#the Adderall headaches are OUT TO GET ME and boy i can tell there's a gas leak in here because its so preppy in here

[vennilavee]

fresh eyes

Pairing: sam wilson x poc reader

Summary: You’re a pharmacist in one of the busiest pharmacies in Brooklyn. When some of the Avengers start picking up their medications from your pharmacy, you know life is about to get infinitely more interesting.

Warnings: cursing, mentions of anxiety/PTSD

Word Count: 2497

A/N: Pharmacists never get any love! ANYWHERE- in books, in television, in fanfiction or anything lmao (maybe I’m biased). and also sam never gets any love so here we are.  I’m nervous for this cause I’ve never written Sam before, please let me know your thoughts! Enjoy!

12 hour shifts at the retail pharmacy were a walk in the park to you now, almost ten years after you had graduated from school. You remember when you were a fresh graduate and you remember how your feet and calves would ache from standing on your feet all day. You remember how you would always be hungry and you would end your shift with a pounding headache.

But now, you were a pro. You opted for comfortable shoes rather than stylish flats, you brought in enough food to last you the day, and you always kept cases of water and plenty of snacks in the pharmacy for you and your technicians. 

Most of your patients were well-mannered and kind. You had come to get to know many of them over the years. They knew you by name and whenever they came to pick up their prescriptions, they would give you a quick update on their lives and ask you about yours. They were almost like your family, in a way. You felt the ache when people sometimes moved away and stopped coming to your pharmacy. But of course, there were people who gave you an attitude when their medications weren’t ready or when you couldn’t get hold of the doctor for more refills for their medications. 

You gave attitude right back, though. In the beginning, you were afraid to. But then you realized that this was your house, that people shouldn’t talk to other people the way that they sometimes spoke to you. With their profanities and raised voices. So you gave the attitude right back, and you quickly became known as the pharmacist who would take no shit from anyone. You had thought that corporate would come down on you hard for being firm and feisty, but it was quite the opposite. 

You were the only one who had lasted this long in this particular pharmacy, and it was a title you wore proudly. This job made you get a thick skin and taught you things about empathy that you thought you already knew. 

Your staff was a godsend- always helpful, ready to take charge when necessary. They were like your family, too. You even hung out sometimes outside of work, when your schedules matched up.

Your pharmacy was busy almost all the time and Mondays were often the worst. Phones would be ringing off of the hook, people would be coming in and out. But you thrived in well-organized chaos. Because that’s what it was- despite all the noise, you were calm and level headed.

You think nothing of it while you verify prescriptions for Steven Grant Rogers. That was a common name, right? And then you verify prescriptions that a psychiatrist has called in for James Buchanan Barnes and Sam Wilson and you know this is not a coincidence. Your technician squeals in excitement- “do you think the Avengers will come here to pick up their meds?!” You scoff, because there’s no way that the Earth’s mightiest soldiers are going to pick up their medications at your pharmacy. Surely Tony Stark has his own personal pharmacy in that obnoxious tower that sat in Manhattan?

You are curious, though, at the medications that they’re taking. Some part of you is glad that they are treating their PTSD and anxiety appropriately, when you see the prescriptions for paroxetine, sertraline, and fluoxetine. You’re benignly proud of them for getting the help they needed. Your heart clenches at the thought of all the things they’ve gone through over and over and over again. 

You sincerely hope they stop by.

Sam Wilson and Bucky Barnes walk into the pharmacy and they’re both pleasantly surprised when nobody recognizes them. Or if they do recognize them, nobody says anything. They’re greeted with eager smiles and starstruck eyes, that they return.

Bucky picks up a pack of peanut M&Ms and Reese’s peanut butter cups before following Sam to the back of the store, to the pharmacy. There’s a line of three or four people, waiting to be called upon. The pharmacy must be short staffed today, because he sees you running back and forth from the computer inside the pharmacy to the bins behind the counter and helping patients as quickly and efficiently as you can. 

Sam watches you curiously when he sees your smile fall and your lips set into an annoyed line. 

“Can I speak to the pharmacist, please?” The woman in front of them asks you, ignoring your white coat that has pharmacist emblazoned in black print.

“I am the pharmacist,” You say, not bothering to keep the bite out of your voice.

“Oh, but you’re so young,” The woman says quickly, “I was expecting someone... else.”

You want to say, “were you expecting someone that didn’t have brown skin?” But you refrain and physically bite the inside of your cheek. The woman asks you about refills on a medication that she wants to pick up, and you tell her that you were unable to fill the medication because the doctor had not sent over the prescription.

And then she raises her voice at you, her eyebrows furrowing in irritation. You sigh and take it, allowing her to use you to get her frustrations out. Because it was your fault that her doctor didn’t send over her medications, right? 

Sam watches you grow almost bored at the interaction. You even play with the ends of your curly hair and push up your glasses, and he can tell you’re raring to roar back at her for raising her voice at you.

“Ma’am, I’m going to have to stop you right there. I can contact your doctor for you about the script, but I can’t fill something that I don’t physically have,” You say calmly, but Bucky and Sam can hear the venom on the tip of your tongue, “I would appreciate it if you didn’t raise your voice like that in my pharmacy.”

The woman sputters at you, as if you would dare to challenge her. She walks away, but not before timidly thanking you for contacting her doctor for her. You stop yourself from rolling your eyes as she walks away. 

“Hey, how can I help you today?” You turn the charm back on and give the two men in front of you a wide smile. As if you hadn’t been thinking of twenty different ways you could feign sickness and close the pharmacy early for the day not even ten seconds ago.

You feel your stomach drop to your feet when you realize that Bucky Barnes and Sam Wilson are standing in front of you, with grins on their faces. You’re certain you look like a fish out of water, with your wide eyes and mouth opening and closing without any words coming out.

“What happened to the woman who told that lady off not even five minutes ago?” Bucky smirks at you while glancing at Sam.

“Yeah, cat got your tongue?” Sam teases. 

“Well,” You manage to say, “It’s not everyday I’m in the presence of greatness.”

You ask them to verify their birthdates before retrieving their prescriptions and try to keep your hands from shaking as you ring them up. You’re certain you’re drooling every time your eyes meet Sam’s eyes. He even winks at you when he notices your staring and you don’t bother to look away. Sam doesn’t miss you push back a stray curl behind your ear, or the way your lips curl up into a smile, or the way your eyes light up at him. 

Bucky stares at the interaction between the two of you and feels like he’s watching a moment that maybe he shouldn’t be watching.

“That was the most flirting I’ve ever seen between two people who hardly exchanged fifteen words,” Bucky informs Sam once they leave and are in his car. 

Sam pushes his shoulder and tells him to shut the fuck up before he shoves him out of the car and Bucky rolls his eyes.

Sam and Bucky start to become regulars at your pharmacy after that. You wonder why they venture all the way from Manhattan to Brooklyn, when there are dozens of pharmacies around the Avengers tower. You realize that they don’t all live at the Tower when you verify their prescriptions- Steve and Bucky live together in Brooklyn and Sam lives not too far from them.

You try not to feel too much like a stalker, but hey, it’s your job right? To make sure that your patients lived where they said they lived?

You’ve even met Steve. He was just as polite as you thought he would be, with a slight flair for sarcasm. You’re surprised by how quickly these three boys have wormed their way into your life in such a short amount of time. Despite your quick 5 minute interactions, you look forward to the next time you’ll be able to see them.

Your technicians are equally as starstruck as you were when you first met them when you told them to ring them up on a particularly busy day.

Bucky noticed Sam’s pouting that day. He wouldn’t shut up about how pretty he thought you looked, with your curly, black hair tied up and strands of it falling into your face, with your white coat and your quiet confidence. He wouldn’t shut up about how he wanted to talk to you, just to even say Hi.

“You just want to make eyes at her,” Bucky says in a sing-song voice later that day, “And you wanna love on her- you wanna take her out on dates, take her home, you wanna-”

“Dude, are you serious? Are you fuckin’ eight years old?” Sam rolls his eyes at Bucky and punches his shoulder, “Tin man thinks he’s got jokes, huh?”

“I’ve got more than just jokes, pal-”

Sam lets him punch his shoulder back and he thinks to himself well, he’s not wrong.

Robberies in pharmacies, especially in the city were pretty common. It had never happened to you, so you hadn’t really thought about what you’d do in the event of one. You had heard from friends and colleagues that people would come in and demand all the cash and all the oxycodone/hydrocodone/Adderall/Vyvanse/anything that could be sold on streets for a profit basically. 

You should have probably prepared for this, you think mildly, as the man in front of you at the counter demands for all the cash while waving a handgun in your face. He is demanding for all the oxycodone, Adderall, Fentanyl, and Vyvanse in your safe. You barely even register the thundering in your ears or the shaking of your hands. 

You had stupidly told your technician to go home early for the night, since it was a Friday night and Fridays weren’t usually that busy. You couldn’t even give a silent signal to let your technician know to call 911. You wished you had gotten that emergency button installed beneath the counter that would automatically dial 911 for you, rather than having to use your phone. Another stupid move on your part.

Your hands are up in surrender, ready to comply. But then you think, who the hell does this guy think he is?

Another stupid move.

“What could you possibly need all that for?” You can’t stop your voice or your lips from moving. You’re terrified and yet it seemed that you didn’t know how to act. He looks momentarily surprised at you. You’re glad that nobody else is in the pharmacy- it’s just you and the front employees who you’re not sure know what’s going on.

You could scream, you think. You could scream and you’d probably be shot in the face. You could try dialing 911 but then you’d still probably be shot in the face.

So the obvious solution is to be a sarcastic little shit. Until you got shot in the face.

“Are you stupid? You stupid fuckin’ bitch-” 

“Alright, relax. There’s no need for names,” You say, gulping. Maybe you should stop being reckless and just acquiesce to his demands. You make your way over to the safe where all the pain medications, Adderall, and Vyvanse are stored.

Sam can smell the tension and he knows something is wrong when the store is eerily quiet. Goosebumps raise on his flesh unwillingly as he makes his way to the back, where he knows he’ll see your smiling face and your dimples.

He’s come alone this time and he came near closing time because he wanted to talk to you. Maybe even charm his way into getting your number. He doesn’t actually need anything, although he told Steve that he would pick up some Claritin since his allergies were picking up despite his super soldier serum. Old habits never really died, he supposed.

A frown his on his lips when he sees this man waving a gun in front of your face. And you’re mouthing off at him, as if his threats don’t scare you. As if you’re made of steel. But Sam sees your hands shaking and your eyes darting around for someway to get help. Your eyes meet his and you struggle to hide your surprise, but you manage to do it anyway.

Tension begins to leave your body when you realize that of course, Sam is here to save the day. His warm, brown eyes make you want to trust him, and you do. You did, almost instantly the first day you met him. You can’t thank his impeccable timing enough and you watch Sam disarm the guy from behind him. He didn’t even see it coming and within seconds, Sam has the handgun in his own hands and the man is on the floor.

All Sam wants to do is beat him to a pulp for threatening you, for waving a fuckin’ gun in your face. But he watches you, standing there warily. You lock up the pharmacy and dial 911 to let them know what has just happened.

You make your way to Sam and don’t realize that you’re shivering. The man is staring at the pair of you with such contempt in his face. It’s weird to you, that you’re staring the man who threatened to shoot you in the face right in the eyes, but here you were. 

When the cops arrive at the pharmacy to collect the stranger, you’re left alone with Sam.

“Hey,” You murmur to Sam, “Thanks. For being a hero and shit.”

“Can this hero have your number?” He waggles his eyebrows and you can’t help the grin that breaks out on your face.

“I suppose my knight in shining armor can have my number,” You agree and press a soft kiss to his cheek. 

“Walk me to my car?” You ask, leaving his embrace to gather your coat and purse.

This time, he’s the one who’s a little starstruck when you grasp his arm as he walks you to your car.

[not-just-any-fangirl]

Flirting With Disaster

A/N: Happy Birthday to @constellunaa! I saw your beautiful drawing of Laxus and Cobra and thought ‘hey what if she actually ships it?’ and then wrote 6.5K of it in hopes that you actually do lmao.

If not, have some hint of nalu bcus I am so sorry

Part of my deaf!Natsu college au bcus I’m a slut for continuing universes! Also shout out to @papalogia for putting up with me yelling about this and for helping with some of the words. Natsu and Cobra are cousins, with Indian!Igneel and his unnamed brother who is Cobra’s dad. 

Also praise @rivendell101 for helping me title it! Apparently I’m useless without my friends :D

College!AU

Pairing: Cobraxus, Nalu, Fairy tail

Words: 6515

Rating: M for language

Part: Oneshot

Laxus wanted to die, and not just because of his pounding headache or the fact that he was in an eight AM lab for fucking chemistry of all things. No, Laxus wanted the sweet embrace of death -or maybe to plead for manslaughter on account of insanity- because of his benchmate.

“Could you please make your stomach make disgusting noises quieter? I’m trying to measure out our chemicals, considering you’re going to be useless today.”

Laxus narrowed his eyes at his labmate, thinking of other uses for the sodium hydroxide solution that was being poured from the erlenmeyer flask to a petri dish.

“Stop looking at me like it’s my fault you decided to do jagerbombs instead of sleeping like a normal human being with an eight AM.”

Laxus scowled. The dude wasn’t even able to see his face, eye on Laxus’ side closed from a nasty looking scar. Laxus felt his own scar over his right eye twinge in sympathy, line thinner than the other boy’s. “How’d you know what I was drinking?” he asked, tongue fuzzy and thick in his mouth and voice rough with disuse. He sounded like his dad, and Laxus wished for another double jager to push back that unwelcome comparison.

“Because you reek of licorice, red bull, and regret.”

Laxus snorted, grinning as he scrawled down the fourth trial’s measurement in his lab notes. “I showered.”

“Don’t feel bad,” the boy drawled, sealing the vacuum box the petri dish now resided in before they turned on the chlorine gas, “it’s a stench that permeates engineering students.”

Laxus frowned, wanting to bite back against the generalization of his major, but flashbacks to the group of twenty somethings doing keg stands and flip cup after their last electrical midterm stopped him. His labmate wasn’t exactly wrong.

But his class had fucking earned going a little wild, especially after the hell that was the four hour midterm of Jose’s quantum nuclear midterm. Laxus was pretty sure that time length wasn’t even allowed by the school board, but seeing as how his grandfather was at a bit of a cold war with the dean, Laxus wasn’t about to say shit.

“Well I’m sure you biology kids know all about the danger of popping illegal prescription pills, don’t you?” he snarked. He had yet to meet one that wasn’t permanently shaking from a near overdose of Adderall, struggling to stay awake to finish making their four hundredth flash card.

“I'm not a biology major,” he said flicking on the highly poisonous gas with the most uncaring expression Laxus has seen on something besides his mirror.

Laxus eyed him critically. “Only biology majors are actually interested in chemistry labs,” he said finally, watching the plastic cube in front of him as the gas reacted with the solution.

“What about chem students?” he asked flatly, switching off the gas lever after the thirty seconds had passed on the stopwatch.

“Those freaks can do this shit in their sleep and try to go and set shit on fire under the fume hoods.” Laxus said just as flatly as his lab partner, focusing on writing down the chemical equations involved in their experiment. “If you aren’t biology then why the hell are you in this lab then?” Laxus asked. He knew why he was there, stupid requirement for his degree saying he need at least a 200 level in each of physics, chem, and bio. Not that Laxus fucking understood why he needed to know how bases and ions reacted to make deadly gases, considering he was going to be an electrical engineer.

Fucking reqs.

The student gave a long suffering sigh, turning his face so Laxus could see his withering look, red-so-dark-it-was-almost-brown hair falling in his face and styled on the sides and back, chin and cheekbones sharp. HIs tan skin was smooth, Laxus fairly certain it was because he could only make two facial expression: blank apathy or an unimpressed sneer. “I’m a toxicology major,” he said, opting for the latter of his whole range of two emotions.

“What the shit is that?” Laxus asked, barking out a laugh before writing the final time when salt crystals stopped forming in their solution.

“It is what it sounds like it would be,” the darker hair boy hissed, opening the cube and retrieving the crystallized solution so they could separate the salt and the bleach.

“It sounds fake,” Laxus snorted, adding a fourth row in the weight of the crystals and the PH of the solution. He must still be drunk to be egging on someone he didn't know, but Laxus really didn't give all that much of a fuck.

“And you still sound drunk,” the boy said coolly. He held out the filtered vial of lab-made bleach. “Here, drink this and it'll disinfect your stomach.”

Laxus blinked at the clear liquid behind the glass before barking a short laugh. “Alright, what's your name for the report.” Lab or human resources to be determined by if his bench mate slipped the chemical into his coffee thermos.

“Cobra,” the boy said, grin sharp in victory at Laxus’ startled expression. “It's similar to my major, don't you think?”

“Still don't know what the fuck toxicology is,” Laxus shrugged, recovering quickly. His cousin’s boyfriend’s name was Natsu and one of her best friend’s Gajeel. At least Cobra was a thing that existed and not a fucking season.

Laxus wrote down the name, frowning at the spot ‘ Freed ’ usually went. His best friend -and ex-boyfriend- unusually absent. Laxus had found out when he sat down from a text from Ever that he was delirious with a fever and needed to be restrained so he couldn't spread it to the rest of the university in his attempt to not miss class. Hence how a late Laxus had ended up with the possible-psychopath as a lab partner.

“It's the study of toxins and poisons you dumbass,” Cobra said flatly. He huffed in irritation before prattling off the volume of the fifth sample of sodium hydroxide. “How did you even pass Biology Two-hundred if you couldn't put together ‘tox-’ and ‘-cology’?”

“By studying for twelve hours and then forgetting everything about that bullshit course.” Laxus said back, defensive. He'd worked hard for that A in the course, and was proud of it.

“Only idiots forget what they've learned,” Cobra hummed, face once more a mix of cocky and blank. How he managed to look bored and superior at the same time was starting to grate on Laxus’ last nerve, though he knew he was one more incident away from academic suspension.

Laxus could really use that shot right now.

At least this was the last trial they needed before he could fuck off and never worry about dealing with Cobra again.

Laxus looked over, taking in an appreciative view. Laxus may be stoic and rough around the edges but he wasn't blind. Cobra was hot , with rich brown skin and spiky hair and two bars in his right ear. His personality might have been garbage, but that'd never stopped Laxus from being able to appreciate someone's aesthetic.

“Take a picture, it'll last longer,” Cobra said, corner of his mouth twitching at his own joke. Laxus remained unfazed, expecting to be caught and uncaring.

“How'd you get your scar?”

“How'd you get yours?” Cobra sneered, flicking on the gas switch and recording the pressure and flow rate of the gas as shown on the display connected to the nozzle.

“Fair,” Laxus hummed. “What's your number?”

“What the fuck? ” Cobra spat, eye large as he whipped his head to look at Laxus. He thought the boy's cheeks might have been a little darker, but he couldn't really tell. The thought made him preen in victory though, that he had gotten the upper hand.

“For the lab report? In case our data doesn't line up?”

Cobra grunted, looking back at the chamber as the reaction took place. “Whatever.”

Laxus blinked when at the end of the lab there was a torn off corner of paper shoved in his notebook, ten digits scrawled across it in sharp handwriting. He shook his head with a rueful smile, typing in the numbers to his contacts under the name ‘Snake Boi’.

Why was everyone he interacted with so fucking weird.

Laxus woke up, sitting straight up in his small single bed that came with his dorm room, staring unseeing into the dark.

“I fucking hit on him.” Laxus whispered to himself.

And Cobra gave him his number .

He jerked the cord from his phone where it had been charging on his bed side table, barely registering the time of 3:47 fucking AM as he blinds himself with the full brightness. Cursing, Laxus adjusted the screen to barely painful before typing a message to Freed. Laxus was smart with books, but interactions with other human beings was a thing Laxus liked to avoid at the best of times. And now he was texting his ex about the possibility of him hitting on some random dude. And succeeding.

Me - 3:47 AM: So uh I asked a guy for his number for a lab cus you have the fucking plague and looking back i think i flirted with him and i think i hit on him and now i have his number uhhhh what the actual fuck is this?? Was I actually hitting on him?? Did he hit back??

Me - 3:48 AM: is hit back the right term?

Me - 3:48 AM: I don’t think it is but I’m going to use it anyway bc fuck english

Laxus flopped back on his pillow, rubbing his scar. Fucking emotions. Did Laxus even want to have been hitting on Cobra? He thought about his fuller bottom lip and the twinkle of mischief in his eye when he was telling Laxus to drink bleach and the way his cologne smelt like the riverside and musk and his stupidly spiky hair that Laxus wanted to fuck up just to see that small fire light his dark eye.

Ah fuck, Laxus wanted to hit on him.

His phone buzzed in his hand, and Laxus blinked in surprise at Freed still being awake. Or maybe he had woken him up. Either way, Laxus wasn’t about to complain about getting some damned advice.

Freed (Sword Emoji) - 3:50 AM: Yes, babe. You were hitting on him. It’s okay, it took you four dates to realize we were dating.

Freed (Sword Emoji) - 3:51 AM: Two weeks to realize we broke up.

Me - 3:52 AM: I’m beginning to realize why you wanted couples therapy

Freed (Sword Emoji) - 3:55 AM: It’s okay babe, I still love you. Now go get laid please, you’re insufferable when horny and have a crush.

Laxus snorted. He wasn’t insufferable , if anyone was insufferable in their group it was Ever and at all times. Insufferable. Ha.

Wait.

Did Freed mean right now? Wouldn’t that be uncouth, as Freed would put it? Did he want a booty call? Or did Laxus want more? Laxus didn’t know what the fuck he wanted to eat most of the time how in all holy hell was he supposed to work out stupid things like feelings .

Ugh.

Me - 4:00 AM: Like... now? Cause its 4 am and idk if hes up. I mean, hes a fucking chem/posion/fuck knows major so probs but wouldn’t it be rude? To start a date with a booty call? I feel like asking for sex this early would be rude

Me - 4:00 AM: both time of day and in regards to a possible relationship

Laxus stared up at his ceiling, eyes barely able to make out the rock poster above his head from the brightness of staring at his phone screen. Him and Bixlow were supposed to be going to the Thunder Claps next saturday and Laxus was looking forward to getting stoned and zoning out to some good rock EDM for a couple hours with one of his best friends so-fucking-much. He startled out of his thoughts at the dark phone buzzing on his chest, screen lighting up with Freed’s text.

Freed (Sword Emoji) - 4:05 AM: I love you, but how you manage to keep your stupidity secret from everyone we know I’ll never comprehend.

Freed (Sword Emoji) - 4:06 AM: No do not text him for a booty call at four am.

Freed (Sword Emoji) - 4:06 AM: You animal.

Me - 4:09 AM: Ohhh, like later today okay i get you

Laxus rolls over, groaning into his pillow. He turned his head, typing another message.

Me - 4:13 AM: Can’t we just date again that was a good thing

Freed (Sword Emoji) - 4:07 AM: No darling. We tried that before and while the sex was amazing you were frankly a horrible boyfriend. But you have grown and I have full confidence in you not fucking this new one up horribly.

Laxus grinned at his phone, rolling his eyes before typing out a quick ‘gee thanks’ and clicking off his phone.

Ah fuck what the shit was he going to say to Cobra?

Laxus adjusted the strap on his shoulder as he exited the math building, three stories tall and made entirely of brick that was probably twenty years old when it was built fifty years ago. He groaned as he rubbed his neck, thankful that he was finally done his last class of the day. How Natsu had gotten into his fourth year electrical physics course Laxus had absolutely no fucking clue, and how that fuckhead had gotten a better grade than him on the last assignment was even more astounding.

Thinking of annoying chemistry majors, Laxus’s pocket burned where his phone rested and the uncontacted number that Laxus felt judging him. He could actually hear Cobra’s snarky voice calling him a pussy in his head, scowling as he continued to walk along the cracked sidewalk.

“Angel I swear to every fucking god in existence if you tell anyone -”

Oh shit, Laxus was really hearing Cobra’s voice.

He looked up, spotting Cobra standing beside a bust of some old dead dude that had helped found math or whatever, a pretty woman with long silver hair pinching his cheek with an almost cruel smile. “That our little snakey has a crush ?” she sang. Cobra’s shoulders tensed, and Laxus leaned against the bust five feet away, curious to see where the fuck this was going to go.

“I talked to the bastard once ,” Cobra snapped, swatting away Angel’s hand. The girl smirked as if Cobra had just told a joke, twirling a piece of hair between her fingers.

“Uh huh, and that’s why you’ve kept your hand on your phone all day. ‘Cus you two ‘talked’ once.” Cobra sputtered, Laxus watching the side of his face twist in a flustered sneer. “Tell me, was he tall and muscular? You always were too easy for the masc types.”

Laxus snorted, covering it with a cough but too late not to draw Angel’s attention, and by extension, Cobra’s. The girl’s face lit up like it was fucking Christmas and Cobra looked like he wished he still had that bleach.

“Awwww you two match face scars!” she cooed, clapping her hands together once in excitement.

“You say another word and I’ll put Kerberos in your fucking bed.”

Angel pouted at Cobra before huffing and flipping her hair over her shoulder. “Whatever, spoil my fun as usual, Erik ,” Cobra -or should Laxus say Erik?- glared at her sharply but Angel carried on, paying his threat display absolutely no attention, “I’m off to make sure Midnight didn’t die in their sleep in whatever nook they’ve found now.”

Laxus returned her small nod as she passed, lifting an eyebrow at her sniff as she looked him over again. He thought it might have been a silent ‘my friend could do better than you’ and judging by the RBF she had Laxus was pretty sure he was right.

Cobra was silent as he glared at Laxus, a new expression painted on his face; pure and clear murder.

“I don’t know what fucking game you’re playing but I’m over it and-”

Laxus interrupted the rant Cobra was spitting at him, looking over his worn but polished combat boots and torn black jeans that were tight enough on his thighs to leave Laxus with no need to imagine how muscular he was, tight black tank top with a deep purple snake skull partially covered by leather jacket that had deep red accented strips of leather along the arms and two over the breasts, dark black studs on the shoulders and back of the arms from what Laxus could see, band patches thrown over the pockets and back as a visual record of all his concerts. Laxus finally eyed the thick black collar with large and shallow spikes on it before meeting Cobra’s pissed-off glare.

“I’m going to the Thunder Claps concert next weekend. Judging by the Poison Blood sticker you got on your ass there I’d say you’re in need of being taken to a concert with good music playing.”

Cobra choked on his words, staring at Laxus blankly before barking a sharp laugh. He drew his pointed gaze over Laxus’s own slides, ripped jeans, loose work out tank, and the large bright yellow headphones that hung around his neck.

“I highly doubt you’d be able to have any taste in music if you insist on dressing like a fucking gym rat, but I won’t turn down free shots and concert tickets,” Cobra smirked at him, grin sharp as he insulted him. Laxus grinned back. Flirting was fun when you got to rip into the person.

“Who said I’d pay for your drinks?”

“The way you can’t take your perverted eyes off me would be a damned good hint that all I have to do is touch your dick and have you wrapped around my little finger.”

“Aw, that’s not a very nice thing to call your dick. I’m sure it’s at least three inches.”

Cobra sneered at him, stepping closer as fire danced in his eye, obviously delighted at the challenge. “Two inches longer than yours.”

“You wanna find out or something? Laxus asked, tipping his head down as he towered over Cobra by a good four inches, stepping forward as well.

“You that desperate to get fucked?” he asked, meeting Laxus’ gaze and holding his own, unperturbed by Laxus’ height.

“ You that desperate to get your face pinned against a wall?”

“Wouldn’t you like to know,” Cobra smirked, thumbs hooked in his belt loops and leaning further into Laxus’ space, looking up at him through thick lashes and a promise of danger and battle of wills in his dark gaze.

“Yeah, I think I fucking would,” Laxus said, unashamed. His smirk widened when Cobra’s faltered and his cheeks got distinctly darker as he blinked up at Laxus, the blond man’s confidence sure enough at this point that he hooked his pointer through one of Cobra’s unfilled belt hoops and pulled his crotch closer so that it brushed against Laxus’. “Wha'dya say, Erik?” Laxus breathed against the shorter man’s lips, noses almost touching.

“Call me that again and I’ll strangle you in your sleep, shithead,” Cobra hissed, not pulling away from him as his eye darted to Laxus’ lips and then back up. Laxus swallowed roughly at the challenge that sparked in his sharp grin as he reached up with both hands and yanked on Laxus’ headphones so that their foreheads touched. “Now why don’t you show me your tiny ass dorm. I ain’t getting my sheets fucked up for a douchebag like you.”

“Ain’t you full of romance?” Laxus snorted, brushing his nose against Cobra’s and barely speaking above a whisper.

“One of us is about to be full of something and I was never big on the flowers and chocolates crap.” Cobra said back, chin tilting up slightly to brush his top lip against Laxus’ lower one.

“Good to know,” Laxus grinned, pulling back before he could actually kiss Cobra. He readjusted the strap on his shoulder again, nodding with his head in the direction of his dorm.

Cobra looked at him like he was a lab report that wasn’t making sense - a thing that Laxus interpreted as baffled and irritated and determined to understand- before nodding and walking towards where Laxus had nodded.They walked in silence, Laxus’ hand twitching each time he almost grazed Cobra’s. It felt wrong to just walk apart considering what they had planned, or at least insinuated, but Laxus had zero fucking clue how to make the first move. Especially because Cobra apparently wasn’t into that. The minutes passed awkwardly as Laxus considered just fucking texting Freed about what to do but also not thinking that texting his ex-boyfriend would be good hook up etiquette. Was this a hook up? Was this all that was? Cobra had said yes -kind of- to the concert and oh fuck Laxus had asked him out on a date without realizing it-

And Cobra said yes again.

They were halfway to his dorm, just passing the English building his cousin Lucy was probably still in working on her seventh draft of her creative writing piece, and her stupid boyfriend probably draped over her like a god damn blanket -how was that for romantic, as if Cobra would ever let Laxus do that to him- when Cobra moved and startled Laxus from his thoughts.

“You’re useless at shit like this aren’t you?” Cobra sighed. He kept looking ahead as he grabbed Laxus’ arm and slung it over his own shoulders. “I could basically hear you thinking about holding my hand. Better?”

Laxus swallowed thickly, grunting an affirmative as his face heated at being caught. He glared at a flock of geese under a tree to their right, channeling his anger into the birds resting in the shade on the warm fall afternoon.

What the fuck had Laxus’ gotten himself into?

“What do you mean you haven’t kissed besides when you fuck ?” Lucy gaped at him, dumbfounded as she gathered her own nine dollar strawberry cooler and Natsu’s four dollar beer, Laxus both thankful and irritated that he had run into his cousin and her dumbass boyfriend at the concert. Bixlow hadn’t been the happiest to give up his ticket, but had been placated by Freed reading aloud first Laxus’ panicked four AM text messages and then his even more panicked nine PM text messages about having just gotten laid before going on an actual date.

Fuck, all of his friends were massive dicks. No wonder he was dating Cobra.

Well, kind of dating Cobra.

“Listen I don’t need to be lectured about relationships by someone who brought their deaf   boyfriend to a fucking concert.” Laxus frowned, careful of the shitty vender beer cups so that he wouldn’t crush them by accident in his annoyance.

“One,” Lucy huffed, half running to keep up with him through the crowd, “ Natsu dragged me here. He likes to be part of the chaos of the crowd and to feel the bass bump through him or whatever. And two, we are still on the topic of you and your inability to have a relationship like a normal human being.”

Laxus rolled his eyes as they walked to where Natsu and Cobra were standing by one of the entrances into the stadium, hands moving quickly and in agitation as they signed to one another.

Laxus couldn’t fucking believe that Lucy was dating his maybe-boyfriend’s cousin.

“You fucking dick, you know I can’t understand ISL!” Natsu roared, throwing his hands above his head, voice loud enough to draw passing glances from a few people entering the large arena.

“Not my fault you don’t know your own heritage,” Cobra sneered, following it with something that Laxus could extrapolate was an insult by the sneer of his lips despite not understanding the other language. “ Ullu de pathe.”

“I can read Hindi on lips,” Natsu hissed. Lucy smiled as she moved the beer in front of his face, Natsu blinking at the sudden liquid blocking his view of Cobra. He smiled down at her, lip ring shifting as it was pulled. Lucy signed a quick hello, her hand flat as she did something that Laxus thought looked like a short and relaxed salute, quickly dropping her hand with her pointer and middle finger intended in a weird peace sign and flicking her lower lip with her middle finger twice.

Natsu grinned and rolled his eyes, Laxus lost at what the gesture meant. He had managed to learn a few swears and the alphabet, but otherwise relied on Natsu’s ability to read lips and speak when interacting with him. He’d offered to take better notes for Natsu in their class, but the stubborn bastard had refused and instead relied on a voice to text app on his phone as he took his own notes from the board.

Cobra signed something, the only sign Laxus caught making him grin at the end; Cobra flicking his hand from under his chin and out with his palm facing towards himself.

“I ain’t a bitch you fucking emo furry.” Natsu spat.

“Just because I respect and collect snakes doesn’t mean I want to fuck them,” Cobra snarled, “and at least I’m passionate about animals that actually exist, dragon boy .” Cobra held his hand so his fingers were splayed, wiggling the three middle fingers as he moved it from his chin outwards, palm facing down this time. “I don’t even know how we’re related, even your fucking hair is off brand! What kinda genetic fuck-up gets pink hair?”

“I like his hair,” Lucy defended. Laxus groaned loudly, throwing his arm around Cobra’s shoulders.

“We're gonna go somewhere else now,” Laxus said to Lucy, nodding at Natsu as he led Cobra away from his own cousin. They moved through the crowd, Cobra fitting nicely under Laxus’ arm as they walked. They entered the stadium, filing their way to the ground level where they would be standing for the show, Laxus letting Cobra stew as he learned the other man liked to do.

“That useless little jackass follows me everywhere,” Cobra hissed. Laxus looked at him from the corner of his eye, debating if he wanted to get into family dynamics right now. Considering how Natsu was more likely to become family than Cobra though...

Laxus swore internally before speaking against his better judgement.

“Technically they decided to come here before you,” Laxus said, not looking at Cobra. He felt him stiffen under his arm, but didn’t pull away.

“Whatever,” Cobra spat, taking a long sip of his beer. Laxus grunted, content with listening to the crowd around them mill between one of the opening acts and Thunder Claps. Two girls were standing by them, talking loudly with flower crowns in their hair and neon bras under white netted tops, one tucked into her short jean shorts and the other hanging down to her mid thigh and touching the top of her thin stockings, her own shorts barely visible under the netted fabric.

Laxus didn’t think he’d have noticed if it weren’t for Cobra tensing again under his arm and leading them away from the girls.

“I know you’re a big fan of my dick but I didn’t peg ya as needing to avoid an entire gender.” Laxus commented, taking a sip of his own drink as he waited for Cobra to speak.

“Their voices were irritating me,” Cobra said flatly, lips turned down slightly in his neutral expression. Normally when Laxus wore that look as his own neutral expression people said he looked liked he was plotting murder, when in reality he just thinking of dumb shit. Laxus was pretty sure Cobra was definitely plotting to murder someone, though. Laxus thought there might have been more to it than what Cobra was telling him but decided to drop it. Freed had been very adamant about not pissing off his date when at a social event.

Cobra took out his phone as Laxus glared at a boy that was staring a little too intently at Cobra’s biceps, revealed by his ripped sleeve tank top. The boy scurried off as Cobra slipped his phone back into the back pocket of his tight jeans. Jeans that Laxus knew for a fact Cobra was wearing because he was aware how tight they were on his ass and Laxus’ appreciation of it.

“Natsu and Lucy will down here in a second and if you say anything about it I will bite your dick off tonight.”

Laxus blinked once before nodding. He pulled Cobra closer to him when the other man downed his drink in a way that the other engineering students would cheer on, and made Laxus respect him just a little bit more.

Natsu and Lucy appeared again like Cobra said, Natsu sending a wary glance at Cobra before smiling brightly. Laxus huffed and sipped his beer as he scanned the crowd again. Natsu didn’t have a fucking single grudge-holding bone in his body when it came to abuse against himself. Laxus also wondered how the pink-haired pyro freak and Cobra were related, though for different reasons.

Laxus noticed Lucy lean towards him and Cobra, Natsu’s attention on the stage as the stagehands brought out the equipment and instruments for Thunder Claps. “If you do anything to ruin this concert for Natsu I will find out where you live and do something so horrible and scarring you’ll never be able to sleep again.” Lucy said sweetly, not bothering to lower her voice as the back of her head was to Natsu. She smiled once, lips pulled up sharply and eyes cold enough to make Laxus’ heart skip a beat like the time he thought he had missed a final. He took another sip of his drink, already half done but choosing to pretend he hadn’t just witnessed his cousin promising to maim another student in a huge crowd. His one law course taught him nothing if not plausible deniability.

He snuck a glance at Cobra’s face, somehow surprised and not at the bright grin pulling up one corner of his mouth.

“I like her.” Cobra said, looking around the crowd as well. Laxus shook his head, offering the rest of his beer to Cobra. “Well isn’t someone trying to get me drunk.”

“You’re much easier to top when you’re already a little fucked up,” Laxus grinned down at him. Cobra snorted, drinking Laxus’ beer and twisting his lips into a sneer, retort lost in his disgust.

“Thought an alcoholic like you would at least know how to drink good beer,” Cobra drawled.

“If you don’t like it I’ll definitely be needing it to deal with you all night,” Laxus said, raising an eyebrow at Cobra. He rolled his eye, taking another large sip with a grimace.

“I’m a fucking delight.”

Laxus snorted loudly, grinning at Cobra’s flat glare.

The crowd began cheering as people in ripped jeans and wearing over a dozen glow stick pieces of jewelry began filing onto the stage, the lights dimming and the crowd enveloping them so there was no place that Laxus wasn’t being touched by slightly sweaty and glitter covered bodies. Cobra glared, hiding deeper under Laxus’ arm and away from the chance of anything too sparkly and happy touching him. “Why’d you agree if concerts ain’t your thing?” Laxus purred, leaning down so his lips brushed his ear.

“I like concerts ,” Cobra hissed back, turning his head so his lips almost brushed Laxus’, “I don’t like raves.”

“This isn’t even close to rave. I’d be on way more drugs if this was a rave ,” Laxus murmured back, distracted by Lucy’s lecture in the back of his head about normal relationships. Heat from where Cobra was pressed against his side and under his arm scorched him, Laxus’ brain focusing on Cobra’s lips and how the top one was thinner than the bottom, a slight dimple under the left corner of his lip where a lip piercing might have once been. Laxus’ throat grew dry at the thought of seeing the silver against his warm-toned skin.

Laxus lifted his gaze to meet Cobra’s, a dark, unreadable expression piercing him.

“Maybe you just wanted to be here with me,” he said, leaning forward slightly so his nose brushed Cobra’s. A slight grin lifted the corner of Cobra’s mouth, a mocking glint flashing in his eye that made Laxus smirk in turn. Whatever Cobra was about to say was lost as the DJ of the band made the bass drop and the crowd went wild, jumping and thrumming around them. Cobra got jostled, shoving him towards Laxus, his forehead pressing into his lips. Laxus glared at the clearly drunk girl who had shoved Cobra and ruined whatever the fuck Laxus had been trying to do.

Laxus grinned when he heard Cobra swear under his breath, pleased that he wasn’t happy about it either. Deciding that a EDM concert probably wasn’t the best place to figure out what the shit was going on between them, Laxus turned his attention to the stage and lost himself in the performance. He sang along with the next few songs, moving with the crowd, bouncing on the balls of his feet and losing himself to the pounding that resonated with his bones and overrode his own heartbeat in his blood.

Cobra shifted slightly in front of him when Lucy and Natsu got crushed to his side, rolling his eye less sarcastically than Laxus expected at Lucy’s mouthed apology. Laxus grinned at the opportunity to both touch and embarrass him, grabbing his hips and pulling him against Laxus’ chest, dancing behind him as one song bled into another, the crowd going wild at the new mix.

Cobra stilled at first, looking over his shoulder with a sharp glare that made Laxus’ smirk grow larger as he rolled his hips against Cobra’s ass. His cheeks looked darker when a strobe light rolled over his face, bathing him in purple light and a voice in the back of Laxus’ mind compared him to what a god of contempt and poison might look like. Thoughts of how fucking whipped he was were forced out of his mind as Cobra gave him a dangerous smile before turning his head back to the stage and crushing his ass into Laxus with a lewd and rough roll. Laxus cursed through a grin, fingers digging into Cobra’s hips, thumbs slipping under the hem of his shirt and moving over the taut skin of his hip bones and stomach.

More songs passed like that, Cobra and Laxus working up a heavy sweat grinding and rutting against one another in the sweltering heat created by a crowd full of young adults doing the same. Laxus pointedly ignored his baby cousin going even harder against Natsu than Cobra was to him, Natsu’s sweaty forehead connected to her jaw as he sucked at her neck, one hand flat on her stomach as he guided her in deep rolls against him in what Laxus was almost disgusted to note was practiced movements.

He didn’t know how well Natsu would understand a ‘touch her and I’ll castrate you’ without being able to hear Laxus’ tone but he was hoping he’d be able to convey the right amount of ‘I could kill you with you hand’ in his eyes when he cornered the pink haired brat after the show.

He was thankful to see Lucy stop trying to ride Natsu’s dick through their clothes, shrieking with joy when Natsu stooped low and put her on his shoulders. She gripped his hair as he stood again, bare thighs clenching around his head and his own hands gripping into her pale skin tightly. Laxus was stopped from straight up decking Natsu for putting his face so close to parts of Lucy Laxus would rather fucking claw his eyes out with a rusty spoon than think about when he noticed Natsu looking up at Lucy. His eyes were soft, fondness almost palpable in an aura around them as they met each other's gazes. Lucy beamed as she smiled down at him, braid messed and slung over one shoulder and glitter paint smeared over her cheek and bare shoulders. Natsu’s smile was lopsided, the couple completely separated from the music and crowd around them as Lucy leaned down, sealing her lips against his sweetly. She pulled back slightly, giggling as Natsu rubbed his nose along hers and they got lost in each others eyes again.

Laxus let his gaze drift to Cobra, an unfamiliar ache in his chest making him frown at the spiked hair in front of him.

“Put me on your shoulders and I’ll create a mosh pit,” Cobra said, serious and flat as he looked over his shoulder at Laxus again. The blond smirked, nodding and forcing his attention back on the stage. He frowned down at Cobra when he stopped dancing against him. He cocked his head at Cobra’s searching scowl, unsure of what was going through his head. "Fuck it,” he grunted, confusion making Laxus knit his eyebrows at Cobra’s low grunt. He froze for a second, Cobra twisting fully in his arms and threading his fingers into the short hairs at the base of Laxus’ neck. He grunted as Cobra slammed his mouth to his, rough and a little awkward as he leaned up into Laxus.

The music dulled in his ears, arms winding around Cobra and pulling him flush against his chest. Their lips slated against one another's easily as the kiss drew on, Cobra’s short nails digging greedily into the back of Laxus’ neck and fisting at his short hair. Laxus nipped at Cobra’s lower lip, opening his mouth at Cobra’s demanding swipe of his tongue along Laxus’ lips.

His hand dropped to push into the back pocket of Cobra’s jeans, squeezing harshly and pulling his body flush to Laxus’ again. Cobra broke the kiss, grinning up at him hungrily and with lewd joy dancing in his eye. Laxus squeezed again, returning the dark smirk. Cobra chuckled under his breath before kissing Laxus softly once, returning to demanding and impatient kisses as if to cover up the almost tender action. Neither said anything, resuming dancing and losing themselves in the atmosphere of the show and trying to one-up one another.

Laxus figured Cobra liked having a boyfriend that wasn’t afraid of a little friendly competition.

His hand released Laxus’ hair, sliding between their bodies and roughly groping at the front of Laxus’ pants. Cobra smirked against his mouth when he grunted at the unexpected touch. His self-pleased grin fell when Laxus pulled his hand from Cobra’s pocket and instead ran along the center seam of his jeans, fingers pressing firmly and rubbing at him there. Laxus looked at Cobra through his lashes, pleased to see Cobra’s deep scowl and to feel his face warm in the lack of space between them.

Okay, so maybe a little less-than-friendly competition.

Not that Laxus was complaining.

[paleorecipecookbook]

RHR: A Three-Step Plan to Fix Conventional Healthcare

In this episode we discuss:

The patient case that inspired the book

Who is this book for?

The mismatch between our medical paradigm and chronic disease

Drug companies and conflicts of interest

How clinicians can help create a new paradigm

The three core problems and how to solve them

What this new paradigm looks like

How do we pay for this? Is it scalable?

How allied providers are the key

Show notes:

Unconventional Medicine by Chris Kresser

Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.

NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping

[smart_track_player url="http://ift.tt/2yiM0Yd" title="A Three-Step Plan to Fix Conventional Healthcare" artist="Chris Kresser" ]

Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.

The patient case that inspired the book

Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.

Is a new healthcare paradigm affordable? Scalable? You bet.

His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.

Who is this book for?

Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.

The mismatch between our medical paradigm and chronic disease

Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.

Drug companies and conflicts of interest

Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.

How clinicians can help create a new paradigm

Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.

The three core problems and how to solve them

To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.

What this new paradigm looks like

Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.

How do we pay for this? Is it scalable?

Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.

How allied providers are the key

Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody.

Source: http://chriskresser.com November 08, 2017 at 04:12PM

[just-jordie-things]

Relax My Beloved - Mickey Milkovich

MICKEY IS STRAIGHT IN THIS FIC JUST FYI

listen to the song here

Relax my beloved, don’t worry for me,

Don’t shed a tear for me always be near for me.

Be confident my love don’t bow your head for me,

Promise you’ll smile for me don’t ever cry for me.

You know these walls they may fall down,

But I’ll still hold on to you,

At heights higher than you’d imagine me too.

You groaned when the light woke you up, immediately pissed off for being awoken.  “Mick” You groaned.  “Would you turn off the light?” Someone chuckled from across the room.

“y/n that would be the fucking sun” You whined, and pushed your face into your pillow.  “Sunshine rise and shine, it’s time to get up” You groaned again, and squinted your eyes.  Mickey was readying your morning pills, and when you looked over your shoulder, Carl was up in his bed, maybe reading a comic book, maybe jerking off, and Liam was fast asleep in bed.

“Liam gets to sleep” You said, and Mickey gave you an eye roll.

“Tough shit, you have timed medications, now come on sit up” You were about to protest, but Mickey tugged you up to sit on the edge of the bed.  “Here’s the glass” He gave you the water, and then handed you a pill.  “Prozac” He said, and you swallowed it down.  “Adderall” He handed you another one, and you swallowed it too.  “Birth control” Mickey smiled as you took that one.  “And an ibuprofen because I know the birth control gives you headaches” You took the final pill and swallowed, and Mickey ruffled your hair.

“Thanks” You said, and stretched as you stood.  The tiredness that had once plagued your head beginning to fade away.  “Is anyone cooking?” You asked, pulling a pair of jeans on over your underwear, and keeping on the tee shirt you’d slept in.

“Yeah Lip’s makin pancakes or some shit” Mickey said, and you followed him out into the hall.

“Pancakes sounds good” You said, putting an arm up on his shoulder, and leaning against him.  Mickey looked over towards you, an arm coming around your lower back and tugging you closer.  “I don’t remember last time I had-”

“I love you” You paused, turning to be standing in front of him.  You stared at him, licking your parted lips in surprise.  He’d never said that to you before. And you were almost convinced that he was just saying it to mess with you.  “Alright, don’t fuckin’ say it back, not like I waited all morning for ya” You smiled slightly, shaking your head and splaying your hands on either side of his face.

“I love you too you fuckin’ idiot” You said, and brought your lips up to his in a sweet kiss.  Mickey wound his arms around your waist, holding you there against him in the middle of the hall on a Saturday morning

Be still my heart, I’m only a moment away,

In the next room or at the break of day.

And I would walk, once again to see your face again,

And I’d hear every word you’d have to say.

“Well then we go get her outta there!” Mickey exclaimed, throwing his arms in the air. The shotgun in his hand still loaded, and seemed to be glued to his palm.

“Let’s shoot some fuckin’ cops” Carl grinned sickeningly.

“If that’s what it takes” Mickey said, pointing at the fourteen year old.

“No- Carl, bed!” Fiona ordered.  “Mickey, put the goddamn gun down before ya shoot somebody.

“We’re not gonna get anywhere if we shoot people” Ian sighed.

“We’re not gonna get anywhere in life if y/n’s not here!” Lip retorted.

“Okay and what’s gonna happen? We go to the fuckin’ looney bin to get her and just shoot a bunch of people!? How’s that helpful in any fuckin’ way!?” Ian yelled, and soon the brothers were pushing at each other.

“Would you just- would everyone-”

“Let me just say,” Sammy cut off Fiona.  “That I think we’re doing much better with her gone.  I really do believe that I do”

In seconds Mickey had the blonde woman shoved against the wall, his gun pressed to her head.

“Mickey!”

“You want her to fucking die in there!? ‘Cause she will!” Lip shouted in the background.

“And killing innocent therapists is gonna help her!?”

“Might I say something-”

“NO!” Everyone yelled at Frank, and it went quiet for a moment, everyone catching their breaths.  Fiona was nearly in tears, as was Mickey but he tried his best not to show it.  He slowly let Sammy go, and she stormed out of the house.

“Good riddance” He muttered.

“Fifi?” Their heads all turned to where a little Liam and footie pajamas was standing in the doorway of the kitchen, and reality sunk in.

Ian and Lip pulled away from each other, Fiona lowered to the ground as Liam waddled in, Frank took his beer to another room, and Mickey tucked his gun into the back of his jeans.

“y/n?” Liam asked Fiona and the woman hugged him, finally breaking down into cries as she held onto the boy.

“She’s in a hospital” She answered honestly.

“Hurt?” Fiona turned to look at Mickey, who surprisingly kneeled onto the ground next to them.

Everyone else left the room.

“Kind of” Mickey told him.

“Broken?” Mickey was smart enough to know the kid meant a broken bone, and he only wished that that were the case.

“Yeah, yeah she’s broken” Mickey’s voice cracked.  Fiona stood, and Liam cocked his head to the side in confusion.  “She’s hurting real bad, she has a special condition, she’s got persistent depressive disorder” He told the boy, eyes watering up.

“Sad?” He only nodded in return.  “Doctors help?” Liam asked, and a few tears slipped onto Mickey’s cheeks.  This was the longest conversation he’s had with the five year old that didn’t involve race cars.

“Yeah, the-the doctors’ll help her” He cried, and Liam did the only thing he was taught to do when someone was crying.  He moved forward and hugged the man.  Mickey wasn’t one much for touching if it wasn’t you, but somehow he’d cradled the child, holding him close and finally letting all the tears rush out.  The wound of you being gone ripped open again, a raw and painful feeling igniting in his chest.

Then maybe again we would weep like we’ve done

a thousand times before

Don’t turn your back on me

or shout as you walk out the door

“Are you nervous?” Fiona asked, looking over from the driver’s seat to where Mickey sat in the passenger’s side.

“No” He answered, leg still bouncing and finger tapping the window sill repeatedly as he stared out the glass.  “Of course I fuckin’ am what if the meds jack up her head and she doesn’t remember me? Or doesn’t wanna see me?” Fiona rolled her eyes.

“That’s a dumb thing to be nervous about”

“Excuse me?” Mickey whipped his head over, staring at her.  Liam sat silently in the backseat, busy playing with an action figure you’d given him for his birthday.

“Just sayin’.  I’m nervous because I don’t wanna make her feel more pained than she is.  You’re sad ‘cause ya think she don’t like ya no more?” Fiona chuckled and shook her head, turning into the facility’s parking lot.  “Lemme tell you something Milkovich.  You remember that time ya cheated on her?”

“I wasn’t cheating! It looked bad when she saw but I swear to fuckin’ Christ it wasn’t-”

“Would you shut up for one goddamn second?” Mickey shut his mouth at her tone.  “That night, she’s bawling her fuckin’ eyes out at the table and I’m tryin’ to help but it’s not workin’.  So I asked what she needed, and ya know what she told me? She said that only you, Mickey milkovich, would be able to calm her down.  And that was why she was so distraught”

Mickey thought back to that day, how a girl at the bar had pushed herself against him before he could say no, and how you’d looked at him coming back from the bathroom.  You hadn’t said a word, just held back a cry and tried not to let the tears fall as you’d pushed past him.  Later that night you’d gone to his place, and told him how much you cared about him.  It had ended well, neither of you had even yelled.  But it was by far the worst bump in your relationship.  At least it was to Mickey.  He never wanted to hurt you like that again.

Then maybe again we would weep like we’ve done

a thousand times before

When the three of them walked into the visiting room, you were already sitting at a chair.  A large glass window separating the table in half.  There was some security on either side of the room, a few doctors talking with patients who spoke with loved ones through the phones.  You tried not to think of it as a prison, but that’s what it was.  But when you saw Mickey, your heart pounded hard in your chest, and you stood up quickly from the chair you sat in.  His eyes found you, and he bolted for the spot on the other side of your window.  His hands fumbled for the phone, as you’d already been holding yours.

“y-y/n” He breathed, and you stared at him with wide eyes.  You began to doubt yourself.  Was he even real? Was this just a hallucination? Perhaps the doctors had started giving you stronger pills, really fucking you up. “I’m here, it’s real” Mickey assured, placing his hand on the glass flat.  Your eyes lit up, sparking real feeling that wasn’t just anxiety.

“Mickey” You said, lining your much smaller hand against the glass where his was.

“Hey… hey how’re you feeling?”

“Better now” You answered honestly, but it wasn’t necessarily what he was looking for.  Mickey didn’t press the question further.

“I missed you like crazy Jesus fucks y/n” Mickey said, noticing the foul glance of the security guard, but he didn’t care.  He had to wait a week and a half until you were aloud to see people.  Your lips curved into a small smile.

“I told them to let you come earlier, I did, I told them” Mickey chuckled slightly at your certainty.

“I tried to to, but uh… I had a lot of…” Mickey looked around at all the guards again.  “Other ideas of seeing you but Gallagher crew told me that kinda shit wasn’t cool” You laughed a little.  But you laughed.  He couldn’t remember the last time he’d heard you laugh.

“Can I say hi?” Fiona asked, and you’d read her lips through the window, nodded.

“I wanna say hi to Fi” You said to Mickey, and he nodded, hesitantly handing the phone to her instead.  His hand fell from the window, and you bit your lip, curling your fingers into your palm before placing your hand back in your lap.

“Heya y/n” Fiona said cheerfully.  You could tell by her paled features and the dark crescents under her eyes that she’d been barely sleeping.  It broke your heart, knowing you were the cause of her pain, of all their pain.  She held Liam at her waist, and set him to his knees on the table.

“Hi Fiona, hi Liam” You waved at the boy, wiggling your fingers and giving a playful, but fake smile to the boy.  He giggled ecstatically, putting both hands on the glass window and pressing his face against it.

“Come on this side n/n!” He said, his grin too big for his face.  Fiona held the phone by his ear so you could speak to him.

“I can’t right now, but I will real soon okay buddy?” He nodded, and you put your hand against the glass where his little one was.  He slapped the glass, as though to high five you, and you did it too.  He did it again, and soon it was a game of who would stop first, both of you rapidly slapping your palm on the window.

“Hey! Hey l/n! Security!”

In seconds, your game turned into a nightmare, as two large men rushed over to you, and pulled you by your arms.

“Hey!” Mickey yelled, loud enough that you could hear without the phone.

“Let me go!” You squealed, wiggling uncomfortably.

“Let her go! They were playing!” Mickey was fuming with anger.  But you were already being shoved into another room.

“I love you! I still love you!” You screamed, body falling limp, as the men literally dragged you away.

Mickey’s heart broke into two, feeling completely helpless, and quite frankly empty.  How was he supposed to protect you when you were trapped in here.

“I still love you too” He responded quietly, but you were already long gone.

Fiona was the one to drag him away.

Don’t turn your back on me

or shout as you walk out the door

It was the day.  Today.  Today was the day.  The day.  

Mickey straightened the collar of his button down, staring nervously at his reflection in the mirror.

“Why the fuck are you all dressed up?” Carl asked from the top of the bunk bed.  He stared down at Mickey with confusion, and a hint of disgust.

“We’re getting y/n back today” Lip said from where he sat on his old bed, already in khakis and a polo shirt.

“And you’re dressed like fuck bags why?” Carl asked blatantly.

“Because jackass we haven’t seen her in a month and today she comes home.  She deserves for us to look nice” Mickey spat, and walked out of the room while buckling up his belt.  He went downstairs, finding Fiona in her nicest jeans and a blouse.

“We leave in five!” She screamed, and handed Mickey a cup of coffee without a word.

“Pass” He said, digging into the fridge.  He pulled out a beer and two minutes later the bottle was empty.

“Breathe” Fiona said gently, noticing the green eyed boy’s leg was jumping wildly on the ground.  They’d been sitting in the waiting room for a whole of six minutes.  It was weird, him and all the Gallaghers, which included Frank for an odd reason, as well as Kevin and Veronica.  All of them dressed to their best, but clearly coming from the roughest of neighborhoods.

“C-can’t” Mickey stuttered back.  “I can’t- I-I can’t catch-” He swallowed a gulp of air, which barely filled his lungs.  He stared at the door which you were presumed to walk through at any moment.

“Breathe, Mickey.  Everything’s fine now remember?” Fiona assured, placing a hand on her shoulder, but he shrugged her off.

“I can’t- I can’t I-I-I can’t breathe”

“I thought I was supposed to take your breath away?” His head snapped up, towards the owner of the voice.  And there you stood, in a tee shirt you’d stolen from him ages ago and jeans.

Apparently he’d been glaring at the wrong door.

“y/n!” Everyone cheered excitedly, all rushing up from their seats, but Mickey had beat them, already pulling you against him and holding you tightly.  You were crying, silently but prominently.  His head pressed against your temple, kissing your cheek over and over.  But his moment was soon turned into a group thing, as everyone surrounded you in the biggest group hug you’d ever been a part of.  You felt Mickey try to squirm out of it, but you just held him tighter, not wanting him to let go of you.

And he didn’t.

His hand was latched in yours as you all left, flipping off any doctor or guard you passed.  And your fingers were still glued together as you got in the backseat of the car.  You in the middle of Mickey and Lip.  Fiona driving and Carl proudly sitting in the front seat.  Debbie and Liam had gone with Kevin and V.  You turned to Mickey, smiling brightly, a true and genuine smile, and he returned it, cupping one of your cheeks and stroking your skin softly with his thumb.

“It sucks not having you around” He said, and it was one of the most romantic things you’ve ever heard.  You didn’t hesitate to lean up and capture his lips in yours, in a long, and very intimate kiss.  In seconds your hands were threaded in his hair, and his tongue was swiping over your lips for permission to enter.  This continued until Carl heard you moan, and turned around in his seat.

“Hot” You stuck your middle finger at his face, not wanting to get interrupted.  But Mickey had already pulled away, still holding you.

“Continue later?” You asked, and he nodded with a smirk.

“It’s been over a month y/n” He said, tucking your hair behind your ear.  “We’ll be continuing for the rest of our lives”

[clamonnaturalhealth]

Multiple Sclerosis Major Improvement

this is from friend that has adult MS, she bought a bottle about 5 days ago…….. Oh and by the way… We got in them drops last week and we both been taking them twice a day now for about 5 days now… And it seems to be helping Heather… She was able to walk Walmart today better than she had been and she has been able to pretty much stop taking her moloxicam & neurotin…

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From Jennifer

I just burned the heck out of my hand with a flat-iron while doing my hair. I put one drop of Hempworx on it and it stopped the burning immediately, and this is the Peppermint! I thought the Peppermint may make it hurt worse, but nope! I totally recommend this for something as simple as burns. It works! Update: No blister today!  Read on the rest of these testimonials are truly amazing, too!!!!! For more information or to place an order go HERE.

Susan shares:

Long testimony! I have suffered for 20 years from fibromyalgia, horrible headaches, super tight painful muscles, stiff joints, depression and anxiety. Most recently March 2016 I suffered a hip injury, started limping which caused greater trochanter bursitis, tendinitis, and I have been limping ever since. This caused problems with my SI joint, muscle spasms in my legs, and plantar fasciitis. I have gotten injections every 4 months just so I could continue working. My quality of life sucked because I was in so much pain. This wonderful woman ordered some CBD oil for me and told me to take it. It took me 4 days to try it and the only reason I did was because My pain kept me from sleeping and I could barely get out of bed. I started out with half a dropper full of 500 mg and It started working immediately! I could feel my muscles instantly relaxing. I’ve been taking half a dropper 2x a day for 2 weeks and I feel like a well oiled machine! I don’t have any joint pain at all and I feel like my whole body moves so smooth. I am not limping anymore and my plantar fasciitis is better. I don’t even think about taking my anxiety medicine because I feel so calm. My headaches are almost non existent and I can go for days without ibuprofen or Tylenol. I am in such a good mood because I feel great! This stuff is a miracle and I wish I would’ve found it sooner. All this stuff didn’t happen overnight..it happened gradually so give it time to work and take it consistently. Thank you God! CBD Oil Is it Legal? What is it? Will it Help Me?

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From Kelli:

HERE IS MY PERSONAL EXPERIENCE::: Well, folks. Its been a week since i started giving Sierra the CBD OIL in place of her 20 mg Adderall 3X daily. I guess i should start this by telling you all that Sierra has ADD/ADHD/ & ODD. While the pills do work, they have horrible side effects, such as thoughts of suicide, depression, sleepiness,and not to mention the horrible mood swings, plus many more that i wont go into. Sierra isn’t quite 15 yet. She has always been on the Honers Roll and been a top student. However, she can sometimes be mean, both physically and emotionaly. I researched this product for months. After all, I was going to be giving it to my child. After seeing other parents sharing about the results that they were having i decided to give it a try. I absolutely HATE giving my child her prescribed medication almost as much as i hated the side affects it gave her. For the past week i have been giving Sierra 5 drops in the morning and 5 drops in the evening. I stopped the medication completely before doing this several days before hand. Her and i both noticed a difference on day 2!!! Not only did i not have to fight with her to take it, but she actually said, “Hey mom, do i take that calming oil again today?” That is NOT normal for her. Within just a cpl of days of taking this oil her mouthing and meaness has all but subsided. There is no more anxiety, her ADHD/ADD is non existant to those around her, and her ODD is nowhere in sight. I cannot tell you how happy I am that i gave this product a try. I am now taking it myself for my pain from my endometriosis and since i started taking it i haven’t taken any over the counter or prescribed meds for pain. I absolutely love this oil and i fell so very grateful that i was introduced to it. All You Need to Know About CBD and Anxiety (Infographic)

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Hey everybody!! I have something new to add….I started using hempworx for anxiety, depression and chronic pain. It has worked fabulously for all of those! I’ve been taking it for 2months and in that time it feels like my body has been refueled!! My pain, shaking, anxiety and depression have completely disappeared but never in a million years did I think it would do what it’s done for my skin!! Not only do I feel healthy but I look healthy too!! It has evened out my skin tone as well as diminish wrinkles!! Also, water is tasting exceptionally good and so is fruit!! It has revived cells that were inactive!!ive used all of the products now and my life as well as my outlook on life has completely changed!! Thank you to hempworx and all the helpful people involved!!! It’s truly amazing y’all!! I have started taking a dropper in the morning, half of a dropper in the middle of the day and a dropper in the evening! I feel wonderful!! I’ve been searching for this feeling for years and now I’ve found it!!

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From Christy: i have been taking the 500mg oil for just over 4 weeks. I have had great results with regaining my clarity, less anxiety, energy level is up, and fewer night sweats. I have also noticed how my finger nails have become harder and grow quicker AND my hair feels thicker and darker. Anyone else experiencing less gray?

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Hello. My name is Glenda. I’d like to share an experience that I haven’t seen here. Today is Tuesday. Sunday night I felt the manifestation of a cold sore, a fever blister, on my lip. I put a drop of HempWorx CBD oil on my lip before going to bed. Yesterday morning, the swelling had gone down and there was no pain. Another few drops throughout the day (maybe three total). Today, Tuesday, completely gone! I love this stuff! Thank you for being patient and showing me this marvelous product which I now share as well. Blessings to all.

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From Jenny .. “My personal testimony: In September of this year, I was about to marry the man of my dreams but my body was so uncooperative. I was on 14 different medications. I was chasing symptoms and side effects. I was miserable, stiff, and in pain all the time. I was about to get married and just barely even mobile. I did a lot of research on different brands. I finally decided to try Hempworx. I started with just 5 drops of 500mg 2x a day. I worked my way up to a full dropper 2x a day and decided to move up to the 750mg. It took some time to really feel a difference. It didn’t happen overnight. After about 3 weeks I started noticing that I was taking less pain medication so I cut down on the long-acting dose I was taking. Over that next week, I started cutting down on everything. Currently, I’m not on ANY extended release pain medication, no NSAIDS for inflammation, no sleep meds, no acid reflux meds. I take my Humira injection weekly and my 2 meds for diabetes and that is IT. From 14 meds down to 3 in a 3-month time frame. My advice to you? Be consistent. Give your body time to adjust to the changes. Don’t give up, you can and WILL feel better!” Fibromyalgia and Chronic Pain, explained, Including CBD Oil

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  Last week, I followed my gut and took Ryan off ridalin, with his doctors consent. He would come home agitated and filled with anxiety and just did not want to be anywhere. No appetite which I was told was normal and loss of sleeping. Headaches and imagining bugs and over moody started to appear after being on it for 6 months BUT he was getting amazing results at school which is what I wanted. Don’t we all want that for our kids.

Last week I decided that was enough, I miss my boy, doing good in school wasn’t worth it. So I reached out and got some ordered. I talked to her back in September but it was working so I wasn’t completely on board just yet….I did my research. I thought it was illegal…BUT ITS NOT!!!! Look you the farm act, CBD oil does NOT have THC which is why you can buy it in Minnesota

The first day of switching with his new meds that aren’t a controlled substance and the oil, his body was adjusting….he did not have a good day. But Tuesday no note was sent home, his school work was done and he was his normal energetic self! The third day was the day it hit me, he got off the bus just tired and Hungary. He’s only in kindergarten, that’s a long day…..I listened to him complain, I put the drops under his tounge because he likes how it makes him feel and five minutes if that complete 360….we were talking about his school day and what he drew and my plans for the night which he didn’t fight me, he was just happy and calm I’m sharing my story because I know alot of children are affected with these controlled substances and it doesn’t have to!!! #cbdoil #itworks #miracledrug

No more Xbox or screens to just make it through the day!!! He’s just happy to be alive and around us again.

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DISCLAIMER: The information here is NOT medical advice. Do not institute any changes in your current health programs without consulting your Medical provider. For medical advice please consult your private physician or preferred health service provider.

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RHR: A Three-Step Plan to Fix Conventional Healthcare

In this episode we discuss:

The patient case that inspired the book

Who is this book for?

The mismatch between our medical paradigm and chronic disease

Drug companies and conflicts of interest

How clinicians can help create a new paradigm

The three core problems and how to solve them

What this new paradigm looks like

How do we pay for this? Is it scalable?

How allied providers are the key

Show notes:

Unconventional Medicine by Chris Kresser

Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.

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Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.

The patient case that inspired the book

Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.

Is a new healthcare paradigm affordable? Scalable? You bet.

His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.

Who is this book for?

Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.

The mismatch between our medical paradigm and chronic disease

Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.

Drug companies and conflicts of interest

Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.

How clinicians can help create a new paradigm

Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.

The three core problems and how to solve them

To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.

What this new paradigm looks like

Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.

How do we pay for this? Is it scalable?

Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.

How allied providers are the key

Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody.

[denisalvney]

RHR: A Three-Step Plan to Fix Conventional Healthcare

In this episode we discuss:

The patient case that inspired the book

Who is this book for?

The mismatch between our medical paradigm and chronic disease

Drug companies and conflicts of interest

How clinicians can help create a new paradigm

The three core problems and how to solve them

What this new paradigm looks like

How do we pay for this? Is it scalable?

How allied providers are the key

Show notes:

Unconventional Medicine by Chris Kresser

Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.

NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping

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Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.

The patient case that inspired the book

Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.

Is a new healthcare paradigm affordable? Scalable? You bet.

His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.

Who is this book for?

Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.

The mismatch between our medical paradigm and chronic disease

Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.

Drug companies and conflicts of interest

Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.

How clinicians can help create a new paradigm

Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.

The three core problems and how to solve them

To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.

What this new paradigm looks like

Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.

How do we pay for this? Is it scalable?

Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.

How allied providers are the key

Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody. RHR: A Three-Step Plan to Fix Conventional Healthcare published first on https://chriskresser.com