Latest / Resiliency Radio with Dr. Jill Carnahan, MD / 334: Resiliency Radio with Dr. Jill: Childhood Immunity & Lifelong Health with Dr. Somer DelSignore

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334: Resiliency Radio with Dr. Jill: Childhood Immunity & Lifelong Health with Dr. Somer DelSignore · Resiliency Radio with Dr. Jill Carnahan, MD

• 0:00
  Dr. Jill Carnahan, MD: Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine.
• 0:07
  Dr. Jill Carnahan, MD: I'm your host, Dr. Jill and with each episode we dive into the heart of healing and personal transformation.
• 0:14
  Dr. Jill Carnahan, MD: Join me as we interview medical experts, thought leaders, innovators of all type, bringing you information to help you on your journey of optimal performance and healing.
• 0:23
  Dr. Jill Carnahan, MD: Today is no different.
• 0:24
  Dr. Jill Carnahan, MD: We have a integrative pediatric doctor from New York who trained under some of the best names who I've had on here before, Ken, Jen Bach and Richard Horowitz and more.
• 0:34
  Dr. Jill Carnahan, MD: She has her own protocol called Reset and you'll want to stay tuned.
• 0:37
  Dr. Jill Carnahan, MD: If you have children in your life, if you're a grandparent or you know, if someone has children, I promise this episode will be relevant for you.
• 0:45
  Dr. Jill Carnahan, MD: Before we do, I just want to remind you that you can find products and services@doctor Jill health.com some of our best sellers are now back in stock.
• 0:53
  Dr. Jill Carnahan, MD: The Tinted Moisturizer with SPF@doctor Jill beauty.com and you can find products and services for mass selectivation, Epstein bar reactivation, gut issues and brain health and many other things@doctor Jill health.com check it out, browse a bit and you'll get a discount on your first purchase.
• 1:14
  Dr. Jill Carnahan, MD: Also, I always want to remind you because many people think I am not accepting new patients.
• 1:18
  Dr. Jill Carnahan, MD: We have Flat Iron Functional Medicine in Lewisville, Colorado and we are accepting new patients.
• 1:23
  Dr. Jill Carnahan, MD: I have an incredible pa, Fawn Elwood and nurse practitioner Hannah and each of them are well trained.
• 1:30
  Dr. Jill Carnahan, MD: They are brilliant at complex cases and I precept all the cases with them.
• 1:34
  Dr. Jill Carnahan, MD: If you want to know or schedule a visit or just even schedule a free call just to get to know our practitioners, you can call 303-993-7910 or you can email info@iron functional medicine.com one of our staff will get back with you and like I said, you can get to know us and see if it's a good fit.
• 1:52
  Dr. Jill Carnahan, MD: Also, if you haven't yet seen the movie Doctor Patient Movie, I like to remind you it's on Amazon Prime.
• 1:58
  Dr. Jill Carnahan, MD: You can also see it@doctor patient movie.com it's inspirational.
• 2:02
  Dr. Jill Carnahan, MD: It's out there for free with commercials and my goal with that movie document is just to inspire and impact your life.
• 2:10
  Dr. Jill Carnahan, MD: If you've seen it, leave some feedback below.
• 2:13
  Dr. Jill Carnahan, MD: Okay, let me introduce our guest.
• 2:14
  Dr. Jill Carnahan, MD: Dr. Somer del Signore is a Pediatric Board Certified, Provider, Fellow at MAPS and AAOT and member of ILADS and ssrp.
• 2:23
  Dr. Jill Carnahan, MD: She was inspired to integrate the Depth of integrated care with precision of medical science by creating the reset protocol.
• 2:30
  Dr. Jill Carnahan, MD: We'll talk about that today.
• 2:31
  Dr. Jill Carnahan, MD: To address the root cause of pediatric and congenital illness.
• 2:34
  Dr. Jill Carnahan, MD: She has many degrees, and she's the founder and CEO of Hudson Valley Integrative Health and Wholesome Root Nutraceuticals in Beacon, New York.
• 2:41
  Dr. Jill Carnahan, MD: Let's welcome Dr. Del Signore.
• 2:45
  Dr. Jill Carnahan, MD: Dr. Del Signore.
• 2:47
  Dr. Jill Carnahan, MD: Did I say that right?
• 2:50
  Dr. Jill Carnahan, MD: Oh, it is such a delight to have you on the podcast.
• 2:54
  Dr. Jill Carnahan, MD: We've just talked and we've crossed paths in many different avenues and conferences, and I always love meeting colleagues who are doing such amazing work.
• 3:02
  Dr. Jill Carnahan, MD: We're going to talk about some of the things you've spoken specifically developed.
• 3:04
  Dr. Jill Carnahan, MD: So, guys, stay tuned.
• 3:05
  Dr. Jill Carnahan, MD: You're in for a real treat today.
• 3:07
  Dr. Jill Carnahan, MD: But before we dive into all of the work that you're doing and the kinds of patients you're seeing and some of the complex chronic things in kiddos, I want to hear a little bit about your journey into medicine and into pediatrics specifically.
• 3:18
  Dr. Somer DelSignore: Right.
• 3:19
  Dr. Somer DelSignore: So it was an interesting journey.
• 3:21
  Dr. Somer DelSignore: As a young child, I knew that I wanted to practice medicine when I was 10.
• 3:27
  Dr. Jill Carnahan, MD: Wow.
• 3:27
  Dr. Somer DelSignore: And I've.
• 3:29
  Dr. Somer DelSignore: I've shared this with one other person, but it.
• 3:31
  Dr. Somer DelSignore: My mother was in a horrific car accident when I was 10, and my stepdad at the time woke my brother and I up and said, we have to go to the hospital and say goodbye to your mom.
• 3:42
  Dr. Somer DelSignore: And so went in, and everyone was losing their minds around her.
• 3:47
  Dr. Somer DelSignore: And I was just really calm, and I said, you know, I don't think it's her time.
• 3:50
  Dr. Somer DelSignore: And then I'm sitting there at 10 years old, and I'm fascinated by.
• 3:54
  Dr. Somer DelSignore: With all the doctors and the nurses and the techs who were coming in essentially, to put her back together.
• 4:00
  Dr. Somer DelSignore: And that just sort of solidified it for me.
• 4:03
  Dr. Somer DelSignore: And from then on, it was.
• 4:05
  Dr. Somer DelSignore: That was the focus.
• 4:07
  Dr. Somer DelSignore: Fast forward.
• 4:09
  Dr. Somer DelSignore: The pediatrics kind of came into play during one of my residencies.
• 4:13
  Dr. Somer DelSignore: I fell in love with it from day one and said, you know what?
• 4:16
  Dr. Somer DelSignore: I don't want to do anything else.
• 4:17
  Dr. Somer DelSignore: This is where I belong.
• 4:19
  Dr. Somer DelSignore: This is what resonates with me.
• 4:21
  Dr. Somer DelSignore: And I want to help these kiddos reach a healthy adulthood, whatever that means.
• 4:27
  Dr. Somer DelSignore: Yeah.
• 4:27
  Dr. Somer DelSignore: And that kind of LED training and then integratively was sort of a next level, like another step, because, you know, you're trained traditionally in.
• 4:37
  Dr. Somer DelSignore: Yeah.
• 4:37
  Dr. Jill Carnahan, MD: Yes.
• 4:38
  Dr. Somer DelSignore: Okay.
• 4:39
  Dr. Somer DelSignore: And then we move on, and we keep asking those healthy why questions.
• 4:42
  Dr. Somer DelSignore: And.
• 4:44
  Dr. Somer DelSignore: And that led me to integrative to say, we really have to connect the dots, connect the systems versus that siloed effect.
• 4:52
  Dr. Somer DelSignore: And that led me to doctor Both Ken Bach and Horowitz later on.
• 5:00
  Dr. Somer DelSignore: I'm here in the Hudson Valley and trained and worked with both of them, and then sort of just took the incredible, you knowledge pearls from both of them, sort of meshed it into sort of my integrative, kind of a more holistic view.
• 5:16
  Dr. Somer DelSignore: And here we have Hudson Valley integrative health.
• 5:18
  Dr. Somer DelSignore: So that.
• 5:19
  Dr. Somer DelSignore: That's sort of a Cliff Notes version I love.
• 5:24
  Dr. Jill Carnahan, MD: It always does seem like there's this, like, healer inside that somehow realizes that this is the work we're meant to do.
• 5:29
  Dr. Jill Carnahan, MD: And sometimes it's 10, it's 20 and.
• 5:31
  Dr. Jill Carnahan, MD: But what a story.
• 5:32
  Dr. Jill Carnahan, MD: And to be witnessing your mother in that and actually be.
• 5:35
  Dr. Jill Carnahan, MD: And even as you said that, I wonder if that calm was like this innate gift to be calm and ability to see the complexities that other doctors are missing.
• 5:44
  Dr. Jill Carnahan, MD: And I have such a deep and special respect for pediatrics because I know I was in the Chicago area and, you know, with ENT and dermatology and all these amazing fields, and then here I'm family medicine and pediatrics and medpe needs.
• 5:56
  Dr. Jill Carnahan, MD: We didn't get much respect.
• 5:58
  Dr. Somer DelSignore: Right.
• 5:58
  Dr. Jill Carnahan, MD: Like what?
• 5:59
  Dr. Jill Carnahan, MD: Like a smart person like you.
• 6:00
  Dr. Jill Carnahan, MD: Why don't you go into, you know, ear, nose, and throat or whatever?
• 6:03
  Dr. Jill Carnahan, MD: But the truth is, we're at the ground level doing this work with the average people, families, kiddos.
• 6:09
  Dr. Jill Carnahan, MD: And again, for you especially, such a deep respect, because your patients are the parents and the kids and these, you know, parents who love their children so dearly and are seeing them not.
• 6:19
  Dr. Jill Carnahan, MD: Not thrive, depending on what's going on.
• 6:22
  Dr. Jill Carnahan, MD: And then again, you have to be really ab.
• 6:24
  Dr. Jill Carnahan, MD: Have an ability to talk to both parties, the parents and the children.
• 6:28
  Dr. Jill Carnahan, MD: And obviously, the parents control the ability to give them a treatment protocol.
• 6:32
  Dr. Jill Carnahan, MD: So I just have the deepest respect for that.
• 6:35
  Dr. Jill Carnahan, MD: And one of the ways I want to start is just I feel like if you're out there and you're a mother or a father or you have grandchildren or, you know, kids, which is 100% of us, all right, you're seen as well as we are, that there is more complexities and there's so many more children that are chronically ill, what do you think it is that we're missing?
• 6:56
  Dr. Jill Carnahan, MD: And I know some of this led to your protocols, but tell us a little bit about your perspective as a pediatrician and what you've seen over the past several decades.
• 7:04
  Dr. Somer DelSignore: Well, it's interesting.
• 7:06
  Dr. Somer DelSignore: I think epigenetics plays a huge role in general foundational health.
• 7:11
  Dr. Somer DelSignore: I think that what we're witnessing now is not, you know, faulty genes or bad luck, but it's a collision with human biology and then environmental exposures in our bodies that weren't designed to navigate or evolve to deal with as quickly as it's coming at us.
• 7:28
  Dr. Somer DelSignore: And we're talking about chemical exposures and processed foods and constant stimulation from EMF and screen time and this disconnect and it's replacing regulation because there's not a lot of face to face time.
• 7:43
  Dr. Somer DelSignore: And that really plays a huge cognitive, biological and emotional effect on all kids and how they grow and develop.
• 7:51
  Dr. Somer DelSignore: And I think that it changes their biomes.
• 7:53
  Dr. Somer DelSignore: I think that it changes the way their immune system responds response.
• 7:56
  Dr. Somer DelSignore: And I find that a lot of kids naturally, even if we're not dealing with, you know, a chronic illness per se from an infection yet that they're already in kind of a fight or flight situation.
• 8:10
  Dr. Somer DelSignore: And, and that's what I see.
• 8:12
  Dr. Somer DelSignore: And they're just not as resilient as you would hope that they would be to sort of weather those storms.
• 8:20
  Dr. Somer DelSignore: Because we know all kids are going to have infections unless they live in a bubble.
• 8:25
  Dr. Somer DelSignore: They're all going to have.
• 8:25
  Dr. Somer DelSignore: Yeah, right.
• 8:26
  Dr. Somer DelSignore: They're going to share things.
• 8:27
  Dr. Somer DelSignore: They're cough and sneeze and laugh and they're going to have infections.
• 8:29
  Dr. Somer DelSignore: And that's just part of childhood.
• 8:31
  Dr. Somer DelSignore: But it's the way that immune system I find is responsive to it.
• 8:34
  Dr. Somer DelSignore: And I just find it's very, you know, hyper aware, I guess you could say.
• 8:39
  Dr. Somer DelSignore: And it doesn't know how to settle back down.
• 8:41
  Dr. Somer DelSignore: So that's what I see.
• 8:43
  Dr. Somer DelSignore: And I also find that once we start digging integratively, that only about 1 in 25 kids within my practice specifically carry one single diagnosis.
• 8:53
  Dr. Jill Carnahan, MD: Yes.
• 8:53
  Dr. Somer DelSignore: The majority of them have seven distinct diagnoses simultaneously.
• 8:59
  Dr. Somer DelSignore: And of those who may have infections like a Lyme disease, about a quarter to maybe 30% have all three Bs.
• 9:10
  Dr. Somer DelSignore: Really?
• 9:10
  Dr. Somer DelSignore: A, you know, Babesian Bartonella is sort of like the posse that travels together.
• 9:15
  Dr. Somer DelSignore: And that's.
• 9:16
  Dr. Somer DelSignore: And that's what I see.
• 9:17
  Dr. Somer DelSignore: So it's always very surprising when parents come to me and we dig and they ask, well, why are you testing for this?
• 9:24
  Dr. Somer DelSignore: Or what?
• 9:24
  Dr. Somer DelSignore: Why are we doing this?
• 9:25
  Dr. Somer DelSignore: We came in for this problem.
• 9:26
  Dr. Jill Carnahan, MD: Yeah, but.
• 9:27
  Dr. Somer DelSignore: And you have to explain, this is the tip of the iceberg.
• 9:30
  Dr. Somer DelSignore: Right.
• 9:30
  Dr. Somer DelSignore: We need to dig and understand why your child is still ill and why they can't seem to overcome whatever this particular symptom may be.
• 9:39
  Dr. Jill Carnahan, MD: What a great overview.
• 9:40
  Dr. Jill Carnahan, MD: I remember years ago, this is decades ago, where I Was like, I don't do mold and I don't do Lyme disease, but it's haha right, haha on me.
• 9:48
  Dr. Somer DelSignore: Right.
• 9:48
  Dr. Jill Carnahan, MD: Primary driver, the environmental toxic load.
• 9:51
  Dr. Jill Carnahan, MD: I would say toxic load, infectious burden.
• 9:53
  Dr. Jill Carnahan, MD: And these two things come together and create immune dysfunction.
• 9:55
  Dr. Jill Carnahan, MD: And then this, what we see in children and adults is unprecedented rates of autism and ADHD and anxiety and allergies and autoimmune disease.
• 10:05
  Dr. Jill Carnahan, MD: The A's, right.
• 10:05
  Dr. Jill Carnahan, MD: All these things.
• 10:06
  Dr. Jill Carnahan, MD: And then like you said, if you're not looking and you trained with two of my heroes and you're among them now, Ken Bach and Richard Horowitz.
• 10:14
  Dr. Jill Carnahan, MD: I, you know, trained with Richard as well and have the deepest respect because he was at the early years really starting to investigate how these infections in particularly affected kids and kids brains and adults and all of that.
• 10:26
  Dr. Jill Carnahan, MD: And we're seeing more and more of that.
• 10:27
  Dr. Jill Carnahan, MD: So like you said, we almost can't go there.
• 10:30
  Dr. Jill Carnahan, MD: And I had that same conversation.
• 10:32
  Dr. Jill Carnahan, MD: Like first of all, if you just ask someone, is there mold in your home?
• 10:34
  Dr. Jill Carnahan, MD: Most people will say no.
• 10:35
  Dr. Somer DelSignore: Right.
• 10:35
  Dr. Jill Carnahan, MD: So you have to ask, has there been any water damage or dishwasher leaks?
• 10:39
  Dr. Jill Carnahan, MD: And on and on.
• 10:40
  Dr. Jill Carnahan, MD: And the same with these tick borne infections.
• 10:42
  Dr. Jill Carnahan, MD: Many people will right away, oh, I've never got a tick bite.
• 10:44
  Dr. Jill Carnahan, MD: My child has never had a tick bite.
• 10:46
  Dr. Jill Carnahan, MD: Right.
• 10:46
  Dr. Jill Carnahan, MD: And we know.
• 10:47
  Dr. Jill Carnahan, MD: Do you want to just maybe let's start with that framework because we don't have to focus only online, but we know that's a big portion of people.
• 10:53
  Dr. Jill Carnahan, MD: And like you said, the Borrelia, Bartonella, babesia is at the root of many of these.
• 10:58
  Dr. Jill Carnahan, MD: What questions do you ask to get to that?
• 11:01
  Dr. Jill Carnahan, MD: What kind of responses are you getting from patients and how do you kind of go deeper to look at these as possible causative agents?
• 11:07
  Dr. Somer DelSignore: Right.
• 11:08
  Dr. Somer DelSignore: So interestingly, having trained with Rich Horowitz utilizing his MSAIDS protocol, so what we did within the practice when I opened this one three years ago was I digitized that MSAIDS protocol and then we additional questions to it that were more pediatric specific and more neuropsych specific.
• 11:26
  Dr. Somer DelSignore: And that was for my Pans autoimmune cephalopathy kit.
• 11:29
  Dr. Somer DelSignore: So that's kind of over here.
• 11:29
  Dr. Somer DelSignore: We'll talk that there.
• 11:30
  Dr. Jill Carnahan, MD: Okay, you got it.
• 11:33
  Dr. Somer DelSignore: So we utilize that one for, to maintain a degree of objectivity and also to be able to gauge.
• 11:40
  Dr. Somer DelSignore: Right.
• 11:40
  Dr. Somer DelSignore: Moving forward with treatment.
• 11:42
  Dr. Somer DelSignore: So I'll start there.
• 11:43
  Dr. Somer DelSignore: And it's a clue because the kids don't always respond.
• 11:47
  Dr. Somer DelSignore: Exactly.
• 11:47
  Dr. Somer DelSignore: And sometimes asking those questions, very objective by parents and Sometimes the kids can't answer some of the physical because they've always had it.
• 11:55
  Dr. Somer DelSignore: You say, does your head hurt?
• 11:56
  Dr. Somer DelSignore: And they'll say, well, no, know, I'm good.
• 11:59
  Dr. Somer DelSignore: But they say, well, you know, do you wake up with pain behind your eyes?
• 12:04
  Dr. Somer DelSignore: Well, sometimes, yeah, but that's always there, you know.
• 12:07
  Dr. Somer DelSignore: And then they'll say, oh, I guess I have.
• 12:08
  Dr. Somer DelSignore: So there's certain symptoms that they have.
• 12:10
  Dr. Somer DelSignore: So it's a little trickier with kids, especially if it was something from a young age.
• 12:14
  Dr. Somer DelSignore: So I'll start with the symptoms.
• 12:16
  Dr. Somer DelSignore: I'll start with an mc, which is a very good validated tool.
• 12:19
  Dr. Somer DelSignore: And then I work backwards.
• 12:21
  Dr. Somer DelSignore: And then from there it's, you know, asking the parents, well, what were the exposures?
• 12:26
  Dr. Somer DelSignore: Not immediately, but any time in their life, have they ever.
• 12:29
  Dr. Somer DelSignore: Any weird illnesses that didn't match with what may have been going around.
• 12:34
  Dr. Somer DelSignore: Do they seem to chronically, you know, have colds compared to their peers?
• 12:37
  Dr. Somer DelSignore: And I was compared to their peers, yes.
• 12:40
  Dr. Somer DelSignore: Do they seem that they're the stamina, Is the stamina there?
• 12:43
  Dr. Somer DelSignore: Is there a fatigue issue?
• 12:44
  Dr. Somer DelSignore: Is there a concentration issue or their sleep issues?
• 12:46
  Dr. Somer DelSignore: And we kind of go through all systems and then I dig in with the parents and they're usually surprised to say, well, what were your exposures?
• 12:54
  Dr. Somer DelSignore: And you know, what was dad's exposures?
• 12:57
  Dr. Somer DelSignore: Mom, what was your exposure?
• 12:58
  Dr. Somer DelSignore: How was your pregnancy?
• 12:59
  Dr. Somer DelSignore: How was your childhood?
• 13:00
  Dr. Somer DelSignore: And they scratched their head a bit.
• 13:02
  Dr. Somer DelSignore: And I have to say, you know, genes translate inflammation translates to the baby and can shape the way the neurological system develops, it can shape the way the immune system develops.
• 13:13
  Dr. Somer DelSignore: And by the way, there are certain, you know, bacteria and other pathogens like tick borne that can be transmitted congenitally.
• 13:22
  Dr. Somer DelSignore: And we are watching that and we are showing that now.
• 13:25
  Dr. Somer DelSignore: And then there's other viruses and other bugs that, that you may have had that didn't necessarily transmit, but the inflammatory response that you experienced passed along to that developing child as well.
• 13:37
  Dr. Somer DelSignore: And that can kind of shape the way that immune system responds in real time once they're born.
• 13:43
  Dr. Somer DelSignore: And so I kind of take that and create that picture and it gives me a good indication of what we have on board based on the symptoms.
• 13:49
  Dr. Somer DelSignore: We, we started with the other potentials what I need to do to test and kind of round that out because I am a diagnostic person, but I try to b how much I'm testing at once because it can be very overwhelming.
• 14:02
  Dr. Somer DelSignore: And then I'm looking historically to try to gauge if this was a more of a lifelong something for this child and perhaps they were already on this alternative pathway from an immune and neurodevelopmental perspective.
• 14:16
  Dr. Somer DelSignore: And that gives me insight on how much I may be able to move that and, or how much effort I need to spend on not only treating whatever XYZ is, but supporting them from a detox and anti inflammatory.
• 14:28
  Dr. Somer DelSignore: So it's this sort of process and web that kind of goes on in my brain.
• 14:31
  Dr. Somer DelSignore: So I have this beautiful structured incense protocol and then everything else is like a spiderweb in my head to kind of connect the dots and you know, and then kind of move them forward.
• 14:40
  Dr. Jill Carnahan, MD: Gosh, I have so many questions but maybe it's a good time to introduce you developed this Reset protocol.
• 14:46
  Dr. Jill Carnahan, MD: Is that the digitized like taking that and creating this program.
• 14:50
  Dr. Jill Carnahan, MD: I can't wait to hear more about it because I know people listening are going to want to know and it's always nice when a clinician sees a pattern like you did, learns from some of the greats like you did and then actually creates a reproducible way to see patients because we all know in our brain how we do it.
• 15:06
  Dr. Jill Carnahan, MD: Tell us about the Reset protocol.
• 15:08
  Dr. Somer DelSignore: Right, so the reset was born, you know, from utilizing the MSITS protocol and then having more of a 10 point system within the practice that's focused on all body systems and then neurologically immune and then infection.
• 15:24
  Dr. Somer DelSignore: So we tried to condense it in a way that was, is more digestible for parents to understand and patients understand.
• 15:31
  Dr. Somer DelSignore: So reset's an acronym for reduce inflammation, eliminate toxins, support gut health, eradicate infection and transform health.
• 15:39
  Dr. Somer DelSignore: So it's a, an all encompassing sort of comprehensive approach to say not only we're going to deal with whatever appears to be broken, but we have to look at all of these other domains and ensure that they're optimized as well for you to ultimately achieve, you know, quality health.
• 15:56
  Dr. Somer DelSignore: And, and so that was pretty much the way that that worked out.
• 16:03
  Dr. Jill Carnahan, MD: I love it and I'm very familiar with msds and even as a clinician it's complicated, right?
• 16:08
  Dr. Jill Carnahan, MD: It's amazing, it's brilliant and I love the simplicity because you're still covering those points within what you've just created.
• 16:15
  Dr. Jill Carnahan, MD: Right.
• 16:15
  Dr. Jill Carnahan, MD: And for me it's sometimes just a very toxic load infectious burden.
• 16:18
  Dr. Jill Carnahan, MD: That simple.
• 16:19
  Dr. Jill Carnahan, MD: Although we know that immune inflammation and inputs and there's way more than that.
• 16:23
  Dr. Jill Carnahan, MD: But I really love that.
• 16:25
  Dr. Jill Carnahan, MD: So let's go to like say we have a kiddo, you know, say it's a seven year old kid who's had some trouble in school, trouble with focus and attention, probably diagnosis of add.
• 16:36
  Dr. Jill Carnahan, MD: Maybe the parents are concerned about some symptoms that are worse after in sore throat or infection.
• 16:42
  Dr. Jill Carnahan, MD: So maybe in the line of where would you start with them?
• 16:45
  Dr. Jill Carnahan, MD: With the kinds of questions you mentioned, a few of them.
• 16:48
  Dr. Jill Carnahan, MD: But how would you start to dive down?
• 16:50
  Dr. Jill Carnahan, MD: And then after that I want to say where would you start with testing?
• 16:52
  Dr. Jill Carnahan, MD: Because that's always just a, a big huge amount of things we could do.
• 16:57
  Dr. Jill Carnahan, MD: Like you mentioned, where do you focus in, on in the first, you know, one or two visits?
• 17:01
  Dr. Somer DelSignore: Right.
• 17:02
  Dr. Somer DelSignore: So the first visit is a data collection and really creating a, a story, a very comprehensive story history for that kid.
• 17:12
  Dr. Somer DelSignore: And again that's where I'm asking with you know, exposures, food allergens, mold toxin exposures, if they're aware.
• 17:20
  Dr. Somer DelSignore: And then I'm also kind of evaluating the parents too and kind of how their responses are me, how are they cognitively, how are they emotionally?
• 17:30
  Dr. Somer DelSignore: Because you pick up a lot of things.
• 17:31
  Dr. Somer DelSignore: What's the dynamic with the mom, the dad, the child or the parents and the child, whoever the caregivers are.
• 17:37
  Dr. Somer DelSignore: And so that clues me in quite a bit.
• 17:40
  Dr. Somer DelSignore: And if, you know, the entire family seems a little inflamed, I'm starting from the environment and I'm going to say let's look at testing for mold, heavy metals, VOCs, plastics, and we'll look at all of those things and there's some really great tests out there that can kind of pick up on many of those toxins.
• 17:58
  Dr. Somer DelSignore: And then I'm also asking about exposures, you know, if you know, did your child have infections like strep, common things, how did they respond with, you know, within a week or two weeks later when we get the heightened, you know, inflammatory response that happens, what was their behavior like?
• 18:16
  Dr. Somer DelSignore: What were they physically like for you?
• 18:18
  Dr. Somer DelSignore: Did anyone else in the house react?
• 18:20
  Dr. Somer DelSignore: And that gives me an indication too, sometimes genetically if there is something from autoimmune cephalopathy, MTHFR mutations and onward.
• 18:28
  Dr. Somer DelSignore: So I'm kind of looking at the family unit as a whole and if there is inflammation and we're seeing that as a key diagnostic component and typically I do see that with adhd, behavioral, it's inflammation.
• 18:42
  Dr. Somer DelSignore: So then I'm looking at, well, what could the root cause be of these things?
• 18:47
  Dr. Somer DelSignore: So yes, environment, and then I go down the path of infection.
• 18:50
  Dr. Somer DelSignore: Let's look for these infections.
• 18:52
  Dr. Somer DelSignore: If there is suspicion of a tick borne infection either based upon the area where they may Live or exposures.
• 19:00
  Dr. Somer DelSignore: Like we're constantly outdoors, we're camping, we have animals, you know, we're, you know, that type of thing.
• 19:06
  Dr. Somer DelSignore: Then then I'm testing for full tick borne but I'm at least getting all viral panels and then a lot of the common infections like mycoplasma and coxackie and you know, strep and other things.
• 19:18
  Dr. Somer DelSignore: And so I'll put that in a bucket to determine.
• 19:20
  Dr. Somer DelSignore: Okay, is this part of the root as model as the environmental.
• 19:23
  Dr. Somer DelSignore: And then now let's look at gut.
• 19:24
  Dr. Somer DelSignore: Let's see what's going on with gut.
• 19:26
  Dr. Somer DelSignore: That's a big component and that gives me, and you know this too, that the degree of inflammation that the body may produce, how the immune system may be functioning, you know, from that perspective.
• 19:37
  Dr. Somer DelSignore: And then look at shoring those things up.
• 19:40
  Dr. Somer DelSignore: So I'm pretty much looking at all things but then the emphasis will be placed based upon the history that I'm getting and then the responses that I'm seeing in front of me when speaking to that family.
• 19:54
  Dr. Jill Carnahan, MD: Hey guys.
• 19:55
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• 20:05
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• 20:11
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• 20:19
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• 20:20
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• 20:26
  Dr. Jill Carnahan, MD: Okay, let's get back to our show.
• 20:27
  Dr. Jill Carnahan, MD: Makes so much sense and toxic load is kind of inevitable.
• 20:31
  Dr. Jill Carnahan, MD: It feels like most all of our patients have some form.
• 20:34
  Dr. Jill Carnahan, MD: Not all of them have mold, but a lot of them do.
• 20:36
  Dr. Jill Carnahan, MD: And then and the infections.
• 20:38
  Dr. Jill Carnahan, MD: And again if you start to ask about exposures, parents will start to click in like oh yeah, every since he had this really bad strep throat at three, he's never quite been the same or he gets flared or so does.
• 20:48
  Dr. Jill Carnahan, MD: I love that you know, ask those kinds of questions.
• 20:51
  Dr. Jill Carnahan, MD: And I love what you're also doing is you're including the parents and kind of giving them aha moments as you ask and they're like oh yeah, I also had that trouble when I was his age or you know the kind of.
• 21:01
  Dr. Jill Carnahan, MD: You've seen that okay genetics which is so huge.
• 21:05
  Dr. Jill Carnahan, MD: I always felt, I mean I have family medicine so I'm not primarily peeds but of course I would see pediatrics and it was so interesting because for me it would mostly be like the mother, father would come in, mostly the mother.
• 21:14
  Dr. Jill Carnahan, MD: And then later, like, would you also see my daughter?
• 21:16
  Dr. Jill Carnahan, MD: Or would you also see my son?
• 21:17
  Dr. Jill Carnahan, MD: Or would you.
• 21:18
  Dr. Jill Carnahan, MD: And it's so interesting because I loved doing that because already knowing whatever patient I treated their family member, I could already predict some of the gut microbiome things.
• 21:27
  Dr. Jill Carnahan, MD: And maybe we start there real quickly because tell us a little for the listeners.
• 21:31
  Dr. Jill Carnahan, MD: How might the gut, the mother's gut microbiome affect the babies, especially through vaginal birth and that.
• 21:37
  Dr. Jill Carnahan, MD: And, and how do you look at that piece?
• 21:40
  Dr. Somer DelSignore: Absolutely.
• 21:40
  Dr. Somer DelSignore: So again, a lot of history there and we know that if it's a C section baby, they probably didn't have well seated, healthy bacteria there and they're going to struggle a bit.
• 21:51
  Dr. Somer DelSignore: And so I do find that's a component of it.
• 21:53
  Dr. Somer DelSignore: I also talk about any antibiotic use, certain types of diets that the mom may have ascribed to.
• 22:02
  Dr. Somer DelSignore: And I know that's challenging sometimes having two kids of my own, it was a very different picture.
• 22:08
  Dr. Somer DelSignore: But, but that certainly plays a huge role as well.
• 22:12
  Dr. Somer DelSignore: And I do find that again, that inflammation plays a big role, April, with how healthy the microbiome is in that child even before they're getting started, and then certainly evaluating the foods that those kids are eating afterwards.
• 22:28
  Dr. Somer DelSignore: How long did they breastfeed?
• 22:30
  Dr. Somer DelSignore: Did they get that colostrum?
• 22:32
  Dr. Somer DelSignore: Did they get those, you know, the immunoglobulin to kind of help line up that inner wall lining and help, you know, feed that system, generally speaking.
• 22:41
  Dr. Somer DelSignore: So it plays a huge role.
• 22:44
  Dr. Somer DelSignore: And again, I mean, I'm sure you experience this too.
• 22:47
  Dr. Somer DelSignore: The parents kind of scratch their heads, like, why are you asking me?
• 22:50
  Dr. Jill Carnahan, MD: Exactly, exactly.
• 22:52
  Dr. Somer DelSignore: So you have to connect it with them, you know, and say that, you know, what you do translates, what you do after they're born also translates from a dietary perspective, from a stress perspective, all the things, all of them.
• 23:07
  Dr. Somer DelSignore: And we only, you know, seem to view the gut is just the bacteria in it when we have to be concerned too, about the nervous system and how it innervates, I mean, all these things.
• 23:17
  Dr. Somer DelSignore: So, yeah, it's an interesting discussion.
• 23:20
  Dr. Jill Carnahan, MD: It is complex and of course you need the parents to be on board, so involving them is so crucial.
• 23:26
  Dr. Jill Carnahan, MD: Which brings me to one of the things I think is most difficult about probably most of your population in any of the children that I've ever seen.
• 23:33
  Dr. Jill Carnahan, MD: They tend to be, especially in the spectrum or any of these kiddos, a Little bit more picky with their taste or their texture issues.
• 23:40
  Dr. Jill Carnahan, MD: So how would you take a kiddo who maybe has some of those things already and maybe a restricted diet and then how do you like to prescribe diet and do you go just gluten free?
• 23:51
  Dr. Jill Carnahan, MD: Do you try to go more strict with their food sensitivities and how do you navigate that with the parents?
• 23:55
  Dr. Somer DelSignore: And that's an interesting one.
• 23:56
  Dr. Somer DelSignore: That is probably the most challenging component of treatment, right.
• 24:00
  Dr. Somer DelSignore: It's easy to give them, but it's difficult to take away their chicken nuggets and their Mac, which is the ongoing joke out there, you know, because that's common, right.
• 24:10
  Dr. Somer DelSignore: So we talk about depending upon how restrictive they are.
• 24:14
  Dr. Somer DelSignore: I will in the beginning kind of let it slide.
• 24:18
  Dr. Somer DelSignore: If there are many other things that we need to address.
• 24:21
  Dr. Somer DelSignore: And the hope is that if I can get neuroinflammation down, if I can nourish the cells in a different way and get a little less resistant from them, then I can start tackling the diet and perhaps also allow the parents to find a nice rhythm and cadence with the treatment.
• 24:41
  Dr. Somer DelSignore: They're chronic, they're multi system issues going on and it can be very overwhelming.
• 24:46
  Dr. Somer DelSignore: And I'd rather save the biggest fear for last, which is diet changing, you know, changes in a kid.
• 24:53
  Dr. Somer DelSignore: So that I get them kind of get the buy in up front to say we're going to work towards that.
• 24:58
  Dr. Somer DelSignore: The diet can stay as it is now.
• 25:00
  Dr. Somer DelSignore: However, we need to work through these things and we're going to tackle that later.
• 25:04
  Dr. Somer DelSignore: So it may be the third visit in before we start to really tackle it.
• 25:08
  Dr. Somer DelSignore: And I, and visits are about every six weeks.
• 25:11
  Dr. Somer DelSignore: So I give them several months of onboarding of the things and then we start with well, what is their absolute comfort?
• 25:17
  Dr. Somer DelSignore: What do they have to have, what soothed them the most?
• 25:21
  Dr. Somer DelSignore: And then we talk about potentially alternatives to that, you know, vagal nerve stimulation, other things to help stimulate that reward center a little bit more.
• 25:32
  Dr. Somer DelSignore: If it's, you know, play time with mom, a special trip somewhere, something that's going to kind of reward that center in the brain and then maybe start to slowly take away that food source that they rely upon.
• 25:43
  Dr. Somer DelSignore: Almost like the binkies or the blankets, whatever the comfort is.
• 25:47
  Dr. Somer DelSignore: So we'll start with that very small and then I'll ask the parents to start with more of a whole food diet.
• 25:53
  Dr. Somer DelSignore: Unless there are signs of really needing to be severely restricted because of an allergy.
• 25:59
  Dr. Somer DelSignore: Or, or something to that effect.
• 26:01
  Dr. Somer DelSignore: But I'll say stick with protein sources, fresh fruits and veggies, and try to eliminate grains.
• 26:06
  Dr. Somer DelSignore: No processed anything, no dyes, no extra sugar.
• 26:09
  Dr. Somer DelSignore: Just stick with whole foods.
• 26:10
  Dr. Somer DelSignore: It's very simple.
• 26:11
  Dr. Somer DelSignore: Shop the perimeter of your market.
• 26:13
  Dr. Somer DelSignore: Don't go in the middle, you know, and just stick with those whole foods.
• 26:18
  Dr. Somer DelSignore: Gluten wise.
• 26:19
  Dr. Somer DelSignore: I do try to cut out gluten with most people.
• 26:21
  Dr. Somer DelSignore: We do talk about how gluten is very different in the United States versus Europe and the top tolerance and all of these things, but we talk about the inflammatory response there and then also trying to remove cow's dairy, unless it is an organic A2 or in some areas, highly tested raw milk, which.
• 26:40
  Dr. Somer DelSignore: That's, there's.
• 26:40
  Dr. Somer DelSignore: That's a little tricky, but it exists.
• 26:44
  Dr. Somer DelSignore: And so we talk about those things and then it's sort of a gradual change.
• 26:51
  Dr. Somer DelSignore: So make exchanges every week, make one exchange in that diet, and usually by that second week we have something that looks acceptable.
• 27:00
  Dr. Somer DelSignore: So it's just encouraging those parents that going cold turkey with anyone won't work, child, adult or otherwise.
• 27:07
  Dr. Somer DelSignore: Right.
• 27:07
  Dr. Somer DelSignore: We all will kind of fall off the wagon.
• 27:10
  Dr. Somer DelSignore: So gradually, just make an exchange every week and put something healthy in there and try to clean up as much as you can and distract.
• 27:18
  Dr. Jill Carnahan, MD: So it's a process that was one of the most beautiful balance.
• 27:24
  Dr. Jill Carnahan, MD: I love it, every bit of it.
• 27:26
  Dr. Jill Carnahan, MD: I worked years for with a pediatric registered dietitian and I really loved working with her because unlike especially back, I've been doing this over 20 years and in the early days, like I'm elimination diet, take out every, you know, and adults or children, it was so hard.
• 27:39
  Dr. Jill Carnahan, MD: And I loved what you said about those exchanges because even with adults, it's like, get your pantry set with things that, you know, you can eat and you love.
• 27:46
  Dr. Jill Carnahan, MD: Otherwise you open the pantry and it's, you know, cheese puffs and bars and things that you can't have, and you're like, well, what do I eat?
• 27:53
  Dr. Jill Carnahan, MD: And then you feel deprived.
• 27:55
  Dr. Jill Carnahan, MD: And again, adults or children, and then the parents filling the burden because so often parents unbeknownst to them are giving rewards like ice cream or, you know, chicken nuggets as a reward because a child feels soothed by that.
• 28:06
  Dr. Jill Carnahan, MD: So you just really address some really important things.
• 28:09
  Dr. Jill Carnahan, MD: I mean, then of course you have to get the parents buy in too, because if they love some of those foods, it's going to be extra hard because, you know, they probably have to change.
• 28:16
  Dr. Jill Carnahan, MD: Otherwise if they're eating that in front of the child, it's not going to go over well.
• 28:20
  Dr. Jill Carnahan, MD: So that was really balance.
• 28:22
  Dr. Jill Carnahan, MD: And like I said, I always love that dietitian because she would never be like so strict.
• 28:27
  Dr. Jill Carnahan, MD: I think that strictness because then it feels like a punishment and you don't want to do that.
• 28:31
  Dr. Jill Carnahan, MD: Yeah.
• 28:32
  Dr. Somer DelSignore: Again, their nervous system's already, they're already in fight mode.
• 28:36
  Dr. Jill Carnahan, MD: Exactly.
• 28:37
  Dr. Somer DelSignore: Let's not add to it.
• 28:38
  Dr. Somer DelSignore: Yeah, right.
• 28:40
  Dr. Jill Carnahan, MD: So that's such a beautiful.
• 28:41
  Dr. Jill Carnahan, MD: So many good tips there.
• 28:42
  Dr. Jill Carnahan, MD: And especially I loved what you emphasized that food can be comfort and many times it's the number one comfort.
• 28:48
  Dr. Jill Carnahan, MD: And so if you're taking away something that's soothing, you have to think about what's the alternatives and what could we do to soothe your system.
• 28:55
  Dr. Jill Carnahan, MD: I really like that.
• 28:55
  Dr. Jill Carnahan, MD: And we know maybe you talk just a little bit about gluteomorphine and Casey morphine because these foods can actually act like a drug on the child's brain.
• 29:02
  Dr. Jill Carnahan, MD: Right.
• 29:03
  Dr. Somer DelSignore: They do.
• 29:04
  Dr. Somer DelSignore: And ours too.
• 29:05
  Dr. Somer DelSignore: Right.
• 29:05
  Dr. Somer DelSignore: And you got to rewire that system for those healthier rewards.
• 29:11
  Dr. Jill Carnahan, MD: Absolutely amazing.
• 29:13
  Dr. Jill Carnahan, MD: So one thing I think that it's getting better.
• 29:15
  Dr. Jill Carnahan, MD: But the more I'm in functional integrative medicine and depression, anxiety, even severe disorders like bipolar and schizophrenia, the more I'm convinced that there's almost always an organic cause, whether it be infection, toxin, gut issues, etc.
• 29:33
  Dr. Jill Carnahan, MD: Parents, I think nowadays are seen in the school systems.
• 29:36
  Dr. Jill Carnahan, MD: You know, they're putting together these plans for behavioral disorders and mood disorders.
• 29:39
  Dr. Jill Carnahan, MD: And I think children as young as three and five are getting diagnosed with bipolar, which is really sad.
• 29:44
  Dr. Jill Carnahan, MD: But you and I look at it differently.
• 29:46
  Dr. Jill Carnahan, MD: Right.
• 29:46
  Dr. Jill Carnahan, MD: The brain and the body are the same.
• 29:48
  Dr. Jill Carnahan, MD: How do you start to have that conversation with a parent about a behavioral disorder that may actually be organic and not blaming the child and also giving them resources and then looking deeper, I feel like that's a really big thing that we, you and I do differently than the classical maybe psychiatrist.
• 30:04
  Dr. Jill Carnahan, MD: And so it's great for the parents to hear that.
• 30:07
  Dr. Jill Carnahan, MD: But how do you start that conversation?
• 30:09
  Dr. Somer DelSignore: Well, I start with hope.
• 30:12
  Dr. Somer DelSignore: We're going to approach this biomedically and biomedically gives us something to hold on to.
• 30:18
  Dr. Somer DelSignore: It gives us a nice strategic plan to move forward.
• 30:22
  Dr. Somer DelSignore: And I don't make false promises.
• 30:24
  Dr. Somer DelSignore: I do say sometimes genetics can align in a way that yes, there may be something psychiatric going on, but we could still mitigate that as well.
• 30:36
  Dr. Somer DelSignore: But the majority of the time I find that it is a biomedical issue, either related to an infection, which we see quite a bit, not just tick borne, but viruses like EBV, HHV6, those types of things that can make their way over.
• 30:50
  Dr. Somer DelSignore: And we see a lot of inflammation and autoimmune is a big component of it.
• 30:55
  Dr. Somer DelSignore: Things like autoimmune encephalopathy, which is very different from encephalitis.
• 30:58
  Dr. Somer DelSignore: And I have this argument all the time.
• 31:00
  Dr. Somer DelSignore: So it's just more of like a basal ganglia cephalopathy and that can be triggered from an infection.
• 31:06
  Dr. Somer DelSignore: So we just talk about biomedically.
• 31:08
  Dr. Somer DelSignore: We're going to work through this, we're going to shore up any deficiencies we may have.
• 31:13
  Dr. Somer DelSignore: We're going to look at D levels, we're going to look at folate, we're going to look at thyroid function, we're going to see what we can do to support any other genetic snips.
• 31:20
  Dr. Somer DelSignore: We'll look at infections and we'll start treating them.
• 31:22
  Dr. Somer DelSignore: And then we're going to start with some natural anti inflammatories, things that are going to hit that cycle and are nourishing to the brain.
• 31:29
  Dr. Somer DelSignore: And then we're going to kind of step back and see how things go.
• 31:31
  Dr. Somer DelSignore: But it's just a very, you know, gentle but directed stepwise approach and find that the majority of the time it is biomedical.
• 31:40
  Dr. Somer DelSignore: And we do lift those bipolar or psychiatric conditions that they really don't have.
• 31:47
  Dr. Somer DelSignore: It's just sort of a byproduct behaviorally of something else that needs to be managed.
• 31:52
  Dr. Somer DelSignore: And we talk about it.
• 31:53
  Dr. Somer DelSignore: I, you know, I usually see patients, half the patients that I see come in from other states.
• 31:59
  Dr. Somer DelSignore: And it's interesting, we were looking at numbers within the practice just to kind of get state of the state, what's going on.
• 32:05
  Dr. Somer DelSignore: And most of these parents are managing their kids because they're not getting anywhere.
• 32:09
  Dr. Somer DelSignore: It's.
• 32:10
  Dr. Somer DelSignore: And, and I get those heartbreaking stories that my child has been on four or five different SSRIs and their affect is so flat that their personality has disappeared, but they're still not better and they still have OCD and they still have ruminations and they still have intrusivity and all of these things and it just breaks your heart.
• 32:31
  Dr. Somer DelSignore: And these are very young kids.
• 32:33
  Dr. Somer DelSignore: So.
• 32:34
  Dr. Somer DelSignore: And then we talk about, you know, just to kind of put in perspective for parents if there's sort of a flip of the switch with their child, that if it truly were organic psychiatric, it wouldn't just happen overnight.
• 32:46
  Dr. Somer DelSignore: It wouldn't just, you know, out of the blue, you wouldn't just develop this.
• 32:51
  Dr. Somer DelSignore: So, and then, you know, we talk about trauma as well.
• 32:54
  Dr. Somer DelSignore: But generally speaking, there are certain patterns of behavior that would lead you to believe that it's not organically psychiatric, that there was a trigger along the way that led to this, and we have to find it.
• 33:06
  Dr. Somer DelSignore: And that seems to, you know, translate well with the parents.
• 33:12
  Dr. Somer DelSignore: And they seem to be on board with certainly exploring it.
• 33:16
  Dr. Somer DelSignore: And again, I don't make the promises that 100% because again, these are growing children.
• 33:20
  Dr. Somer DelSignore: Personality wise, they may be a little more type A, I know that I would was, but they may be a little more higher strong than, you know, other family members and perceived as anxious, but it's, you know, normal to them, but at least, you know, lifting things in a way that they are functional and they're not on these heavy medications for the rest of their lives and they understand their bodies more and how to mitigate it.
• 33:43
  Dr. Somer DelSignore: And saying that perhaps I just need to have a little extra corin or maybe an ibuprofen, or maybe I'm coming down with something burnt is, you know, I need that so loft.
• 33:51
  Dr. Somer DelSignore: Or I need, you know, so that's kind of how we approach it.
• 33:54
  Dr. Jill Carnahan, MD: Oh, that's so beautiful.
• 33:56
  Dr. Jill Carnahan, MD: You mentioned ocd, obsessive compulsive disorder, which of course our listeners are familiar with.
• 34:00
  Dr. Jill Carnahan, MD: But I find this is particularly interesting because it can be a hallmark of certain infections or brain inflammation.
• 34:07
  Dr. Jill Carnahan, MD: Encephalopathy, as you mentioned.
• 34:08
  Dr. Jill Carnahan, MD: What would parents notice?
• 34:10
  Dr. Jill Carnahan, MD: What would be some of the common things that are maybe a little different from adults that might be considered in this bucket of ocd?
• 34:16
  Dr. Jill Carnahan, MD: That if a parent's listening and they just think, oh, my child's a little strange.
• 34:19
  Dr. Jill Carnahan, MD: And then you would say, wait, that could be actually infection.
• 34:22
  Dr. Jill Carnahan, MD: What behaviors or things have you heard from your parents about children with this kind of presentation?
• 34:29
  Dr. Somer DelSignore: Right.
• 34:30
  Dr. Somer DelSignore: So it is a little perplexing to a lot of parents to say, well, they, you know, they'll only play with this friend.
• 34:36
  Dr. Somer DelSignore: So they seem to be social, but with just this friend.
• 34:40
  Dr. Somer DelSignore: Or they seem to be able to go to dance class, but they can't go to gymnastics any longer.
• 34:47
  Dr. Somer DelSignore: So it's sort of the rules in their heads.
• 34:48
  Dr. Somer DelSignore: The parents.
• 34:49
  Dr. Somer DelSignore: Well, you're just being stubborn, you know, just being obstinate.
• 34:52
  Dr. Somer DelSignore: What's your, what's the problem?
• 34:54
  Dr. Somer DelSignore: And so it's really interesting with that.
• 34:56
  Dr. Somer DelSignore: Or they'll repeat themselves over and over as if to remind themselves or that or, you know, tap the door handles before they walk through a threshold.
• 35:06
  Dr. Somer DelSignore: And it's just these quirky things.
• 35:08
  Dr. Somer DelSignore: But to say those are rules.
• 35:09
  Dr. Somer DelSignore: Those are ruminating rules in their heads or you know, like the movie Rain Man.
• 35:15
  Dr. Somer DelSignore: Right.
• 35:15
  Dr. Somer DelSignore: They have to have this many fish sticks on the plate or boots have to be this color or you know, things like that.
• 35:23
  Dr. Somer DelSignore: So we see some of those behaviors and the parents will say, yeah, they're a little quirky, they're just a little challenging, a little awesome, but OCD doesn't necessarily resonate with them.
• 35:32
  Dr. Somer DelSignore: Right, right.
• 35:33
  Dr. Somer DelSignore: You know, it was interesting.
• 35:35
  Dr. Somer DelSignore: Yeah.
• 35:35
  Dr. Jill Carnahan, MD: And then if you had that presentation, obviously you could be dealing with brain inflammation.
• 35:40
  Dr. Jill Carnahan, MD: But what are some of the infections that you see most likely present with those kinds of symptoms?
• 35:45
  Dr. Somer DelSignore: I do see strep quite a bit.
• 35:48
  Dr. Somer DelSignore: I also see coxacky is a big one.
• 35:51
  Dr. Somer DelSignore: Wow.
• 35:53
  Dr. Somer DelSignore: I think that's a rather common and then certainly tick borne illnesses.
• 35:59
  Dr. Somer DelSignore: All three bees I find do contribute, honestly from a neurological perspective.
• 36:04
  Dr. Somer DelSignore: And again, when most of them are riding together, it's sometimes it's hard to differentiate which in particular I find that Babisi ot in particular has a lot of OCD and in Bartonella as well.
• 36:19
  Dr. Somer DelSignore: So a lot of common things and then not so common to it.
• 36:25
  Dr. Jill Carnahan, MD: So there's all kinds of wonderful labs for tick borne infections.
• 36:29
  Dr. Jill Carnahan, MD: I'd love to know your top two or three.
• 36:31
  Dr. Jill Carnahan, MD: And then also viral titers can be complicated.
• 36:35
  Dr. Jill Carnahan, MD: Do you test T cell function?
• 36:36
  Dr. Jill Carnahan, MD: Do you test blood igg, IGM titers and look at numbers?
• 36:40
  Dr. Jill Carnahan, MD: What is kind of your gestalt for looking at the infection in a kiddo?
• 36:44
  Dr. Somer DelSignore: Right.
• 36:45
  Dr. Somer DelSignore: So I utilize tlab and Galaxy as well as ige and then sometimes vibrant and just depending upon the situation, depending upon the size of the child, compliance, that sort of thing.
• 36:57
  Dr. Somer DelSignore: They all use a little bit different platforms.
• 37:00
  Dr. Somer DelSignore: So that's why I get the, you know, some, some tests will pick up on certain bugs and others won't so much.
• 37:05
  Dr. Somer DelSignore: But that's the best way to try to capture it.
• 37:08
  Dr. Somer DelSignore: And so I will look at fish tests, I will look at IGG IGMs.
• 37:13
  Dr. Somer DelSignore: If it's a congenital, I'm not focused as much on IGG and IGM because that immune system developed alongside those bugs.
• 37:24
  Dr. Somer DelSignore: Right.
• 37:24
  Dr. Somer DelSignore: So you're not necessarily going to get a strong response, but we'll at least do some fish testing to see if something's active there and then once you sort of start test, you know, treating and you retest and sometimes after you've corrected, then the IGG IGMs will pop up positive and then that gets very confusing.
• 37:39
  Dr. Somer DelSignore: Right.
• 37:40
  Dr. Somer DelSignore: But so those are sort of my specialty tests that I'll utilize and then viral tests Quest LabCorp Many times I can get reasonable studies from them and I am looking at full ebv panels and IGG IGMs for most of that and then looking at immunoglobulins and T cell responses and things like that.
• 38:03
  Dr. Somer DelSignore: So putting it all together, brilliant.
• 38:06
  Dr. Jill Carnahan, MD: Couldn't agree more.
• 38:07
  Dr. Jill Carnahan, MD: I think it's so important and it's complicated.
• 38:09
  Dr. Jill Carnahan, MD: So people need someone like you who's really going to that deep level and understanding because there's T cells, there's B cells, there's you know, the IL6s and Nile 2s and TNF Alphas and all kinds of immune signals.
• 38:20
  Dr. Jill Carnahan, MD: So I love that you're so comprehensive.
• 38:22
  Dr. Jill Carnahan, MD: You touched on toxic exposure and one of my favorite topics is mold related illness.
• 38:27
  Dr. Jill Carnahan, MD: How often do you find some toxic exposure, especially mold in the home is related to some of the kiddos presentations?
• 38:34
  Dr. Somer DelSignore: I would say nearly all, yes.
• 38:38
  Dr. Somer DelSignore: Some level of mold exposure and you know the.
• 38:46
  Dr. Somer DelSignore: There is surprise from the parents to say well our house is new.
• 38:50
  Dr. Somer DelSignore: And when the same discovery that you had mentioned earlier was there water damage.
• 38:55
  Dr. Somer DelSignore: Anyway, where are you close to a water reservoir.
• 38:58
  Dr. Somer DelSignore: What's the humidity level generally in your house and surrounding.
• 39:01
  Dr. Somer DelSignore: And then I'm asking, well, what kind of foods are you eating?
• 39:03
  Dr. Somer DelSignore: It's in nut butters, it's in coffee, it's in teas, it's in chocolates.
• 39:06
  Dr. Somer DelSignore: All the things we have a reason to live for.
• 39:09
  Dr. Somer DelSignore: Good things, right?
• 39:11
  Dr. Somer DelSignore: Grains.
• 39:11
  Dr. Somer DelSignore: It's in all the grains.
• 39:13
  Dr. Somer DelSignore: And I joke to say, well, do you want, you know, molds organically or do you want glyphosates?
• 39:18
  Dr. Somer DelSignore: Which one do you want?
• 39:19
  Dr. Jill Carnahan, MD: Yeah, I know, right?
• 39:20
  Dr. Somer DelSignore: Which one do we want to deal with of here?
• 39:22
  Dr. Somer DelSignore: But because it is in my families who are really organic, they're like, oh, but we're doing sport.
• 39:27
  Dr. Somer DelSignore: How many PB and JS are they eating a week?
• 39:29
  Dr. Somer DelSignore: You know, what are you giving them?
• 39:31
  Dr. Somer DelSignore: And so it is a great deal I find is really in food source.
• 39:35
  Dr. Somer DelSignore: Once we really nail it down and have the parents testing the house and there's nothing we find it in food.
• 39:40
  Dr. Somer DelSignore: We find that's usually if we change the diet up, it does help us clear it quicker.
• 39:45
  Dr. Somer DelSignore: And I also had that discussion with the mold that new houses have sheetrock and Sheetrock has paper and mold grows on the back of the paper really nicely.
• 39:53
  Dr. Somer DelSignore: Yes, almost.
• 39:55
  Dr. Somer DelSignore: Sometimes those older homes with like horsehair plaster walls are safer and more mold resistant.
• 40:02
  Dr. Somer DelSignore: And so it's not about the newness of the house.
• 40:05
  Dr. Somer DelSignore: It's about that moisture level and that exposure beyond.
• 40:09
  Dr. Jill Carnahan, MD: I love that you say that because that's even today in clinic, you know, when I'm seeing patients frequently I hear, oh, but I have a new home or we even built the home or ourselves or it's a multi million, you know, the very expensive home.
• 40:21
  Dr. Jill Carnahan, MD: It doesn't matter, does it?
• 40:22
  Dr. Jill Carnahan, MD: It just doesn't matter as far as the.
• 40:24
  Dr. Jill Carnahan, MD: If there's drywall, if there was one moisture shoe.
• 40:26
  Dr. Jill Carnahan, MD: And what I see, like I'm driving all the time on these areas where they're building up multi family homes or even just beautiful new custom homes and the sheetrock or the wood is sitting out in snow and rain and not drying.
• 40:39
  Dr. Jill Carnahan, MD: I'm like, oh my goodness, that's going to have mold.
• 40:41
  Dr. Jill Carnahan, MD: You know, so people don't realize.
• 40:42
  Dr. Jill Carnahan, MD: And again, we're using materials that are much more porous than we used to, like stone.
• 40:46
  Dr. Jill Carnahan, MD: It's like the three little pigs, right?
• 40:48
  Dr. Jill Carnahan, MD: The stone and the brick and that would have been much better, even strong concrete than the plastic and.
• 40:54
  Dr. Jill Carnahan, MD: Or not the plastic, but the sheetrock that you mentioned.
• 40:57
  Dr. Jill Carnahan, MD: So super common.
• 40:58
  Dr. Jill Carnahan, MD: And I'm in Colorado, which is a very dry, kind of not humid state and we have just as much issues and like crawl spaces are an issue.
• 41:06
  Dr. Jill Carnahan, MD: So you have to be pretty good detective to ask the questions.
• 41:09
  Dr. Jill Carnahan, MD: And many parents I'm sure, just like my patients are kind of like in denial smile that there's not an issue.
• 41:14
  Dr. Jill Carnahan, MD: So I'm glad that you said that because I would agree.
• 41:16
  Dr. Jill Carnahan, MD: I years ago when I had my mold illness and then learned how to recover and started asking questions, I was very careful not to project any of my experience onto patients and assume.
• 41:26
  Dr. Jill Carnahan, MD: But I kept finding mold.
• 41:27
  Dr. Jill Carnahan, MD: I'm like, wow, this is like I kept being surprised because I was so careful not to project that everybody has mold, right?
• 41:33
  Dr. Jill Carnahan, MD: But the truth is, so many of our patients have mold related illness.
• 41:39
  Dr. Somer DelSignore: Absolutely.
• 41:39
  Dr. Somer DelSignore: Yeah.
• 41:40
  Dr. Somer DelSignore: 100.
• 41:41
  Dr. Jill Carnahan, MD: So as we kind of wrap up, I love that you've, you know, have this clear reset protocol.
• 41:46
  Dr. Jill Carnahan, MD: We'll make sure and let people find.
• 41:47
  Dr. Jill Carnahan, MD: Know where they can find you and everything.
• 41:48
  Dr. Jill Carnahan, MD: But for the page, for the patient or the parent out there that's listening and they have a child with maybe some behavioral issues or some complex issues that they're not sure what the root is.
• 42:00
  Dr. Jill Carnahan, MD: How would you speak to them if you were speaking to them as far as finding hope, finding answers, finding a practitioner like you, or coming to see you, what would you say to that person out there?
• 42:11
  Dr. Somer DelSignore: You know, I, I would certainly say that you know, root cause medicine is a category.
• 42:15
  Dr. Somer DelSignore: It's not alternative, it's a category.
• 42:17
  Dr. Somer DelSignore: And it's a mindset.
• 42:19
  Dr. Somer DelSignore: And many of us have trained inside that, the traditional medical model and experience that it's great for so many things, but in certain conditions, maybe not so much.
• 42:30
  Dr. Somer DelSignore: And we have to just show you what is actually happening inside your kid's body and understand that it's not one thing and it's never just one thing.
• 42:39
  Dr. Somer DelSignore: And we just have to be really comprehensive about our approach.
• 42:42
  Dr. Jill Carnahan, MD: Fantastic.
• 42:43
  Dr. Jill Carnahan, MD: I know this is full of hope.
• 42:45
  Dr. Jill Carnahan, MD: Before we end, I have a few kind of more rapid questions I want to ask you.
• 42:49
  Dr. Somer DelSignore: Okay.
• 42:50
  Dr. Jill Carnahan, MD: What is one lab test that you wish other pediatricians would either order more or understand better?
• 42:58
  Dr. Somer DelSignore: I think that MTHFR mutations are a good one and we can get those very easily without specialty tests.
• 43:05
  Dr. Somer DelSignore: Right.
• 43:07
  Dr. Somer DelSignore: And I think that if.
• 43:08
  Dr. Somer DelSignore: If pediatricians could manage that, and they should BE in that 15 minutes of seeing, you could absolutely manage it.
• 43:14
  Dr. Somer DelSignore: And that would help so much from a neurological perspective, from an inflammatory perspective, from a neuro health perspective, from autoimmune, all of it.
• 43:22
  Dr. Somer DelSignore: If they sort of understand the.
• 43:25
  Dr. Somer DelSignore: That that genetic enzyme process that's not working so well and help to correct it, that certainly could.
• 43:33
  Dr. Somer DelSignore: Could help that child.
• 43:34
  Dr. Jill Carnahan, MD: Brilliant.
• 43:35
  Dr. Jill Carnahan, MD: That was such a wise answer.
• 43:37
  Dr. Jill Carnahan, MD: Gut and mitochondria are frequently issues.
• 43:39
  Dr. Jill Carnahan, MD: Where do you start?
• 43:42
  Dr. Somer DelSignore: Typically, I will start with the gut.
• 43:44
  Dr. Somer DelSignore: I think that the mitochondria is fatigued out for a reason and we can throw all that we want at that mitochondria to support it, but we're just going to wire that kid a little bit more and not get them anywhere.
• 43:56
  Dr. Somer DelSignore: So I find that we definitely need that gut to work.
• 43:58
  Dr. Somer DelSignore: Work.
• 43:59
  Dr. Somer DelSignore: It seems like a boring, you know, organ system.
• 44:04
  Dr. Somer DelSignore: Right.
• 44:04
  Dr. Somer DelSignore: It's like, oh, the gi.
• 44:05
  Dr. Somer DelSignore: Right.
• 44:06
  Dr. Somer DelSignore: But it's meant for so many other things other than digestion and elimination.
• 44:09
  Dr. Somer DelSignore: And that's sort of like our source.
• 44:11
  Dr. Somer DelSignore: Our source of health is right there.
• 44:13
  Dr. Jill Carnahan, MD: Oh, I couldn't agree more.
• 44:14
  Dr. Jill Carnahan, MD: If you could give in the first visit just one nutrition habit that would change a family's life, what would that one bit of wisdom be on your first visit?
• 44:22
  Dr. Somer DelSignore: Nutrition.
• 44:24
  Dr. Somer DelSignore: Stick with whole foods.
• 44:25
  Dr. Jill Carnahan, MD: Good with whole foods.
• 44:27
  Dr. Somer DelSignore: Very simply, yes.
• 44:29
  Dr. Jill Carnahan, MD: Oh, very good.
• 44:30
  Dr. Jill Carnahan, MD: There's so many great supplements and herbal remedies and things.
• 44:32
  Dr. Jill Carnahan, MD: If you had just one vitamin or nutrient or herbal thing to give to a, a patient in the first visit, where, what would that look like?
• 44:40
  Dr. Somer DelSignore: Given our.
• 44:41
  Dr. Somer DelSignore: The environmental exposures, we say, I think it would be glutathione.
• 44:44
  Dr. Somer DelSignore: If they tolerate it's my.
• 44:46
  Dr. Somer DelSignore: It's like my Windex.
• 44:47
  Dr. Somer DelSignore: You think freque.
• 44:48
  Dr. Somer DelSignore: It's like the Windex.
• 44:49
  Dr. Somer DelSignore: It's.
• 44:49
  Dr. Somer DelSignore: Give it to everybody.
• 44:50
  Dr. Somer DelSignore: It works for everything.
• 44:51
  Dr. Jill Carnahan, MD: I love it.
• 44:52
  Dr. Jill Carnahan, MD: Every one of these are like, yes, go.
• 44:54
  Dr. Somer DelSignore: You get glutathy.
• 44:55
  Dr. Somer DelSignore: Yes.
• 44:56
  Dr. Jill Carnahan, MD: Oh, my goodness.
• 44:57
  Dr. Jill Carnahan, MD: This one's going to hit home.
• 44:58
  Dr. Jill Carnahan, MD: And then we'll let people know where they can find you.
• 45:00
  Dr. Jill Carnahan, MD: But the healthiest children of the future will be those whose parents.
• 45:04
  Dr. Jill Carnahan, MD: What, what, what could the parents do right now?
• 45:07
  Dr. Jill Carnahan, MD: Or people who are wanting to have children.
• 45:09
  Dr. Somer DelSignore: Parents who let them play.
• 45:13
  Dr. Somer DelSignore: Experience.
• 45:14
  Dr. Jill Carnahan, MD: Yeah.
• 45:15
  Dr. Somer DelSignore: You know, and keep life simple.
• 45:19
  Dr. Somer DelSignore: Absolutely.
• 45:19
  Dr. Jill Carnahan, MD: Oh, I love that.
• 45:21
  Dr. Jill Carnahan, MD: There's a man I know whose children.
• 45:23
  Dr. Jill Carnahan, MD: I. I watched him father them before.
• 45:26
  Dr. Jill Carnahan, MD: And one thing I always loved, he gives them these safety containers.
• 45:32
  Dr. Jill Carnahan, MD: So he gives them instruction.
• 45:33
  Dr. Jill Carnahan, MD: He gives them things like that.
• 45:34
  Dr. Jill Carnahan, MD: But he lets them do crazy things.
• 45:36
  Dr. Jill Carnahan, MD: But he's there, he's safe.
• 45:38
  Dr. Jill Carnahan, MD: He knows exactly what he's doing.
• 45:39
  Dr. Jill Carnahan, MD: He's watching them.
• 45:40
  Dr. Jill Carnahan, MD: And I always admire that.
• 45:41
  Dr. Jill Carnahan, MD: That may be a little different what you're saying, but I always, when I see that, I'm like, how cool is that?
• 45:45
  Dr. Jill Carnahan, MD: That it's not like this helicopter parents say, don't do this.
• 45:47
  Dr. Jill Carnahan, MD: Don't touch the water.
• 45:48
  Dr. Jill Carnahan, MD: Don't jump off that rock.
• 45:49
  Dr. Jill Carnahan, MD: He's there, he's got safety measures.
• 45:51
  Dr. Jill Carnahan, MD: They know what to do, they know how to do it.
• 45:52
  Dr. Jill Carnahan, MD: And I love watching that in action because.
• 45:56
  Dr. Jill Carnahan, MD: Because he's creating that container of safety, but he's letting them really explore the world and do boy things that could be kind of dangerous.
• 46:03
  Dr. Jill Carnahan, MD: And I, I think that's, you know, really powerful to experience that.
• 46:06
  Dr. Jill Carnahan, MD: And then the bravery they experience, like, oh, my gosh, I did.
• 46:09
  Dr. Jill Carnahan, MD: I jumped off a big rock or whatever thing they did.
• 46:12
  Dr. Jill Carnahan, MD: And I really admire that.
• 46:14
  Dr. Somer DelSignore: So, yeah, it's very empowering.
• 46:16
  Dr. Somer DelSignore: It's, you know, very good for their neurological system and to learn and their autonomic nervous system to help them.
• 46:23
  Dr. Somer DelSignore: Themselves soothe when.
• 46:24
  Dr. Somer DelSignore: When things don't go the way they want it to let them get a little dirty.
• 46:27
  Dr. Jill Carnahan, MD: Yes.
• 46:28
  Dr. Somer DelSignore: Important.
• 46:29
  Dr. Jill Carnahan, MD: It's good for the immune system.
• 46:30
  Dr. Jill Carnahan, MD: Right?
• 46:30
  Dr. Somer DelSignore: Good for the immune system.
• 46:32
  Dr. Somer DelSignore: Yes.
• 46:32
  Dr. Somer DelSignore: That microbiome, that immune system.
• 46:34
  Dr. Somer DelSignore: They need that exposure.
• 46:35
  Dr. Somer DelSignore: Absolutely.
• 46:36
  Dr. Jill Carnahan, MD: So good.
• 46:37
  Dr. Jill Carnahan, MD: This was just full of practical stuff and just really appreciate what you're doing in the world to change the lives of adults and their kids.
• 46:45
  Dr. Jill Carnahan, MD: Where can people find you if they want to know more about your practice, or the Reset Program critical.
• 46:51
  Dr. Somer DelSignore: So they can follow me on Instagram @Doctor Somer DeLore.
• 46:55
  Dr. Somer DelSignore: And my website is www.hudson valley integrative.health.com awesome.
• 47:02
  Dr. Jill Carnahan, MD: And if you're watching driving wherever you're at, this will be in the show notes.
• 47:06
  Dr. Jill Carnahan, MD: Thanks again for coming on the show.
• 47:08
  Dr. Jill Carnahan, MD: It was so fun to have you.
• 47:09
  Dr. Somer DelSignore: Thank you, Jill.
• 47:10
  Dr. Somer DelSignore: It was a pleasure.
• 47:12
  Dr. Jill Carnahan, MD: Hey guys, wasn't that interview with Dr. Del Signor absolutely fascinating?
• 47:17
  Dr. Jill Carnahan, MD: I don't know if you're a parent or you have kids or grandkids, but hopefully you found some really practical tips and tricks in that interview that are helpful because so many of our kiddos now are suffering with mood disorders or behavioral disorders.
• 47:29
  Dr. Jill Carnahan, MD: And I do not believe that prescriptions are always the answer.
• 47:34
  Dr. Jill Carnahan, MD: There's so many other root causes and I hope that this was helpful.
• 47:37
  Dr. Jill Carnahan, MD: Great information.
• 47:38
  Dr. Jill Carnahan, MD: If you know a parent or a grandparent who has a child who's suffering, would you please share this interview just for helpful information that they know that there's more hope and ability to find a doctor like her out there to help.
• 47:51
  Dr. Jill Carnahan, MD: You can find all the show notes below.
• 47:53
  Dr. Jill Carnahan, MD: You can find her website and all the links there as well.
• 47:56
  Dr. Jill Carnahan, MD: And as you know, we come back every week with a new episode of Resiliency Radio.
• 48:00
  Dr. Jill Carnahan, MD: If you haven't yet liked or subscribed on YouTube, join our over 1 million viewers and subscribers there.
• 48:07
  Dr. Jill Carnahan, MD: You can click the bell to be notified of future episodes and I will see you again next week for another episode of Resiliency Radio.