Please Excuse My Dear Aunt Sally
Don't worry, this article does not include any math! I'll be borrowing this concept and applying it to Functional medicine!
For some background, I'd like to refer back to all those forgotten math classes from high school. In algebra, there is a required sequence when performing operations in a mathematical expression to arrive at the correct solution... If I'm already losing you, please stay with me. If the order is followed incorrectly, you would only have an interpretation of a solution, rather than the correct solution, and wouldn't know it was wrong until the teacher wrote on your test with red ink.
To get to the correct solution, a specific order is required. Any deviation from this sequence results in the incorrect solution, but it may not be known until a professional informs you. If you want optimal health, then a specific sequence of intervention is required. If not properly followed, a doctor or specialist may tell you that you have a disease... or worse!
To better understand the application of the order of intervention, we must first discuss the order of dysfunction. Most of the time it looks something like this:
Stressor is experienced.
Symptom presents.
Take something for that symptom.
Symptom returns.
Take more of something for that symptom.
New symptom presents.
Take something new for that new symptom.
New (and original?) symptom returns.
Take something new ... and the cycle continues.
After continually taking something for a symptom, this leads to a doctor's visit, a diagnosis, pharmaceuticals are prescribed, surgery is advised... you get the idea. This is because the symptom is being addressed while the cause of the symptom continues to burden the body. But what if we did something else at the beginning that prevented the progression of the dysfunction? What if there was a way to understand and apply the proper order to use all of the modalities we have access to?
I present to you, the Functional Medicine P.E.M.DaS!
Applying PEMDAS to Functional Medicine
Step 1. Proactive
Proactive simply means adopting healthy habits before illness and disease arrive. The more proactive we are in our health, the lower the chance of experiencing symptoms and disease. Examples of proactive steps in health are:
Diet
Organic
Non-GMO
Grass-Fed / Free-Range
Unpackaged and Unprocessed
Filtered Water
Rest
Sleep hygiene
Exercise
Just get out and move!
Stress Reduction Techniques
Having an intentional outlet for stress
Avoiding harmful chemicals in household and personal care products
Providing time each day for yourself
Regular chiropractic care
Supplements
Best if based on Step 2 results, but can also be done proactively
We must be proactive in our health, otherwise we will be forced to react to sickness. A state of health is only achieved with intention. Without intentional healing, then there is unintentional falling towards disease. This unintentional progression of disease is not due to the nature of the human body, but rather it is due to the convenience driven society we participate in. Chronic illness is the price to pay for convenience.
Step 2. Evaluate
Sometimes being proactive isn't enough to outpace symptoms and disease. This does not necessarily reflect healthy efforts, but sometimes contributors to metabolic stress are outside of our control. Despite proactive efforts, we can be left having to clean up the mess that HIDDEN stressors can cause.
In order to properly address these contributors to metabolic stress, holistic and comprehensive evaluation is essential. First, we must have an understanding of what we are addressing before addressing it. Always start evaluation with conventional medicine so we can either identify, or rule out, a health crisis. If conventional evaluation comes back with out-of-range markers that require further medical assistance, pursue these methods until stabilization has been achieved. After following medical guidance, you can make the decision to continue evaluation that identifies the cause of the crisis. However, if conventional medicine's evaluations come back without answers or appear "normal," then this is the perfect opportunity to seek evaluation from functional medicine.
Functional evaluation will include a thorough history intake, exploring and understanding all present and past symptoms (big and small) and pursuing comprehensive investigation through proper lab testing. This functional evaluation identifies HIDDEN stressors and healing opportunities. Knowing what stressors are in our "stress bucket" allows for intervention before dysfunction leads to disease. Learn more about the stress bucket by clicking the button below:
Step 3. Medicinals
In America, if someone says "medicine," we commonly think of Tylenol, Ibuprofen, and other pharmaceuticals. However, these are pharmaceutical drugs rather than true medicine. Medicine is defined as a "healing substance" and health is defined as "a state of the body in which every cell, tissue and organ are functioning at 100%." Prescription drugs cannot heal the body nor achieve a state of health, because they can only synthetically inhibit, alter and replace functions of the human body. While prescription drugs can be very useful to create stability and help to get out of a state of crisis, health is not attained through the use of pharmaceuticals.
Medicinals in the context of Functional Medicine is referring to substances that heal, nourish and improve the function of the human body. Vitamins, minerals, herbs, nutraceuticals, and homeopathic remedies are just some examples of Medicinals. Once proper evaluations have taken place, then it is time to take action on those findings with focused and intentional Medicinals. These will improve functions of the body while simultaneously addressing the root cause of disease and symptoms.
Step 4. Drugs and Surgery
Last in the sequence is the most invasive and aggressive option. While Drugs and Surgery do not promote health, they are sometimes necessary to create stability and get out of a health crisis. I would never advise against the use of pharmaceuticals and surgical procedures! In fact, I even recommend seeking guidance from licensed medical doctors before seeking guidance from Functional Medicine Practitioners. The purpose of placing Drugs and Surgery last is simply because if steps 1-3 outlined above are followed, very few people would need pharmaceutical or surgical intervention.
The majority of Americans experience mild to moderate sub-optimal health. Few Americans actually experience a health crisis. However, over 60% of Americans are taking one indefinite medication (once prescribed, it is not discontinued) and 36% of Americans are taking three or more indefinite medications*1. With the minority of diseases coming from genetic predisposition, this leaves a majority of Americans overmedicated. And those with genetic predispositions are NOT destined to fall victim to disease; it simply means they will need to lean more on the Functional Medicine PEMDaS than those that do not.
Conclusion
Every step of the Functional Medicine PEMDaS has its place. One is not better than the other, but rather they all serve different functions. If followed in order, you'll likely never need steps 2, 3 and 4. If followed out of order, you may feel like you have the correct solution, but will fall further and further from good health because "The greatest medicine of all is teaching people how not to need it" - Hippocrates.
If you'd like to learn more about improving your health with Functional Medicine's PEMDaS, click the button below to schedule a free consultation with a Board-Certified Holistic Health Practitioner!
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