really get the health and wellness, is when you make sure you're helping to heal and repair, and putting everything back together after all of the destruction of the antibiotics, or what-have-you. 

Lauren: I like that you bring that up, because something that happens for a lot of Lyme patients is also the herx, right, the Herxheimer reaction that we hear about, which is … during that healing process, during the treatment process, that sometimes things can get worse before they get better, too.

Dr. Kelley: That’s a common reaction. I'm okay with mild herxes, but I am not okay with massive herxes where people can't function. That's way too messy, and that's way too much destruction. We can handle a little bit. And a big part of our conversation is, here's some different tools that you can use to help reduce that Herxheimer reaction to make everything much more manageable.

Lauren: I like that you take that approach, it's much more moderate. So how disciplined should patients be when it comes to this treatment and lifestyle? Does the diagnosis and the start of treatment mean that they need to upend their lives totally, if they've got a really severe infection? Or is it about taking that balanced approach and trying to find some kind of homeostasis in there?

Dr. Kelley: That’s where I tend to come about things … how can we make this fit into your life? How can we go at your pace? How can we work this into your budget and your time and all of those things? There certainly are people where we’ll try that approach, and it's like, this is not working, we've got to do something else — bigger, whatever. So there are definitely both aspects, I guess, but I generally don't ask people to totally uproot their lives or, or change things.

There certainly are things I will ask them to stop doing, like drinking pop or eating sugar, fast food has just gotta go. Smoking, please stop. 

Lauren: Just generally, that’s good advice!

Dr. Kelley: Good advice for everybody. I tend to be much more even keel and balanced, I guess, in that sense. But I'm also persistent, and so if things are not working, we try something new. Like, I'm not going to keep doing the same thing over and over again, if we're not getting results.

Lauren: That’s the definition of insanity, isn't it.

Dr. Kelley: Yes, it is.

Lauren: So what are your top tips? If you've got Top Three Tips for someone who is living with some kind of chronic something, be it Lyme or otherwise, what do you want chronic illness patients to know?

Dr. Kelley: One, they're not alone, and they can find a physician or provider who will listen to them and care for them. So don't stop until you get that. That can take a while to find that person, but keep going because you will find that person who will listen to you and help you in this process. Two, never underestimate the power of your brain and your ability to manage this and cope with all of this; a lot of it comes from inside. So I am in no way saying that this is being made up or that it’s all from their brain. That it's just mental or that kind of thing. That's not what I'm saying. What I'm saying is that we can change how we approach this, we can change our attitude, we can change those toxic thoughts and build new ones. Yes, that aspect of things is incredibly hard. But the patients that I can convince to make those changes … they’re the ones who heal better faster longer. To approach that and to understand that some of our own toxic thoughts and our own history play a role. To get them to manage that. And let's see, do I have a third? 

Lauren: Maybe it's just the two? 

Dr. Kelley: Those are good advice tidbits to throw out there.

Lauren: They really are. Can you also tell everyone where they can find you in your practice — because say they live outside of the Chicago area and they want to at least maybe call for a consult or something like that. How can people find you and get in touch?

Dr. Kelley: Absolutely. They can come to our website which is CaseIntegrativeHealth.com. We're also on Facebook and Instagram. And they can call. Another silver lining of COVID is that telemedicine has become a real thing. And I am licensed in several states now. And so there's a possibility that we will be able to see you as a patient, even if you don't live and can drive to Chicago, which is where our hub is at this point.

Lauren: That’s fabulous. The telemedicine thing is changing the face of health care and accessibility.

Dr. Kelley: We have patients from all over. It’s great, we have a map where we put pins in for people, and we’ve been able to broaden that and help more people, which is really cool.

Lauren: That's amazing. Is there anything else you'd love to share with the audience who's tuning in today, before I release you?

Dr. Kelley: I think that's the gist of it. That's kind of my story and my take on this and how I approach everything.

At the end of the day, my goal is to be my patients’ partner. I’m going to help them through it.

They’re going to ask me to do some hard stuff, but I'm going to be there through the thick of it. We're going to come up with decisions together, and what's going to work best for them and make sense for them. And I'm persistent, I don't give up very easily, like I said. So we do everything we can to help. What we do is … we call them disco balls. So when we have patients who regain their health, we literally have a disco ball … we turn a light on and we take a picture. And then in our map and our map where our patients are, we turn that little blue dot into a disco ball dot. Because it's such a big deal, and this is why we're here. This is why we do what we do, for people to feel like they have their life back. So we celebrate that.

Lauren:  I love that. And I love that you bring up the idea of partnership between patient and doctor, because this is something that's come up with all of the good practitioners that I've had on the show — that there's a curiosity, there's a setting-aside of ego, and there is this concept that is very deeply rooted in the practice that you are partnering with these patients and their health. So I'm so glad you bring that up. It gives me a lot of faith in you as a practitioner, and I really hope for anyone who's tuning in that if you need help, go look Dr. Kelley up, and look up integrative medicine and see if this might be a pathway that could help you.

Dr. Kelley: Absolutely, please do. 

Lauren: Well Dr. Kelley, it’s been a pleasure to speak to you, to meet you. Thank you so much for taking the time today. And stay safe in that snowstorm.

Dr. Kelley: I will. Thank you, and have a great day!

Lauren: You, too!


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